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Among outpatients with coronavirus disease 2019 (COVID-19) due to the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) δ (delta) variant who did and did not receive 2 vaccine doses at 7 days after symptom onset, there was no difference in viral shedding (cycle threshold difference 0.59, 95% CI, −4.68 to 3.50; P = .77) with SARS-CoV-2 cultured from 2 (7%) of 28 and 1 (4%) of 26 outpatients, respectively.
Artifacts, including ceramics, ground stone, and soil samples, as well as dental calculus, recovered from sites in the eastern North American central Plains were submitted to multiple laboratories for analysis of microbotanical remains. Direct accelerator mass spectrometer (AMS) dates of 361–197 cal BC provide evidence for the earliest use of maize (Zea mays ssp. mays) in this region. Squash (Cucurbita sp.), wild rice (cf. Zizania spp.), and palm (Arecaceae sp.) microremains were also found. This research adds to the growing evidence of the importance of microbotanical analysis in documenting plant use and in the identification of early maize. The combined data on early maize from the eastern Plains adds to our understanding of the timing and dispersal of this crop out of the American Southwest. Alternative explanations for the adoption and early use of maize by eastern central Plains communities include its value as a secondary resource, as an addition to an existing farming strategy, or as a component of Middle Woodland rituals.
There are many structural problems facing the UK at present, from a weakened National Health Service to deeply ingrained inequality. These challenges extend through society to clinical practice and have an impact on current mental health research, which was in a perilous state even before the coronavirus pandemic hit. In this editorial, a group of psychiatric researchers who currently sit on the Academic Faculty of the Royal College of Psychiatrists and represent the breadth of research in mental health from across the UK discuss the challenges faced in academic mental health research. They reflect on the need for additional investment in the specialty and ask whether this is a turning point for the future of mental health research.
Johannesburg was still a brash mining town, better known for the production of wealth than knowledge, and the University of the Witwatersrand a mere ten years old when, in 1932, these ten lectures were delivered under the auspices of the University Philosophical Society. They portrayed the ideas of the university's leading academics of the day, and the programme of lectures reveals a studied effort to introduce an element of bipartisan political representation between English and Afrikaner in South Africa by including Wits' first principal, Jan Hofmeyr, and politician, D.F. Malan, as discussion chairs. Yet, no black intellectuals were represented and, indeed, the politics of racial segregation bursts through the text only in a few of the contributions. For the most part, race is alluded to only in passing. As Saul Dubow explains in his new introduction to this re-issue of the lectures, Our Changing World-View was an occasion for Wits' leading faculty members to position the young university as a mature institution with a leadership role in public affairs. Above all, it was a means to project the university as a research as well as a teaching institution, led by a vigorous and ambitious cohort of liberal-minded intellectuals. That all were male and white will be immediately apparent to readers of this reissued volume. Ranging from economics, psychology, a spurious rebuttal of evolution to a substantial revisionist history and the perils of the 'machine age', this book is a sombre reflection of intellectual history and the academy's role in promulgating political and social divisions in South Africa.
Although no drugs are licensed for the treatment of personality disorder, pharmacological treatment in clinical practice remains common.
This study aimed to estimate the prevalence of psychotropic drug use and associations with psychological service use among people with personality disorder.
Using data from a large, anonymised mental healthcare database, we identified all adult patients with a diagnosis of personality disorder and ascertained psychotropic medication use between 1 August 2015 and 1 February 2016. Multivariable logistic regression models were constructed, adjusting for sociodemographic, clinical and service use factors, to examine the association between psychological services use and psychotropic medication prescribing.
Of 3366 identified patients, 2029 (60.3%) were prescribed some form of psychotropic medication. Patients using psychological services were significantly less likely to be prescribed psychotropic medication (adjusted odds ratio 0.48, 95% CI 0.39–0.59, P<0.001) such as antipsychotics, benzodiazepines and antidepressants. This effect was maintained following several sensitivity analyses. We found no difference in the risk for mood stabiliser (adjusted odds ratio 0.79, 95% CI 0.57–1.10, P = 0.169) and multi-class psychotropic use (adjusted odds ratio 0.80, 95% CI 0.60–1.07, P = 0.133) between patients who did and did not use psychological services.
Psychotropic medication prescribing is common in patients with personality disorder, but significantly less likely in those who have used psychological services. This does not appear to be explained by differences in demographic, clinical and service use characteristics. There is a need to develop clear prescribing guidelines and conduct research in clinical settings to examine medication effectiveness for this population.
Radio-Frequency Identification (RFID) system technology is a key element for the realization of the Industry 4.0 vision, as it is vital for tasks such as entity tracking, identification and asset management. However, the plethora of RFID systems’ elements in combination with the wide range of factors that need to be taken under consideration along with the interrelations amongst them, make the problem of identification and design of the right RFID system, based on users’ needs particularly complex. The research outlined in this paper seeks to optimize this process by developing an integrating schema that will encapsulate this information in a form that is both human and machine processible. Human readability will allow a shared understanding of the RFID technology domain; machine readability, automated reasoning engines to perform logical deduction techniques returning implicit information. For this purpose, the novel RFID System Configuration Ontology (RFID SCO) is developed. Hence, non-RFID experts are enabled to identify the most suitable RFID system according to their needs and RFID experts to retrieve all the relevant information required for the efficient design of the corresponding RFID system. The RFID SCO is validated and tested successfully against real-world scenarios provided by domain experts.
Prior studies indicate greater disease burden for obesity among rural compared with urban residents but no differences for mood disorder based on geographic location. Recent attention has focused on the need to examine regional rural–urban disparities in disease burden. We focused on mood disorders and obesity prevalence within three southeastern Minnesota counties served by the Mayo Clinic Center for Translational Science Award, in Rochester, Minnesota, as these were top priorities identified in community health needs assessments.
Cross-sectional study to assess the association of rural–urban locality on 5-year (2009–2014) prevalence of mood disorder and obesity obtained using the Rochester Epidemiological Project medical records linkage system, among subjects residing in three mixed rural–urban counties on April 1, 2014. Multivariable analyses adjusted for demographics, socioeconomic status using an individual housing-based measure, and counties.
The study cohort (percent rural location) included 91,202 (15%) for Olmsted, 10,197 (51%) in Dodge, and 10,184 (57%) in Wabasha counties. On multivariate analysis, 5-year prevalence of mood disorders and obesity was significantly greater for urban compared with rural residents, after adjusting for confounders; odds ratios (95% confidence intervals): 1.21 (1.17–1.26), P < 0.001, and 1.05 (1.01–1.10), P = 0.016, respectively. Observed effects were not modified in additional models adjusted for health care utilization (HCU; ≥1 general medical examination visit and flu vaccination).
Rural–urban health disparities for burden of mood disorders and obesity are independent of socioeconomic status and HCU in a Midwestern community. It is important to assess potential regional heterogeneity of rural–urban disparities on health outcomes.
To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS).
Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M).
Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline.
Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes.
The purpose of this article is to describe the process of developing and implementing a transdisciplinary community-based research center, the Center for Health Equity Research (CHER) Chicago, to offer a model for designing and implementing research centers that aim to address structural causes of health inequality.
Scholars from diverse backgrounds and disciplines formed a multidisciplinary team for the Center and adopted the structural violence framework as the organizing conceptual model. All Center activities were based on community partnership. The Center activities were organized within three cores: administrative, investigator development, and community engagement and dissemination cores. The key activities during the first year were to develop a pilot grant program for early-stage investigators (ESIs) and to establish community partnership mechanisms.
CHER provided more than 60 consultations for ESIs, which resulted in 31 pilot applications over the three application cycles. Over 200 academic and community partners attended the community symposium and discussed community priority. Some challenges encountered were to improve communication among investigators, to clarify roles and responsibilities of the three cores, and to build consensus on the definition and operationalization of the concept of structural violence.
There is an increasing need for local hubs to facilitate transdisciplinary collaboration and community engagement to effectively address health inequity. Building consensus around a shared vision among partners is a difficult and yet important step toward achieving equity.
Benzobicyclon will be the first 4-hydroxyphenylpyruvate dioxygenase (HPPD)–inhibiting herbicide available in US rice production pending registration completion. An observation of benzobicyclon controlling weedy rice in two field trials prompted a greenhouse and field evaluation to determine if benzobicyclon would control weedy rice accessions from Arkansas, Mississippi, and southeastern Missouri. A total of 100 accessions were screened in the greenhouse and field. Percentage mortality was determined in the greenhouse, and percentage control was recorded in the field. Benzobicyclon at 371 g ai ha–1 caused at least 80% mortality of 22 accessions in the greenhouse and at least 80% control of 30 accessions in the field. For most accessions, individual plants within the accession varied in response to benzobicyclon. Based on these results, the sensitivity of weedy rice to benzobicyclon varies across accessions collected in the midsouthern United States, and it may provide an additional control option for weedy rice in some fields.
An estimated 293,300 healthcare-associated cases of Clostridium difficile infection (CDI) occur annually in the United States. To date, research has focused on developing risk prediction models for CDI that work well across institutions. However, this one-size-fits-all approach ignores important hospital-specific factors. We focus on a generalizable method for building facility-specific models. We demonstrate the applicability of the approach using electronic health records (EHR) from the University of Michigan Hospitals (UM) and the Massachusetts General Hospital (MGH).
We utilized EHR data from 191,014 adult admissions to UM and 65,718 adult admissions to MGH. We extracted patient demographics, admission details, patient history, and daily hospitalization details, resulting in 4,836 features from patients at UM and 1,837 from patients at MGH. We used L2 regularized logistic regression to learn the models, and we measured the discriminative performance of the models on held-out data from each hospital.
Using the UM and MGH test data, the models achieved area under the receiver operating characteristic curve (AUROC) values of 0.82 (95% confidence interval [CI], 0.80–0.84) and 0.75 ( 95% CI, 0.73–0.78), respectively. Some predictive factors were shared between the 2 models, but many of the top predictive factors differed between facilities.
A data-driven approach to building models for estimating daily patient risk for CDI was used to build institution-specific models at 2 large hospitals with different patient populations and EHR systems. In contrast to traditional approaches that focus on developing models that apply across hospitals, our generalizable approach yields risk-stratification models tailored to an institution. These hospital-specific models allow for earlier and more accurate identification of high-risk patients and better targeting of infection prevention strategies.
Palmer amaranth is one of the most problematic weeds in the midsouthern United States, and the evolution of resistance to protoporphyrinogen oxidase (PPO) inhibitors in biotypes already resistant to glyphosate and acetolactate synthase (ALS) inhibitors is a major cause of concern to soybean and cotton growers in these states. A late-season weed-escape survey was conducted in the major row crop–producing counties (29 counties) to determine the severity of PPO-inhibitor resistance in Arkansas. A total of 227 Palmer amaranth accessions were sprayed with fomesafen at 395 g ha−1 to identify putative resistant plants. A TaqMan qPCR assay was used to confirm the presence of the ΔG210 codon deletion or the R128G/M (homologous to R98 mutation in common ragweed) target-site resistance mechanisms in the PPX2 gene. Out of the 227 accessions screened, 44 were completely controlled with fomesafen, and 16 had only one or two severely injured plants (≥98% mortality) when compared with the 1986 susceptible check (100% mortality). The remaining 167 accessions were genotypically screened, and 82 (49%) accessions were found to harbor the ΔG210 deletion in the PPX2 gene. The R128G was observed in 47 (28%) out of the 167 accessions screened. The mutation R128M, on the other hand was rare, found in only three accessions. About 13% of the accessions were segregating for both the ΔG210 and R128G mutations. Sixteen percent of the tested accessions had mortality ratings <90% and did not test positive for the ΔG210 or the R128G/M resistance mechanisms, indicating that a novel target or non–target site resistance mechanism is likely. Overall, PPO inhibitor–resistant Palmer amaranth is widespread in Arkansas, and the ΔG210 resistance mechanism is especially dominant in the northeast corridor, while the R128G mutation is more prevalent in counties near Memphis, TN.
Benzobicyclon is the first 4-hydroxyphenylpyruvate dioxygenase-inhibiting herbicide pursued for commercial registration in U.S. rice production. A study was conducted in 2015 and 2016 to evaluate the response of eight rice cultivars to post-flood application timings of benzobicyclon at 494 g ai ha-1 (proposed 2X rate). ‘Caffey’, ‘CL151’, ‘CLXL745’, ‘Jupiter’, ‘LaKast’, ‘Mermentau’, ‘Roy J’, and ‘XL753’ were evaluated in response to applications of benzobicyclon. The highest level of visible injury was observed in LaKast at 7% in 2015. No visible injury was detected among other cultivars either year at 2 weeks after treatment. In 2015 and 2016, no more than a four-day delay to reach 50% heading occurred across all cultivars. Rough rice yield was not affected by any of the post-flood application timings of benzobicyclon. A second study was conducted in 2016 at three locations throughout Arkansas to investigate the tolerance of 19 tropical japonica (inbred and hybrid) and two indica inbred cultivars to a premix containing benzobicyclon at 494 g ai ha-1 and halosulfuron at 72 g ai ha-1 applied 1 week after flooding. The tropical japonica cultivars have excellent crop safety to benzobicyclon while application to the indica cultivars, Rondo and Purple Marker, expressed severe phytotoxicity. Benzobicyclon caused less than a 2 d delay in heading to the japonica cultivars. Rough rice yield of the tropical japonica cultivars was not affected by benzobicyclon while yields of both indica cultivars were negatively affected. Benzobicyclon can safely be applied to drill-seeded tropical japonica inbred and hybrid cultivars in a post-flood application without concerns for crop injury. Benzobicyclon should not be used on indica cultivars as it will cause severe injury, delayed heading, and yield loss.