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Background: Patients with inflammatory arthritis are at increased risk of prosthetic joint infections (PJIs), but diagnosis in these patients can be challenging because active inflammatory arthritis produces elevated inflammatory markers that may mimic those seen in PJI. Purpose: In this pilot study, we sought to identify the clinical, microbiologic, and histopathologic features of culture-positive and culture-negative PJI in patients with inflammatory arthritis who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA). We also sought to obtain preliminary data to support a definitive study of optimal methods for PJI diagnosis in patients with inflammatory arthritis. Methods: We performed a retrospective analysis of TKA and THA patients treated for PJI from 2009 to 2018 at a single tertiary care orthopedic institution. Data were extracted from a longitudinally maintained hospital infection database. We reviewed hematoxylin and eosin slides of osteoarthritis and inflammatory arthritis PJI cases matched 3:1, respectively, by age, sex, and culture status. Clinical characteristics were evaluated using the Fisher exact test, χ2 test, Student t test, and Mann-Whitney U test where appropriate. Results: A total of 807 PJI cases were identified (36 inflammatory arthritis and 771 osteoarthritis cases). Patients with inflammatory arthritis presented younger, had a higher Charlson Comorbidity Index, more frequently used glucocorticoids, were more likely women, and had a higher proportion of culture-negative PJI compared with osteoarthritis patients. Of the 88 inflammatory arthritis cases reviewed for histopathology, a higher proportion of culture-positive than culture-negative PJI cases had >10 polymorphonuclear leucocytes per high-power field and met Musculoskeletal Infection Society criteria but presented with less chronic inflammation. Conclusions: This retrospective prognostic study suggests that culture-negative PJI may be more frequent in patients with inflammatory arthritis than in those with osteoarthritis. Chronic infections, antibiotic use, or misdiagnosis may be contributing factors to unclear PJI diagnoses among culture-negative cases. This preliminary work supports the need for further studies to assess the differences in clinical features between culture-negative and culture-positive PJI in patients with inflammatory arthritis and the ability of biological diagnostic markers to discriminate between them in this population.

Funding: This work was supported by Fisheries and Oceans Canada (DFO) Maritimes and National Geographic emerging explorer grant to L.J.F, with support by and Natural Sciences and Engineering Research Council of Canada (NSERC) and Killam Nova Scotia Doctoral Scholarships. Work was also supported by US Office of Naval Research and US Strategic Environmental Research and Development Program (SERDP), DFO, University of Windsor, Crown-Indigenous Relations and Northern Affairs Canada, Nunavut Fisheries Association, Government of Nunavut, and NSERC. Funding and resources for sequencing the northern bottlenose whale genome was supported by the CanSeq150 program of Canada’s Genomics Enterprise. Information on wildlife population structure, demographic history, and adaptations are fundamental to understanding species evolution and informing conservation strategies. To study this ecological context for a cetacean of conservation concern, we conducted the first genomic assessment of the northern bottlenose whale, Hyperoodon ampullatus, using whole-genome resequencing data (n = 37) from five regions across the North Atlantic Ocean. We found a range-wide pattern of isolation-by-distance with a genetic subdivision distinguishing three subgroups: the Scotian Shelf, western North Atlantic, and Jan Mayen regions. Signals of elevated levels of inbreeding in the Endangered Scotian Shelf population indicate this population may be more vulnerable than the other two subgroups. In addition to signatures of inbreeding, evidence of local adaptation in the Scotian Shelf was detected across the genome. We found a long-term decline in effective population size for the species, which poses risks to their genetic diversity and may be exacerbated by the isolating effects of population subdivision. Protecting important habitat and migratory corridors should be prioritized to rebuild population sizes that were diminished by commercial whaling, strengthen gene flow, and ensure animals can move across regions in response to environmental changes. Publisher PDF

Introduction: The most common complication following transcutaneous osseointegration for amputees is infection. Although an obvious source of contamination is the permanent stoma, operative site contamination at the time of implantation may be an additional source. This study investigates the impact of unexpected positive intraoperative cultures (UPIC) on postoperative infection. Methods: Charts were reviewed for 8 patients with UPIC and 22 patients with negative intraoperative cultures (NIC) who had at least 1 year of post-osseointegration follow-up. All patients had 24 h of routine postoperative antibiotic prophylaxis, with UPIC receiving additional antibiotics guided by culture results. The main outcome measure was postoperative infection intervention, which was graded as (0) none, (1) antibiotics unrelated to the initial surgery, (2) operative debridement with implant retention, or (3) implant removal. Results: The UPIC vs. NIC rate of infection management was as follows: Grade 0, 6/8 = 75 % vs. 14/22 = 64 %, p = 0.682; Grade 1, 2/8 = 25 % vs. 8/22 = 36.4 % (Fisher's p = 0.682); Grade 2, 1/8 = 12.5 % vs. 0/22 = 0 % (Fisher's p = 0.267); Grade 3, 0/8 = 0 % vs. 1/22 = 4.5 % (Fisher's p = 1.000). No differences were statistically significant. Conclusions: UPIC at index osseointegration, managed with directed postoperative antibiotics, does not appear to increase the risk of additional infection management. The therapeutic benefit of providing additional directed antibiotics versus no additional antibiotics following UPIC is unknown and did not appear to increase the risk of other adverse outcomes in our cohort.

Background The development of treatments for cognitive deficits associated with central nervous system disorders is currently a significant medical need. Despite the great need for such therapeutics, a significant challenge in the drug development process is the paucity of robust biomarkers to assess target modulation and guide clinical decisions. We developed a novel, translatable biomarker of neuronal glutamate metabolism, the 13C-glutamate+glutamine (Glx) H3:H4 labeling ratio, in nonhuman primates using localized 1H-magnetic resonance spectroscopy combined with 13C-glucose infusions. Methods We began with numerical simulations in an established model of brain glutamate metabolism, showing that the 13C-Glx H3:H4 ratio should be a sensitive biomarker of neuronal tricarboxylic acid cycle activity, a key measure of overall neuronal metabolism. We showed that this biomarker can be measured reliably using a standard 1H-magnetic resonance spectroscopy method (point-resolved spectroscopy sequence/echo time = 20 ms), obviating the need for specialized hardware and pulse sequences typically used with 13C-magnetic resonance spectroscopy, thus improving overall clinical translatability. Finally, we used this biomarker in 8 male rhesus macaques before and after administration of the compound BNC375, a positive allosteric modulator of the α7 nicotinic acetylcholine receptor that enhances glutamate signaling ex vivo and elicits procognitive effects in preclinical species. Results The 13C-Glx H3:H4 ratios in the monkeys showed that BNC375 increases neuronal metabolism in nonhuman primates in vivo, detectable on an individual basis. Conclusions This study demonstrates that the ratio of 13C-Glx H3:H4 labeling is a biomarker that may provide an objective readout of compounds affecting glutamatergic neurotransmission and could improve decision making for the development of therapeutic agents.

Background: An intra-articular infection after anterior cruciate ligament (ACL) reconstruction (ACLR) is a rare complication but one with potentially devastating consequences. The rare nature of this complication raises difficulties in detecting risk factors associated with it and with worse outcomes after one has occurred. Purpose: To (1) evaluate the association between an infection after ACLR and potential risk factors in a large single-center cohort of patients who had undergone ACLR and (2) assess the factors associated with ACL graft retention versus removal. Study Design: Case-control study; Level of evidence, 3. Methods: All ACLR procedures performed at our institution between January 2010 and December 2018 were reviewed; a total of 11,451 procedures were identified. A retrospective medical record review was performed to determine the incidence of infections, patient and procedure characteristics associated with an infection, infection characteristics, incidence of ACL graft retention, and factors associated with the retention versus removal of an ACL graft. Multivariable logistic regression analysis was used to identify potential risk factors for an infection after ACLR. Results: Of the 11,451 ACLR procedures, 48 infections were identified (0.42%). Multivariable logistic regression analysis revealed revision ACLR (odds ratio [OR], 3.13 [95% CI, 1.55-6.32]; P = .001) and younger age (OR, 1.06 [95% CI, 1.02-1.10]; P = .001) as risk factors for an infection. Compared with bone–patellar tendon–bone autografts, both hamstring tendon autografts (OR, 4.39 [95% CI, 2.15-8.96]; P < .001) and allografts (OR, 5.27 [95% CI, 1.81-15.35]; P = .002) were independently associated with an increased risk of infections. Overall, 15 ACL grafts were removed (31.3%). No statistically significant differences besides the number of irrigation and debridement procedures were found for retained versus removed grafts, although some trends were identified ( P = .054). Conclusion: In a large single-center cohort of patients who had undergone ACLR and those with an infection after ACLR, patients with revision cases and younger patients were found to have a higher incidence of infection. The use of bone–patellar tendon–bone autografts was found to be associated with the lowest risk of infection after ACLR compared with both hamstring tendon autografts and allografts. Larger cohorts with a larger number of infection cases are needed to determine the factors associated with graft retention versus removal.

This article provides an overview of the NASA Atmospheric Tomography (ATom) mission and a summary of selected scientific findings to date. ATom was an airborne measurements and modeling campaign aimed at characterizing the composition and chemistry of the troposphere over the most remote regions of the Pacific, Southern, Atlantic, and Arctic Oceans, and examining the impact of anthropogenic and natural emissions on a global scale. These remote regions dominate global chemical reactivity and are exceptionally important for global air quality and climate. ATom data provide the in situ measurements needed to understand the range of chemical species and their reactions, and to test satellite remote sensing observations and global models over large regions of the remote atmosphere. Lack of data in these regions, particularly over the oceans, has limited our understanding of how atmospheric composition is changing in response to shifting anthropogenic emissions and physical climate change. ATom was designed as a global-scale tomographic sampling mission with extensive geographic and seasonal coverage, tropospheric vertical profiling, and detailed speciation of reactive compounds and pollution tracers. ATom flew the NASA DC-8 research aircraft over four seasons to collect a comprehensive suite of measurements of gases, aerosols, and radical species from the remote troposphere and lower stratosphere on four global circuits from 2016 to 2018. Flights maintained near-continuous vertical profiling of 0.15–13-km altitudes on long meridional transects of the Pacific and Atlantic Ocean basins. Analysis and modeling of ATom data have led to the significant early findings highlighted here.

Funding: This study was supported by grants from the Office of Naval Research N00014-18-1-2822, DoD SERDP contract W912HQ20C0056, IPEV (Institut Paul Emile Victor) under the Antarctic research program 109 (C. Barbraud) and 1201 (C. Gilbert & C. Guinet), and CNES-TOSCA as part of the SNO-MEMO. The ability of marine mammals to accumulate sufficient lipid energy reserves is vital for mammals' survival and successful reproduction. However, long-term monitoring of at-sea changes in body condition, specifically lipid stores, has only been possible in elephant seals performing prolonged drift dives (low-density lipids alter the rates of depth change while drifting). This approach has limited applicability to other species. Using hydrodynamic performance analysis during transit glides, we developed and validated a novel satellite-linked data logger that calculates real-time changes in body density (∝lipid stores). As gliding is ubiquitous amongst divers, the system can assess body condition in a broad array of diving animals. The tag processes high sampling rate depth and three-axis acceleration data to identify 5 s high pitch angle glide segments at depths >100 m. Body density is estimated for each glide using gliding speed and pitch to quantify drag versus buoyancy forces acting on the gliding animal. We used tag data from 24 elephant seals (Mirounga spp.) to validate the onboard calculation of body density relative to drift rate. The new tags relayed body density estimates over 200 days and documented lipid store accumulation during migration with good correspondence between changes in body density and drift rate. Our study provided updated drag coefficient values for gliding (Cd,f = 0.03) and drifting (Cd,s = 0.12) elephant seals, both substantially lower than previous estimates. We also demonstrated post-hoc estimation of the gliding drag coefficient and body density using transmitted data, which is especially useful when drag parameters cannot be estimated with sufficient accuracy before tag deployment. Our method has the potential to advance the field of marine biology by switching the research paradigm from indirectly inferring animal body condition from foraging effort to directly measuring changes in body condition relative to foraging effort, habitat, ecological factors and anthropogenic stressors in the changing oceans. Expanding the method to account for diving air volumes will expand the system's applicability to shallower-diving (

Only two Coccoloba-associated xerocomoid boletes with smooth basidiospores are currently known from the Dominican Republic, namely Boletus ruborculus and Xerocomus coccolobae. A multilocus phylogenetic analysis of four gene markers (ITS, LSU, RPB2, TEF1) reveals that B. ruborculus forms an autonomous clade in the Boletaceae corresponding to a novel genus, which is introduced here as Tropicoboletus gen. nov., whereas X. coccolobae is confirmed as a member of Xerocomus s. str. Tropicoboletus is sister to subfamily Xerocomoideae in the combined RPB2/TEF1 Boletaceae-wide analysis. Accurate morphological descriptions of the two species based on well-annotated samples are provided, accompanied by color photographs of fresh specimens in habitat and line drawings of their main anatomical features. The holotype collections of B. ruborculus and X. coccolobae were successfully sequenced and re-examined anatomically. The distribution range of Tropicoboletus ruborculus comb. nov. is extended from the original locality in Puerto Rico to the Dominican Republic and Mexico where its presence is reported for the first time. Similarly, the Dominican collections of X. coccolobae represent the first documented occurrence of this species for the Island of Hispaniola. Based on molecular and morphological evidence, we conclude that the Belizean species Xerocomus olivaceus is conspecific with X. coccolobae and is therefore reduced into synonymy. In addition, the holotypes of Xerocomus caeruleonigrescens, Xerocomus cuneipes, and Xerocomus pseudoboletinus var. pini-caribaeae were microscopically re-studied, although their exact taxonomic placement remains unresolved in the absence of any phylogenetic inference. Molecular investigation of a paratype of Boletus guadelupae resulted in a conspecificity with the recently described Singerocomus atlanticus from Brazil, extending the biogeographic coverage of Singerocomus to the Caribbean. Accordingly, the new combination Singerocomus guadelupae is proposed and S. atlanticus is synonymized. Finally, a putative novel Xerocomus s. str. species is discovered from the Dominican Republic but not formally described for the time being due to the paucity of material available.

Atmospheric electrical discharges are now known to generate unexpectedly large amounts of the atmosphere’s primary oxidant, hydroxyl (OH), in thunderstorm anvils, where electrical discharges are caused by atmospheric charge separation. The question is “Do other electrical discharges also generate large amounts of oxidants?” In this paper, we demonstrate that corona formed on grounded metal objects under thunderstorms produce extreme amounts of OH, hydroperoxyl (HO2), and ozone (O3). Hundreds of parts per trillion to parts per billion of OH and HO2were measured during seven thunderstorms that passed over the rooftop site during an air quality study in Houston, TX in summer 2006. A combination of analysis of these field results and laboratory experiments shows that these extreme oxidant amounts were generated by corona on the inlet of the OH-measuring instrument and that corona are easier to generate on lightning rods than on the inlet. In the laboratory, increasing the electric field increased OH, HO2, and O3, with 14 times more O3generated than OH and HO2, which were equal. Calculations show that corona on lightning rods can annually generate OH that is 10–100 times ambient amounts within centimeters of the lightning rod and on high-voltage electrical power lines can generate OH that is 500 times ambient a meter away from the corona. Contrary to current thinking, previously unrecognized corona-generated OH, not corona-generated UV radiation, mostly likely initiates premature degradation of high-voltage polymer insulators.

Background: The impact of previous SARS-CoV-2 infection on the morbidity of elective total joint arthroplasty (TJA) is not fully understood. This study reports on the association between previous COVID-19 disease, hospital length of stay (LOS), and in-hospital complications after elective primary TJA. Methods: Demographics, comorbidities, LOS, and in-hospital complications of consecutive 340 patients with a history of COVID-19 were compared with those of 5014 patients without a history of COVID-19 undergoing TJA. History of COVID-19 was defined as a positive IgG antibody test for SARS-CoV-2 before surgery. All patients were given both antibody and polymerase chain reaction tests before surgery. Results: Patients with a history of COVID-19 were more likely to be obese (43.8% vs 32.4%, P < .001), Black (15.6% vs 6.8%, P < .001), or Hispanic (8.5% vs 5.4%, P = .028) than patients without a history of COVID-19. COVID-19 treatment was reported by 6.8% of patients with a history of COVID-19. Patients with a history of COVID-19 did not have a significantly longer median LOS after controlling for other factors (for hip replacements, median 2.9 h longer, 95% confidence interval = −2.0 to 7.8, P = .240; for knee replacements, median 4.1 h longer, 95% confidence interval = −2.4 to 10.5, P = .214), but a higher percentage were discharged to a post–acute care facility (4.7% vs 1.9%, P = .001). There was no significant difference in in-hospital complication rates between the 2 groups (0/340 = 0.0% vs 22/5014 = 0.44%, P = .221). Conclusions: We do not find differences in LOS or in-hospital complications between the 2 groups. However, more work is needed to confirm these findings, particularly for patients with a history of more severe COVID-19. Level of evidence: II.

The seabed of Halifax Harbour contains a variety of features that can be classified into natural and anthropogenic features. Natural features are formed by nature and consist of bedforms such as sand waves, sedimentary furrows, boulder berms, moraines, pockmarks, etc. Anthropogenic features are those formed by human activity and include anchor marks, cables, shipwrecks, dredge spoils, bridge and dock remains, etc. The anthropogenic imprint on the Harbour bottom is very dense, particularly in the inner Harbour, and makes the collection of natural unaffected seabed samples difficult. This poster illustrates and describes boulder berms, dredged areas and spoils, spud can marks, mining pits, and enigmatic gravel circles.

The seabed of Halifax Harbour contains a number of features that can be classified into natural and anthropogenic features. Natural features are formed by nature and consist of bedforms such as sand waves, sedimentary furrows, boulder berms, moraines, pockmarks, etc. Anthropogenic features are those formed by human activity and include anchor marks, cables, shipwrecks, dredge spoils, bridge and dock remains. The anthropogenic imprint on the Harbour bottom is very dense, particularly in the inner Harbour, and makes the collection of natural unaffected samples difficult. This poster illustrates and describes anchor marks, gassy sediments, sedimentary furrows, pockmarks, the remnants of submarine net emplacements, vehicles dumped on the seabed, and an area of seafloor rich in glass bottles.

Halifax Harbour has many myths associated with its history and some of them are related to the geology. Here we present three of the more popular ones and the modern evidence to clarify the story. They are: 1. That a curse has been placed on the bridges of The Narrows, 2. That the Halifax Explosion of 1917 in The Narrows created a large crater on the seabed of the harbour, and 3. That a tunnel was built to connect Georges Island with Citadel Hill under the harbour floor.

The mapping of Halifax Harbour has revealed the presence of about 45 shipwrecks in the Harbour. Near the mouth of the harbour, over 50 magnetic anomalies have been discovered, most of which also represent shipwrecks. There may be many others that are buried beneath the muddy sediments that require other techniques for discovery. Together they represent a rich archaeological heritage yet to be fully explored.

Osteoarticular mycoses are chronic debilitating infections that require extended courses of antifungal therapy and may warrant expert surgical intervention. As there has been no comprehensive review of these diseases, the International Consortium for Osteoarticular Mycoses prepared a definitive treatise for this important class of infections. Among the etiologies of osteoarticular mycoses are Candida spp., Aspergillus spp., Mucorales, dematiaceous fungi, non-Aspergillus hyaline molds, and endemic mycoses, including those caused by Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides species. This review analyzes the history, epidemiology, pathogenesis, clinical manifestations, diagnostic approaches, inflammatory biomarkers, diagnostic imaging modalities, treatments, and outcomes of osteomyelitis and septic arthritis caused by these organisms. Candida osteomyelitis and Candida arthritis are associated with greater events of hematogenous dissemination than those of most other osteoarticular mycoses. Traumatic inoculation is more commonly associated with osteoarticular mycoses caused by Aspergillus and non-Aspergillus molds. Synovial fluid cultures are highly sensitive in the detection of Candida and Aspergillus arthritis. Relapsed infection, particularly in Candida arthritis, may develop in relation to an inadequate duration of therapy. Overall mortality reflects survival from disseminated infection and underlying host factors.

Top marine predators, such as odontocetes, pinnipeds, and seabirds, are known to forage around fishing boats because fishermen aggregate and/or discard their prey. Recently, there have been reports of humpback whales interacting with fishing boats. However, whether humpback whales utilise discard fish as a food source and how they forage around fishing boats is unknown. This study reports for the first time, the foraging behaviour of a humpback whale around fishing boats. Three whales were tagged using a suction-cup tag containing a video camera, and a behavioural data logger in the coastal area of Tromsø, Norway. Video data from one tagged whale showed that the whale remained in close vicinity of fishing boats for 43 minutes, and revealed the presence of large numbers of dead fish, fish-eating killer whales, fishing boats, and fishing gear. In waters with large numbers of dead fish, the whale raised its upper jaw, a motion associated with engulfing discard fish from fishing boats, and this feeding behaviour differed markedly from lunge-feeding observed in two other whales in the same area. This behaviour was defined as “pick-up feeding”. The behavioural data logger showed that there was no lunge feeding when the whale foraged around fishing boats. This study showed a novel humpback whale foraging strategy: low energy gain from scattered prey but also low energy costs because high-energy lunge feeding was not required.

Funding: Office of Naval Research - N000142012697, N000142112096; Strategic Environmental Research and Development Program - RC20-1097, RC20-7188, RC21-3091. Assessing cumulative effects of human activities on ecosystems is required by many jurisdictions, but current science cannot meet regulatory demands. Regulations define them as effect(s) of one human action combined with other actions. Here we argue for an approach that evaluates the cumulative risk of multiple stressors for protected wildlife populations within their ecosystems. Monitoring effects of each stressor is necessary but not sufficient to estimate how multiple stressors interact to affect wildlife populations. Examining the mechanistic pathways, from cellular to ecological, by which stressors affect individuals can help prioritize stressors and interpret how they interact. Our approach uses health indicators to accumulate the effects of stressors on individuals and to estimate changes in vital rates, driving population status. We advocate using methods well-established in human health and integrating them into ecosystem-based management to protect the health of commercially and culturally important wildlife populations and to protect against risk of extinction for threatened species. Our approach will improve abilities to conserve and manage ecosystems but will also demand significant increases in research and monitoring effort. We advocate for increased investment proportional to the economic scale of human activities in the Anthropocene and their pervasive effects on ecology and biodiversity. Publisher PDF

Rapid climate change in Arctic and Subarctic ecosystems is altering the spatio-temporal dynamics and abundance of resources. Whether highly mobile predators can respond and match their movements to changed resource peaks remains largely unclear. In the last decade, humpback whales (Megaptera novaeangliae) established a new foraging site in fjords of northern Norway during the winter, outside of their presumed foraging season. We used photographic matching to show that whales first sighted during fall in the Barents Sea foraged in northern Norway from late October to February, staying for up to three months and showing high inter-annual return rates (up to 82%). The number of identified whales increased steadily from 2010 to 2016. Genetic sexing and hormone profiling in both areas suggest higher proportions of pregnancy and a female bias in Norwegian waters. This indicates that the new site may be particularly important for pregnant females, likely to improve body condition before migration. Our results suggest that baleen whales can respond to nutritional opportunities along their migration pathways, in some cases by extending their feeding season. This supports the idea that migrating marine mammals can access novel prey resources as part of their response to environmental changes.

Background Over 1 million Americans undergo joint replacement each year, and approximately 1 in 75 will incur a periprosthetic joint infection. Effective treatment necessitates pathogen identification, yet standard-of-care cultures fail to detect organisms in 10% to 20% of cases and require invasive sampling. We hypothesized that cell-free DNA (cfDNA) fragments from microorganisms in a periprosthetic joint infection can be found in the bloodstream and utilized to accurately identify pathogens via next-generation sequencing. Methods In this prospective observational study performed at a musculoskeletal specialty hospital in the U.S., we enrolled 53 adults with validated hip or knee periprosthetic joint infections. Participants had peripheral blood drawn immediately prior to surgical treatment. Microbial cfDNA from plasma was sequenced and aligned to a genome database with >1,000 microbial species. Intraoperative tissue and synovial fluid cultures were performed per the standard of care. The primary outcome was accuracy in organism identification with use of blood cfDNA sequencing, as measured by agreement with tissue-culture results. Results Intraoperative and preoperative joint cultures identified an organism in 46 (87%) of 53 patients. Microbial cfDNA sequencing identified the joint pathogen in 35 cases, including 4 of 7 culture-negative cases (57%). Thus, as an adjunct to cultures, cfDNA sequencing increased pathogen detection from 87% to 94%. The median time to species identification for cases with genus-only culture results was 3 days less than standard-of-care methods. Circulating cfDNA sequencing in 14 cases detected additional microorganisms not grown in cultures. At postoperative encounters, cfDNA sequencing demonstrated no detection or reduced levels of the infectious pathogen. Conclusions Microbial cfDNA from pathogens causing local periprosthetic joint infections can be detected in peripheral blood. These circulating biomarkers can be sequenced from noninvasive venipuncture, providing a novel source for joint pathogen identification. Further development as an adjunct to tissue cultures holds promise to increase the number of cases with accurate pathogen identification and improve time-to-speciation. This test may also offer a novel method to monitor infection clearance during the treatment period. Level of evidence Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Introduction. The concept of the SES stipulates that officials exercising state supervision (control) are obliged to detect and prevent violations of fire and technogenic safety requirements established by law [14]. Іn such situations, he bears full responsibility for violation of the requirements of fire, technogenic safety established by the legislation.Purpose. To propose an algorithm of actions of authorized officials during state supervision (control) in the field of technogenic and fire safety during the practical implementation of the provisions of the Civil Protection Code of Ukraine (further- the CZU Code) and the Law of Ukraine "On Basic Principles of State Supervision (Control)" Dated April 5, 2007 (further- Memorandum № 877).Methods. Analysis of existing regulations governing the implementation of state supervision (control) in the field of tech-nogenic and fire safety and its practical implementation by authorized officials of the SESResults. Ways to improve the activities of state supervision (control) in the field of fire and technogenic safety and the powers of officials to implement it are considered. The main directions of implementation of preventive measures by state supervision bodies are given. The necessity of using a new approach to the state management of fire, technogenic safety and civil protection is highlighted. Conclusion. Order of the Ministry of Internal Affairs of Ukraine "On approval of the Instruction on registration of materials on administrative offences and recognition as invalid of some orders of the Ministry of Internal Affairs of Ukraine" from 27.07.2016 № 725 should be supplemented with a clause on the interaction of article 185-14КУпАП. "Creation of obstacles in the activity of authorized officials of the central body of executive power, which implements the state policy on state supervision (control) in the field of fire and technogenic safety, related to conducting inspections".

Two main features define a sunspot as an object: a strong magnetic field and a low umbra temperature. The same can be said about a facular knot, in the center of which there is a dark micropore, and the magnetic field is several hundred Gauss (which noticeably exceeds the level of equipartition of about 200–250 G), sometimes reaching 1000 or 1200 G. The temperature decrease in these activity elements is explained by the suppression of circulation (overturning) convection by a strong vertical magnetic field. The first to express this idea was Biermann (1941). Within the framework of this conception, a saturation effect should be expected: when the magnetic field completely suppresses convection, its further growth should not lead to a decrease in temperature. There is still no clear answer to the question of the saturation effect. We will try to answer it in the first part of the work according to the Solar Dynamics Observatory. We show that saturation occurs at B = 2300–2400 G. A further increase in the magnetic field of the spot no longer leads to a decrease in the brightness of its umbra. The relationship of the magnetic field and intensity is also manifested in long-period oscillations of the magnetic field of spots. In this case, the brightness of the spot umbra changes in antiphase with its magnetic field (Efremov et al., 2020) in accordance with the theoretical model of a shallow sun spot (Solov’ev and Kirichek, 2014, 2016). A similar effect was established by us in the second part of this work for facular knots: during slow facular oscillations with periods of more than 1 h, its brightness changes in antiphase with a magnetic field. The obtained results convincingly confirm the Birman hypothesis.

Both angry and depressed patients may become a potential violent risk to self or others under some conditions. Means/harm reduction is a standard part of safety planning in violent risk clinical emergencies. Fortunately, a minority of patients in US households have access to firearms. Safe storage practices, temporary transfer of firearms, and removal of ammunition are options for reducing the risk to self and others. Psychotherapeutic work on the causes of and relief from the factors triggering anger or depression are essential to making the potentially violent individual not violent.

Soil microbial property is one of the fundamental indicators of soil health and quality, yet it has not been routinely examined in most soil testing protocols most likely due to the inconvenience o...

Two-stage exchange arthroplasty is considered the gold standard for treatment of periprosthetic joint infection (PJI) following total knee arthroplasty (TKA). Antibiotic cement spacers can include cement-based spacers (CBS), new components (NEW), and autoclaved components (ACL). The factors that most influence post-reimplantation prosthesis (PRP) survival were determined. A retrospective database review of patients undergoing two-stage exchange arthroplasty from 2008 to 2014 was performed. There were 85 patients, 25 patients and 30 patients in CBS, NEW and ACL groups, respectively. Patient, disease and surgical characteristics were collected and analyzed. Post-reimplantation prosthesis (PRP) survival was modeled using the Kaplan–Meier method. Cox proportional hazard modeling was then performed to identify risk factors associated with implant failure. Overall PRP survival was 82% in 140 unilateral TKAs. PRP survival between groups was 81%, 96% and 73% within the minimum 2-year follow-up period, respectively. There was a difference in median interval-to-reimplantation between groups (CBS, 72.0 days; NEW, 111.0 days; ACL, 84.0 days, p = 0.003). Adjusting for time-to-reimplantation, NEW spacers demonstrated greater PRP survival compared with ACL spacers (p = 0.044), and a trend towards greater survival compared with CBS spacers (p = 0.086). Excluding early failures (

Funding for data collection was provided by the BBC Natural History Unit, Fundação para a Ciência e a Tecnologia (grant number SFRH/BD/30303/2006), the Icelandic Research Fund (i. Rannsóknasjóður) through a START Postdoctoral Fellowship (grant number 120248042) and a Project Grant (grant number 163060‐051), the National Geographic Global Exploration Fund (grant number GEFNE65‐12), a Marie Curie International Incoming Fellowship (project number 297116), the Office of Naval Research (grant number N00014‐08‐1‐0984), and a Russell Trust Award from the University of St. Andrews. Killer whale call repertoires can provide information on social connections among groups and populations. Killer whales in Iceland and Norway exhibit similar ecology and behavior, are genetically related, and are presumed to have been in contact before the collapse of the Atlanto-Scandian herring stock in the 1960s. However, photo-identification suggests no recent movements between Iceland and Norway but regular movement between Iceland and Shetland. Acoustic recordings collected between 2005 and 2016 in Iceland, Norway, and Shetland were used to undertake a comprehensive comparison of call repertoires of Northeast Atlantic killer whales. Measurements of time and frequency parameters of calls from Iceland (n = 4,037) and Norway (n = 1,715) largely overlapped in distribution, and a discriminant function analysis had low correct classification rate. No call type matches were confirmed between Iceland and Norway or Shetland and Norway. Three call types matched between Iceland and Shetland. Therefore, this study suggests overall similarities in time and frequency parameters but some divergence in call type repertoires. This argues against presumed past contact between Icelandic and Norwegian killer whales and suggests that they may not have been one completely mixed population. Postprint

The microbiome plays a major role in human physiology by influencing obesity, inducing inflammation, and impacting cancer therapies. During the 60th Annual Meeting of the Society of the Alimentary Tract (SSAT) at the State-of-the-Art Conference, experts in the field discussed the influence of the microbiome. This paper is a summary of the influence of the microbiome on obesity, inflammatory bowel disease, pancreatic cancer, cancer therapies, and gastrointestinal optimization. This review shows how the microbiome plays an important role in the development of diseases and surgical complications. Future studies are needed in targeting the gut microbiome to develop individualized therapies.

Background COVID-19, the illness caused by the novel coronavirus, SARS-CoV-2, has sickened millions and killed hundreds of thousands as of June 2020. New York City was affected gravely. Our hospital, a specialty orthopedic hospital unaccustomed to large volumes of patients with life-threatening respiratory infections, underwent rapid adaptation to care for COVID-19 patients in response to emergency surge conditions at neighboring hospitals. Purposes We sought to determine the attributes, pharmacologic and other treatments, and clinical course in the cohort of patients with COVID-19 who were admitted to our hospital at the height of the pandemic in April 2020 in New York City. Methods We conducted a retrospective observational cohort study of all patients admitted between April 1 and April 21, 2020, who had a diagnosis of COVID-19. Data were gathered from the electronic health record and by manual chart abstraction. Results Of the 148 patients admitted with COVID-19 (mean age, 62 years), ten patients died. There were no deaths among non-critically ill patients transferred from other hospitals, while 26% of those with critical illness died. A subset of COVID-19 patients was admitted for orthopedic and medical conditions other than COVID-19, and some of these patients required intensive care and ventilatory support. Conclusion Professional and organizational flexibility during pandemic conditions allowed a specialty orthopedic hospital to provide excellent care in a global public health emergency. Electronic supplementary material The online version of this article (10.1007/s11420-020-09779-z) contains supplementary material, which is available to authorized users.

In modern conditions, the problems of fire safety in Ukraine become especially important. A significant increase of fires that have occurred in the country recently, have led to deaths and injuries and significant material damage. In this case, the introduction of modern effective methods of fire safety is particularly acute. The article shows main attention to significant shortcomings in the system of state regulation of fire safety in Ukraine, especially: lack of effective state supervision and control, non-compliance of domestic practices with standards and norms of high-educated countries, underdeveloped market of insurance services in the field of fire insurance. However, the no interest of the state, as well as individuals and legal entities in the use of risk-oriented approach with economic leverage in the form of an appropriate insurance system, lack of remote control by the state over business activities, low level of fire safety. The leading role in ensuring supervision and control belongs to the state itself, which must combine state and public beliefs and coercion, by applying to public relations appropriate measures provided for in the functioning of fire safety management.

Animal-mounted data logging devices are used to study the behaviour, physiology, and ecology of free-ranging marine mammals, as well as their reactions to controlled exposures. It is important to consider whether collected data are representative of natural behaviour or biased by responses to tagging. In species with stereotypical diving behaviour, tagging responses can be quantified by identifying anomalous dives. Data from 36 suction cup tag deployments on sperm whalesPhyseter macrocephalusfrom 4 locations were analysed to consider whether tagging effects were evident within 5 dive parameters: maximum dive depth, dive duration, descent speed, depth difference between start of clicking and first prey capture attempt, and buzz rate. Linear mixed models were generated for each response parameter and covariates for dive index were added to assess whether model fit improved when the order of dives was taken into account. Time-decaying tagging effects were noted in maximum dive depth (first dives were 25% shallower than average) and buzz rate (first dives contained 34% fewer buzzes per minute than average). In the Azores, the first 3 dives subsequent to tag attachment featured faster descent speeds than average. The whales were likely responding to the cumulative ‘dose’ of research activity at the surface: multiple boat approaches, tag placement, and general disturbance. Disturbance should be minimised during tagging, and the extent and duration of responses should be quantified. Modelling of quantified tagging responses could enable correction of these responses in tag data.

The hydroxyl radical (OH) reacts with thousands of chemical species in the atmosphere, initiating their removal and the chemical reaction sequences that produce ozone, secondary aerosols, and gas-phase acids. OH reactivity, which is the inverse of OH lifetime, influences the OH abundance and the ability of OH to cleanse the atmosphere. The NASA Atmospheric Tomography (ATom) campaign used instruments on the NASA DC-8 aircraft to measure OH reactivity and more than 100 trace chemical species. ATom presented a unique opportunity to test the completeness of the OH reactivity calculated from the chemical species measurements by comparing it to the measured OH reactivity over two oceans across four seasons. Although the calculated OH reactivity was below the limit of detection for the ATom instrument used to measure OH reactivity throughout much of the free troposphere, the instrument was able to measure the OH reactivity in and just above the marine boundary layer. The mean measured value of OH reactivity in the marine boundary layer across all latitudes and all ATom deployments was 1.9 s−1, which is 0.5 s−1 larger than the mean calculated OH reactivity. The missing OH reactivity, the difference between the measured and calculated OH reactivity, varied between 0 and 3.5 s−1, with the highest values over the Northern Hemisphere Pacific Ocean. Correlations of missing OH reactivity with formaldehyde, dimethyl sulfide, butanal, and sea surface temperature suggest the presence of unmeasured or unknown volatile organic compounds or oxygenated volatile organic compounds associated with ocean emissions.

Background A number of clinical trials have been conducted, assessing the role of long-term (>1 year) Suppressive Antibiotic Treatment (SAT) combined with debridement, antibiotics and implant retention (DAIR) for the management of periprosthetic joint infection (PJI). However, no systematic review of the literature has been published to date to evaluate complications associated with long term antibiotic treatment and overall survivorship free from reoperation and revision for infection after DAIR for total hip and total knee PJI. Methods The US National Library of Medicine (PubMed/MEDLINE), EMBASE, and the Cochrane Database of Systematic Reviews were queried for publications from January 1980 to December 2018 utilizing keywords pertinent to total knee arthroplasty, total hip arthroplasty, periprosthetic joint infection and antibiotic suppression. Results Overall, 7 articles of low quality (level III or IV) were included in this analysis. The studies included in this systematic review included 437 cases of PJI treated surgically with DAIR and then with SAT. The overall mean infection-free rate of SAT following DAIR was 75% (318/424 patients), while the all-cause reoperation rate was 6.7%. Overall the mean rate of adverse effects associated with long term antibiotic use was 15.4% and the mean rate of adverse effects leading to discontinuation of SAT was 4.3%. There was no study to show significant differences between acute (either postoperative or haematogenous, with onset of symptoms ≤4 weeks) and chronic (onset of symptoms >4 weeks) infections and failure rates of DAIR with SAT. The literature is inconclusive on the influence of anatomic location (hip versus knee) as well as microorganism on the success rate of DAIR with SAT. Conclusions The results of this systematic review demonstrate that there is still only low-quality evidence regarding the therapeutic effect of DAIR combined with SAT, which is not enough to draw definitive conclusions. Further high-quality prospective studies are needed to better understand SAT’s efficacy and safety in a controlled fashion. Although discontinuation of antibiotic treatment due to side effects was found to be low, the high rates of adverse effects noted after DAIR with SAT demonstrate the underlying frailty and complexity of many patients with PJI, and the imperfect therapies available. While S. aureus appears to be a risk factor for increased risk of SAT failure, there is not enough data to establish which patients would benefit most from DAIR with postoperative SAT.

Background: The role of daptomycin, a potent, safe, convenient anti-staphylococcal antibiotic, in treatment of prosthetic joint infection (PJI) is unclear. We evaluated our experience with the largest cohort of patients with staphylococcal PJI managed with daptomycin.Methods: A cohort of staphylococcal hip and knee PJI treated with daptomycin was identified by hospital records from 2009 to 2016. All cases met Musculoskeletal Infection Society International Consensus criteria for PJI. The primary endpoint was 2 year prosthesis retention. Univariate analyses and regression statistics were calculated.Results: 341 patients with staphylococcal PJI were analyzed. 154 two-stages (77%) and 74 DAIR procedures (52%) met criteria for treatment success at 2 years. 77 patients were treated with daptomycin, of which 34 two-stages (68%) and 15 DAIRs (56%) achieved treatment success. Pairwise and regression analysis found no association between treatment success and daptomycin use. Organism (DAIR only) and Charlson Comorbidity Index scores (DAIR and two-stage) were significantly associated with treatment outcome. Six daptomycin patients (7.8%) had adverse side effects.Discussion: Daptomycin fared no better or worse than comparable antibiotics in a retrospective cohort of staphylococcal hip and knee PJI patients, regardless of surgical strategy.Conclusion: The convenient dosing, safety, and potency of daptomycin make it an attractive antibiotic for staphylococcal PJI. However, these advantages must be weighed against higher costs and rare, but serious side effects.

Funding was provided by the US Navy Living Marine Resources and Office of Naval Research programs, Netherlands Ministry of Defence, Norwegian Ministry of Defence, UK Defence Science and Technology Laboratory, and DGA French Ministry of Defence. Acoustic signals travel efficiently in the marine environment, allowing soniferous predators and prey to eavesdrop on each other. Our results with four cetacean species indicate that they use acoustic information to assess predation risk and have evolved mechanisms to reduce predation risk by ceasing foraging. Species that more readily gave up foraging in response to predatory sounds of killer whales also decreased foraging more during 1- to 4-kHz sonar exposures, indicating that species exhibiting costly antipredator responses also have stronger behavioral reactions to anthropogenic noise. This advance in our understanding of the drivers of disturbance helps us to predict what species and habitats are likely to be most severely impacted by underwater noise pollution in oceans undergoing increasing anthropogenic activities. As human activities impact virtually every animal habitat on the planet, identifying species at-risk from disturbance is a priority. Cetaceans are an example taxon where responsiveness to anthropogenic noise can be severe but highly species and context specific, with source–receiver characteristics such as hearing sensitivity only partially explaining this variability. Here, we predicted that ecoevolutionary factors that increase species responsiveness to predation risk also increase responsiveness to anthropogenic noise. We found that reductions in intense-foraging time during exposure to 1- to 4-kHz naval sonar and predatory killer whale sounds were highly correlated (r = 0.92) across four cetacean species. Northern bottlenose whales ceased foraging completely during killer whale and sonar exposures, followed by humpback, long-finned pilot, and sperm whales, which reduced intense foraging by 48 to 97level responses to killer whale playbacks, implying a similar level of perceived risk. The correlation cannot be solely explained by hearing sensitivity, indicating that species- and context-specific antipredator adaptations also shape cetacean responses to human-made noise. Species that are more responsive to predator presence are predicted to be more disturbance sensitive, implying a looming double whammy for Arctic cetaceans facing increased anthropogenic and predator activity with reduced ice cover. Publisher PDF

Funding Acknowledgements Type of funding sources: None. Introduction Patients with PIMS-TS present with features of vasculitis (bright coronary arteries and diffuse coronary ectasia on transthoracic echocardiography) and prothrombotic features (e.g. elevated D Dimers) indicating involvement of the endothelial layer in the inflammatory process. Impairment in endothelial function may contribute to the acute but also to possible long-term consequences in patients with PIMS-TS. The aim of this pilot study is to assess non-invasively the endothelial (dys)function using reactive hyperemic peripheral arterial tonometry (RH-PAT) 6 months after the acute inflammatory phase. Methods Ten patients with previous diagnosis of PIMS-TS were compared to age-matched controls. The endothelial function was assessed using the EndoPAT device which provides the reactive hyperemic index (RHI) of endothelial function in a 15-min test. Cardiac function indices by means of LV fractional shortening (FS) was also assessed. Results There were no significant differences regarding age (11.2 ± 3.0 vs 13.6 ± 2.4, p = 0.063), height, weight and body surface area, (BSA: 1.49 ± 0.36 vs 1.52 ± 0.25, p = 0.856) in patients with previous diagnosis of PIMS-TS and controls respectively. The two groups also had similar LV systolic function assessed by FS (36.3 ± 9.1% vs 36.7 ± 7.1%, p = 0.922). The RHI in the PIMS TS group was similar to the control group (1.65 ± 0.43 vs 1.81 ± 0.60, p = 0.533 respectively). Conclusions. Patients with PIMS-TS who may present with features of vasculitis during the acute phase, do not show evidence of endothelial dysfunction during the long term follow-up, suggesting resolution. Further studies are required to accurately determine the endothelial (dys)function during the acute phase of the inflammatory syndrome and course.

The island of Surtsey originated from an underwater eruption in 1963 and has since been studied extensively, illustrating the colonization and succession by numerous species in both the terrestrial and marine habitats. However, there is little information on the cetaceans occurring near the island. Here we show that killer whales, pilot whales and minke whales are observed within the Surtsey Nature Reserve in June-August, although survey effort within this area has been lower than in other parts of the Vestmannaeyjar archipelago. Thus, we expect the list of species will increase with higher effort in the future. Killer whales were the species observed most commonly and were seen during the summer months, most often on the east and north coasts. Both observational and animal-attached tag data suggest killer whales were feeding within the reserve, and the only prey identified was herring. However, seasonal survey effort limits a comprehensive understanding of the prey killer whales may target within this area and particularly whether killer whales may target the seal colonies established here during autumn and winter. In the future, increased effort in summer and at other times of the year, would help fill in these gaps in our knowledge of the importance of the Surtsey nature reserve for cetaceans.

Funding: This work was supported by the UK Defense and Science Technology Laboratory (DSTLX-1000137649), NL Ministry of Defence (Cerema-DGA #1883003901), FR Ministry of Defence, and US Navy Living Marine Resources program (N39430-17-C-1935). PLT was supported by US Office of Naval Research (ONR) grant numbers N00014-18-1-2062 and N00014-20-1-2709, as well as by the Strategic Environmental Research and Development Program (SERDP) contracts RC20-1097, RC21-3091, and RC20-7188. Auditory masking by anthropogenic noise may impact marine mammals relying on sound for important life functions, including echolocation. Animals have evolved antimasking strategies, but they may not be completely effective or cost-free. We formulated seven a priori hypotheses on how odontocete echolocation behavior could indicate masking. We addressed six of them using data from 15 tagged sperm whales subject to experimental exposures of pulsed and continuous active sonar (PAS and CAS). Sea state, received single-pulse sound exposure level (SELsp), whale depth and orientation towards surface, and sonar were considered as candidate covariates representing different masking conditions. Echolocation behavior, including buzz duration and search range, varied strongly with depth. After controlling for depth and angle to the surface, the likelihood of buzzing following a click train decreased with sea state (t = −7.3, p < .001). There was little evidence for changes in 10 tested variables with increasing sonar SELsp, except reduced buzzing consistent with previously reported feeding cessation (t = −2.26, p = .02). A potential Lombard effect was detected during echolocation with sea state and SELsp, despite off-axis measurement and right-hand censoring due to acoustic clipping. The results are not conclusive on masking effects on sperm whale echolocation, highlighting challenges and opportunities for future anthropogenic masking studies. Postprint Postprint

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) glycoprotein D614G mutation became the predominant globally circulating variant after its emergence in the early coronavirus disease 2019 (COVID-19) pandemic. Studies showed that this mutation results in an open conformation of the S glycoprotein receptor-binding domain (RBD), and increased angiotensin 1-converting enzyme 2 (ACE2) binding and fusion, which result in an increase in SARS-CoV-2 transmissibility and infectivity. Dynamic tracking of SARS-CoV-2 showed that the D614G variant became predominant after emergence in Europe and North America, but not in China. The current absence of selective pressures from antiviral treatment suggests that the driving force for viral evolution could be variations in human population genetics. Results show that ACE2 expression is higher in Asian populations than that in European, North American, and African populations. This supports the idea that lower ACE2 expression is a driving force in the positive selection for the D614G mutation. This study suggests that the dynamics of the SARS-CoV-2 D614G mutation during the early-to-mid pandemic is associated with enhanced transmission efficiency in populations with lower ACE2 expression. Understanding the role that human genetic diversity plays in the adaptive evolution of SARS-CoV-2 may have an important impact on public health and measures to control the pandemic.