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Colonization of the gut and airways by pathogenic bacteria can lead to local tissue destruction and life-threatening systemic infections, especially in immunologically compromised individuals. Here, we describe an mRNA-based platform enabling delivery of pathogen-specific immunoglobulin A (IgA) monoclonal antibodies into mucosal secretions. The platform consists of synthetic mRNA encoding IgA heavy, light, and joining (J) chains, packaged in lipid nanoparticles (LNPs) that express glycosylated, dimeric IgA with functional activity in vitro and in vivo. Importantly, mRNA-derived IgA had a significantly greater serum half-life and a more native glycosylation profile in mice than did a recombinantly produced IgA. Expression of an mRNA encoded Salmonella-specific IgA in mice resulted in intestinal localization and limited Peyer's patch invasion. The same mRNA-LNP technology was used to express a Pseudomonas-specific IgA that protected from a lung challenge. Leveraging the mRNA antibody technology as a means to intercept bacterial pathogens at mucosal surfaces opens up avenues for prophylactic and therapeutic interventions., Competing Interests: Declaration of interests C.E.D., A.F.R., T.Y., M.J.M., Z.W., Y.-T.L., B.R.F., S.H., D.L., R.K., S.L., C.J.H., I.L.R., H.K., M.K., A.C., and O.J.P. are employees of and shareholders in Moderna, Inc. C.E.D. and O.J.P. are co-inventors on international patent WO 2022/212191 A1. E.N. was an employee of and shareholder in Moderna Inc. at the time of the study., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Secretory IgA (SIgA) is the most abundant antibody type in intestinal secretions where it contributes to safeguarding the epithelium from invasive pathogens like the Gram-negative bacterium, Salmonella enterica serovar Typhimurium (STm). For example, we recently reported that passive oral administration of the recombinant monoclonal SIgA antibody, Sal4, to mice promotes STm agglutination in the intestinal lumen and restricts bacterial invasion of Peyer's patch tissues. In this report, we sought to recapitulate Sal4-mediated protection against STm in human Enteroids and human intestinal organoids (HIOs) as models to decipher the molecular mechanisms by which antibodies function in mucosal immunity in the human gastrointestinal tract. We confirm that Enteroids and HIO-derived monolayers are permissive to STm infection, dependent on HilD, the master transcriptional regulator of the SPI-I type three secretion system (T3SS). Stimulation of M-like cells in both Enteroids and HIOs by the addition of RANKL further enhanced STm invasion. The apical addition of Sal4 mouse IgA, as well as recombinant human Sal4 dimeric IgA (dIgA) and SIgA resulted a dose-dependent reduction in bacterial invasion. Moreover, basolateral application of Sal4 dIgA to Enteroid and HIO monolayers gave rise to SIgA in the apical compartment via a pathway dependent on expression of the polymeric immunoglobulin receptor (pIgR). The resulting Sal4 SIgA was sufficient to reduce STm invasion of Enteroid and HIO epithelial cell monolayers by ~20-fold. Recombinant Sal4 IgG was also transported in the Enteroid and HIOs, but to a lesser degree and via a pathway dependent on the neonatal Fc receptor (FCGRT). The models described lay the foundation for future studies into detailed mechanisms of IgA and IgG protection against STm and other pathogens.

Peyer's patches are organized gut-associated lymphoid tissues (GALT) in the small intestine and the primary route by which particulate antigens, including viruses and bacteria, are sampled by the mucosal immune system. Antigen sampling occurs through M cells, a specialized epithelial cell type located in the follicle-associated epithelium (FAE) that overlie Peyer's patch lymphoid follicles. While Peyer's patches play an integral role in intestinal homeostasis, they are also a gateway by which enteric pathogens, like Salmonella enterica serovar Typhimurium (STm), cross the intestinal barrier. Once pathogens like STm gain access to the underlying network of mucosal dendritic cells and macrophages they can spread systemically. Thus, Peyer's patches are at the crossroads of mucosal immunity and intestinal pathogenesis. In this chapter, we provide detailed methods to assess STm entry into mouse Peyer's patch tissues. We describe Peyer's patch collection methods and provide strategies to enumerate bacterial uptake. We also detail a method for quantifying bacterial shedding from infected animals and provide an immunohistochemistry protocol for the localization of STm along the gastrointestinal tract and insight into pathogen transit in the presence of protective antibodies. While the protocols are written for STm, they are easily tailored to other enteric pathogens., (© 2022. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

Many bacterial pathogens secrete A (2) B 5 toxins comprising two functionally distinct yet complementary "A" and "B" subunits to benefit the pathogens during infection. The lectin-like pentameric B subunits recognize specific sets of host glycans to deliver the toxin into target host cells. Here, we offer the molecular mechanism by which neutralizing antibodies, which have the potential to bind to all glycan-receptor binding sites and thus completely inhibit toxin binding to host cells, are inhibited from exerting this action. Cryogenic electron microscopy (cryo-EM)-based analyses indicate that the skewed positioning of the toxin A subunit(s) toward one side of the toxin B pentamer inhibited neutralizing antibody binding to the laterally located epitopes, rendering some glycan-receptor binding sites that remained available for the toxin binding and endocytosis process, which is strikingly different from the counterpart antibodies recognizing the far side-located epitopes. These results highlight additional features of the toxin-antibody interactions and offer important insights into anti-toxin strategies., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

As the predominant antibody type in mucosal secretions, human colostrum, and breast milk, secretory IgA (SIgA) plays a central role in safeguarding the intestinal epithelium of newborns from invasive enteric pathogens like the Gram-negative bacterium Salmonella enterica serovar Typhimurium (STm). SIgA is a complex molecule, consisting of an assemblage of two or more IgA monomers, joining (J)-chain, and secretory component (SC), whose exact functions in neutralizing pathogens are only beginning to be elucidated. In this study, we produced and characterized a recombinant human SIgA variant of Sal4, a well-characterized monoclonal antibody (mAb) specific for the O5-antigen of STm lipopolysaccharide (LPS). We demonstrate by flow cytometry, light microscopy, and fluorescence microscopy that Sal4 SIgA promotes the formation of large, densely packed bacterial aggregates in vitro . In a mouse model, passive oral administration of Sal4 SIgA was sufficient to entrap STm within the intestinal lumen and reduce bacterial invasion into gut-associated lymphoid tissues by several orders of magnitude. Bacterial aggregates induced by Sal4 SIgA treatment in the intestinal lumen were recalcitrant to immunohistochemical staining, suggesting the bacteria were encased in a protective capsule. Indeed, a crystal violet staining assay demonstrated that STm secretes an extracellular matrix enriched in cellulose following even short exposures to Sal4 SIgA. Collectively, these results demonstrate that recombinant human SIgA recapitulates key biological activities associated with mucosal immunity and raises the prospect of oral passive immunization to combat enteric diseases.

Nearly all clinical isolates of Salmonella Typhi, the cause of typhoid fever, are antibiotic resistant. All S. Typhi isolates secrete an A 2 B 5 exotoxin called typhoid toxin to benefit the pathogen during infection. Here, we demonstrate that antibiotic-resistant S. Typhi secretes typhoid toxin continuously during infection regardless of antibiotic treatment. We characterize typhoid toxin antibodies targeting glycan-receptor-binding PltB or nuclease CdtB, which neutralize typhoid toxin in vitro and in vivo , as demonstrated by using typhoid toxin secreted by antibiotic-resistant S. Typhi during human cell infection and lethal dose typhoid toxin challenge to mice. TyTx11 generated in this study neutralizes typhoid toxin effectively, comparable to TyTx4 that binds to all PltB subunits available per holotoxin. Cryoelectron microscopy explains that the binding of TyTx11 to CdtB makes this subunit inactive through CdtB catalytic-site conformational change. The identified toxin-neutralizing epitopes are conserved across all S. Typhi clinical isolates, offering critical insights into typhoid toxin-neutralizing strategies., Competing Interests: The authors declare no competing interests., (© 2021 The Author(s).)

Non-typhoidal Salmonella enterica strains, including serovar Typhimurium (STm), are an emerging cause of invasive disease among children and the immunocompromised, especially in regions of sub-Saharan Africa. STm invades the intestinal mucosa through Peyer's patch tissues before disseminating systemically. While vaccine development efforts are ongoing, the emergence of multidrug resistant strains of STm affirms the need to seek alternative strategies to protect high-risk individuals from infection. In this report, we investigated the potential of an orally administered O5 serotype-specific IgA monoclonal antibody (mAb), called Sal4, to prevent infection of invasive Salmonella enterica serovar Typhimurium (STm) in mice. Sal4 IgA was delivered to mice prior to or concurrently with STm challenge. Infectivity was measured as bacterial burden in Peyer's patch tissues one day after challenge. Using this model, we defined the minimal amount of Sal4 IgA required to significantly reduce STm uptake into Peyer's patches. The relative efficacy of Sal4 in dimeric and secretory IgA (SIgA) forms was compared. To assess the role of isotype in oral passive immunization, we engineered a recombinant IgG1 mAb carrying the Sal4 variable regions and evaluated its ability to block invasion of STm into epithelial cells in vitro and Peyer's patch tissues. Our results demonstrate the potential of orally administered monoclonal IgA and SIgA, but not IgG, to passively immunize against invasive Salmonella. Nonetheless, the prophylactic window of IgA/SIgA in the mouse was on the order of minutes, underscoring the need to develop formulations to protect mAbs in the gastric environment and to permit sustained release in the small intestine., Competing Interests: AR, JD, SL, GW, and NM declare that no competing interests exist. MP, KW, and LZ are employees of MappBio, Inc.

The reaction of 2-pyridylphosphonic acid (LH(2)) with iron(II) perchlorate and iron(III) nitrate afforded an interconnected, double-layered, cationic iron cage, [{Fe(36)L(44)(H(2)O)(48)}](20+) (1a), the largest interconnected, polynuclear ferric cage reported to date. Magnetic studies on 1a revealed antiferromagnetic coupling between the spins on adjacent Fe(III) ions.

A cationic, pentanuclear aluminium phosphonate cage, [L(4)Al(5)Cl(6)(THF)(6)]Cl, 1, supported by (phthalimidomethyl) phosphonate, (L), has been synthesized and characterized. This polynuclear cage features the phosphonate ligand in an unusual coordination mode, supporting five aluminium atoms in two different environments. In comparison, the aqueous reaction of LH(2) with In(ClO(4))(3) afforded [{(LH)In(H(2)O)}(H(2)O)(2)(ClO(4))](n), 2, an indium(III) phosphonate coordination polymer, that has been crystallographically characterized. Reactions of the corresponding phosphonate ester, diethyl (phthalimidomethyl) phosphonate, (L'), with GaI(3) and InCl(3) afforded the simple coordination complexes, [L'·GaI(3)], 3, and [L'·InCl(3)(THF)], 4.

The coordination preferences of the tetradentate Schiff base, N,N'-ethylenebis(acetylacetoimine), H(2)L, with a variety of group 13 precursors, led to the formation of a series of mono and binuclear products. The reaction of H(2)L with AlMe(3) and Me(2)GaCl afforded the binuclear complexes, [L{Al(Me)(2)}(2)] 1 and [H(2)L{GaCl(Me)(2)}(2)], 3, the latter an adduct of the neutral ligand. Treatment of 1 with iodine generated the cationic Al(III) complex, [LAl(thf)(2)]I, 2, while the addition of n-BuLi to H(2)L, followed by reaction with GaCl(3) and InCl(3) led to an ionic complex [{LGaCl}(2)(μLi)]GaCl(4), 4, an In(III) dimer, [LInCl](2), 5 and monomeric [LInCl(thf)], 6. In contrast, the reaction of [In{N(SiMe(3))(2)}(3)] with H(2)L yielded a homoleptic, air stable, indium complex, [L(3)In(2)], 7. All products were definitively characterized by X-ray crystallography and their structures confirmed by pertinent spectroscopic techniques.

The 1D polymeric Schiff base zinc complex, [LZn(2)Et(2)](n), where LH(2) = (NN'-ethylene-bis(4-iminopentan-2-one)) has been demonstrated as a useful synthetic metallo building block for the synthesis of homo and heteronuclear zinc cages. The reaction of [LZn(2)Et(2)](n) with CdI(2) afforded the hetero-nuclear cage, 1, [L(2)Zn(4)(Et)(2)CdI(4)], while reaction with HgI(2) afforded a hexanuclear zinc cage, [L(2)Zn(6)(Et)(4)(μ(4)O)(μ(3)OEt)I], 2. The versatility of [LZn(2)Et(2)](n) as a metallo building block is demonstrated through the reaction with ferrocenyl carboxylic acid, affording the ferrocenyl supported zinc cage, [L(2)Zn(8)(FcCO(2))(4)(Et)(2)(OEt)(2)(μ(4)O)(2)], 3, while the reaction with Er(III) acetate afforded the decanuclear zinc cage, [L(3)Zn(10)(μ(4)O)(4)(Et)(6)], 4.

Stoichiometric reduction of the bulky β-diketiminato germanium(II) chloride complex [((But)Nacnac)GeCl] ((But)Nacnac = [{N(Dip)C(Bu(t))}(2)CH](-), Dip = C(6)H(3)Pr(i)(2)-2,6) with either sodium naphthalenide or the magnesium(I) dimer [{((Mes)Nacnac)Mg}(2)] ((Mes)Nacnac = [(MesNCMe)(2)CH](-), Mes = mesityl) afforded the radical complex [((But)Nacnac)Ge:](•) in moderate yields. X-ray crystallographic, EPR/ENDOR spectroscopic, computational, and reactivity studies revealed this to be the first authenticated monomeric, neutral germanium(I) radical.

The reactions of AlCl 3.6H 2O and GaCl 3 with 2-pyridylphosphonic acid (2PypoH 2) and 4-pyridylphosphonic acid (4PypoH 2) afford cyclic aluminum and gallium phosphonate structures of [(2PypoH) 4Al 4(OH 2) 12]Cl 8.6H 2O ( 1), [(4PypoH) 4Al 4(OH 2) 12]Cl 8.11H 2O ( 2), [(2PypoH) 4Al 4(OH 2) 12](NO 3) 8.7H 2O ( 3), [(2PypoH) 2(2Pypo) 4Ga 8Cl 12(OH 2) 4(thf) 2](GaCl 4) 2..8thf ( 4), and [(2PypoH) 2(2Pypo) 4Ga 8Cl 12(OH 2) 4(thf) 2](NO 3) 2.9thf ( 5). Structures 1- 3 feature four aluminum atoms bridged by oxygen atoms from the phosphonate moiety and show structural resemblance to the secondary building units found in zeolites and aluminum phosphates. The gallium complexes, 4 and 5, have eight gallium atoms bridged by phosphonate moieties with two GaCl 4 (-) counterions present in 4 and nitrate ions in 5. The cage structures 1- 3 are interlinked by strong hydrogen bonds, forming polymeric chains that, for aluminum, are thermally robust. Exchange of the phosphonic acid for the more flexible 4PyCH 2PO 3H 2 afforded a coordination polymer with a 1:1 Ga:P ratio, {[(4PyCH 2PO 3H)Ga(OH 2) 3](NO 3) 2.0.5H 2O} x ( 6). Complexes 1- 6 were characterized by single-crystal X-ray diffraction, NMR, and mass spectrometry and studied by TGA.

Reaction of [Yb(CpPh5)(C[triple bond]CPh)(thf)]2 (CpPh5 = pentaphenylcyclopentadienyl), prepared from Yb(C triple bond CPh)2 and HCpPh5 or Yb metal, HgPh(C[triple bond]CPh) and HCpPh5, with a controlled amount of diglyme (dig), and of Eu(C triple bond CPh)2, P triple bond CBut and dig, yield the unusual organolanthanoid(II) dicationic complexes [Yb(C[triple bond]CPh)(dig)(thf)2]2[CpPh5]2.4thf and [Eu(C triple bond CPh)(dig)2]2[P2C3But3]2 respectively.

A sequence of first row transition metal(II) dithiolates M(SAr)(2) (M = Cr(1), Mn(2), Fe(3), Co(4), Ni(5) and Zn(6); Ar = C(6)H(3)-2,6-(C(6)H(2)-2,4,6-Pr(i)(3))(2)) has been synthesized and characterized. Compounds 1-5 were obtained by the reaction of two equiv of LiSAr with a metal dihalide, whereas 6 was obtained by treatment of ZnMe(2) with 2 equiv of HSAr. They were characterized by spectroscopy, magnetic measurements, and X-ray crystallography. The dithiolates 1, 2, and 4-6 possess linear or nearly linear SMS units with further interactions between M and two ipso carbons from C(6)H(2)-2,4,6-Pr(i)(3) rings. The iron species 3, however, has a bent geometry, two different Fe-S distances, and an interaction between iron and one ipso carbon of a flanking ring. The secondary M-C interactions vary in strength in the sequence Cr(2+) approximately Fe(2+) > Co(2+) approximately Ni(2+) > Mn(2+) approximately Zn(2+) such that the manganese and zinc compounds have essentially two coordination but the chromium and iron complexes are quasi four and three coordinate, respectively. The geometric distortions in the iron species 3 suggested that the structure represents the initial stage of a rearrangement into a sandwich structure involving metal-aryl ring coordination. The bent structure of 3 probably also precludes the observation of free ion magnetism of Fe(2+) recently reported for Fe{C(SiMe(3))(3)}(2). DFT calculations on the model compounds M(SPh)(2) (M = Cr-Ni) support the higher tendency of the iron species to distort its geometry.

The synthesis and characterization of the first divalent germanium, tin, and lead monoamide derivatives of the parent amide group -NH(2) are presented. They have the general formula (ArMNH(2))(2) (M = Ge, Ar = Ar'(C(6)H(3)-2,6-Pr(i)(2)) or Ar* (C(6)H(3)-2,6(C(6)H(2)-2,4,6-Pr(i)(3))); M = Sn, Ar = Ar*; M = Pb, Ar = Ar*). For germanium and tin, they were obtained by reacting the corresponding terphenyl halides of the group 14 elements with liquid ammonia in diethyl ether. The lead amide derivative (Ar*PbNH(2))(2) was synthesized by reaction of LiNH(2) with Ar*PbBr in diethyl ether. The compounds were characterized by IR and multinuclear NMR spectroscopies and by X-ray crystallography in the case of the (Ar'GeNH(2))(2) or (Ar*SnNH(2))(2) derivatives. They possess dimeric structures with two -NH(2) groups bridging the germanium and tin centers. For lead, the reaction with ammonia led to isolation of a stable ammine complex of formula Ar*PbBr(NH(3)) which was characterized by IR and NMR spectroscopies and by X-ray crystallography. It is the first structural characterization of a divalent lead ammine complex.

The reduction of the digermene Ar'(H)GeGe(H)Ar' (Ar' = C6H3-2,6(C6H3-2,6-Pri2)2) with Li, Na, or K afforded [Li(THF)3Et2O][LiAr'(H)GeGe(H)Ar'] (1), Na2Ar'Ge(mu-H)2GeAr' (2), or K2{Ar'(H)GeGe(H)Ar'} (3), which have three different structures. 1 features a planar C(ipso)H)GeGe(H)C(ipso) dianion core with an associated Li+ cation. In contrast, 2 features a unique bridged hydride structure in which two Na+ ions also bridge the germaniums. In 3, the C(ipso)(H)GeGe(H)C(ipso) array has a nonplanar trans bent core with associated K+ ions. There is single Ge-Ge bonding in 1 and 3, but the Ge-Ge bonding in 2 may involve biradical character.

The first, well-characterized 1,2-dilithium salt of a group 14 element ethenide species, [[(dioxane)(0.5)(Et2O)LiGeC6H3-2,6-Mes2]2]infinity, shows that the positions of the cations have a large effect on the length of the Ge-Ge double bond.

The genetic diversity of enteric viruses co-circulating in a cohort of patients with viral gastroenteritis in a large tertiary paediatric hospital in London, UK, was determined. Multiple strains of noroviruses (NV), sapoviruses (SV) and astroviruses (HAsV) were detected in these patients, indicating the likelihood of multiple introductions from different sources, possible sub-clinical infections and simultaneous infection with different viruses in immunocompromised and other patients. Routine screening of immunocompromised patients and infection control procedures are important to prevent nosocomial infection., (Copyright 2004 Wiley-Liss, Inc.)

This article describes the methods used to investigate 407 outbreaks of acute non-bacterial gastroenteritis occurring in the North-West of England between January 2000 and July 2001 and suspected to be caused by noroviruses (NV) [Mayo (2002) Arch Virol 147:1655-1663]. These included 319 outbreaks in hospitals and nursing homes and 88 other settings. Eight hundred and seventy-one faecal samples from 407 outbreaks were tested using electron microscopy (EM), an enzyme-linked immunosorbent assay (ELISA) specific for Grimsby virus (GRV) capsid antigen and/or by reverse transcriptase-polymerase chain reaction (RT-PCR) for NV, allowing the utility of each assay for routine diagnosis to be assessed. Preliminary genomic characterisation of detected strains was performed using the heteroduplex mobility assay (HMA) and DNA sequencing. The results demonstrate the continuing predominance of GII-4 GRV strain of NV as a cause of outbreaks, particularly in hospital and nursing home settings. Overall, NV were detected in 223/407 (55%) of outbreaks tested. However, a wide range of apparently diverse strains was identified, including several not previously reported. Genomic characterisation revealed clusters of linked outbreaks not recognised previously., (Copyright 2004 Wiley-Liss, Inc.)

The title compound is the first stable structural analogue for the monobridged isomer of a heavier group 14 alkene analogue.

A study was undertaken to investigate the diversity of noroviruses (NVs) in fecal samples from patients from 529 outbreaks and 141 sporadic cases of gastroenteritis in the North of England from September 1998 to August 2001. NV strains were detected by electron microscopy and characterized by a combination of the Grimsby virus antigen enzyme-linked immunosorbent assay, reverse transcriptase PCR, the heteroduplex mobility assay, and DNA sequencing. Twenty-one distinct NV strains, including several novel or variant strains not seen previously, were found circulating in the population studied. Genogroup II NVs were responsible for 83% of the outbreaks. Several strains cocirculated at any one time. The Bristol (Grimsby/Lordsdale) and Hawaii (Girlington) genotypes were the most prevalent among the NVs identified, detected in 49 and 20% of the outbreaks, respectively. A limited number of other genogroup II and I strains were cocirculating. The virus populations detected in hospitals and nursing homes were distinct from those found in community-based outbreaks. Outbreaks in hospitals and nursing homes were more likely to be caused by genogroup II strain Grimsby or Girlington (P < 0.0001) than by other genogroup II or I strains.

The molecular diversity of norovirus (NV) strains associated with 26 outbreaks of NV gastroenteritis has been determined. The outbreaks occurred on 14 cruise ships from seven cruise lines, during the period from 1998 to 2002. The ships cruised in seas worldwide, including the Mediterranean, the Baltic and the Caribbean. Genogroup I NVs were more common in the cruise ship setting than in hospitals, with 38% of the cruise ship outbreaks associated with genotype I NVs, as compared to < 10% in hospital and other semi-closed institutions in the UK. Outbreaks on cruise ships were more common in the period April to September, than in the winter. Two mixed genogroup I and II outbreaks were detected, which suggested contaminated food or water as the source of the infection.

The reduction of terphenylgermanium(II) or terphenyltin(II) chlorides with alkali metals was investigated. Treatment of Ar'GeCl or ArGeCl (Ar' = C(6)H(3)-2,6-Dipp(2), Dipp = C(6)H(3)-2,6-Pr(i)(2); Ar = C(6)H(3)-2,6-Trip(2), Trip = C(6)H(2)-2,4,6-Pr(i)(3)) with lithium, sodium, or potassium afforded the neutral alkyne analogues Ar'GeGeAr', 1, ArGeGeAr, 2, the singly reduced radical species NaArGeGeAr, 3, or KAr'GeGeAr', 4, or the doubly reduced compounds Li(2)Ar'GeGeAr', 5, Na(2)ArGeGeAr, 6, or K(2)ArGeGeAr, 7. Similarly, reduction of Ar'SnCl or ArSnCl afforded the neutral Ar'SnSnAr', 8, or ArSnSnAr, 9, the radical anions [(THF)(3)Na[rSnSnAr]], 10, [K(THF)(6)][Ar'SnSnAr'], 11, [K(THF)(6)][ArSnSnAr], 12, [K(18-crown-6)(THF)(2)] [ArSnSnAr], 13, or the doubly reduced Na(2)ArSnSnAr, 14, K(2)Ar'SnSnAr', 15, or K(2)ArSnSnAr, 16. The compounds were characterized by UV-vis, (1)H and (13)C NMR or EPR spectroscopy. The X-ray crystal structures of all compounds were determined except those of 2 and 9. The neutral 1 and 8 displayed planar, trans-bent CMMC (M = Ge and Sn) cores with M-M-C angles of 128.67(8) and 125.24(7) degrees, respectively. The M-M bond lengths, 2.2850(6) and 2.6675(4)A, indicated considerable multiple character and a bond order approaching two. Single and double reduction of the neutral species resulted in the narrowing of the M-M-C angles by ca. 12-32 degrees and changes in the Ge-Ge and Sn-Sn bond lengths. One-electron reduction afforded a slight (ca. 0.03-0.05A) lengthening of the Ge-Ge bonds in the case of germanium species 3 and 4 and a greater lengthening (ca. 0.13-0.15A) for the Sn-Sn bonds in the tin compounds 10-13. The addition of another electron yielded salts of the formal dianions [Ar'MMAr'](2)(-) and [ArMMAr](2)(-) which are isoelectronic to the corresponding doubly bonded, neutral arsenic and antimony derivatives. All the dianion salts were obtained as contact ion triples with two alkali metal cations complexed between aryl rings. The Ge-Ge bonds in the dianions of 5-7 were longer, whereas the Sn-Sn distances in the dianions in 14, 15, and 16 were shorter than those in the monoanions. Unusually, the Li(2)Ar'GeGeAr' salt, 5, displayed a longer Ge-Ge bond (by ca. 0.06A) than those of its Na(+) or K(+) analogue salts which was attributed to the greater polarizing power of Li(+). It was concluded that the M-M bond lengths in 3-7 and 10-16 are dependent on several factors that include M-M-C angle, Coulombic repulsion, alkali metal cation size, and the character of the molecular energy levels. The M-M bonding in the neutral compounds was accounted for in terms of a second-order Jahn-Teller mixing of sigma- and a pi-orbital which afforded bond orders near two for the neutral compounds, 1, 2, 8, and 9. Calculations on MeMMMe (M = Ge or Sn) model species showed that the LUMO corresponded to an orbital that had n(+) lone pair character. The slight Ge-Ge bond length increase upon one-electron reduction is consistent with these results, and the further bond lengthening upon double reduction is consistent with increased Coulombic repulsion. The greater Sn-Sn bond length increase seen for one-electron reduction of the tin species is probably due to the increased p-character of orbitals comprising the Sn-Sn sigma-bond when the Sn-Sn-C angle is decreased by ca. 30 degrees. Upon further reduction, the slight decrease in the Sn-Sn bond is probably a result of the reduced importance of Coulombic repulsion due to the larger size of tin and a widening of the Sn-Sn-C angles which may shorten the Sn-Sn sigma-bond.

The reduction of Ar'GeCl (Ar' = C6H3-2,6-Dipp2; Dipp = C6H3-2,6-Pri2) with LiBH(Bus)3 affords the first heavier group 14 element dimetallene hydride Ar'(H)GeGe(H)Ar' which, upon further reaction with PMe3, yields the base-stabilized isomeric form Ar'(H)2GeGeAr'.PMe3.

A commercially available enzyme immunoassay, the IDEIA Norwalk-like virus (NLV) enzyme linked immunosorbent assay (ELISA; Dako Cytomation, Ely, UK) for detecting NLV antigen in faecal samples and determining the NLV genogroup was evaluated. The performance of the ELISA was compared with that of electron microscopy and the reverse transcription polymerase chain reaction by testing a panel of faecal samples collected from patients involved in outbreaks of gastroenteritis. When compared with reverse transcription-polymerase chain reaction (RT-PCR), the ELISA had a sensitivity and specificity of 55.5 and 98.3%, respectively. This compares with a sensitivity and specificity for EM of 23.9 and 99.2%, respectively. The sensitivity and specificity of the ELISA for determining the aetiology of a Norwalk virus-like outbreak, based on two or more positive samples within an outbreak, were 52.2 and 100% when two samples were collected from an outbreak and 71.4 and 100% when six or more samples were collected. The ELISA correctly identified the NLV genogroups of viruses previously characterised by partial DNA sequencing. The ELISA is a suitable alternative to the preliminary screening by EM for investigating outbreaks of gastroenteritis. Outbreaks, negative by ELISA should be examined by RT-PCR in order to detect strains non-reactive in the assay and virus strains from representative ELISA positive outbreaks should be characterised fully to allow the genetic diversity of NLVs co-circulating in the population to be described.

Background: To examine the long-term costs of implanting a left ventricular assist device, we reviewed the initial hospitalization and outpatient costs for 12 patients who received a vented electric left ventricular assist device, and projected the first-year costs., Methods: We used the ratio-of-cost-to-charges method to measure hospital costs and payments for physician time. We examined time trends in the resource use of 50 pneumatic left ventricular assist device recipients, using actuarial techniques and regression modeling., Results: The average actual cost of left ventricular assist device support is $221,313 over an average of 9.5 months. If there had been no Food and Drug Administration regulatory policy precluding hospital discharge before 30 days, this value would have been $201,148. Based on this latter figure, the average predicted first-year cost is $219,139. The length of the intensive care unit stay, one of the most costly components of care, decreased significantly over time., Conclusions: The high costs of left ventricular assist device implantation are similar to those reported for cardiac transplantation. Given their success in supporting survival, we anticipate that these devices will be similarly cost-effective. However, further research is imperative to determine the cost-effectiveness of these devices beyond the introductory phase, when costs, benefits, and Food and Drug Administration requirements have stabilized.

Objectives: To validate a method for salivary diagnosis of measles and to assess the diagnostic accuracy of notified cases of measles., Design: Blood and saliva samples were collected within 90 days of onset of symptoms from patients clinically diagnosed as having measles and tested for specific IgM by antibody capture radioimmunoassay., Setting: 17 districts in England and one in southern Ireland during August 1991 to February 1993., Subjects: 236 children and adults with measles notified by a general practitioner., Results: Specific IgM was detected in serum in only 85 (36%) of the 236 cases. In cases associated with outbreaks and tested within six weeks of onset, 53/57 (93%) of samples were IgM positive, thereby confirming the sensitivity of serum IgM detection as a marker of recent infection. The serological confirmation rate was lower in cases with a documented history of vaccination (13/87; 15%) than in those without (70/149; 47%) and varied with age, being lowest in patients under a year, of whom only 4/36 (11%) were confirmed. Measles specific IgM was detected in 71/77 (92%) of adequate saliva samples collected from patients with serum positive for IgM. In cases where measles was not confirmed, 6/101 had rubella specific IgM and 5/132 had human parvovirus B19 specific IgM detected in serum., Conclusions: The existing national surveillance system for measles, which relies on clinically diagnosed cases, lacks the precision required for effective disease control. Saliva is a valid alternative to serum for IgM detection, and salivary diagnosis could play a major role in achieving measles elimination. Rubella and parvovirus B19 seem to be responsible for a minority of incorrectly diagnosed cases of measles in the United Kingdom and other infectious causes of measles-like illness need to be sought.

In Shark Bay, Western Australia, male bottlenose dolphins (Tursiops sp.) cooperate in pairs and triplets to sequester and control the movements of females. We refer to this behavior as "herding" and to the male pairs and triplets as alliances. During a 25-month study (1987-1989) on the social relationships of males, we documented herding in 10 alliances. Males preferentially herded nonpregnant females likely to be in estrus. Alliance members associated with one another consistently when not herding females. Each alliance associated preferentially with one or two other alliances. Occasionally, two alliances combined and took females from another alliance or defended females against such efforts. This study documents multiple-level male alliances within a social group outside of humans.