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Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was one of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from 1 August to 8 December 2020. There were 62,970 COVID-19 tests conducted with 1,435 people testing positive for a positivity rate of 2.28%. A total of 1,670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3,500 with approximately 80 of these positive (11 per day). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of one per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.
The rapid spread of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) throughout key regions of the United States in early 2020 placed a premium on timely, national surveillance of hospital patient censuses. To meet that need, the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), the nation’s largest hospital surveillance system, launched a module for collecting hospital coronavirus disease 2019 (COVID-19) data. We present time-series estimates of the critical hospital capacity indicators from April 1 to July 14, 2020.
From March 27 to July 14, 2020, the NHSN collected daily data on hospital bed occupancy, number of hospitalized patients with COVID-19, and the availability and/or use of mechanical ventilators. Time series were constructed using multiple imputation and survey weighting to allow near–real-time daily national and state estimates to be computed.
During the pandemic’s April peak in the United States, among an estimated 431,000 total inpatients, 84,000 (19%) had COVID-19. Although the number of inpatients with COVID-19 decreased from April to July, the proportion of occupied inpatient beds increased steadily. COVID-19 hospitalizations increased from mid-June in the South and Southwest regions after stay-at-home restrictions were eased. The proportion of inpatients with COVID-19 on ventilators decreased from April to July.
The NHSN hospital capacity estimates served as important, near–real-time indicators of the pandemic’s magnitude, spread, and impact, providing quantitative guidance for the public health response. Use of the estimates detected the rise of hospitalizations in specific geographic regions in June after they declined from a peak in April. Patient outcomes appeared to improve from early April to mid-July.
Energy deficit is common during prolonged periods of strenuous physical activity and limited sleep, but the extent to which appetite suppression contributes is unclear. The aim of this randomized crossover study was to determine the effects of energy balance on appetite and physiologic mediators of appetite during a 72-hr period of high physical activity energy expenditure (PAEE, ˜2300kcal/d) and limited sleep designed to simulate military operations (SUSOPS). Ten men consumed an energy-balanced diet while sedentary for 1d (REST) followed by energy balanced (BAL) and energy deficient (DEF) controlled diets during SUSOPS. Appetite ratings, gastric emptying time (GET), and appetite-mediating hormone concentrations were measured. Energy balance was positive during BAL (18±20%) and negative during DEF (-43±9%). Relative to REST, hunger, desire to eat and prospective consumption ratings were all higher during DEF (26±40%, 56±71%, 28±34%, respectively), and lower during BAL (-55±25%, -52±27%, -54±21%, respectively; Pcondition<0.05). Fullness ratings did not differ from REST during DEF, but were 65±61% higher during BAL (Pcondition<0.05). Regression analyses predicted hunger and prospective consumption would be reduced and fullness increased if energy balance were maintained during SUSOPS, and energy deficits of ≥25% would be required to elicit increases in appetite. Between-condition differences in GET and appetite-mediating hormones identified slowed gastric emptying, increased anorexigenic hormone concentrations, and decreased fasting acylated ghrelin concentrations as potential mechanisms of appetite suppression. Findings suggest that physiologic responses that suppress appetite may deter energy balance from being achieved during prolonged periods of strenuous activity and limited sleep.
Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation.
The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation.
A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures.
Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED.
Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.
There is mounting evidence for the potential for the natural dietary antioxidant and anti-inflammatory amino acid l-Ergothioneine (ERGO) to prevent or mitigate chronic diseases of aging. This has led to the suggestion that it could be considered a ‘longevity vitamin.’ ERGO is produced in nature only by certain fungi and a few other microbes. Mushrooms are, by far, the leading dietary source of ERGO, but it is found in small amounts throughout the food chain, most likely due to soil-borne fungi passing it on to plants. Because some common agricultural practices can disrupt beneficial fungus–plant root relationships, ERGO levels in foods grown under those conditions could be compromised. Thus, research is needed to further analyse the role agricultural practices play in the availability of ERGO in the human diet and its potential to improve our long-term health.
Clinical intuition suggests that personality disorders hinder the treatment of depression, but research findings are mixed. One reason for this might be the way in which current assessment measures conflate general aspects of personality disorders, such as overall severity, with specific aspects, such as stylistic tendencies. The goal of this study was to clarify the unique contributions of the general and specific aspects of personality disorders to depression outcomes.
Patients admitted to the Menninger Clinic, Houston, between 2012 and 2015 (N = 2352) were followed over a 6–8-week course of multimodal inpatient treatment. Personality disorder symptoms were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition Axis II Personality Screening Questionnaire at admission, and depression severity was assessed using the Patient Health Questionnaire-9 every fortnight. General and specific personality disorder factors estimated with a confirmatory bifactor model were used to predict latent growth curves of depression scores in a structural equation model.
The general factor predicted higher initial depression scores but not different rates of change. By contrast, the specific borderline factor predicted slower rates of decline in depression scores, while the specific antisocial factor predicted a U shaped pattern of change.
Personality disorder symptoms are best represented by a general factor that reflects overall personality disorder severity, and specific factors that reflect unique personality styles. The general factor predicts overall depression severity while specific factors predict poorer prognosis which may be masked in prior studies that do not separate the two.
The metamorphic history of the Mesoarchean Amikoq Layered Complex within the Akia terrane of SW Greenland was characterised by electron microprobe mineral data and detailed petrography on 12 representative samples, integrated with zircon U–Pb geochronology and petrology. The complex intruded into a >3004 Ma supracrustal association now consisting of granoblastic metabasites with subordinate quartz-rich gneiss. Supracrustal host rocks contain a relict high-temperature assemblage of orthopyroxene–clinopyroxene (± pigeonite exsolution lamellae, exsolved at ~975–1010°C), which is interpreted to pre-date the Amikoq intrusion. Cumulate to granoblastic-textured rocks of the main Amikoq Layered Complex range modally from leuconorite to melanorite, orthopyroxenite to harzburgite/dunite and rare hornblende melagabbro. Observed mineralogy of main complex noritic lithologies is essentially relict igneous with orthopyroxene–biotite and hornblende–plagioclase thermometers yielding temperatures of ~800–1070°C. An anatectic zircon megacryst from a patchy quartzo–feldspathic leucosome hosted in an orthopyroxene-dominated Amikoq rock reflects local anatexis at peak metamorphic P–T conditions and yields an intrusion minimum age of 3004 ± 9 Ma. Field observations indicate local anatexis of orthopyroxene-dominated lithologies, possibly indicating a post-intrusion peak temperature of >900°C. The last preserved stages of retrogression are recorded in paragneiss plagioclase–garnet, biotite–garnet and host rock ilmenite–magnetite pairs (≤3 kbar and ~380–560°C).
The Amikoq Complex intruded a MORB-like crustal section and the former remained relatively undisturbed in terms of modal mineralogy. Preservation of igneous textures and mineralogy are related to an anhydrous, high-grade metamorphic history that essentially mimics igneous crystallisation conditions, whereas local high-strain zones acted as fluid pathways resulting in hydrous breakdown of igneous minerals. There is no evidence of equilibration of the intrusion at sub-amphibolite-facies conditions.
Hookworms are some of the most widespread of the soil-transmitted helminths (STH) with an estimated 438.9 million people infected. Until relatively recently Ancylostoma ceylanicum was regarded as a rare cause of hookworm infection in humans, with little public health relevance. However, recent advances in molecular diagnostics have revealed a much higher prevalence of this zoonotic hookworm than previously thought, particularly in Asia. This study examined the prevalence of STH and A. ceylanicum in the municipalities of Palapag and Laoang in the Philippines utilizing real-time polymerase chain reaction (PCR) on stool samples previously collected as part of a cross-sectional survey of schistosomiasis japonica. Prevalence of hookworm in humans was high with 52.8% (n = 228/432) individuals positive for any hookworm, 34.5% (n = 149/432) infected with Necator americanus, and 29.6% (n = 128/432) with Ancylostoma spp; of these, 34 were PCR-positive for A. ceylanicum. Considering dogs, 12 (n = 33) were PCR-positive for A. ceylanicum. This is the first study to utilize molecular diagnostics to identify A. ceylanicum in the Philippines with both humans and dogs infected. Control and elimination of this zoonotic hookworm will require a multifaceted approach including chemotherapy of humans, identification of animal reservoirs, improvements in health infrastructure, and health education to help prevent infection.
This 17-year prospective study applied a social-developmental lens to the challenge of distinguishing predictors of adolescent-era substance use from predictors of longer term adult substance use problems. A diverse community sample of 168 individuals was repeatedly assessed from age 13 to age 30 using test, self-, parent-, and peer-report methods. As hypothesized, substance use within adolescence was linked to a range of likely transient social and developmental factors that are particularly salient during the adolescent era, including popularity with peers, peer substance use, parent–adolescent conflict, and broader patterns of deviant behavior. Substance abuse problems at ages 27–30 were best predicted, even after accounting for levels of substance use in adolescence, by adolescent-era markers of underlying deficits, including lack of social skills and poor self-concept. The factors that best predicted levels of adolescent-era substance use were not generally predictive of adult substance abuse problems in multivariate models (either with or without accounting for baseline levels of use). Results are interpreted as suggesting that recognizing the developmental nature of adolescent-era substance use may be crucial to distinguishing factors that predict socially driven and/or relatively transient use during adolescence from factors that predict long-term problems with substance abuse that extend well into adulthood.
The Shyok Suture in western Himalaya preserves a record of the opening and closure of the Mesotethys Ocean between the Shyok ophiolite and Karakoram terrane prior to the India–Eurasia collision. The formation age of the Shyok ophiolite was unknown, which impeded correlation with similar rocks along the Shyok Suture in Pakistan and corresponding sutures in Tibet. We report the first zircon U–Pb ages of a newly documented suite, here named the Changmar Complex. The Changmar Complex gabbronorite and plagiogranite yielded SHRIMP U–Pb zircon Late Jurassic ages of 159.4 ± 0.9 Ma and 151.9 ± 1.5 Ma. Their highly positive initial εHf values (+14.9 to +16.9) indicate a juvenile mantle origin, without continental crust influence on the magma source. The Shyok ophiolite represents either: (1) a separate island arc that preceded formation of the Cretaceous–Eocene Ladakh Arc; or (2) the oldest magmatism and early stage of the Ladakh Arc. Intrusive and extrusive mafic rocks from the Shyok Suture analysed in this study have typical supra-subduction zone enrichment characteristics in their geochemistry and are classified as part of the volcanic-arc ophiolite. The U–Pb age and Hf isotopic signatures for the Shyok ophiolite are similar to the Late Jurassic Matum Das tonalite within the Kohistan Arc; we therefore suggest that they are part of the same intra-oceanic island-arc system that formed in the Mesotethys Ocean prior to Late Jurassic time.
The otoliths (ear stones) of fishes are commonly used to describe the age and growth of marine and freshwater fishes. These non-skeletal structures are fortuitous in their utility by being composed of mostly inorganic carbonate that is inert through the life of the fish. This conserved record functions like an environmental chronometer and bomb-produced radiocarbon (14C)—a 14C signal created by atmospheric testing of thermonuclear devices—can be used as a time-specific marker in validating fish age. However, complications from the hydrogeology of nearshore marine environments can complicate 14C levels, as was the case with gray snapper (Lutjanus griseus) along the Gulf of Mexico coast of Florida. Radiocarbon of these nearshore waters is influenced by freshwater input from the karst topography of the Upper Floridan Aquifer—estuarine waters that are 14C-depleted from surface and groundwater inputs. Some gray snapper likely recruited to this kind of environment where 14C levels were depleted in the earliest otolith growth, although age was validated for individuals that were not exposed to 14C-depleted waters to an age of at least 25 years with support for a 30-year lifespan.
Although the Peritraumatic Distress Inventory (PDI) and Peritraumatic Dissociative Experiences Questionnaire (PDEQ) are both useful for identifying adults at risk of developing acute and chronic post-traumatic stress disorder (PTSD), they have not been validated in school-aged children. The present study aims at assessing the psychometric properties of the PDI and PDEQ in a sample of French-speaking school children.
One-hundred and thirty-three school-aged victims of road traffic accidents were consecutively enrolled into this study via the emergency room. Mean(SD) age was 11.7(2.2) and 56.4% (n=75) of them were of male gender. The 13-item self-report PDI (range 0-52) and the 10-item self report PDEQ (range 10-50) were assessed within one week of the accident. Symptoms of PTSD were assessed 1 and 6 months later using the 20-item self-report Child Post-Traumatic Stress Reaction Index (CPTS-RI) (range 0-80).
Mean(SD) PDI and PDEQ scores were 19.1(10.1) and 21.1(7.6), respectively, while mean(SD) CPTS-RI scores at 1- and 6-months were 22.6(12.4) and 20.6(13.5), respectively. Cronbach's alpha coefficients were 0.8 and 0.77 for the PDI and PDEQ, respectively. The 1-month test-retest correlation coefficient (n=33) was 0.77 for both measures. The PDI demonstrated a 2-factor structure while the PDEQ displayed a 1-factor structure. As with adults, the two measures were inter-correlated (r=0.52) and correlated with subsequent PTSD symptoms (r=0.21−0.56; p< 0.05).
The PDI and PDEQ are reliable and valid in school-aged children, and predict PTSD symptoms.
It remains unknown whether peritraumatic reactions predict PTSD symptoms in younger populations. To prospectively investigated the power of self-reported peritraumatic distress and dissociation to predict the development of PTSD symptoms at 1-month in school-aged children.
A sample of 103 school-aged children (8-15 years old) admitted to an Emergency Department after a road traffic accident were consecutively enrolled. Peritraumatic distress was assessed using the Peritraumatic Distress Inventory (range 0-52) and peritraumatic dissociation was assessed using the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) (range 10-50). PTSD symptoms were measured at 1-month by both the child version of the clinician-administered PTSD Scale (CAPS-CA) (range: 0-136) and the Child Post-traumatic Stress Reaction Index (CPTS-RI) (range 0-80).
Mean(SD) participants’ age was 11.7(2.2) and 53.4% (n=55) of them were of male gender. At baseline, mean PDI and PDEQ scores were 21.4 (SD=7.8) and 19.2 (SD=10.2), respectively. At 1-month, mean self-reported (CPTS-RI) and interviewer-based (CAPS-CA) PTSD symptom scores were 23.2 (SD=12.1) and 19 (SD=16.9), respectively. According to the CAPS-CA, 5 children (4.9%) suffered from full PTSD. Bivariate analyses demonstrated a significant association between peritraumatic variables (PDI and PDEQ) and both CAPS-CA and CPTS-RI (r=0.22-0.57; all p< 0.05). However, in a multivariate analysis, PDI was the only significant predictor of acute PTSD symptoms (Beta=0.33, p< 0.05).
As has been found in adults, peritraumatic distress is a robust predictor of who will develop PTSD symptoms among school-aged children.
Cannabis is the world's most commonly used illicit substance. Whilst its effects on perception are well documented, little is known about the neural basis of these effects and how they are modulated by two of cannabis sativa's most abundant active ingredients, Delta-9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD).
We used fMRI to assess the effects of THC and CBD on brain activation during a simple visual and auditory stimulation paradigm in healthy volunteers.
Fourteen right handed male subjects were scanned on 3 occasions. Identical 10mg THC, 600mg CBD and placebo capsules were allocated in a balanced double blinded pseudorandomised crossover design.
Ingestion of THC and CBD led to reliable increases in plasma levels of each substance and for THC concomitant increases in anxiety, intoxication and positive psychotic symptoms; CBD and placebo caused no significant symptoms. Visual and auditory stimulation led to robust activations in occipital and temporal cortices respectively under placebo conditions. Administration of THC led to decreased activation in primary sensory cortices relative to placebo whilst CBD led to an increase in activation in right temporal regions during auditory stimulation and right striate cortex activation during visual stimulation. THC mediated reduction of activation in this area during auditory stimulation correlated with a concomitant rise in psychotic symptoms.
These data indicate that the different psychoactive constituents of cannabis have dissociable effects on sensory processing, often in opposite directions
Cannabis is the world's most widely used illicit drug. It can impair verbal learning and induce psychosis, both acutely and possibly following long term use. But, where cannabis acts in the brain to impair verbal learning and induce psychotic symptoms is unclear. The aim of this study was to clarify how one of the main psychoactive ingredients of cannabis, delta-9-tetrahydrocannabinol (THC) acts on the brain to impair verbal learning and induce psychotic symptoms.
15 healthy males with minimal exposure to cannabis, were studied on 2 occasions approximately 1 month apart, following oral administration of 10mg of THC or placebo 1 hour prior to scanning, in a double-blind design. MR images were acquired on a 1.5T GE camera while subjects performed a Verbal paired associates task with separate encoding followed by retrieval conditions, with the conditions repeated in the same sequence 4 times. We examined the main effects of drug, task and drug- task interactions.
Administration of THC abolished the normal linear decrement in parahippocampal activation across successive encoding blocks and was associated with a trend for impaired word recall. Administration of THC also altered the normal time-dependent change in ventral striatal activation during retrieval of word pairs which was directly correlated with concurrently induced psychotic symptoms.
These results suggest that impairment in learning and verbal memory associated with cannabis use may be mediated through its action in the medial temporal cortex while psychotic symptoms may be induced through its action in the ventral striatum.
The most striking, yet poorly understood morphological features of the human cerebral cortex are the complex arrangements of its foldings: the sulci and gyri. Cortical gyrification is formed during fetal age and childhood. Thus, indices measuring the folding pattern could provide cues for the neurodevelopmental pathopsychology.
A fully-automated method was applied to T1 magnetic resonance images to extract, label and measure the sulcus area in the whole cortex. Gyrification was assessed using both global and local sulcal indices, defined respectively as the ratio between the total sulcal area, or the area of each labeled sulcus, and the outer cortex area.
As a validation, MRI datasets in controls showed that handedness modify the folding of the motor area in dominant hemisphere (Mangin 2004), and differences in left and right superior temporal sulci which may stem from language-based asymmetries (Ochiai 2004). In a sample of schizophrenia patients with treatment-resistant auditory hallucination, global sulcal surface index was decreased, and local sulci surface indices differed in language-related regions. Further analyses are performed in samples from various MR datasets. Statistics on such measurements should generalize across patients and hospitals.
The potential of the gyrification pattern for the neuroimage-based inference of developmental deviation will be examined.
This study examined the effect of Delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on brain activation during a motor inhibition task.
Functional magnetic resonance imaging and behavioural measures were recorded while 15 healthy volunteers performed a Go/No-Go task following administration of either THC or CBD or placebo in a double-blind, pseudo-randomized, placebo-controlled repeated measures within-subject design.
Relative to placebo, THC attenuated activation in the right inferior frontal and the anterior cingulate gyrus. In contrast, CBD deactivated the left temporal cortex and insula. These effects were not related to changes in anxiety, intoxication, sedation, and psychotic symptoms.
These data suggest that THC attenuates the engagement of brain regions that mediate response inhibition. CBD modulated function in regions not usually implicated in response inhibition.
Impaired working memory is a core feature of schizophrenia and is linked with altered engagement the lateral prefrontal cortex. Although altered PFC activation has been reported in people with increased risk of psychosis, at present it is not clear if this neurofunctional alteration differs between familial and clinical risk states and/or increases in line with the level of psychosis risk. We addressed this issue by using functional MRI and a working memory paradigm to study familial and clinical high-risk groups. We recruited 17 subjects at ultra-high-risk (UHR) for psychosis, 10 non-affected siblings of patients with schizophrenia (familial high risk [FHR]) and 15 healthy controls. Subjects were scanned while performing the N-back working memory task. There was a relationship between the level of task-related deactivation in the medial PFC and precuneus and the level of psychosis risk, with deactivation weakest in the UHR group, greatest in healthy controls, and at an intermediate level in the FHR group. In the high-risk groups, activation in the precuneus was associated with the level of negative symptoms. These data suggest that increased vulnerability to psychosis is associated with a failure to deactivate in the medial PFC and precuneus during a working memory task, and appears to be most evident in subjects at clinical, as opposed to familial high risk.
Biases in cognition such as Jumping to Conclusions (JTC) and Verbal Self-Monitoring (VSM) are thought to underlie the formation of psychotic symptoms. This prospective study in people with an At Risk Mental State (ARMS) for psychosis examined how these cognitive biases changed over time, and predicted clinical and functional outcomes. Twenty-three participants were assessed at clinical presentation and a mean of 31 months later. Performance on a JTC and VSM tasks were measured at both time points. Relationships to symptom severity, level of function and the incidence of psychotic disorder were then examined. The levels of symptoms, function and VSM all improved over time, while JTC was stable. Five participants (22%) developed a psychotic disorder during the follow-up period, but the risk of transition was not related to performance on either task at baseline, or to longitudinal changes in task performance. JTC performance correlated with symptom severity at baseline and follow-up. Similarly, performance on the two tasks was not related to the level of functioning at follow-up. Thus, while the ARMS is associated with both VSM and JTC biases, neither predict the onset of psychosis or the overall functional outcome.