Patients with single-ventricle CHD undergo a series of palliative surgeries that culminate in the Fontan procedure. While the Fontan procedure allows most patients to survive to adulthood, the Fontan circulation can eventually lead to multiple cardiac complications and multi-organ dysfunction. Care for adolescents and adults with a Fontan circulation has begun to transition from a primarily cardiac-focused model to care models, which are designed to monitor multiple organ systems, and using clues from this screening, identify patients who are at risk for adverse outcomes. The complexity of care required for these patients led our centre to develop a multidisciplinary Fontan Management Programme with the primary goals of earlier detection and treatment of complications through the development of a cohesive network of diverse medical subspecialists with Fontan expertise.

Among patients with schizophrenia (SZ) and bipolar I disorder (BD-I) treated with second-generation antipsychotics (SGAs), clinically-significant weight gain (CSWG) and treatment interruptions (TIs) are challenges that may result in morbidity/mortality.

CSWG and TIs were assessed among patients who initiated oral SGAs of moderate-to-high weight gain risk (no exposure to index SGAs/first-generation antipsychotics for =12 months) using medical records/claims (OM1 Data Cloud; January 2013-February 2020). Outcomes included CSWG (=7% increase in baseline weight) and TIs (switches [to SGAs of low weight gain risk/long-acting injectables] or discontinuations [no SGAs for >30 days]). Descriptive analyses included proportions of patients with CSWG and TIs, and median time to these outcomes.

Approximately three-quarters of patients were overweight/obese at baseline (SZ: N=8,174; BD-I: N=9,142). Within 3 months of SGA initiation, 12% of all patients experienced CSWG. For patients on treatment with index SGAs for >6 months (SZ: 29%; BD-I: 27%), 28% (SZ) and 30% (BD-I) experienced CSWG during follow-up. Median time to CSWG was 14 weeks. CSWG results were numerically similar among patients with SZ and BD-I.

Over 96% of patients had TIs during follow-up (median time of 12 [SZ] and 13 [BD-I] weeks). Among patients with CSWG and subsequent TIs and weight measurements, 74% did not return to baseline weight after interrupting treatment; the remainder returned to baseline weight with median times of 38 (SZ) and 39 (BD-I) weeks. Results suggest that most patients with CSWG do not return to baseline weight after stopping treatment with oral SGAs of moderate-to-high weight gain risk.

Funding. Alkermes, Inc.

We present a case of late symptom onset of COVID-19 infection 72 days after initial diagnosis in an immunocompromised 53-year-old man. SARS-CoV-2 was cultured from his sputum sample at this time, and genomic sequencing suggested reinfection was unlikely. After receipt of convalescent plasma, SARS-CoV-2 became undetectable by PCR 111 days after diagnosis, although SARS-CoV-2 antibodies remained not detectable. This case posed difficult public health management issues in a low prevalence COVID-19 setting as the person required extended home isolation given his prolonged SARS-CoV-2 PCR detection.

We study the link between fiscal austerity and Nazi electoral success. Voting data from a thousand districts and a hundred cities for four elections between 1930 and 1933 show that areas more affected by austerity (spending cuts and tax increases) had relatively higher vote shares for the Nazi Party. We also find that the localities with relatively high austerity experienced relatively high suffering (measured by mortality rates) and these areas’ electorates were more likely to vote for the Nazi Party. Our findings are robust to a range of specifications including an instrumental variable strategy and a border-pair policy discontinuity design.

Since the discovery of Perkinsus marinus as the cause of dermo disease in Crassostrea virginica, salinity and temperature have been identified as the main environmental drivers of parasite prevalence. However, little is known about how these variables affect the movement of the parasite from host to water column. In order to elucidate how environmental factors can influence the abundance of this parasite in the water column, we conducted a series of experiments testing the effects of time of day, temperature and salinity on the release of P. marinus cells from infected oysters. We found that P. marinus cells were released on a diurnal cycle, with most cells released during the hottest and brightest period of the day (12:00–18:00). Temperature also had a strong and immediate effect on the number of cells released, but salinity did not, only influencing the intensity of infection over the course of several months. Taken together, our results demonstrate that (1) the number of parasites in the water column fluctuates according to a diurnal cycle, (2) temperature and salinity act on different timescales to influence parasite abundance, and (3) live infected oysters may substantially contribute to the abundance of transmissive parasites in the water column under particular environmental conditions.

A single specimen of Oriostoma globosum (von Schlotheim, 1820) from the Silurian-age (Wenlockian) Laurel Limestone in southeastern Indiana preserves a partial, multispiral operculum in situ within the aperture. Only eight specimens of in situ Oriostoma opercula have previously been illustrated from Canada and Europe, and this is the first from the United States. Oriostoma huntingtonensis Kindle, 1904, from younger Silurian (Ludlovian–Pridolian) strata in northern Indiana is considered a synonym of the more widespread O. globosum, and it was described as having associated loose multispiral calcareous opercula in the same strata.

We performed a prospective study of 501 patients, regardless of symptoms, admitted to the hospital, to estimate the predictive value of a negative nasopharyngeal swab for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). At a positivity rate of 10.2%, the estimated negative predictive value (NPV) was 97.2% and the NPV rose as prevalence decreased during the study.

Optical tracking systems typically trade off between astrometric precision and field of view. In this work, we showcase a networked approach to optical tracking using very wide field-of-view imagers that have relatively low astrometric precision on the scheduled OSIRIS-REx slingshot manoeuvre around Earth on 22 Sep 2017. As part of a trajectory designed to get OSIRIS-REx to NEO 101955 Bennu, this flyby event was viewed from 13 remote sensors spread across Australia and New Zealand to promote triangulatable observations. Each observatory in this portable network was constructed to be as lightweight and portable as possible, with hardware based off the successful design of the Desert Fireball Network. Over a 4-h collection window, we gathered 15 439 images of the night sky in the predicted direction of the OSIRIS-REx spacecraft. Using a specially developed streak detection and orbit determination data pipeline, we detected 2 090 line-of-sight observations. Our fitted orbit was determined to be within about 10 km of orbital telemetry along the observed 109 262 km length of OSIRIS-REx trajectory, and thus demonstrating the impressive capability of a networked approach to Space Surveillance and Tracking.

Genetic assays to identify herbicide-resistant plants are a promising tool to reduce herbicide failures. However, the genetic basis of herbicide resistance is frequently unknown. In clonal weed species, DNA fingerprinting could be a useful tool to identify known resistant versus susceptible genets (clones) that occur in multiple locations, without an immediate need for understanding the genetic mutation(s) conferring resistance. Eurasian watermilfoil (Myriophyllum spicatum L.) and hybrids with native northern watermilfoil (Myriophyllum spicatum × Myriophyllum sibiricum Kom.) are mostly clonal invasive aquatic plants, and the same clones can be found in multiple waterbodies. Previously, a clone was confirmed as resistant to the commonly used herbicide fluridone, and a recent genetic survey in Michigan identified this genotype (MG-237) in at least seven other lakes. We hypothesized that MG-237 collected from different lakes would also exhibit fluridone resistance. However, MG-237 may have accumulated resistance mutations at different times during its spread across Michigan, resulting in fluridone-resistant and fluridone-susceptible MG-237 clones distributed in different lakes. We used a herbicide assay to test the response of several accessions, including MG-237 accessions from multiple lakes, to the Michigan operational rate of 6 µg L−1 fluridone. We found that all accessions of MG-237 exhibited resistance to 6 µg L−1 fluridone. A second genotype (MG-377) was also resistant to 6 µg L−1 fluridone. The rest of the accessions were found to be significantly injured by 6 µg L−1 fluridone. Our results suggest that 6 µg L−1 fluridone would not effectively control waterbodies dominated by MG-237 or MG-377, whereas waterbodies dominated by the other genotypes in our study would likely be controlled. Although more studies are needed to identify the variation in sensitivity of the accessions tested here and the genetic basis of fluridone resistance in Myriophyllum, our results suggest that multilocus genotype data may be an effective tool to identify and track herbicide-resistant genotypes of Myriophyllum in the short term.