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The American Zika virus (ZIKV) epidemic has highlighted the need to gain a better understanding of this emerging virus. The goal of this study was to describe the clinical symptoms, laboratory findings, and risk factors for symptomatic ZIKV infection in an area with ongoing transmission of other arboviral infections. We recruited patients at least 2 years of age seeking care at public health centers in León, Nicaragua, between January 2016 and August 2017, for fever, maculopapular rash, and/or nonsuppurative conjunctivitis with a duration of less than 1 week. A laboratory diagnosis of ZIKV was established using a combination of molecular and serological tests. Clinical and laboratory findings and potential risk factors were compared between participants with and without acute ZIKV infection. Fifty-eight (26%) of the 225 participants included in the analysis were found to have acute ZIKV infection. Pregnancy and reports of previous arboviral infection were associated with a higher risk of ZIKV infection. Rash, conjunctivitis, sore throat, and lower absolute neutrophil counts were associated with acute ZIKV infection. The clinical characteristics and risk factors identified were consistent with those identified by previous studies; however, we found sore throat to be a feature of ZIKV infection. We also found that neutrophil counts were lower in ZIKV-infected subjects. These clinical symptoms and laboratory data may help clinicians suspect ZIKV infection during future outbreaks.

Der nachfolgend dargestellten Auslegungsmethode liegt die Erwagung zugrunde, dass das Fortbestehen des europaischen Einigungsprojektes und die Durchsetzungsfahigkeit des EU-Rechts entscheidend davon abhangen, dass es in den Bevolkerungen der Mitgliedstaaten einen gewissen Grundkonsens zu Existenz und Legitimitat der EU und ihres Rechts gibt. Gefragt wird hier danach, ob und, falls ja, auf welche Weise, hierzu auch durch die Auslegung und Anwendung des EU-Rechts beigetragen werden kann. Im Folgenden wird versucht, entsprechende Uberlegungen begrifflich und konzeptionell zu verselbstandigen und theoretisch zu strukturieren (integrationsdynamische Auslegungsmethode). Ein besonderes Anwendungsfeld findet eine integrationsdynamische Auslegungsmethode auf dem Gebiet der Grundfreiheiten vor, die daher in Bezug auf Begrundung und Anwendung dieser Auslegungsmethode besondere Aufmerksamkeit erfahren.

The recent Zika virus (ZIKV) epidemic in the Americas has revealed rare but serious manifestations of infection. ZIKV has emerged in regions endemic for dengue virus (DENV), a closely related mosquito-borne flavivirus. Cross-reactive antibodies confound studies of ZIKV epidemiology and pathogenesis. The immune responses to ZIKV may be different in people, depending on their DENV immune status. Here, we focus on the human B cell and antibody response to ZIKV as a primary flavivirus infection to define the properties of neutralizing and protective antibodies generated in the absence of preexisting immunity to DENV. The plasma antibody and memory B cell response is highly ZIKV type–specific, and ZIKV-neutralizing antibodies mainly target quaternary structure epitopes on the viral envelope. To map viral epitopes targeted by protective antibodies, we isolated 2 type-specific monoclonal antibodies (mAbs) from a ZIKV case. Both mAbs were strongly neutralizing in vitro and protective in vivo. The mAbs recognize distinct epitopes centered on domains I and II of the envelope protein. We also demonstrate that the epitopes of these mAbs define antigenic regions commonly targeted by plasma antibodies in individuals from endemic and nonendemic regions who have recovered from ZIKV infections.

Norovirus is a leading cause of pediatric gastroenteritis. Understanding norovirus epidemiology is essential for reducing disease burden. We conducted a case-control study to describe the distribution, clinical features, and risk factors of norovirus gastroenteritis among children < 5 years of age in León, Nicaragua. Cases were children testing positive for norovirus and controls were children living in the cases' communities. Study staff interviewed mothers of enrolled cases and controls to obtain detailed exposure information including food, water, and sanitation sources; recent exposures; household characteristics; and handwashing practices. In addition, study staff requested stool samples tobe tested for norovirus from select household members. We used descriptive statistics to understand the epidemiologic and clinical features of gastroenteritis episodes. To analyze potential risk factors, weused Firth's penalized logistic regression to estimate crude and adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs). There were 102 children with gastroenteritis, 18 cases of norovirus and 31 controls. Norovirus cases occurred later in the year, corresponding to a delay in the rainy season. Cases were more likely to have a household member with norovirus in their stool as compared with controls [crude OR: 13.3 (95% CI: 2.5, 136.2) and adjusted OR: 11.5 (95% CI: 1.6, 223.2)]. In addition, alcohol-based hand sanitizer use among household members was reported for 10 (32%) of controls and but never for cases. Further research is needed to understand household transmission of norovirus in low- and middle-income countries and the potential impact of hand sanitizer use.

Das elfte Gesetz zur Anderung des Atomgesetzes (Laufzeitverlangerungsgesetz) und das 13. Gesetz zur Anderung des Atomgesetzes sind in heftige Kritik geraten. Der allgemeine Unmut entzundet sich dabei nicht nur an materiellen Mangel, sondern auch und vor allem am zweifelhaftem Vorgehen im Rahmen des inneren und auseren Gesetzgebungsverfahrens, etwa an der extrem kurzen Verfahrensdauer und der nicht ausreichenden Begrundung der 13. Atomgesetznovelle. Der vielfach zum Ausdruck gebrachten Emporung fehlt es bisweilen allerdings an einer hinreichenden verfassungsrechtlichen Fundierung. Der Diskurs krankt nicht selten daran, dass nicht hinreichend zwischen verfassungswidrigen Verhaltensweisen einerseits und blos verfassungspolitisch unerwunschten Akten andererseits differenziert wird. Erforderlich ist dafur eine fundierte Beschaftigung mit dem Masstab und Begriff der Rationalitat und seiner Verankerung im Grundgesetz. Mit dem vorliegenden Beitrag soll nicht nur die im Vergleich zu materiellen Rationalit...

The aim of this paper is to partially solve the problem of visualization of clusters of particles resulting from numerical methods in engineering. Two methods for removing non-visible particles from some view point of the camera were developed. These are divided depending on the type of information available: particle systems with contour information (surface mesh) and particle systems without contour information (methods without mesh). In both cases, the results are very good, it is achieved removing large amount of particles that do not affect the final image, permitting interact with the results of numerical methods.