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Guided by the theory of communicative (dis)enfranchisement (TCD), this study analyzes 738 narratives describing negative (n = 381) and positive (n = 357) patient–provider interactions recounted by 399 female-identifying patients residing in 22 countries who are living with poorly understood chronic overlapping pain conditions (COPCs) such as fibromyalgia, vulvodynia, and endometriosis. Using thematic co-occurrence analysis (TCA), a novel method that builds on the identification of themes to map and visualize conceptual interrelationships, we identify nine enactments of (dis)enfranchising talk (DT) across three functions (discrediting, silencing, and stereotyping), four domains of consequences of DT (perceptual, emotional, physical, and material), and two patterns of co-occurrence between functions and consequences of DT (discrediting and physical, silencing and emotional). We illustrate how three MAXQDA software features can facilitate multi-coder TCA in large qualitative datasets. We offer theoretical implications and practical implications for communication researchers, patients, and medical providers toward improving difficult conversations concerning chronic pain.

OBJECTIVE To describe the surgical removal of intra-articular loose bodies (LBs) from the cervical articular process joints (APJs) in five horses and to describe the outcome of the surgery. STUDY DESIGN Short case series. ANIMALS Five client-owned horses with naturally occurring LBs within the cervical APJs. METHODS Medical records were reviewed of horses that were diagnosed with LBs of the cervical APJs on computed tomography (CT), where the LBs were subsequently removed surgically. Details of case selection and surgical technique were reviewed along with postoperative complications and clinical outcome. Histopathology was performed on LBs in some cases. RESULTS Surgery was performed on six APJs in five horses. Of the 14 LBs identified with CT, 13 were successfully removed from the C4/C5, C5/C6 and C6/C7 articulations. No surgical complications were encountered, and clinical signs of cervical dysfunction improved in all horses. All clinical cases returned to ridden work by 6 months post surgery. Histopathologic examination revealed the removed structures to be osteochondral or chondral loose bodies consisting of cartilaginous proliferation with or without ossification and central necrosis. CONCLUSIONS Surgical removal of LBs is achievable from the cervical APJs and can result in the resolution of cervical pain. This procedure offers a new treatment option for management of selected horses with cervical pain, following thorough assessment and CT imaging.

Platelet-rich plasma is a blood-derived, autologous product, which contains a mixture of growth factors, cells and cytokines. These substances are integral in the regulation of the inflammatory process and repair of tissues, although their methods of action are highly complex and not fully elucidated. The content of a platelet-rich plasma product is variable and the optimal concentrations of prime constituents such as platelets, growth factors and leucocytes are not known. A lack of uniformity of products and treatment protocols, along with study design limitations, means that the efficacy of platelet-rich plasma in healing tendon and ligament injuries is yet to be proven or disproven. Nevertheless platelet-rich plasma has gained widespread use in clinical practice primarily for the treatment of these injuries, among other applications. There are no widespread published or anecdotal concerns over the safety of platelet-rich plasma; however, synovial fluid analysis reveals an acute inflammatory response following intra-articular injection of a leucocyte-rich product.

Psychosocial and physiologic stressors, such as depression and obesity, during pregnancy can have negative consequences, such as increased systemic inflammation, contributing to chronic disease for both mothers and their unborn children. These conditions disproportionately affect racial/ethnic minorities. The effects of recommended dietary patterns in mitigating the effects of these stressors remain understudied.We aimed to evaluate the relations between maternal Mediterranean diet adherence (MDA) and maternal and offspring outcomes during the first decade of life in African Americans, Hispanics, and Whites.This study included 929 mother-child dyads from the NEST (Newborn Epigenetics STudy), a prospective cohort study. FFQs were used to estimate MDA in pregnant women. Weight and height were measured in children between birth and age 8 y. Multivariable linear regression models were used to examine associations between maternal MDA, inflammatory cytokines, and pregnancy and postnatal outcomes.More than 55% of White women reported high MDA during the periconceptional period compared with 22% of Hispanic and 18% of African American women (If replicated in larger studies, our data suggest that MDA provides a potent avenue by which effects of prenatal stressors on maternal and fetal outcomes can be mitigated to reduce ethnic disparities in childhood obesity.

Background: \ud The SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes.\ud \ud Methods: \ud This cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status.\ud \ud Findings: \ud Individual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low.\ud \ud Interpretation: \ud This large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant.\ud \ud Funding: \ud Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were rising during early summer 2021 in many countries as a result of the Delta variant. We assessed reverse transcription polymerase chain reaction swab positivity in the Real-time Assessment of Community Transmission–1 (REACT-1) study in England. During June and July 2021, we observed sustained exponential growth with an average doubling time of 25 days, driven by complete replacement of the Alpha variant by Delta and by high prevalence at younger, less-vaccinated ages. Prevalence among unvaccinated people [1.21% (95% credible interval 1.03%, 1.41%)] was three times that among double-vaccinated people [0.40% (95% credible interval 0.34%, 0.48%)]. However, after adjusting for age and other variables, vaccine effectiveness for double-vaccinated people was estimated at between ~50% and ~60% during this period in England. Increased social mixing in the presence of Delta had the potential to generate sustained growth in infections, even at high levels of vaccination.

Summary A SARS-CoV-2 variant carrying the Spike protein amino acid change D614G has become the most prevalent form in the global pandemic. Dynamic tracking of variant frequencies revealed a recurrent pattern of G614 increase at multiple geographic levels: national, regional and municipal. The shift occurred even in local epidemics where the original D614 form was well established prior to the introduction of the G614 variant. The consistency of this pattern was highly statistically significant, suggesting that the G614 variant may have a fitness advantage. We found that the G614 variant grows to higher titer as pseudotyped virions. In infected individuals G614 is associated with lower RT-PCR cycle thresholds, suggestive of higher upper respiratory tract viral loads, although not with increased disease severity. These findings illuminate changes important for a mechanistic understanding of the virus, and support continuing surveillance of Spike mutations to aid in the development of immunological interventions., Highlights: - A SARS-CoV-2 variant with Spike G614 has replaced D614 as the dominant pandemic form - The consistent increase of G614 at regional levels may indicate a fitness advantage - G614 is associated with lower RT PCR Ct’s, suggestive of higher viral loads in patients - The G614 variant grows to higher titers as pseudotyped virions

We have developed periscope, a tool for the detection and quantification of sub-genomic RNA (sgRNA) in SARS-CoV-2 genomic sequence data. The translation of the SARS-CoV-2 RNA genome for most open reading frames (ORFs) occurs via RNA intermediates termed “sub-genomic RNAs”. sgRNAs are produced through discontinuous transcription which relies on homology between transcription regulatory sequences (TRS-B) upstream of the ORF start codons and that of the TRS-L which is located in the 5’ UTR. TRS-L is immediately preceded by a leader sequence. This leader sequence is therefore found at the 5’ end of all sgRNA. We applied periscope to 1,155 SARS-CoV-2 genomes from Sheffield, UK and validated our findings using orthogonal datasets and in vitro cell systems. Using a simple local alignment to detect reads which contain the leader sequence we were able to identify and quantify reads arising from canonical and non-canonical sgRNA. We were able to detect all canonical sgRNAs at expected abundances, with the exception of ORF10. A number of recurrent non-canonical sgRNAs are detected. We show that the results are reproducible using technical replicates and determine the optimum number of reads for sgRNA analysis. In VeroE6 ACE2+/− cell lines, periscope can detect the changes in the kinetics of sgRNA in orthogonal sequencing datasets. Finally, variants found in genomic RNA are transmitted to sgRNAs with high fidelity in most cases. This tool can be applied to all sequenced COVID-19 samples worldwide to provide comprehensive analysis of SARS-CoV-2 sgRNA.

Clostridioides difficile is the leading cause of infectious diarrhea and one of the most common healthcare-acquired infections worldwide. We performed a systematic search and a bibliometric analysis of mathematical and computational models for Clostridioides difficile transmission. We identified 33 publications from 2009 to 2021. Models have underscored the importance of asymptomatic colonized patients in maintaining transmission in health-care settings. Infection control, antimicrobial stewardship, active testing, and vaccination have often been evaluated in models. Despite active testing and vaccination being not currently implemented, they are the most commonly evaluated interventions. Some aspects of C. difficile transmission, such community transmission and interventions in health-care settings other than in acute-care hospitals, remained less evaluated through modeling.

The Cosmic Ray Exposure Sequencing Science (CRESS) payload system was a proof of concept experiment to assess the genomic impact of space radiation on seeds. CRESS was designed as a secondary payload for the December 2016 high-altitude, long-duration south polar balloon flight carrying the Boron and Carbon Cosmic Rays in the Upper Stratosphere (BACCUS) experiment. Investigation of the biological effects of Galactic Cosmic Radiation (GCR), particularly those of ions with High-Z and Energy (HZE), was of interest due to the genomic damage this type of radiation inflicts. The biological effects of radiation above Antarctica (ANT) were studied using Arabidopsis thaliana seeds and compared to a simulation of GCR at Brookhaven National Laboratory (BNL) and to laboratory control seeds. The CRESS payload was broadly designed to 1U CubeSat specifications (10 cm × 10 cm × 10 cm, ≤1.33 kg), maintained 1 atm internal pressure, and carried an internal cargo of 580,000 seeds and twelve CR-39 Solid-State Nuclear Track Detectors (SSNTDs). Exposed BNL and ANT M0 seeds showed significantly reduced germination rates and elevated somatic mutation rates when compared to non-irradiated controls, with the BNL mutation rate also being higher than that of ANT. Genomic DNA from plants presenting distinct aberrant phenotypes was evaluated with whole-genome sequencing using PacBio SMRT technology, which revealed an array of structural genome variants in the M0 and M1 plants. This study was the first whole-genome characterization of space-irradiated seeds and demonstrated both the efficiency and efficacy of Antarctic long-duration balloons for the study of space radiation effects on eukaryote genomes.

The concept of using informative wavelength imagery to monitor plant health and ecosystem stability from space is derived from the deployment of Landsat and the development of the Normalized Difference Vegetative Index, or NDVI. NDVI presents the relative reflectance of the Near IR from plant leaves as a measure of relative plant health in terrestrial habitats and landscapes. However, the use of NDVI and NDVI-like imagery is rapidly evolving toward higher spatial resolution and more localized assessments of plant health, such as the use of drone imagery to monitor outdoor farms, and the use of mounted cameras within indoor growing facilities. With the advancement of plant growth systems in support of human space exploration, especially to the moon and Mars, remote assessment of plant health within exploration habitats becomes a critical element for development. This project examines the deployment of NDVI-like capabilities within a planetary analog greenhouse on the Antarctic ice shelf. The EDEN ISS Antarctica project provides a case study on the practical use of specific wavelength imagery to monitor plant health within space exploration environments. GoPro cameras, modified to dual bandpass capabilities, provided Single Image NDVI analyses for a year within the EDEN ISS Future Exploration Greenhouse at the Neumayer Station III in Antarctica. Images were acquired on site, analyzed remotely, and archived for the entire duration of the deployment through a combination of back-room science activities and operational communications with the Neumayer Station III. The results provide insights into the potential use of specific imaging wavelengths to enhance crop production in space exploration.

The age of potential mates has been proposed to be an important target for mate choice by females. Alternative hypotheses predict preferences in either direction. Females might be expected to prefer older males because such males have demonstrated their capacity to survive. Alternatively, they might prefer younger males that have not accumulated deleterious mutations. Preferences in both directions have been observed in laboratory experiments, suggesting that this is an issue that needs to be understood within its ecological context. We measured individual behaviour and reproductive success in a natural population of the field cricket Gryllus campestris over 10 years. We found that in this annual insect, a male's age relative to his peers was poorly correlated with his life span. This suggests that there is limited potential for selection to favour female choice for older males because a strategy of choosing older males would not significantly increase a female's likelihood of mating with a long-lived male. Older males were more successful at pairing up with females at a burrow, but once paired they were less likely to mate with them. By genotyping the next generation of adults we confirmed that observations of both pairing up with a female and matings were associated with successful offspring production. However, there was no relationship between how old a male was at mating and how many adult offspring he had. This lack of evidence for any fitness benefits to females from mate choice in relation to male age was consistent with the observation that the age of males had opposite effects on their success in pairing up with females compared to their success in mating with them.

Management of a chronic wound presents a common challenge in equine practice. Thorough evaluation of the animal and wound is required to identify intrinsic and extrinsic factors that can prevent healing. Additional investigation may require radiography, ultrasonography, bacterial culture and histopathology in order to identify underlying complicating factors. External factors such as ongoing trauma, bacterial colonisation and excess movement require management utilising debridement, coaptation and appropriate use of antimicrobial therapy. Wound specific factors such as bone sequestra and the propensity for exuberant granulation in the distal limb require careful evaluation and proactive management. Once inhibitory factors have been addressed, second intention healing can be optimised through the principles of moist wound healing and by the use of skin grafting techniques. Island grafting techniques can be performed in the field and should be considered as a cost-effective method of improving the quality and speed of wound healing.

Introduction Syphilis is a well-known STI caused by the bacterium Treponema pallidum. It can result in genital lesions and substantial morbidity and mortality. Recently, there has been an alarming global resurgence of syphilis with infections rising to unprecedented rates. As such, it is increasingly pertinent to test genital lesions for syphilis.Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) and Varicella zoster virus (VZV) cause lesions in cutaneous and mucocutaneous sites. While HSV-1 and HSV-2 are commonly known to cause genital lesions, recent publications have also found VZV in genital specimens. This unexpected finding suggests that reactivation of VZV in this atypical presentation is not as uncommon as previously believed. Using our highly specific PlexZyme technology that enables efficient multiplexing in real-time PCR (qPCR), we have developed a genital lesion assay for the detection of syphilis, HSV-1, HSV-2 and VZV to facilitate prompt and correct treatment of these STI pathogens. Methods To develop a genital lesion assay, the syphilis target was added to our existing HSV-1, HSV-2 and VZV assay (also containing a DNA extraction/amplification control) in a single-well multiplex qPCR. The performance of the assay was evaluated on 90 genital specimens for which in-house PCR results for syphilis had been determined. Results The genital lesion assay showed robust performance in multiplex with sensitive detection to 10 copies for all targets. The multiplexed assay detected 54/57 syphilis positives, corresponding to a sensitivity and specificity of 94.7% and 100.0%, respectively. The assay also detected 4 HSV-1 and 2 HSV-2 infections (2 and 1 syphilis co-infections, respectively). Conclusion The lesion assay offers simultaneous detection and differentiation of pathogens that cause genital lesions. In response to the current emerging syphilis outbreak, this assay could provide a rapid and effective method of determining the infectious agent responsible for genital lesions, supporting earlier detection and rapid treatment to reduce morbidity or worse outcomes.

Ureaplasma spp. are associated with preterm birth. In recent times, it has become apparent that Ureaplasma parvum, but not Ureaplasma urealyticum, is of most relevance. We recently demonstrated this in Australian pregnant women and using high-resolution melt (HRM) PCR, further showed that U. parvum genotype SV6 was of particular significance. However, our assay was unable to identify multiple genotypes in the same sample, required a separate species-level qPCR for low titre samples and was not ideal for diagnostic laboratories due to the nature of HRM PCR result interpretation. Consequently, our current study developed a novel, one-step PlexPCR assay capable of detecting U. parvum and genotypes SV1, SV3 and SV6 in a single reaction directly from clinical samples. We then validated this using vaginal swab DNA from our Australian cohort of pregnant women. The PlexPCR was highly sensitive, detecting all targets to between 0.4 × 10-5 ng DNA (SV3) and 0.4 × 10-6 ng DNA (U. parvum, SV1 and SV6). Compared to our HRM PCR, the PlexPCR defined genotype distribution in all seven cases previously reported as 'mixed', and detected another eight cases where multiple genotypes (two) were present in samples previously reported as single genotypes using HRM PCR. SIGNIFICANCE AND IMPACT OF THE STUDY Ureaplasma spp. have been associated with prematurity for decades, however, only a minority of studies have examined this beyond the genus level. In those that have, Ureaplasma parvum has been strongly associated with preterm birth. We recently demonstrated this in Australian women and further showed that U. parvum genotype SV6 was of particular significance. Our PlexPCR assay allows rapid detection and concurrent genotyping of U. parvum in clinical samples and may be of particular interest to obstetricians, particularly those caring for women at a high risk of preterm birth, and any other disease phenotypes where U. parvum is of interest.

Social networks have become an integral part of our society, and for good reason, which make it easier for people to keep in touch with their friends and family, while also generating new and interesting social data. However, the incredible volume of personal information exposed by these networks has some potentially severe social consequences. First, in order to protect themselves legally, many social websites have adopted privacy policies that do little to protect an individual's rights. Second, ethically questionable data collection practices on social networks by third party developers are becoming more commonplace. Finally, the data collected from social networks are being used and analyzed in previously unanticipated ways, suggesting that it is important to protect even the most mundane data. As a result, there is a need for users to be better informed about the dangers to their personal privacy and security, especially when granting permissions to third party applications from relatively unknown developers. In this paper, we present Privacy Pal, a simple and effective analysis and visualization tool that allows users to gain an increased level of understanding on the security and privacy risks associated with granting permissions to third party applications in online social networks, like Facebook.