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Abstract Background The gut microbiota (GM) has proven to be essential for both physical health and mental wellbeing, yet the forces that ultimately shape its composition remain opaque. One critical force known to affect the GM is the social environment. Prior work in humans and free-ranging non-human primates has shown that cohabitation and frequent social interaction can lead to changes in GM composition. However, it is difficult to assess the direction of causation in these studies, and interpretations are complicated by the influence of uncontrolled but correlated factors, such as shared diet. Results We performed a 15-month longitudinal investigation wherein we disentangled the impacts of diet and social living conditions on GM composition in a captive cohort of 13 male cynomolgus macaques. The animals were in single housing for the first 3 months of the study initially with a variable diet. After baseline data collection they were placed on a controlled diet for the remainder of the study. Following this diet shift the animals were moved to paired housing for 6 months, enabling enhanced social interaction, and then subsequently returned to single housing at the end of our study. This structured sequencing of diet and housing changes allowed us to assess their distinct impacts on GM composition. We found that the early dietary adjustments led to GM changes in both alpha and beta diversity, whereas changes in social living conditions only altered beta diversity. With respect to the latter, we found that two particular bacterial families — Lactobacillaceae and Clostridiaceae — demonstrated significant shifts in abundance during the transition from single housing to paired housing, which was distinct from the shifts we observed based on a change in diet. Conversely, we found that other bacteria previously associated with sociality were not altered based on changes in social living conditions but rather only by changes in diet. Conclusions Together, these findings decouple the influences that diet and social living have on GM composition and reconcile previous observations in the human and animal literatures. Moreover, the results indicate biological alterations of the gut that may, in part, mediate the relationship between sociality and wellbeing.

Abstract This position statement addresses the critical concerns and recommended practices surrounding the use of panel food testing for diagnosing food allergies. Food allergies are a significant public health concern, and the misdiagnosis of food allergies remains a prevalent concern, made worse by the ongoing use of panel food testing. The practice of screening patients for multiple food allergens, regardless of clinical relevance, is commonly referred to as “panel food testing.” Fundamentally, a panel food test is not simply a single test; a panel food test is a series of several distinct tests for multiple foods, each with its own variable predictive value. These tests have not been adequately validated as screening tests and carry a considerable false positive rate. The resulting false diagnoses lead to unnecessary dietary restrictions, increased healthcare costs, and significant psychosocial distress for patients and their families.

Abstract Multinucleated skeletal muscle cells need to acquire additional nuclei through fusion with activated skeletal muscle stem cells when responding to both developmental and adaptive growth stimuli. A fundamental question in skeletal muscle biology has been the reason underlying this need for new nuclei in cells that already harbor hundreds of nuclei. Here we utilize nuclear RNA-sequencing approaches and develop a lineage tracing strategy capable of defining the transcriptional state of recently fused nuclei and distinguishing this state from that of pre-existing nuclei. Our findings reveal the presence of conserved markers of newly fused nuclei both during development and after a hypertrophic stimulus in the adult. However, newly fused nuclei also exhibit divergent gene expression that is determined by the myogenic environment to which they fuse. Moreover, accrual of new nuclei through fusion is required for nuclei already resident in adult myofibers to mount a normal transcriptional response to a load-inducing stimulus. We propose a model of mutual regulation in the control of skeletal muscle development and adaptations, where newly fused and pre-existing myonuclear populations influence each other to maintain optimal functional growth.

Abstract Background Oral immunotherapy (OIT) is an increasingly utilized management strategy for IgE-mediated food allergy. Despite promising efficacy and effectiveness, there is still a lack of data surrounding the reasons for discontinuation of OIT. The primary reason stated in the literature for discontinuation is adverse gastrointestinal effects. Social factors contributing to OIT discontinuation have not been well reported. We hypothesize that social considerations are significant contributors to treatment discontinuation. Methods We completed a retrospective chart review of 50 patients treated in community pediatric allergy practices who discontinued OIT out of 507 patients who were started on OIT between October 1, 2017-October 27, 2022. Reasons for discontinuation were identified and classified into five main categories: unsafe care decisions, anxiety, adverse effects of OIT, uncontrolled comorbidity and social factors. Categories were not exclusive. Results 507 patients were started on OIT, with data available for 50 patients who discontinued OIT, aged 10 months to 18 years and 2 months. The overall discontinuation rate was 9.8%, of which 40 patients (80%) discontinued during buildup, 9 patients (18%) discontinued during maintenance and one patient on two food OIT discontinued one food during buildup and one during maintenance (2%). Thirty-four patients (68%) had multiple reasons for discontinuing OIT. Social factors were the most common reason for discontinuation and were identified in 32 patients (64%). Twenty-four patients (48%) discontinued OIT due to adverse effects. Gastrointestinal symptoms were the most prevalent, while anaphylaxis contributed to discontinuation in 15 patients (30%). Anxiety led to discontinuation in 17 patients (34%). Conclusions Our data highlights the importance of social factors and anxiety in the success of OIT completion. Our results support the need to consider not only the patient’s medical history, but also their social history and support networks when selecting patients who are good candidates for OIT to optimize the successful completion of OIT.

Abstract Provision of non-invasive vascular imaging results to individuals has been shown to improve cardiovascular disease risk factor control: its impact on diet remains uncertain. In this two-arm, single-blind, parallel, 12-week randomized controlled trial, 240 participants, 57.5% females aged 60–80 y had abdominal aortic calcification and clinical assessments performed at a hospital clinic. Participants were randomized 1:1 to receive (intervention n = 121) or not (control n = 119) their calcification results. Both groups received educational resources on cardiovascular disease risk control and were unblinded to the intervention. Outcome measures were performed at baseline and 12 weeks. The primary outcomes of the study were changes in fruit and vegetable intake measures over 12 weeks assessed using plasma carotenoid concentrations (biomarkers of FV intake) and a food frequency questionnaire. Secondary outcomes included 12-week changes in other aspects of the diet, physical activity, body weight, blood pressure, heart rate, lipid profile, glucose concentrations, estimated cardiovascular disease risk score, and medication use. Between-group differences were tested using linear mixed-effects regression. There were no between-group differences in the primary outcomes at 12 weeks: plasma carotenoids (mean difference +0.03 µg/mL [95%CI −0.06, 0.13]) and fruit and vegetable intakes (+18 g/d [−37, 72]). However, the provision of calcification results led to between-group differences in serum total (−0.22 mmol/L [−0.41, −0.04]) and non-HDL (−0.19 mmol/L [−0.35, −0.03]) cholesterol, and estimated cardiovascular disease risk score (−0.24% [−0.47, −0.02]). No between-group differences were seen for other secondary outcomes. In this work, providing vascular imaging results did not improve diet but did improve some cardiovascular disease risk factors (Australian and New Zealand Clinical Trials Registry ACTRN12618001087246).

Abstract Background To promote rural practice and increase enrollment in the entry-level Master of Science Physical Therapy program at the University of Alberta, the Department of Physical Therapy developed a rural physical therapy satellite campus located in a farming region in central Alberta. A distributed learning format was used to connect the rural cohort to the main urban campus. Real time video conferencing was used to connect the two campuses for all lectures, seminars and clinical skills classes. This evaluation aimed to describe a unique rural training program for physical therapy students and its effectiveness in promoting work in rural communities after graduation. Methods Physical Therapy students in the first three years (2012–2015) of commencing the rural satellite program (n = 280) were surveyed, and six focus groups were held to capture student experiences, satisfaction and engagement. Data were collected on employment locations of the 2012–2019 graduates’ first physical therapy position and current employment. Results Survey results suggested comparable levels of satisfaction and engagement for all physical therapy students regardless of campus. Focus group data revealed that students quickly accepted the distributed learning technological interface, enjoyed their local campuses, and felt connected to instructors and student colleagues. Compared to the overall physical therapy workforce, a higher percentage of physical therapists graduating from the rural campus reported working in rural centers for both their first and current jobs. Conclusion Regardless of campus, students were satisfied and equally engaged in the physical therapy program. Students who completed the physical therapy program in a rural setting tended to work rurally after graduation. A distributed learning model may be useful for other healthcare training programs to promote engagement in rural health.

Abstract Objective This study measured eye movements in children with a history of opsoclonus‐myoclonus ataxia syndrome in order to identify abnormalities in saccade and pupil behavior that map onto specific alterations in brainstem pathways. Methods We used video‐based eye tracking while participants freely viewed 10 min of short (2–4 s) video clips without instructions. Clip transitions represented a large visual perturbation and we quantified multiple characteristics of saccade and pupil responses following these transitions in 13 children recovering from opsoclonus‐myoclonus and 13 healthy, age‐matched control participants. Results The frequency of saccades and distribution of fixation durations differed between the groups. Following the clip transitions, children recovering from opsoclonus‐myoclonus ataxia syndrome exhibited longer time to initiate saccades, leading to a delay in harvesting visual information. Clip transitions to lighter clips produced similar pupil constriction responses in the two groups. However, clip transitions to darker clips produced dilation responses that were initiated earlier and of greater magnitude in opsoclonus‐myoclonus ataxia syndrome, suggesting removal or suppression of a signal that delays dilation. Interpretation Children with a history of opsoclonus‐myoclonus ataxia syndrome demonstrated key abnormalities in saccade and pupil metrics. We propose a novel hypothesis in which dysfunction in the pathway from the superior colliculus to the mesencephalic and pontine reticular formation that houses the saccade and pupil premotor circuits could produce these results.

Abstract Background The oculomotor circuit spans many cortical and subcortical areas that have been implicated in psychiatric disease. This, combined with previous findings, suggests that eye tracking may be a useful method to investigate eating disorders. Therefore, this study aimed to assess oculomotor behaviors in youth with and without an eating disorder. Methods Female youth with and without an eating disorder completed a structured task involving randomly interleaved pro-saccade (toward at a stimulus) and anti-saccade (away from stimulus) trials with video-based eye tracking. Differences in saccades (rapid eye movements between two points), eye blinks and pupil were examined. Results Youth with an eating disorder (n = 65, M age = 17.16 ± 3.5 years) were compared to healthy controls (HC; n = 65, M age = 17.88 ± 4.3 years). The eating disorder group was composed of individuals with anorexia nervosa (n = 49), bulimia nervosa (n = 7) and other specified feeding or eating disorder (n = 9). The eating disorder group was further divided into two subgroups: individuals with a restrictive spectrum eating disorder (ED-R; n = 43) or a bulimic spectrum eating disorder (ED-BP; n = 22). In pro-saccade trials, the eating disorder group made significantly more fixation breaks than HCs (F(1,128) = 5.33, p = 0.023). The ED-BP group made the most anticipatory pro-saccades, followed by ED-R, then HCs (F(2,127) = 3.38, p = 0.037). Groups did not differ on rate of correct express or regular latency pro-saccades. In anti-saccade trials, groups only significantly differed on percentage of direction errors corrected (F(2, 127) = 4.554, p = 0.012). The eating disorder group had a significantly smaller baseline pupil size (F(2,127) = 3.60, p = 0.030) and slower pro-saccade dilation velocity (F(2,127) = 3.30, p = 0.040) compared to HCs. The ED-R group had the lowest blink probability during the intertrial interval (ITI), followed by ED-BP, with HCs having the highest ITI blink probability (F(2,125) = 3.63, p = 0.029). Conclusions These results suggest that youth with an eating disorder may have different oculomotor behaviors during a structured eye tracking task. The oculomotor behavioral differences observed in this study presents an important step towards identifying neurobiological and cognitive contributions towards eating disorders.

Aspen exists as the most abundant and industrially important forest type in contemporary Minnesota. Historically, the species was seen as economically undesirable yet saw prolific increases in abundance due to pine harvest and fire. The Leech Lake Reservation exists as a unique case study of tribal-U.S. Forest Service co-management, with 90 % of reservation land within Chippewa National Forest boundaries. This large geographical intersection was created by a series of American Indian law policies and makes the relationship between the Chippewa National Forest and the Leech Lake Band of Ojibwe unique within the USDA National Forest System. Comparison of pre-reservation and more modern forest/land cover types within the modern-day boundaries of the Leech Lake Reservation were conducted alongside investigation of historical management authority documentation of Chippewa National Forest and Leech Lake Band of Ojibwe cooperation and broader historical management of aspen in Minnesota. Results suggest historical power dynamics between the Chippewa National Forest and Leech Lake Band of Ojibwe influenced decreasing pine and increasing aspen on the Leech Lake Reservation. However, the modern relationship between the Chippewa National Forest and the Leech Lake Band of Ojibwe shows the potential for successful co-management within the shared goals of aspen management.

Background: A proposed new global definition of ARDS seeks to update the Berlin definition and account for nonintubated ARDS and ARDS diagnoses in resource-variable settings. Research Question: How do ARDS epidemiologic characteristics change with operationalizing the new global definition of ARDS in a resource-limited setting? Study Design and Methods: We performed a real-use retrospective cohort study among adult patients meeting criteria for the Berlin definition of ARDS or the global definition of ARDS at ICU admission in two public hospitals in the KwaZulu-Natal Department of Health, South Africa, from January 2017 through June 2022. Results: Among 5,760 adults (aged ≥ 18 years) admitted to the ICU, 2,027 patients (35.2%) met at least one ARDS definition, including 1,218 patients meeting the Berlin definition of ARDS (60.1% of all ARDS diagnoses) and 809 new diagnoses of the global definition of ARDS that were not captured by the Berlin definition alone (39.9% of all ARDS diagnoses and 14.0% of all ICU admissions). After adjustment for hospital-level factors, patients who met only the global definition of ARDS criteria (ie, who would not have been captured by the Berlin definition) showed no statistically significant ICU mortality difference vs patients with ARDS according to the Berlin definition (21.7% [95% CI, 18.9%-24.4%] vs 23.8% [95% CI, 21.5%-26.2%]; OR, 0.88 [95% CI, 0.70-1.10]; P = .25). In prespecified exploratory subgroup analyses, patients without COVID-19 who met only the criteria for the global definition of ARDS showed reduced ICU mortality (14.2% [95% CI, 11.6%-16.9%] vs 22.2% [95% CI, 19.8%-24.6%]; OR, 0.58 [95% CI, 0.45-0.75]; P < .0005) compared with patients without COVID-19 who met the Berlin definition for ARDS. Interpretation: The new global definition of ARDS captures a significant proportion of patients who would not have been included by the Berlin definition alone. These additional patients with ARDS may have heterogenous patterns of outcomes among diagnostic subgroups, including by COVID-19 status, compared with patients with ARDS according to the Berlin definition.

Background: Rugby league is a popular collision sport among Australian adolescent and young adult men. Concussion is one of the more common injuries in rugby league. Few studies have examined concussion in youth rugby league. To examine medically diagnosed concussions from a single season within two elite-level pathway rugby league competitions by evaluating game play risk factors and conducting a video review of potential concussion signs. Methods: All players involved in the Queensland Rugby League's (QRL) under 18 years and under 20 years age group competitions during the 2019 season were included in this study. Data included all head injury assessments (HIAs) identified in real-time through the QRL injury surveillance system for these two QRL age group competitions. The purpose of this study was to (i) report the rates of HIAs and medically diagnosed concussions; (ii) examine video signs of potential concussion; (iii) review game play risk factors related to HIAs and concussions; and (iv) determine the number of days until a concussed player returned to match play and the number of subsequent games missed by concussed players. Results: There were 86 HIAs and 30 medically diagnosed concussions from the two competitions. The concussion incidence was 2.93 per 1000 player match hours in the under 18-year age group and 5.75 per 1000 player match hours in the under 20-year age group. Slow to stand was the most commonly observed video sign (78.6%; 22/28 concussions). Most concussed players (91%, 21/23) missed at least one subsequent game (M ​= ​1.4, SD ​= ​1.7, range ​= ​0–7 games), with the average days to return-to-play being 15.7 (SD ​= ​7.0, range ​= ​7–41 days). Conclusions: In elite-level pathway rugby league, the incidences of HIAs and medically diagnosed concussions were higher in the under 20 age group than the under 18 age group. Both age groups had lower incidences of HIAs and concussions than professional adult rugby league players. Return-to-play following concussion was similar across the two age groups and differed considerably compared to the elite level, with a longer time before return to play for the younger elite level development pathway players.

The pupil is modulated by luminance, arousal, bottom-up sensory, and top-down cognitive signals, and has increasingly been used to assess these aspects of brain functioning in health and disease. However, changes in pupil dynamics across the lifespan have not been extensively examined, hindering our ability to fully utilize the pupil in probing these underlying neural processes in development and aging in healthy and clinical cohorts. Here, we examined pupil responses during the interleaved pro−/anti-saccade task (IPAST) in healthy participants across the lifespan (n = 567, 5–93 years of age). Based on the extracted measurements of pupil dynamics, we demonstrated age-related changes in pupil measures and task modulation. Moreover, we characterized the underlying factors and age-related effects in components of pupil responses that may be attributed to developmental and aging changes in the associated brain regions. Finally, correlations between factors of pupil dynamics and saccade behaviors revealed evidence of shared neural processes in the pupil and saccade control circuitries. Together, these results demonstrate changes in pupil dynamics as a result of development and aging, providing a baseline with which altered pupil responses due to neurological deficits at different ages can be studied.

Gender-based violence (GBV) poses a significant concern in the construction and natural resources industries, where women, due to lower social status and integration, are at heightened risk. This systematic review aimed to identify the prevalence and experience of GBV in the construction and natural resources industries. A systematic search across databases including PubMed, OVID, Scopus, Web of Science, and CINAHL was conducted. The Risk of Bias Instrument for Cross-sectional Surveys of Attitudes and Practices by McMaster University and the Critical Appraisal of Qualitative Studies by the Center for Evidence Based Medicine at the University of Oxford were used to assess the studies included in the review. Six articles were included after full-text analysis. GBV was reported in the construction, mining, urban forestry, and arboriculture sectors. Workplace GBV was measured differently across the studies, and all studies examined more than one form of GBV. The main forms of GBV discussed in these studies were discrimination, sexual harassment, and sexism. The studies provided some insight for demographic factors that may or may not be associated with GBV, such as age, region of work, and number of years working in the industry. The review also suggests that workplace GBV has a negative impact on mental health and well-being outcomes, such as higher levels of stress and lower job satisfaction. The current research has not established the effectiveness of interventions, tools, or policies in these workplaces. Thus, additional research should include intervention studies that aim to minimize or prevent GBV in male-dominated workplaces. The current study can bring awareness and acknowledgement towards GBV in the workplace and highlight the importance of addressing it as this review outlines the negative consequences of GBV on mental health and well-being in these male-dominated industries.

Microplastics (MPs) have emerged as widespread environmental pollutants, causing significant threats to aquatic ecosystems and organisms. This review examines the toxic effects of MPs on fishes, with a focus on neurobehavioural, physiological, and reproductive impacts, as well as the underlying mechanisms of toxicity. Evidence indicates that MPs induce a range of neurobehavioural abnormalities in fishes, affecting social interactions and cognitive functions. Altered neurotransmitter levels are identified as a key mechanism driving behavioural alterations following MP exposure. Physiological abnormalities in fishes exposed to MPs are also reported, including neurotoxicity, immunotoxicity, and oxidative stress. These physiological disruptions can compromise the individual health of aquatic organisms. Furthermore, reproductive abnormalities linked to MP exposure are discussed, with a particular emphasis on disruptions in endocrine signaling pathways. These disruptions can impair reproductive success in fish species, impacting population numbers. Here we explore the critical role of endocrine disruptions in mediating reproductive effects after exposure to MPs, focusing primarily on the hypothalamic-pituitary-gonadal axis. Our review highlights the urgent need for interdisciplinary research efforts aimed at elucidating the full extent of MP toxicity and its implications for aquatic ecosystems. Lastly, we identify knowledge gaps for future research, including investigations into the transgenerational impacts, if any, of MP exposure and quantifying synergetic/antagonistic effects of MPs with other environmental pollutants. This expanded knowledge regarding the potential risks of MPs to aquatic wildlife is expected to aid policymakers in developing mitigation strategies to protect aquatic species.

Consensus criteria for traumatic encephalopathy syndrome (TES) specify that at least one core clinical feature of cognitive impairment (CI; e.g., difficulties with memory, executive function) or neurobehavioral dysregulation (ND; e.g., explosiveness, rage, and mood lability) be present and not fully accounted for by other health disorders. Associations between self-reported symptoms that mirror the core clinical features of TES?and how they may be related to concomitant medical conditions?remain unclear. The purpose of this study was to evaluate the association of medical conditions and football exposures with TES clinical features (CI+/?, ND+/?) in 1741 former professional American-style football (ASF) players (age, 57.7???13.9 years; professional seasons, 6.6???3.9 years). Demographics (age, race/ethnicity, current body mass index, age of first football exposure, use of performance-enhancing drugs, position played, and past concussion symptoms), self-reported medical conditions (anxiety, depression, attention-deficit hyperactivity disorder [ADHD], sleep apnea, headache, stroke, hypertension, heart disease, high cholesterol, erectile dysfunction, and low testosterone) were collected. Of 1741 participants, 7.4% were CI+ and/or ND+ (n?=?129). Participants who were CI+ or ND+ were more likely to report one or more coexisting medical conditions than participants who did not report CI or ND (odds ratio [OR]?=?2.04; 95% confidence interval: 1.25?3.47; p?=?0.003). Separate general linear models for each medical condition that adjusted for demographics and football-related factors identified significant associations between ADHD, diabetes, erectile dysfunction, headaches, sleep apnea, anxiety, and low testosterone and CI+ and/or ND+ (ORs?=?1.8?6.0). Chi-square automatic interaction detection (CHAID) multi-variable decision tree models that incorporated medical conditions and football exposures accurately differentiated former players meeting either CI or ND clinical criteria from those meeting none (accuracy?=?91.2?96.6%). CHAID identified combinations of depression, headache, sleep apnea, ADHD, and upper quartiles of concussion symptom history as most predictive of CI+ and/or ND+ status. CI+ and/or ND+ players were more likely to report medical conditions known to cause cognitive symptoms. Concussion exposure and medical conditions significantly increased the likelihood that a former ASF player would demonstrate cognitive or neurobehavioral dysfunction. Clinicians engaged with this population should consider whether treatable coexisting condition(s) could account for some portion of the clinical picture associated with TES presentation.

Motorists are required to interact with both roadway infrastructure and various users. The complexity of the driving task in certain scenarios can influence the frequency and severity of crashes. Turning vehicles at intersections, for example, pose a collision risk for both motorized and non-motorized road users. The primary goal of this paper is to investigate the underlying factors which contribute to right-turn crashes at signalized intersections. Five years of crash data across Oregon were collected. A random parameters binary logit model was developed to predict the likelihood of whether a crash resulted in an injury or fatality. It was found that 14 variables were statistically significant in contributing to crash severity. The results obtained show that dry conditions and a posted speed limit of 30 mi/hr or 35 mi/hr contributed to a higher percentage of severe crashes, while fixed-object crashes and snowy weather had a higher likelihood of resulting in no injury crashes. Time-of-day (9:00 p.m. to 6:00 a.m.), lighting conditions (dusk), gender (male driver), crash type (vehicle–pedestrian and rear-end), and driver-level crash cause (driver sped too fast for conditions, driver did not yield right-of-way, and driver disregarded the traffic control device) all led to an increase in probability of a fatal or injury crash. The vehicle–pedestrian conflict variable had the highest impact on increasing the probability of such a crash while turning right at a signalized intersection. This observation is important because right turns are often permitted during the pedestrian walk and clearance indications, and often drivers do not give right-of-way to pedestrians.

Abstract In a warming climate, an intensifying fire regime and higher likelihood of extreme rain are expected to increase watershed sediment yield in many regions. Understanding regional variability in landscape response to fire and post‐fire rainfall is essential for managing water resources and infrastructure. We measured sediment yield resulting from sequential wildfire and extreme rain and flooding in the upper Carmel River watershed (116 km2), on the central California coast, USA, using changes in sediment volume mapped in a reservoir. We determined that the sediment yield after fire and post‐fire flooding was 854–1,100 t/km2/yr, a factor of 3.5–4.6 greater than the long‐term yield from this watershed and more than an order of magnitude greater than during severe drought conditions. In this first large‐scale field validation test of the WEPPcloud/wepppy framework for the Water Erosion Prediction Project (WEPP) model on a burned landscape, WEPP predicted 81%–106% of the measured sediment yield. These findings will facilitate assessing and predicting future fire effects in steep watersheds with a Mediterranean climate and indicate that the increasingly widespread use of WEPP is appropriate for evaluating post‐fire hillslope erosion even across 100‐km2 scales under conditions without debris flows.

IMPORTANCE:. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has evolved through multiple phases in the United States, with significant differences in patient centered outcomes with improvements in hospital strain, medical countermeasures, and overall understanding of the disease. We describe how patient characteristics changed and care progressed over the various pandemic phases; we also emphasize the need for an ongoing clinical network to improve the understanding of known and novel respiratory viral diseases. OBJECTIVES:. To describe how patient characteristics and care evolved across the various COVID-19 pandemic periods in those hospitalized with viral severe acute respiratory infection (SARI). DESIGN:. Severe Acute Respiratory Infection-Preparedness (SARI-PREP) is a Centers for Disease Control and Prevention Foundation-funded, Society of Critical Care Medicine Discovery-housed, longitudinal multicenter cohort study of viral pneumonia. We defined SARI patients as those hospitalized with laboratory-confirmed respiratory viral infection and an acute syndrome of fever, cough, and radiographic infiltrates or hypoxemia. We collected patient-level data including demographic characteristics, comorbidities, acute physiologic measures, serum and respiratory specimens, therapeutics, and outcomes. Outcomes were described across four pandemic variant periods based on a SARS-CoV-2 sequenced subsample: pre-Delta, Delta, Omicron BA.1, and Omicron post-BA.1. SETTING:. Multicenter cohort of adult patients admitted to an acute care ward or ICU from seven hospitals representing diverse geographic regions across the United States. PARTICIPANTS:. Patients with SARI caused by infection with respiratory viruses. MAIN OUTCOMES AND RESULTS:. Eight hundred seventy-four adult patients with SARI were enrolled at seven study hospitals between March 2020 and April 2023. Most patients (780, 89%) had SARS-CoV-2 infection. Across the COVID-19 cohort, median age was 60 years (interquartile range, 48.0–71.0 yr) and 66% were male. Almost half (430, 49%) of the study population belonged to underserved communities. Most patients (76.5%) were admitted to the ICU, 52.5% received mechanical ventilation, and observed hospital mortality was 25.5%. As the pandemic progressed, we observed decreases in ICU utilization (94% to 58%), hospital length of stay (median, 26.0 to 8.5 d), and hospital mortality (32% to 12%), while the number of comorbid conditions increased. CONCLUSIONS AND RELEVANCE:. We describe increasing comorbidities but improved outcomes across pandemic variant periods, in the setting of multiple factors, including evolving care delivery, countermeasures, and viral variants. An understanding of patient-level factors may inform treatment options for subsequent variants and future novel pathogens.

The movement ecology of Bull Trout (Salvelinus confluentus) in watersheds at the northern geographic range extent is not well understood. We implanted 54 Bull Trout with acoustic transmitters in the Prairie Creek watershed, Northwest Territories, Canada and tracked fish from July 2011 to October 2012 using 19 stationary hydrophones. Bull Trout movement patterns generally corresponded to two groups, as a result of individual variation within and across seasons. The first group exhibited seasonal variations in movement and habitat use, moving most (range 11.7–115.9 km) and occupying the largest home ranges in summer and autumn, while exhibiting little movement during winter and spring. The second group made negligible movements within seasons and resided in localized areas. Restricted movement in winter resulted in a severe range contraction. The average distance moved within a season was 11.5 km (range 0.3–64.9 km per fish). The unusually high prevalence of stationarity in this watershed suggest fish can complete all life processes (spawning, feeding, and rearing) in short reaches (

Abstract Background Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs. Methods Our study was informed by the Levesque et al.’s (2013) “conceptual framework of access to health care.” We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed. Results Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participants’ Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participants’ attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and ‘normal’ results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants. Conclusion With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately.

Abstract We require a better understanding of the relative contribution of different modes of non-genetic inheritance in behavioral trait development. Thus, we investigate variation in exploratory behavior, which is ecologically relevant and a target of selection. The metabolic hypothesis predicts exploratory behavior to be size-dependent across taxa. This size-dependency is cancelled out under high perceived risk, allowing us to determine the transgenerationally integrated estimated level of risk. Using fathead minnows Pimephales promelas, we manipulated perceived risk in mothers, fathers, caring males and offspring through continuous exposure to either conspecific alarm cues or to a control water treatment. In 1000 four-month old offspring, we determined body sizes and exploratory behavior. Perceived high risk in mothers, followed by personal risk, was most effective in eliminating size-dependent behavior whereas effects of paternal risk on offspring behavioral development were substantially weaker. When maternal risk is high, environmental mismatches between parents prevented offspring from responding appropriately to personal high risk. The environment of the caring male also impacted offspring behavior to a greater extent than that of its genetic parents. Our study highlights the high relative importance of maternal, personal and caring male risk environments and showcases potential costs of an environmental mismatch between parental sexes.

African swine fever (ASF) is an acute, highly hemorrhagic viral disease in domestic pigs and wild boars. The disease is caused by African swine fever virus, a double stranded DNA virus of the Asfarviridae family. ASF can be classified into 25 different genotypes, based on a 478 bp fragment corresponding to the C-terminal sequence of the B646L gene, which is highly conserved among strains and encodes the major capsid protein p72. The C-terminal end of p72 has been used as a PCR target for quick diagnosis of ASF, and its characterization remains the first approach for epidemiological tracking and identification of the origin of ASF in outbreak investigations. Recently, a new classification of ASF, based on the complete sequence of p72, reduced the 25 genotypes into only six genotypes; therefore, it is necessary to have the capability to sequence the full-length B646L gene (p72) in a rapid manner for quick genotype characterization. Here, we evaluate the use of an amplicon approach targeting the whole B646L gene, coupled with nanopore sequencing in a multiplex format using Flongle flow cells, as an easy, low cost, and rapid method for the characterization and genotyping of ASF in real-time.

African swine fever virus (ASFV) is the causative agent of an often lethal disease in domestic pigs, African swine fever (ASF). ASF is currently a pandemic disease challenging pig production in Eurasia. While the ASFV genome encodes for over 160 proteins, the function of most of them are still not characterized. Among those ASF genes with unknown functions is the E111R gene. It has been recently reported that the deletion of the E111R gene from the genome of the virulent Chinese field isolate SY18 strain produced a reduction of virus virulence when pigs were inoculated at relatively low doses. Conversely, we report here that deletion of the ASFV gene E111R in the Georgia 2010 isolate does not alter the virulence of the parental virus in experimentally inoculated pigs. A recombinant virus lacking the E111R gene, ASFV-G-∆E111R was intramuscularly (IM) inoculated in domestic pigs at a dose of 102 HAD50 of ASFV-G-∆E111R and compared with animals that received a similar dose of virulent ASFV-G. Both, animals inoculated with either the recombinant ASFV-G-∆E111R or the parental virus developed a fatal form of the disease and were euthanized around the 6th–7th day post-inoculation (dpi).

African swine fever virus (ASFV) is the causative agent of African swine fever (ASF), a highly infectious and lethal disease of domesticated swine. Outbreaks of ASF have been mostly restricted to the continent of Africa. The outbreaks that have occurred outside of Africa were controlled by extensive depopulation of the domesticated pig population. However, in 2007, an outbreak occurred in the country of Georgia, where ASFV infected wild pigs and quickly spread across eastern Europe. Since the reintroduction of ASF into Europe, variants of the current pandemic strain, ASFV Georgia 2007/01 (ASFV-G), which is classified as Genotype 2 based on p72 sequencing, have been reported in countries within western Europe, Asia, and the island of Hispaniola. Additionally, isolates collected in 2020 confirmed the presence of variants of ASFV-G in Nigeria. Recently, we reported similar variants of ASFV-G collected from domestic pigs suspected of dying of ASF in Ghana in 2022. Here, we retroactively report, based on full-length sequencing, that similar variants were present in Ghana in 2021. The SNP analysis revealed derivatives of ASFV with distinct genetic markers. Furthermore, we identified three full-length ASFV genomes as Genotype 1, indicating that there were two genotypes circulating in proximity during the 2021 ASF outbreaks in Ghana.

Obtaining a complete good-quality sequence and annotation for the long double-stranded DNA genome of the African swine fever virus (ASFV) from next-generation sequencing (NGS) technology has proven difficult, despite the increasing availability of reference genome sequences and the increasing affordability of NGS. A gap analysis conducted by the global African swine fever research alliance (GARA) partners identified that a standardized, automatic pipeline for NGS analysis was urgently needed, particularly for new outbreak strains. Whilst there are several diagnostic and research labs worldwide that collect isolates of the ASFV from outbreaks, many do not have the capability to analyze, annotate, and format NGS data from outbreaks for submission to NCBI, and some publicly available ASFV genomes have missing or incorrect annotations. We developed an automated, standardized pipeline for the analysis of NGS reads that directly provides users with assemblies and annotations formatted for their submission to NCBI. This pipeline is freely available on GitHub and has been tested through the GARA partners by examining two previously sequenced ASFV genomes; this study also aimed to assess the accuracy and limitations of two strategies present within the pipeline: reference-based (Illumina reads) and de novo assembly (Illumina and Nanopore reads) strategies.