Researching COVID to enhance recovery Troxel, Andrea B; Bind, Marie-Abele C; Flotte, Thomas J ...
PloS one,
01/2024, Letnik:
19, Številka:
1
Journal Article
Recenzirano
Importance RECOVER-Pathology is a cross-sectional study of decedents dying at least 15 days following initial SARS-CoV-2 infection. Eligible decedents must meet WHO criteria for suspected, probable, ...or confirmed infection and must be aged 18 years or more at the time of death. Enrollment occurs at 7 sites in four U.S. states and Washington, DC. Comprehensive autopsies are conducted according to a standardized protocol within 24 hours of death; tissue samples are sent to the PASC Biorepository for later analyses. Data on clinical history are collected from the medical records and/or next of kin. The primary study outcomes include an array of pathologic features organized by organ system. Causal inference methods will be employed to investigate associations between risk factors and pathologic outcomes. RECOVER-Pathology is the largest autopsy study addressing PASC among US adults. Results of this study are intended to elucidate mechanisms of organ injury and disease and enhance our understanding of the pathophysiology of PASC.
Discharge against medical advice (AMA) is an important, yet understudied, aspect of health care—particularly in trauma populations. AMA discharges result in increased mortality, increased readmission ...rates, and higher health care costs.
The goal of this analysis was to determine what factors impact a patient's odds of leaving the hospital prior to treatment.
We performed a retrospective analysis of the National Trauma Data Bank on adult trauma patients (older than 14 years) from 2013 to 2015. Of the 1,770,570 patients with known disposition, excluding mortality, 24,191 patients (1.4%) left AMA. We ascertained patient characteristics including age, sex, race, ethnicity, insurance status, ETOH, drug use, geographic location, Injury Severity Score (ISS), injury mechanism, and anatomic injury location. Multivariate logistic regression models were used to determine which patient factors were associated with AMA status.
Uninsured (odds ratio OR 2.72; 95% confidence interval CI 2.58–2.86) or Medicaid-insured (OR 2.50; 95% CI 2.37–2.63) trauma patients were significantly more likely to leave AMA than patients with private insurance. Compared to white patients, African-American patients (OR 1.06; 95% CI 1.02–1.11) were more likely, and Native-American (OR 0.62; 95% CI 0.52–0.75), Asian (OR 0.59; 95% CI 0.49–0.69), and Hispanic (OR 0.80; 95% CI 0.75–0.85) patients were less likely, to leave AMA when controlling for age, sex, ISS, and type of injury.
Insurance status, race, and ethnicity are associated with a patient's decision to leave AMA. Uninsured and Medicaid patients have more than twice the odds of leaving AMA. These findings demonstrate that racial and socioeconomic disparities are important targets for future efforts to reduce AMA rates and improve outcomes from blunt and penetrating trauma.
SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or organ dysfunction after the acute phase of infection, termed Post-Acute Sequelae of SARS-CoV-2 (PASC), or long COVID. The ...characteristics, prevalence, trajectory and mechanisms of PASC are poorly understood. The objectives of the Researching COVID to Enhance Recovery (RECOVER) tissue pathology study (RECOVER-Pathology) are to: (1) characterize prevalence and types of organ injury/disease and pathology occurring with PASC; (2) characterize the association of pathologic findings with clinical and other characteristics; (3) define the pathophysiology and mechanisms of PASC, and possible mediation via viral persistence; and (4) establish a post-mortem tissue biobank and post-mortem brain imaging biorepository.
RECOVER-Pathology is a cross-sectional study of decedents dying at least 15 days following initial SARS-CoV-2 infection. Eligible decedents must meet WHO criteria for suspected, probable, or confirmed infection and must be aged 18 years or more at the time of death. Enrollment occurs at 7 sites in four U.S. states and Washington, DC. Comprehensive autopsies are conducted according to a standardized protocol within 24 hours of death; tissue samples are sent to the PASC Biorepository for later analyses. Data on clinical history are collected from the medical records and/or next of kin. The primary study outcomes include an array of pathologic features organized by organ system. Causal inference methods will be employed to investigate associations between risk factors and pathologic outcomes.
RECOVER-Pathology is the largest autopsy study addressing PASC among US adults. Results of this study are intended to elucidate mechanisms of organ injury and disease and enhance our understanding of the pathophysiology of PASC.
Endangered animals in captivity may display reduced brain sizes due to captive conditions and limited genetic diversity. Captive diets, for example, may differ in nutrition and texture, altering ...cranial musculature and alleviating constraints on cranial shape development. Changes in brain size are associated with biological fitness, which may limit reintroduction success. Little is known about how changes in brain size progress in highly managed carnivoran populations and whether such traits are retained among reintroduced populations. Here, we measured the endocranial volume of preserved Mexican wolf skulls across captive generations and between captive, wild, and reintroduced populations and assessed endocranial volume dependence on inbreeding and cranial musculature. Endocranial volume increased across captive generations. However, we did not detect a difference among captive, wild, and reintroduced groups, perhaps due to the variability across captive generations. We did not find a relationship between endocranial volume and either inbreeding or cranial musculature, although the captive population displayed an increase in the cross-sectional area of the masseter muscle. We hypothesize that the increase in endocranial volume observed across captive generations may be related to the high-quality nutrition provided in captivity.
Captive facilities such as zoos are uniquely instrumental in conservation efforts. To fulfill their potential as bastions for conservation, zoos must preserve captive populations as appropriate ...proxies for their wild conspecifics; doing so will help to promote successful reintroduction efforts. Morphological changes within captive populations may be detrimental to the fitness of individual animals because these changes can influence functionality; thus, it is imperative to understand the breadth and depth of morphological changes occurring in captive populations. Here, we conduct a meta-analysis of scientific literature reporting comparisons of cranial measures between captive and wild populations of mammals. We investigate the pervasiveness of cranial differences and whether cranial morphological changes are associated with ecological covariates specific to individual species, such as trophic level, dietary breadth, and home range size.
Cranial measures of skull length, skull width, and the ratio of skull length-to-width differed significantly between many captive and wild populations of mammals reported in the literature. Roughly half of captive populations differed from wild populations in at least one cranial measure, although the degree of changes varied. Carnivorous species with a limited dietary breadth displayed the most consistent changes associated with skull widening. Species with a more generalized diet displayed less morphological changes in captivity.
Wild and captive populations of mammals differed in cranial morphology, but the nature and magnitude of their cranial differences varied considerably across taxa. Although changes in cranial morphology occur in captivity, specific changes cannot be generalized for all captive mammal populations. The nature of cranial changes in captivity may be specific to particular taxonomic groups; thus, it may be possible to establish expectations across smaller taxonomic units, or even disparate groups that utilize their cranial morphology in a similar way. Given that morphological changes occurring in captive environments like zoos have the potential to limit reintroduction success, our results call for a critical evaluation of current captive husbandry practices to prevent unnecessary morphological changes.
The development of microbial networks is central to ecosystem functioning and is the hallmark of complex natural systems. Characterizing network development over time and across environmental ...gradients is hindered by the millions of potential interactions among community members, limiting interpretations of network evolution. We developed a feature selection approach using data winnowing that identifies the most ecologically influential microorganisms within a network undergoing change. Using a combination of graph theory, leave-one-out analysis, and statistical inference, complex microbial communities are winnowed to identify the core organisms responding to external gradients or functionality, and then network development is evaluated against these externalities. In a plant invasion case study, the winnowed microbial network became more influential as the plant invasion progressed as a result of direct plant-microbe links rather than the expected indirect plant-soil-microbe links. This represents the first use of structural equation modeling to predict microbial network evolution, which requires identification of keystone taxa and quantification of the ecological processes underpinning community structure and function patterns.
Hypercarnivorous mammal species are among the most vulnerable to population losses and endangerment. Among species belonging to Family Canidae, hypercarnivores are frequently subject to intense ...conservation efforts including captive breeding and reintroduction attempts. However, hypercarnivorous species may be most vulnerable to morphological changes in captivity, potentially altering their cranial functionality and limiting their reintroduction success. Other canid species with varying dietary preferences are also maintained in captivity, although it is unknown if morphological changes are prevalent across all captive canid populations or if these changes are concentrated primarily within hypercarnivores. To examine whether canids display morphological changes in captivity regardless of dietary preference, we assessed cranial and mandibular shape of 1621 specimens representing 15 canid species using geometric morphometric techniques. All hypercarnivores (4 species) and many hypocarnivores (5 of 7 species) differed between captive and wild populations in at least one shape variable. None of the mesocarnivores (4 species) differed in any shape variable. Among the carnivory types, hypercarnivorous species had the most pronounced differences in shape, particularly associated with a widening and shortening of the cranium within captive populations. Changes in cranial shape may impact an animal's ability to successfully capture and consume prey, therefore differences in cranial shape in captive populations may represent an obstacle to future reintroduction success. By examining cranial and mandibular shape differences between captive and wild populations, we explore the long-term impacts of captivity in canids in an effort to mitigate these negative effects in the future and increase the potential for reintroduction success.
•Crania from wild canids are significantly different from crania of captive canids.•Captive hypercarnivous canids display the most pronounced cranial changes.•Cranial changes are related to morphological regions essential to functionality.•Cranial differences arising in captivity could negatively affect reintroduction.
During late childhood and early adolescence, youth experience heightened stress exposure and rates of mental health disorders, emphasizing the need to investigate how youth cope with stress as a ...potential mechanism of risk and/or resilience. This study examined youths’ age, gender, and peer-related stress exposure as moderators of the relationships among coping and anxious/depressed symptoms during this important developmental period. To sample participants with a broad range of internalizing psychopathology symptoms, a community sample of 120 older children and adolescents (46% female, M age = 12.28) was recruited through mental health clinics and a university-based study finder in a southeastern metropolitan area. Participants completed a battery of questionnaires assessing coping strategies, stress exposure, demographic information, and anxious/depressed symptoms in a cross-sectional study. Analyses included interactions among age, gender, and peer stress as predictors of youths’ coping strategies and anxious/depressed symptoms. There were significant associations between age, gender, coping strategies, and symptoms, where girls reported more anxiety and depression symptoms compared to boys, and primary and secondary control coping strategy use increased with age. The findings expand upon previous studies by showing gender differences in the relation among secondary control coping and internalizing problems at different ages. Additionally, findings demonstrate that degrees of peer stress exposure show associations with disengagement coping across development, which may contribute to the onset of internalizing symptoms in older girls. Findings may be used to inform interventions by promoting the use of more adaptive forms of coping to prevent internalizing disorders in youth. Limitations and directions for future research are discussed.
When Europeans arrived in America, the Brazilian Atlantic rainforest covered approximately 1,290,000 km
2
. Now, only 8% of the biome’s original vegetation remains. One of the largest areas is Tijuca ...Forest National Park. In this work, the concentrations of 13 carbonyl compounds in an isolated area inside Tijuca Forest, in an urban park with primary and secondary vegetation (Gericinó Natural Park) and in two typical urban areas (Tijuca District and the city of Nilópolis) were determined. The main compounds were formaldehyde and acetaldehyde. The formaldehyde mean concentrations were 0.98 ± 1.00, 1.27 ± 1.67, 3.09 ± 1.60 and 2.33 ± 2.17 μg m
−3
for Tijuca Forest, Gericinó Natural Park, Tijuca District and the city of Nilópolis, respectively. The mean acetaldehyde concentrations were, for the same locations, 0.93 ± 1.05, 2.94 ± 2.54, 2.78 ± 0.91 and 5.48 ± 1.90 μg m
−3
. The results indicate that the compounds measured within the forest are transported from the city and that the trees play an important role in removing air pollutants. In contrast, the Gericinó protected area is heavily affected by urban emissions, and its capacity to dilute or absorb pollutants is low because of the sparse vegetation.
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