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We assessed patterns of enteric infections caused by 14 pathogens, in a longitudinal cohort study of sequelae in British Columbia (BC) Canada, 2005–2014. Our population cohort of 5.8 million individuals was followed for an average of 7.5 years/person; during this time, 40 523 individuals experienced 42 308 incident laboratory-confirmed, provincially reported enteric infections (96.4 incident infections per 100 000 person-years). Most individuals (38 882/40 523; 96%) had only one, but 4% had multiple concurrent infections or more than one infection across the study. Among individuals with more than one infection, the pathogens and combinations occurring most frequently per individual matched the pathogens occurring most frequently in the BC population. An additional 298 557 new fee-for-service physician visits and hospitalisations for enteric infections, that did not coincide with a reported enteric infection, also occurred, and some may be potentially unreported enteric infections. Our findings demonstrate that sequelae risk analyses should explore the possible impacts of multiple infections, and that estimating risk for individuals who may have had a potentially unreported enteric infection is warranted.
Childhood trauma is strongly associated with poor health outcomes. Although many studies have found associations between adverse childhood experiences (ACEs), a well-established indicator of childhood trauma and diet-related health outcomes, few have explored the relationship between ACEs and diet quality, despite growing literature in epidemiology and neurobiology suggesting that childhood trauma has an important but poorly understood relationship with diet. Thus, we performed a cross-sectional study of the association of ACEs and adult diet quality in the Southern Community Cohort Study, a largely low-income and racially diverse population in the southeastern United States. We used ordinal logistic regression to estimate the association of ACEs with the Healthy Eating Index-2010 (HEI-10) score among 30 854 adults aged 40–79 enrolled from 2002 to 2009. Having experienced any ACE was associated with higher odds of worse HEI-10 among all (odds ratio (OR) 1⋅22; 95 % confidence interval (CI) 1⋅17, 1⋅27), and for all race–sex groups, and remained significant after adjustment for adult income. The increasing number of ACEs was also associated with increasing odds of a worse HEI-10 (OR for 4+ ACEs: 1⋅34; 95 % CI 1⋅27, 1⋅42). The association with worse HEI-10 score was especially strong for ACEs in the household dysfunction category, including having a family member in prison (OR 1⋅34; 95 % CI 1⋅25, 1⋅42) and parents divorced (OR 1⋅25; 95 % CI 1⋅20, 1⋅31). In summary, ACEs are associated with poor adult diet quality, independent of race, sex and adult income. Research is needed to explore whether trauma intervention strategies can impact adult diet quality.
Coronavirus disease 2019 (COVID-19) has been associated with various neurological and atypical head/eyes/ears/nose/throat (HEENT) manifestations. We sought to review the evidence for these manifestations.
In this systematic review and meta-analysis, we compiled studies published until March 31, 2021 that examined non-respiratory HEENT, central, and peripheral nervous system presentations in COVID-19 patients. We included 477 studies for qualitative synthesis and 59 studies for meta-analyses.
Anosmia, ageusia, and conjunctivitis may precede typical upper/lower respiratory symptoms. Central nervous system (CNS) manifestations include stroke and encephalopathy, potentially with brainstem or cranial nerve involvement. MRI studies support CNS para-/postinfectious etiologies, but direct neuroinvasion seems very rare, with few cases detecting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the CNS. Peripheral nervous system (PNS) manifestations include muscle damage, Guillain–Barre syndrome (GBS), and its variants. There was moderate-to-high study heterogeneity and risk of bias. In random-effects meta-analyses, anosmia/ageusia was estimated to occur in 56% of COVID-19 patients (95% CI: 0.41–0.71, I2:99.9%), more commonly than in patients without COVID-19 (OR: 14.28, 95% CI: 8.39–24.29, I2: 49.0%). Neurological symptoms were estimated to occur in 36% of hospitalized patients (95% CI: 0.31–0.42, I2: 99.8%); ischemic stroke in 3% (95% CI: 0.03–0.04, I2: 99.2%), and GBS in 0.04% (0.033%–0.047%), more commonly than in patients without COVID-19 (OR[stroke]: 2.53, 95% CI: 1.16–5.50, I2: 76.4%; OR[GBS]: 3.43,1.15–10.25, I2: 89.1%).
Current evidence is mostly from retrospective cohorts or series, largely in hospitalized or critically ill patients, not representative of typical community-dwelling patients. There remains a paucity of systematically gathered prospective data on neurological manifestations. Nevertheless, these findings support a high index of suspicion to identify HEENT/neurological presentations in patients with known COVID-19, and to test for COVID-19 in patients with such presentations at risk of infection.
Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.
Objectives: To evaluate prospective and retrospective memory abilities in Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans with and without a self-reported history of blast-related mild traumatic brain injury (mTBI). Methods: Sixty-one OEF/OIF/OND Veterans, including Veterans with a self-reported history of blast-related mTBI (mTBI group; n=42) and Veterans without a self-reported history of TBI (control group; n=19) completed the Memory for Intentions Test, a measure of prospective memory (PM), and two measures of retrospective memory (RM), the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised. Results: Veterans in the mTBI group exhibited significantly lower PM performance than the control group, but the groups did not differ in their performance on RM measures. Further analysis revealed that Veterans in the mTBI group with current PTSD (mTBI/PTSD+) demonstrated significantly lower performance on the PM measure than Veterans in the control group. PM performance by Veterans in the mTBI group without current PTSD (mTBI/PTSD-) was intermediate between the mTBI/PTSD+ and control groups, and results for the mTBI/PTSD- group were not significantly different from either of the other two groups. Conclusions: Results suggest that PM performance may be a sensitive marker of cognitive dysfunction among OEF/OIF/OND Veterans with a history of self-reported blast-related mTBI and comorbid PTSD. Reduced PM may account, in part, for complaints of cognitive difficulties in this Veteran cohort, even years post-injury. (JINS, 2018, 24, 324–334)
Transcranial magnetic stimulation (TMS) is an effective and safe therapy for major depressive disorder (MDD). This study assessed quality of life (QOL) and functional status outcomes for depressed patients after an acute course of TMS.
Forty-two, U.S.-based, clinical TMS practice sites treated 307 outpatients with a primary diagnosis of MDD and persistent symptoms despite prior adequate antidepressant pharmacotherapy. Treatment parameters were based on individual clinical considerations and followed the labeled procedures for use of the approved TMS device. Patient self-reported QOL outcomes included change in the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the EuroQol 5-Dimensions (EQ-5D) ratings from baseline to end of the acute treatment phase.
Statistically significant improvement in functional status on a broad range of mental health and physical health domains was observed on the SF-36 following acute TMS treatment. Similarly, statistically significant improvement in patient-reported QOL was observed on all domains of the EQ-5D and on the General Health Perception and Health Index scores. Improvement on these measures was observed across the entire range of baseline depression symptom severity.
These data confirm that TMS is effective in the acute treatment of MDD in routine clinical practice settings. This symptom benefit is accompanied by statistically and clinically meaningful improvements in patient-reported QOL and functional status outcomes.
Dispersed facies basal ice – massive (i.e. structureless) ice with dispersed debris aggregates – is present at the margins of many glaciers and, as a product of internal glacial processes, has the potential to provide important information about the mechanisms of glacier flow and the nature of the subglacial environment. The origin of dispersed facies is poorly understood, with several hypotheses having been advanced for its formation, and there is disagreement as to whether it is largely a sedimentary or a tectonic feature. We test these established hypotheses at the temperate glacier Svínafellsjökull, Iceland, and find that none fully account for dispersed facies characteristics at this location. Instead, dispersed facies physical, sedimentological and stable-isotope (δ18O, δD) characteristics favour a predominantly tectonic origin that we suggest comprises the regelation and strain-induced metamorphism of debris-rich basal ice that has been entrained into an englacial position by tectonic processes operating at the base of an icefall. Further thickening of the resultant dispersed facies may also occur tectonically as a result of ice flow against the reverse bed slope of a terminal overdeepening. Lack of efficient subglacial drainage in the region of the overdeepening may limit basal melting and thus favour basal ice preservation, including the preservation of dispersed facies. Despite the relatively low sediment content of dispersed facies ( ∼1.6% by volume), its thickness (up to 25 m) and ubiquity at Svínafellsjökull results in a significant contribution to annual sediment discharge (1635–3270 m3 a−1) that is ∼6.5 times that contributed by debris-rich stratified facies basal ice.
We present comprehensive study of ultrafast charge carrier dynamics in a variety of organic molecular crystals. In all samples, we observed sub-picosecond charge photogeneration and band-like transport, characterized by (i) an increase in charge carrier mobility as the temperature decreases in a wide temperature range of at least 20 K – 300 K and (ii) mobility anisotropy in the a-b plane of the crystals. The temperature dependence of the decay dynamics of the transient photoconductivity reveals the presence of shallow trapping sites in herring-bone-type-structured crystals (such as pentacene (Pc), tetracene (Tc), and rubrene (Rub)), while such traps are apparently absent in “brick-wall”-type crystals (such as functionalized pentacene (FPc)). We also report on the measurements of the charge carrier mobility anisotropy in the a-b plane of two types of FPc single crystals. Anisotropies of approximately 3.5 and 11.6 were obtained in the crystals characterized by crystal structures favoring two-dimensional and one-dimensional charge transport, respectively, consistent with the degree of π-overlap along different directions in the crystals.
This study examines the behavioural responses to ultrasound in 52 species from the family Cicindelidae using both tethered flight and non-flight assays. Tethered flying tiger beetles respond to trains of bat-like ultrasonic pulses with a short-latency, multi-component behaviour. There was no variation in the nature of the behavioural responses regardless of geographical distribution or phylogenetic position. Lowest mean behavioural thresholds lie predominantly between 30 and 45 kHz. Sensitivity, however, varies widely, and several species do not respond at all in these assays. The lowest thresholds for responders are most often between 70 and 80 dB SPL. Almost all subgenera of North American tiger beetles in the genus Cicindela have at least some species with low-threshold acoustic behaviour. The single exception is the large subgenus Cicindela where all species are completely unresponsive or have very high thresholds. There was little relationship between habitat and responsiveness to ultrasound, but there is a strong correlation with seasonal activity – species with adults active in the spring and autumn (all in the subgenus Cicindela) do not show ultrasound-triggered behaviour whereas summer-active species generally do. Superimposing these data on a current phylogeny of the North American tiger beetles suggests that acoustic behaviour (and hearing) is a shared primitive trait among the taxa examined here and that there have been at least five independent losses of this character.
Variations in the electrical and mechanical properties of silsesquioxane spin-on glass thin films are examined as a function of curing time and temperature. Particular attention is paid to the trade-off between producing low dielectric constant films, suitable for advanced microelectronic interconnection structures, and mechanically stable films, able to withstand semiconductor wafer fabrication processes. Two critical aspects of the mechanical stability of spin-on glasses are shown to be: the positive thermal expansion mismatch with silicon–leading to tensile film stresses; and reactivity with water–leading to susceptibility to stress-corrosion cracking.
We present results that demonstrate the potential of the Packard Tri-Carb® Model 2770TR/SL for radiocarbon dating. For 2 g of sample benzene, a stable background count rate of 0.307 cpm and a stable counting efficiency of 64.78% were determined using a 13–75 keV counting window. Changes to the mathematical routines for t-SIE (quench indicating parameter) calculation and a reduction in the activity of the external standard have enabled stability of the t-SIE to be achieved, and combined with the use of a suitable balance point counting window; all of these factors give the stability of performance required for 14C dating. Calculations based on the above parameters indicate that the limit of detection for 2 g samples, counted for 5000 min, is >48,900 yr bp. The great advantage of this system is that these data were acquired using inexpensive standard 7-mL low potassium borosilicate glass vials. Vial holders manufactured from BGO reduced the background to 0.15 cpm with a minimum effect on efficiency (64.46% for 13–75 keV). A similar calculation of the limit of detection gave >51,700 bp. The use of the BGO vial holders in other instruments employing time-resolved liquid scintillation counting (TR-LSC) (Models 2250CA and 2260XL) also brought about significant improvements in detection limits.