IgA Complexes Induce Neutrophil Extracellular Trap Formation More Potently Than IgG Complexes

Neutrophil extracellular trap (NET) formation is a powerful instrument to fight pathogens, but may induce collateral damage in the affected tissues. Besides pathogen-derived factors, immune complexes are potent inducers of NET formation. Neutrophils express IgA and IgG specific Fc receptors (FcRs) and therefore respond to complexed IgA and IgG. Especially in the context of autoimmune diseases, IgA and IgG immune complexes have been shown to trigger NET formation, a process that putatively contributes to disease severity. However, it is of question if both antibody classes stimulate neutrophils to the same extent. In this study, we compared the capability of IgA and IgG complexes formed by heat aggregation to induce NET formation. While stimulation of neutrophils with IgA complexes robustly induced NET formation, complexed IgG only marginally increased the amount of NETs compared to the unstimulated control. Mixing IgA with IgG before heat aggregation did not increase the effect of complexed IgA on neutrophils. By contrast, the presence of IgG complexes seemed to disturb neutrophil stimulation by IgA complexes. The capacity of complexed IgG to induce NET formation could not be increased by the addition of autologous serum or the removal of terminal sialic acid in the Fc glycan. Together, our data show that IgA is a much more potent inducer of NET formation than IgG. IgA may thus be the main driving force in (auto)immune complex-mediated NET formation.

Outbreak of NDM-1-Producing Escherichia coli in a Coronavirus Disease 2019 Intensive Care Unit in a Mexican Tertiary Care Center

The SARS-CoV-2 pandemic has resulted in a surge of critically ill patients. Hospitals have had to adapt to the demand by repurposing areas as intensive care units. This has resulted in high workload and disruption of usual hospital workflows. Surge capacity guidelines and pandemic response plans do not contemplate how to limit collateral damage from issues like hospital-acquired infections. It is vital to ensure quality of care in surge scenarios.

Missed training, collateral damage from COVID 19?

Background: during the COVID-19 pandemic a total lockdown was enforced all over Italy starting on March 9th. This resulted in the shrinking of economic activities. In addition, all formal occupational security-training courses were halted, among them the 81/08 law lectures and Basic Life Support-Defibrillation (BLS-D) laymen training courses. The aim of the study was to evaluate the impact of the pandemic on BLS-D laymen training courses in the Lombardy region. Methods: BLS-D training courses records for the Lombardy region were analysed. The analysis was conducted from 2016 to 2020 as part of the Hippo project. Results: between 2017 and 2019 BLS-D trained laymen kept increasing, moving from 53,500 trained individuals up to 74,700. In 2020 a stark reduction was observed with only 22,160 individuals trained. Formal courses were not halted completely during 2020. Still, in the months available for training, the number of individuals enrolled showed a sharp 50% reduction. Conclusions: laymen training courses for emergency management are a fundamental component of primary prevention practice. The 81/08 and 158/12 Italian laws have decreed this practice mandatory on the workplace. Following the enforcement of the lockdown and the subsequent interruption of emergency management courses, efforts will be necessary to re-establish and guarantee the high quality training of the pre-pandemic period.

COVID-19 collateral damage—psychological burden and behavioural changes among older adults during the first outbreak in Stockholm, Sweden: a cross-sectional study

ObjectivesTo explore the indirect negative effects of COVID-19 restrictions (collateral damage) on the lives and health of older adults living in central Stockholm, and to characterise the sociodemographic profile of those with the highest susceptibility to this damage.DesignCross-sectional study.SettingDistrict of Kungsholmen in Stockholm, Sweden.ParticipantsOlder adults aged 68 years and above (n=1231) who participated in the ad hoc COVID-19-related phone questionnaire administered by trained staff between May and June 2020 and who had previously attended the regular follow-up assessment of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016–2019.Primary and secondary outcome measuresThree dimensions of collateral damage: psychological burden (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use since the beginning of the pandemic. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage.ResultsVast majority of participants adhered to the national public health recommendations, with over three-quarters practising self-isolation (n=928). Half of the sample reported psychological burden, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants (77.8%) were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of both individual and co-occurring dimensions of collateral damage.ConclusionsCOVID-19 and its restrictions during the first half of 2020 had a negative effect on the health and lives of a majority of the elderly living in central Stockholm. Women were at a higher risk of these negative consequences. We emphasise the need for predefined, evidence-based interventions to support those who are most susceptible to these consequences, both during the pandemic and once the outbreak is overcome.

He Shall Repay the Lamb Fourfold

When retributive divine punishment against David in 2 Samuel 12 includes the death of David and Bathsheba’s newborn child, troubling issues surrounding God’s character are identified by many commentators. In order to examine the divine violence against David’s household in 2 Samuel 11–20 in Part 1, the terms punishment and retribution are defined. Punishment is pain imposed on a person judicially determined as guilty, either through declaration by an authorised party or through transgression of an established law. By this definition, David’s newborn is not individually punished but either collectively punished as part of David’s household, or the victim of collateral damage. Retribution is distinguished from natural consequences that proceed from transgressions, and defined as backward looking, proportional payback for an offence. Elements of Kant’s formulation for retributive punishment are introduced.

Collateral Damage: The Relationship Between High-Salience Events and Variation in Racial Discrimination

To what extent are individual or organizational biases affected by racially salient events? We propose that acts of discrimination and the individual biases that undergird them are sensitive to high-salience events and will oscillate with the salience of the focal attribute. In short, that the propensity to discriminate reflects both individual and environmental differences, and therefore a given person may become more prone to discriminate in the aftermath of a high-salience event. We test our hypothesis in three online experiments that examine how varying the salience of race affects the evaluation of in-group or out-group founders. We find that respondents evaluate their in-group members more favorably, and out-group members less favorably, when exposed to a high-salience event, which translates into a significant disadvantage for the minority (African American) group. We complement these studies with an assessment of how police shootings affect fundraising outcomes on Kickstarter to confirm the external validity of our findings. Together, these studies indicate that racially salient events depress the quality evaluations and success odds of African American entrepreneurs relative to others. Hence, discrimination levels can be affected by salient yet unrelated events, and such events are consequential for the economic fortunes of individuals belonging to minority and disadvantaged groups.