Search

Abstract Background Lyme neuroborreliosis is the disseminated stage of an infectious disease caused by Borrelia burgdorferi (BB). The most prevalent clinical manifestations include meningoradiculitis and involvement of the cranial nerves with lymphocytic meningitis. Facial nerve is the most frequently affected cranial nerve. Neuroborreliosis presenting as encephalitis is only scarcely described in the literature. Methods Medical records of patients between 2014 and 2024 were screened and reviewed for neuroborreliosis. Patients were only included if they met the diagnostic criteria for definite neuroborreliosis. Results A total of seven patients with neuroborreliosis induced encephalitis were identified. The median age was 72 years, and except for one man, all patients were women. Clinical manifestations ranged from cognitive impairments resembling primary dementia to movement disorders mimicking Parkinson's disease, tremor, and epileptic seizures. In 5/7 patients (71%) they occurred between August to September. In addition to central nervous system involvement, all patients exhibited characteristic features of neuroborreliosis like painful meningoradiculitis or peripheral facial palsy. An elevated cell count in cerebrospinal fluid (CSF), positive oligoclonal bands, and blood-CSF barrier dysfunction indicated by an elevated albumin quotient (QAlb) was found in all patients. Advanced age, in which immunosenescence can occur, might contribute in developing encephalitis caused by neuroborreliosis in the patients of this cohort. Conclusion Neuroborreliosis can present with symptoms that mimic various neurological disorders, such as dementia, movement disorders, and epilepsy. Radiculitis, peripheral facial palsy or meningitis are an additional hint for this infectious disease. Analysis of CSF, which includes testing for intrathecally produced BB antibodies, is crucial for the diagnosis.

A new species of Harmonicon F. O. Pickard-Cambridge, 1896, is described from the Cerrado biome in Central-West Brazil, representing the first non-Amazonian and the southernmost record for the genus. Furthermore, we present a new diagnosis of the genus, expanding its original diagnosis, and redescribe its type species, Harmonicon rufescens F. O. Pickard-Cambridge, 1896, based on an adult female specimen from the same biogeographical area of its type locality.

Aim: To assess lung function in patients with persistent dyspnea 1 year after mild coronavirus disease 2019 (COVID-19) and compare with those hospitalized with moderate or critical COVID-19. Methods: Adults with confirmed severe acute respiratory syndrome coronavirus-2 infection with mild COVID-19 and persistent dyspnea (n = 18) or with moderate (n = 34) or critical COVID-19 (n = 19) were followed up 11–13 months after initial infection. Inclusion criteria were age < 65 years, no smoking history, and no preexisting respiratory diseases. Sociodemographic and clinical data were collected, and patients underwent spirometry and measurement of diffusing capacity for carbon monoxide (DLCO). Results: The non-hospitalized patients were significantly younger and more often female compared with those in the moderate and critical groups (P = 0.002 and P < 0.001, respectively). No significant differences in comorbidities or body mass index (BMI) were noted between severity groups. An obstructive spirometry pattern (ratio of forced expiratory volume during the first exhalation second to forced vital capacity under the lower limit of normal (LLN)) was found in 5.6, 5.9, and 5.3% of patients in the mild, moderate, and critical groups, respectively (P = 0.995). Abnormal DLCO (< LLN) rates were seen in 5.6, 16.7, and 47.4% in the mild, moderate, and critical groups, respectively (P = 0.018). DLCO, expressed as a z-score, was significantly lower in the critical group compared with the mild group after adjustment for age, sex, and BMI. Conclusion: Only a few subjects with mild COVID-19 and persistent dyspnea had abnormal lung function 1 year after initial infection, assessed based on spirometry and DLCO measurements. An obstructive spirometry pattern at 1-year follow-up was uncommon even in patients with moderate or critical COVID-19. Impaired DLCO was more common in patients with critical COVID-19.

Introduction Regional anesthesia aids in management of acute pain in the emergency department, but many emergency physicians remain inadequately trained. Further complicating medical education, our academic center continues to use remote learning as the primary setting for residency didactics. This project aims to create a remote conference session on ultrasound-guided serratus anterior plane blocks (USG-SAPB). Methods We used the ADDIE (analyze, design, develop, implement, evaluate) model for curricular design, with emergency medicine residents as our intended learners. For the analyze element, we examined clinical need and resident program evaluation feedback. For design, we utilized best practices for remote learning, principles of mental rehearsal, and multimodal instructional theory. For develop, we completed recruitment of faculty leads, materials, and beta testing of each component. We implemented our 50-minute session on the videoconferencing platform Zoom. For evaluate, we created a program evaluation survey based on Kirkpatrick's evaluation model. Results Seventeen learners completed the evaluation. For Kirkpatrick level 1, 94% reported being very or extremely satisfied. For Kirkpatrick level 2, 91% ranked their presession confidence level in performing USG-SAPB as not at all or slightly confident, compared to the postsession, where 88% ranked themselves as moderately, very, or extremely confident. For Kirkpatrick level 3, 94% reported that they would incorporate at least a moderate amount of content into clinical practice. Discussion This remote learning session on USG-SAPB demonstrated high levels of learner satisfaction, improvement in learner confidence, and potential to impact learners’ clinical practice. Future studies can elucidate patient outcomes related to educational sessions.

Abstract Background BK polyomavirus (BKPyV) infection after kidney transplantation can lead to serious complications such as BKPyV-associated nephropathy (BKPyVAN) and graft loss. The aim of this study was to investigate the incidence of BKPyVAN after implementing a BKPyV screening program, to map the distribution of BKPyV genotypes and subtypes in the Uppsala-Örebro region and to identify host and viral risk factors for clinically significant events. Methods This single-center prospective cohort study included kidney transplant patients aged ≥ 18 years at the Uppsala University Hospital in Sweden between 2016 and 2018. BKPyV DNA was analyzed in plasma and urine every 3 months until 18 months after transplantation. Also genotype and subtype were determined. A logistic regression model was used to analyze selected risk factors including recipient sex and age, AB0 incompatibility and rejection treatment prior to BKPyVAN or high-level BKPyV DNAemia. Results In total, 205 patients were included. Of these, 151 (73.7%) followed the screening protocol with 6 plasma samples, while184 (89.8%) were sampled at least 5 times. Ten (4.9%) patients developed biopsy confirmed BKPyVAN and 33 (16.1%) patients met criteria for high-level BKPyV DNAemia. Male sex (OR 2.85, p = 0.025) and age (OR 1.03 per year, p = 0.020) were identified as significant risk factors for developing BKPyVAN or high-level BKPyV DNAemia. BKPyVAN was associated with increased viral load at 3 months post transplantation (82,000 vs.

Abstract In healthy individuals, the intestinal epithelium forms a tight barrier to prevent gut bacteria from reaching blood circulation. To study the effect of probiotics, dietary compounds and drugs on gut barrier formation and disruption, human gut epithelial and bacterial cells can be cocultured in an in vitro model called the human microbial crosstalk (HuMiX) gut-on-a-chip system. Here, we present the design, fabrication and integration of thin-film electrodes into the HuMiX platform to measure transepithelial electrical resistance (TEER) as a direct readout on barrier tightness in real-time. As various aspects of the HuMiX platform have already been set in their design, such as multiple compressible layers, uneven surfaces and nontransparent materials, a novel fabrication method was developed whereby thin-film metal electrodes were first deposited on flexible substrates and sequentially integrated with the HuMiX system via a transfer-tape approach. Moreover, to measure localized TEER along the cell culture chamber, we integrated multiple electrodes that were connected to an impedance analyzer via a multiplexer. We further developed a dynamic normalization method because the active measurement area depends on the measured TEER levels. The fabrication process and system setup can be applicable to other barrier-on-chip systems. As a proof-of-concept, we measured the barrier formation of a cancerous Caco-2 cell line in real-time, which was mapped at four spatially separated positions along the HuMiX culture area.

Abstract Vaccination, especially with multiple doses, provides substantial population-level protection against COVID-19, but emerging variants of concern (VOC) and waning immunity represent significant risks at the individual level. Here we identify correlates of protection (COP) in a multicenter prospective study following 607 healthy individuals who received three doses of the Pfizer-BNT162b2 vaccine approximately six months prior to enrollment. We compared 242 individuals who received a fourth dose to 365 who did not. Within 90 days of enrollment, 239 individuals contracted COVID-19, 45% of the 3-dose group and 30% of the four-dose group. The fourth dose elicited a significant rise in antibody binding and neutralizing titers against multiple VOCs reducing the risk of symptomatic infection by 37% [95%CI, 15%-54%]. However, a group of individuals, characterized by low baseline titers of binding antibodies, remained susceptible to infection despite significantly increased neutralizing antibody titers upon boosting. A combination of reduced IgG levels to RBD mutants and reduced VOC-recognizing IgA antibodies represented the strongest COP in both the 3-dose group (HR = 6.34, p = 0.008) and four-dose group (HR = 8.14, p = 0.018). We validated our findings in an independent second cohort. In summary combination IgA and IgG baseline binding antibody levels may identify individuals most at risk from future infections.

El conflicto social surge cuando uno o más grupos expresan reclamos hacia la autoridad y llevan a cabo diversas acciones coercitivas en tiempo y espacio para alcanzar sus objetivos. Nos preguntamos si los 10,000 conflictos registrados por la Fundación Unir Bolivia entre 2010 y 2020 revelan patrones de interacción y vínculos entre los grupos de protesta. Los datos basados en eventos tienen una naturaleza bidimensional que presentan desafíos analíticos, en este trabajo aplicamos la proyección de grafos bipartitos con el algoritmo "common neighbor", para obtener un grado unidimensional y aplicar el análisis de red. Como resultado, se obtuvo una red en la que 15 de cada 100 conflictos permiten al menos un vínculo entre dos de los más de 7,000 grupos de protesta, resultando en una estructura tipo núcleo-periferia que indica cierta segregación de los nodos con menor grado de vinculación. Adicionalmente, ponderamos la frecuencia de enlaces para eliminar grupos densos de conexión y confirmamos que la protesta individual y las alianzas momentáneas predominan en los conflictos. Los grupos con mayor grado de conexión están asociados con un menor costo de radicalidad y duración del conflicto y forman comunidades con roles específicos en la economía estatal.

Computerized cognitive tests have the potential to cost-effectively detect and monitor cognitive impairments and thereby facilitate treatment for these conditions. However, relatively few of these tests have been validated in a variety of populations. Brain on Track, a self-administered web-based test, has previously been shown to have a good ability to differentiate between healthy individuals and patients with cognitive impairment in Portuguese populations. The objective of this study was to validate the differential ability and evaluate the usability of Brain on Track in a Swedish memory clinic setting. Brain on Track was administered to 30 patients with mild cognitive impairment/mild dementia and 30 healthy controls, all scheduled to perform the test from home after one week and after three months. To evaluate the usability, the patient group was interviewed after completion of the testing phase. Patients scored lower than healthy controls at both the first (median score 42.4 vs 54.1, p

Post-marketing reports of suspected adverse drug reactions are important for establishing the safety profile of a medicinal product. However, a high influx of reports poses a challenge for regulatory authorities as a delay in identification of previously unknown adverse drug reactions can potentially be harmful to patients. In this study, we use natural language processing (NLP) to predict whether a report is of serious nature based solely on the free-text fields and adverse event terms in the report, potentially allowing reports mislabelled at time of reporting to be detected and prioritized for assessment. We consider four different NLP models at various levels of complexity, bootstrap their train-validation data split to eliminate random effects in the performance estimates and conduct prospective testing to avoid the risk of data leakage. Using a Swedish BERT based language model, continued language pre-training and final classification training, we achieve close to human-level performance in this task. Model architectures based on less complex technical foundation such as bag-of-words approaches and LSTM neural networks trained with random initiation of weights appear to perform less well, likely due to the lack of robustness that a base of general language training provides.

Human activities have precipitated a rise in the levels of introgressive gene flow among animals. The investigation of conspecific populations at different time points may shed light on the magnitude of human-mediated introgression. We used the red junglefowl Gallus gallus, the wild ancestral form of the chicken, as our study system. As wild junglefowl and domestic chickens readily admix, conservationists fear that domestic introgression into junglefowl may compromise their wild genotype. By contrasting the whole genomes of 51 chickens with 63 junglefowl from across their natural range, we found evidence of a loss of the wild genotype across the Anthropocene. When comparing against the genomes of junglefowl from approximately a century ago using rigorous ancient-DNA protocols, we discovered that levels of domestic introgression are not equal among and within modern wild populations, with the percentage of domestic ancestry around 20–50%. We identified a number of domestication markers in which chickens are deeply differentiated from historic junglefowl regardless of breed and/or geographic provenance, with eight genes under selection. The latter are involved in pathways dealing with development, reproduction and vision. The wild genotype is an allelic reservoir that holds most of the genetic diversity of G. gallus, a species which is immensely important to human society. Our study provides fundamental genomic infrastructure to assist in efforts to prevent a further loss of the wild genotype through introgression of domestic alleles. Author summary The red junglefowl Gallus gallus from tropical Asia is the ancestral form of the chicken, which is arguably the most important domestic animal on Earth. Here we discovered an increase in genetic exchange between red junglefowl and chickens in recent years, making wild populations increasingly domestic genomically. By using whole genome sequences of chickens and red junglefowl from two time points, we show that domestic introgression has increased across the wild range at varying levels over the course of a century. We also identified genes that might have played a role in the domestication of the species using the samples from a century ago, in which domestic contribution was lower than in modern day samples. We found eight genes under selection which are involved in development, reproduction and vision, and which might be fundamental to the nature of domestic chickens as distinct from their ancestral wild counterparts. Our study brings to light the current and ongoing loss of the wild junglefowl genotype, suggesting that efforts may be needed to safeguard its full genetic diversity.

Human activities have precipitated a rise in the levels of introgressive gene flow among animals. The investigation of conspecific populations at different time points may shed light on the magnitude of human-mediated introgression. We used the red junglefowl Gallus gallus, the wild ancestral form of the chicken, as our study system. As wild junglefowl and domestic chickens readily admix, conservationists fear that domestic introgression into junglefowl may compromise their wild genotype. By contrasting the whole genomes of 51 chickens with 63 junglefowl from across their natural range, we found evidence of a loss of the wild genotype across the Anthropocene. When comparing against the genomes of junglefowl from approximately a century ago using rigorous ancient-DNA protocols, we discovered that levels of domestic introgression are not equal among and within modern wild populations, with the percentage of domestic ancestry around 20-50%. We identified a number of domestication markers in which chickens are deeply differentiated from historic junglefowl regardless of breed and/or geographic provenance, with eight genes under selection. The latter are involved in pathways dealing with development, reproduction and vision. The wild genotype is an allelic reservoir that holds most of the genetic diversity of G. gallus, a species which is immensely important to human society. Our study provides fundamental genomic infrastructure to assist in efforts to prevent a further loss of the wild genotype through introgression of domestic alleles.

Slope deformations, i.e., all types of landslides of rock masses (flow, creep, fall down, etc.), caused by gravitational forces, are the most widespread implementation of geological hazards and a negative geomorphological phenomenon that threatens the security of the population, destroy all utility values of the affected regions, negatively affects the environment, and cause considerable economic damage. Nowadays, the Global Navigation Satellite Systems (GNSS) provide accurate data for precise observations around the world due to the growing number of satellites from multiple operators, as well as more powerful and advanced technologies and the implementation of mathematical and physical models more accurately describing systematic errors that degrade GNSS observations such as ionospheric, tropospheric, and relativistic effects or multipath. The correct combination of measurement methods provides even more precise, i.e., better measurement results or estimates of unknown parameters. The combination of measurement procedures and their significant evaluations represent the essential attribute of deformation monitoring of landslides concerning the protection of the environment and the population’s safety in the interest areas for the sustainable development of human society. This article presents the establishment and use of a local geodetic network in particular local space for various needs. Depending upon the specific conditions, it is possible to use GNSS technology to obtain accurate observations and achieve the results applicable to the deformation survey for subsequent processing of the adjustment procedure.

Abstract The geomagnetic field behavior in polar regions remains poorly understood and documented. Although a number of Late Holocene paleomagnetic secular variation (PSV) records exist from marginal settings of the Amerasian Basin in the Arctic Ocean, their age control often relies on a handful of radiocarbon dates to constrain ages over the past 4,200 years. Here we present well‐dated Late Holocene PSV records from two sediment cores recovered from the Chukchi Sea, Arctic Ocean. The records are dated using 26 14C measurements, with local marine reservoir corrections calibrated using tephra layers from the 3.6 cal ka BP Aniakchak eruption in Northern Alaska. These 14C‐based chronologies are extended into the post‐bomb era using caesium‐137 dating, and mercury isochrons. Paleomagnetic measurements and rock magnetic analyses reveal stable characteristic remanent magnetization directions, and a magnetic mineralogy dominated by low‐coercivity minerals. The PSV records conform well to global spherical harmonic field model outputs. Centennial to millennial scale directional features are synchronous between the cores and other Western Arctic records from the area. Due to the robust chronology, these new high‐resolution PSV records provide a valuable contribution to the characterization of geomagnetic field behavior in the Arctic over the past few thousand years, and can aid in developing age models for suitable sediments found in this region.