Underperformed and Underreported Testing for Persistent Oropharyngeal Poliovirus Infections in Primary Immune Deficient Patients—Risk for Reemergence of Polioviruses

Background Individuals with primary immune deficiencies (PIDs) may excrete poliovirus for extended periods and remain a major reservoir for polio after eradication. Poliovirus can spread by fecal–oral or oral–oral transmission. In middle- and high-income countries, oral–oral transmission may be more prevalent than fecal–oral transmission of polioviruses where PIDs patients survive longer. Our aim was to determine the prevalence of prolonged or persistent oropharyngeal poliovirus infections in PIDs. Methods We performed a literature search for reports of prolonged (excreting poliovirus for ≥6 months and ≤5 years) or persistent (excreting poliovirus for >5 years) poliovirus infections in PIDs. Results There were 140 PID cases with prolonged or persistent poliovirus infections. All had poliovirus-positive stools. Testing of oropharyngeal mucosa was only reported for 6 cases, 4 of which were positive. Molecular analyses demonstrated independent evolution of poliovirus in the gut and oropharyngeal mucosa in 2 cases. Seven PIDs had multiple lineages of the same poliovirus serotype in stools without information about polioviruses in oropharyngeal mucosa. Conclusions Testing for persistence of poliovirus in oropharyngeal mucosa of PID patients is rare, with virus recovered in 4 of 5 cases in whom stools were positive. Multiple lineages or serotypes in 7 additional PID cases may indicate separate foci of infection, some of which might be in oropharyngeal mucosa. We recommend screening throat swabs in addition to stools for poliovirus in PID patients. Containment protocols for reducing both oral–oral and fecal–oral transmission from PID patients must be formulated for hospitals and community settings.

Cyclic Triangle Factors in Regular Tournaments

Both Cuckler and Yuster independently conjectured that when $n$ is an odd positive multiple of $3$ every regular tournament on $n$ vertices contains a collection of $n/3$ vertex-disjoint copies of the cyclic triangle. Soon after, Keevash \& Sudakov proved that if $G$ is an orientation of a graph on $n$ vertices in which every vertex has both indegree and outdegree at least $(1/2 - o(1))n$, then there exists a collection of vertex-disjoint cyclic triangles that covers all but at most $3$ vertices. In this paper, we resolve the conjecture of Cuckler and Yuster for sufficiently large $n$.

Methodological Guidelines for the Technical Training of Judo Players in the Military System

Judo, a sport playing a vital role in the training of the military, leads to the achievement of positive, multiple and unique effects, both in terms of developing the motor skills, but also in the formation, consolidation and improvement of applicative skills and aptitudes specific to close combat. The paper highlights the fact that the methods and contents specific to combat sports represent a useful and effective way of meeting the formative objectives in the context of the current Romanian Army missions, facilitating the physical adaptation of the combatants to the new demands imposed by the modern battlefield, characteristic of the actions carried out by NATO military structures.