Abstract
Background
The purpose of this study was to estimate prevalence of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients admitted to obstetric ...inpatient units throughout the United States as detected by universal screening. We sought to describe the relationship between obstetric inpatient asymptomatic infection rates and publicly available surrounding community infection rates.
Methods
A cross-sectional study in which medical centers reported rates of positive SARS-CoV-2 testing in asymptomatic pregnant and immediate postpartum patients over a 1–3-month time span in 2020. Publicly reported SARS-CoV-2 case rates from the relevant county and state for each center were collected from the COVID Act Now dashboard and the COVID Tracking Project for correlation analysis.
Results
Data were collected from 9 health centers, encompassing 18 hospitals. Participating health centers were located in Alabama, California, Illinois, Louisiana, New Jersey, North Carolina, Pennsylvania, Rhode Island, Utah, and Washington State. Each hospital had an active policy for universal SARS-CoV-2 testing on obstetric inpatient units. A total of 10 147 SARS-CoV-2 tests were administered, of which 124 were positive (1.2%). Positivity rates varied by site, ranging from 0–3.2%. While SARS-CoV-2 infection rates were lower in asymptomatic obstetric inpatient groups than the surrounding communities, there was a positive correlation between positivity rates in obstetric inpatient units and their surrounding county (P=.003, r=.782) and state (P=.007, r=.708).
Conclusions
Given the correlation between community and obstetric inpatient rates, the necessity of SARS-CoV-2–related healthcare resource utilization in obstetric inpatient units may be best informed by surrounding community infection rates.
There was a significant positive correlation between SARS-CoV-2 positivity rates in obstetric inpatient units and their surrounding county and state. Healthcare resource utilization related to SARS-CoV-2 testing in obstetric inpatient units may be best informed by surrounding community infection rates.
Exoplanets can evolve significantly between birth and maturity, as their atmospheres, orbits, and structures are shaped by their environment. Young planets (<1 Gyr) offer an opportunity to probe the ...critical early stages of this evolution, where planets evolve the fastest. However, most of the known young planets orbit prohibitively faint stars. We present the discovery of two planets transiting HD 63433 (TOI 1726, TIC 130181866), a young Sun-like ( ) star. Through kinematics, lithium abundance, and rotation, we confirm that HD 63433 is a member of the Ursa Major moving group (τ = 414 23 Myr). Based on the TESS light curve and updated stellar parameters, we estimate that the planet radii are 2.15 0.10 R⊕ and 2.67 0.12 R⊕, the orbital periods are 7.11 and 20.55 days, and the orbital eccentricities are lower than about 0.2. Using High Accuracy Radial velocity Planet Searcher for the Northern hemisphere velocities, we measure the Rossiter-McLaughlin signal of the inner planet, demonstrating that the orbit is prograde. Since the host star is bright (V = 6.9), both planets are amenable to transmission spectroscopy, radial velocity measurements of their masses, and more precise determination of the stellar obliquity. This system is therefore poised to play an important role in our understanding of planetary system evolution in the first billion years after formation.
Despite 40 years of control efforts, onchocerciasis (river blindness) remains one of the most important neglected tropical diseases, with 17 million people affected. The etiological agent, Onchocerca ...volvulus, is a filarial nematode with a complex lifecycle involving several distinct stages in the definitive host and blackfly vector. The challenges of obtaining sufficient material have prevented high-throughput studies and the development of novel strategies for disease control and diagnosis. Here, we utilize the closest relative of O. volvulus, the bovine parasite Onchocerca ochengi, to compare stage-specific proteomes and host-parasite interactions within the secretome. We identified a total of 4260 unique O. ochengi proteins from adult males and females, infective larvae, intrauterine microfilariae, and fluid from intradermal nodules. In addition, 135 proteins were detected from the obligate Wolbachia symbiont. Observed protein families that were enriched in all whole body extracts relative to the complete search database included immunoglobulin-domain proteins, whereas redox and detoxification enzymes and proteins involved in intracellular transport displayed stage-specific overrepresentation. Unexpectedly, the larval stages exhibited enrichment for several mitochondrial-related protein families, including members of peptidase family M16 and proteins which mediate mitochondrial fission and fusion. Quantification of proteins across the lifecycle using the Hi-3 approach supported these qualitative analyses. In nodule fluid, we identified 94 O. ochengi secreted proteins, including homologs of transforming growth factor-β and a second member of a novel 6-ShK toxin domain family, which was originally described from a model filarial nematode (Litomosoides sigmodontis). Strikingly, the 498 bovine proteins identified in nodule fluid were strongly dominated by antimicrobial proteins, especially cathelicidins. This first high-throughput analysis of an Onchocerca spp. proteome across the lifecycle highlights its profound complexity and emphasizes the extremely close relationship between O. ochengi and O. volvulus. The insights presented here provide new candidates for vaccine development, drug targeting and diagnostic biomarkers.
Disks in binary systems can cause exotic eclipsing events. MWC 882 (BD -22 4376, EPIC 225300403) is such a disk-eclipsing system identified from observations during Campaign 11 of the K2 mission. We ...propose that MWC 882 is a post-Algol system with a B7 donor star of mass in a 72-day orbit around an A0 accreting star of mass . The disk around the accreting star occults the donor star once every orbit, inducing 19-day long, 7% deep eclipses identified by K2 and subsequently found in pre-discovery All-Sky Automated Survey and All Sky Automated Survey for Supernovae observations. We coordinated a campaign of photometric and spectroscopic observations for MWC 882 to measure the dynamical masses of the components and to monitor the system during eclipse. We found the photometric eclipse to be gray to 1%. We found that the primary star exhibits spectroscopic signatures of active accretion, and we observed gas absorption features from the disk during eclipse. We suggest that MWC 882 initially consisted of a 3.6 M donor star transferring mass via Roche lobe overflow to a 2.1 M accretor in a 7-day initial orbit. Through angular momentum conservation, the donor star is pushed outward during mass transfer to its current orbit of 72 days. The observed state of the system corresponds with the donor star having left the red giant branch ∼0.3 Myr ago, terminating active mass transfer. The present disk is expected to be short-lived (102 yr) without an active feeding mechanism, presenting a challenge to this model.
The earthworm
Lumbricus rubellus (Hoffmeister, 1843) is a terrestrial pollution sentinel. Enzyme activity and transcription of phase II detoxification superfamily glutathione transferases (GST) is ...known to respond in earthworms after soil toxin exposure, suggesting GST as a candidate molecular-based pollution biomarker. This study combined sub-proteomics, bioinformatics and biochemical assay to characterise the
L. rubellus GST complement as pre-requisite to initialise assessment of the applicability of GST as a biomarker.
L. rubellus possesses a range of GSTs related to known classes, with evidence of tissue-specific synthesis. Two affinity-purified GSTs dominating GST protein synthesis (Sigma and Pi class) were cloned, expressed and characterised for enzyme activity with various substrates. Electrospray ionisation mass spectrometry (ESI-MS) and tandem mass spectrometry (MS/MS) following SDS-PAGE were superior in retaining subunit stability relative to two-dimensional gel electrophoresis (2-DE). This study provides greater understanding of Phase II detoxification GST superfamily status of an important environmental pollution sentinel organism.
This study currently provides the most comprehensive view of the Phase II detoxification enzyme superfamily of glutathione transferases within the important environmental pollution sentinel earthworm Lumbricus rubellus.
Pulmonary tuberculosis contributes to increased morbidity and mortality in severely malnourished children in endemic settings. Despite high clinical suspicion, few tuberculosis prevalence estimates ...exist in malnourished African children. Diagnostics such as Xpert MTB/RIF may help to determine pulmonary tuberculosis prevalence, however its performance in severely malnourished children is largely unknown.
We conducted a prospective observational study evaluating Xpert compared to smear microscopy and liquid culture on induced sputums among severely malnourished children (aged 6 to 60 months) at Kamuzu Central Hospital in Lilongwe, Malawi. From February 1 to May 30, 2012, children who met World Health Organization 2006 guidelines for severe acute malnutrition were evaluated using clinical symptoms, tuberculin skin tests, chest radiographs, and induced sputums. National Institute of Health (NIH) consensus case definitions were used to estimate tuberculosis prevalence.
Three hundred severely malnourished children (median age 18.5 months, IQR 12.1-25.6) had one induced sputum performed; 295 (98.3%) received two. Fifty-two (17.6%) were HIV-infected. Over 25% had tuberculosis exposure with 48/297 (16.2%) reporting contact and 40/287 (13.9%) with positive TST. Two (0.7%) patients had confirmed tuberculosis by Xpert and culture, but only one had positive smear microscopy. Twenty (6.7%) patients fulfilled probable and 97 (66%) met possible tuberculosis NIH case definitions. Overall mortality was 9.7%.
Microbiologic confirmation likely underestimates the prevalence of pulmonary tuberculosis in severely malnourished children. In our study, Xpert on induced sputums did not increase case finding. Future studies are needed using Xpert among targeted groups of severely malnourished children and on non-sputum specimens.
Context. Stars can maintain their observable magnetic activity from the pre-main sequence (PMS) to the tip of the red giant branch. However, the number of known active giants is much lower than ...active stars on the main sequence (MS) since the stars spend only about 10% of their MS lifetime on the giant branch. Due to their rapid evolution it is difficult to estimate the stellar parameters of giant stars. A possibility for obtaining more reliable stellar parameters for an active giant arises when it is a member of an eclipsing binary system. Aims. We have discovered EPIC 211759736, an active spotted giant star in an eclipsing binary system during the Kepler K2 Campaign 5. The eclipsing nature allows us to much better constrain the stellar parameters than in most cases of active giant stars. Methods. We have combined the K2 data with archival HATNet, ASAS, and DASCH photometry, new spectroscopic radial velocity measurements, and a set of follow-up ground-based BVRCIC photometric observations, to find the binary system parameters as well as robust spot models for the giant at two different epochs. Results. We determined the physical parameters of both stellar components and provide a description of the rotational and long-term activity of the primary component. The temperatures and luminosities of both components were examined in the context of the Hertzsprung–Russell diagram. We find that both the primary and the secondary components deviate from the evolutionary tracks corresponding to their masses in the sense that the stars appear in the diagram at lower masses than their true masses. Conclusions. We further evaluate the proposition that traditional methods generally result in higher masses for active giants than what is indicated by stellar evolution tracks in the HR diagram. A possible reason for this discrepancy could be a strong magnetic field, since we see greater differences in more active stars.
Identifying factors associated with mortality among acutely ill HIV-infected children presenting with advanced HIV disease may help clinicians optimize care for those at highest risk of death.
Using ...data from a randomized controlled trial (NCT02063880), we determined baseline sociodemographic, clinical, and laboratory cofactors of mortality among HIV-infected children in Kenya.
We enrolled hospitalized, HIV-infected, antiretroviral therapy-naive children (0-12 years), initiated antiretroviral therapy, and followed up them for 6 months. We used Cox proportional hazards regression to estimate hazard ratios (HRs) for death and 95% confidence intervals (CIs).
Of 181 enrolled children, 39 (22%) died. Common diagnoses at death were pneumonia or suspected pulmonary tuberculosis 23 (59%) and gastroenteritis 7 (18%). Factors associated with mortality in univariate analysis included age <2 years HR 3.08 (95% CI: 1.50 to 6.33), orphaned or vulnerable child (OVC) HR 2.05 (95% CI: 1.09 to 3.84), weight-for-age Z score <-2 HR 2.29 (95% CI: 1.05 to 5.00), diagnosis of pneumonia with hypoxia HR 5.25 (95% CI: 2.00 to 13.84), oral thrush HR 2.17 (95% CI: 1.15 to 4.09), persistent diarrhea HR 3.81 (95% CI: 1.89 to 7.69), and higher log10 HIV-1 viral load HR 2.16 (95% CI: 1.35 to 3.46) (all P < 0.05). In multivariable analysis, age <2 years and OVC status remained significantly associated with mortality.
Young age and OVC status independently predicted mortality. Hypoxic pneumonia, oral thrush, and persistent diarrhea are important clinical features that predict mortality. Strategies to enhance early diagnosis in children and improve hospital management of critically ill HIV-infected children are needed.
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