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A literary text is, for a book artist, like a score for a musician or a script for an actor: a basis on which to construct an artistic performance. Book artist Claire Van Vliet has, at her Janus Press, constructed dazzling broadsides and artist books based on poetry by, among others, Hayden Carruth, Galway Kinnell, and Margaret Kaufman. These works test or ignore boundaries between conventional categories such as book and broadside, two-dimensional display, and three-dimensional construction. The object she built based on Denise Levertov’s poem “Batterers” unfolds especially powerfully in time and three-dimensional space.

The Bar-headed Goose is the only true goose species or Anserinae to migrate solely within the Central Asian Flyway, and thus, it is an ideal species for observing the effects of both land use and climate change throughout the flyway. In this paper, we investigate the home range, movement pattern, and habitat selection of Bar-headed Geese (Anser indicus) during the breeding season at Qinghai Lake, which is one of their largest breeding areas and a major migration staging area in the flyway. We identified several areas used by the geese during the breeding season along the shoreline of Qinghai Lake and found that most geese had more than one core use area and daily movements that provided insight into their breeding activity. We also observed the intensive use of specific wetlands and habitats near Qinghai Lake. These data provide interesting insights into the movement ecology of this important species and also provide critical information for managers seeking to understand and respond to conservation concerns threatening Bar-headed Geese, such as landscape and habitat changes.

While nest usurpation and subsequent incubation of eggs and even brooding of chicks from other species has been reported for Common Terns (Sterna hirundo), such behavior is considered rare. We report an observation of a Common Tern pair usurping the Least Tern (Sternula antillarum) nest and brooding the Least Tern chicks. While the Least Tern pair attempted to provide care for the chicks, the Common Terns displayed aggressive behavior and defended the nest. Though both species attempted to feed the chicks, no feeding events were observed due to harassment from the other species. Neither pair was observed nesting prior to or following this event, and all chicks are believed to have been lost to predation. We discuss the possible scenarios leading to the observed usurpation event, the possibility that usurpations are more common than previously believed, and the need for different monitoring methods to elucidate the causes of usurpations.

Background: We herein report two cases of sudden onset symptomatic pulmonary hypertension after coronavirus disease 2019 (COVID-19) vaccination. Case Summary: Pulmonary hypertension in previously healthy adult males occurred within three weeks of receiving the second dose of the Pfizer (BNT162b2) mRNA COVID-19 vaccine from different lots. Both patients experienced a sudden onset of severe fatigue and dyspnea on exertion with negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) testing. The diagnosis was made by serial transthoracic echocardiography in the first case and by both transthoracic echocardiography and right heart catheterization in the second. Both cases resulted in functional limitations and likely permanent organ damage. No evidence of pulmonary emboli was detected in either case. Discussion: Pulmonary hypertension is a serious disease characterized by damage to lung vasculature and restricted blood flow through narrowed arteries from the right to left heart. The onset of symptoms is typically insidious, progressive and incurable, leading to right heart failure and premature death. The World Health Organization (WHO) classifies pulmonary hypertension into five categories and recently re-defined it as a resting mean pulmonary artery pressure greater than 20 mmHg. Sudden onset pulmonary hypertension would only be expected in the settings of surgical pneumonectomy or massive pulmonary emboli with compromise of at least 50% of the lung vasculature. We present here two novel cases of sudden onset pulmonary hypertension without evidence of pulmonary emboli, both of which occurred after receiving a COVID-19 mRNA vaccine.

Wild waterbirds, and especially wild waterfowl, are considered to be a reservoir for avian influenza viruses, with transmission likely occurring at the agricultural-wildlife interface. In the past few decades, avian influenza has repeatedly emerged in China along the East Asian-Australasian Flyway (EAAF), where extensive habitat conversion has occurred. Rapid environmental changes in the EAAF, especially distributional changes in rice paddy agriculture, have the potential to affect both the movements of wild migratory birds and the likelihood of spillover at the agricultural-wildlife interface. To begin to understand the potential implications such changes may have on waterfowl and disease transmission risk, we created dynamic Brownian Bridge Movement Models (dBBMM) based on waterfowl telemetry data. We used these dBBMM models to create hypothetical scenarios that would predict likely changes in waterfowl distribution relative to recent changes in rice distribution quantified through remote sensing. Our models examined a range of responses in which increased availability of rice paddies would drive increased use by waterfowl and decreased availability would result in decreased use, predicted from empirical data. Results from our scenarios suggested that in southeast China, relatively small decreases in rice agriculture could lead to dramatic loss of stopover habitat, and in northeast China, increases in rice paddies should provide new areas that can be used by waterfowl. Finally, we explored the implications of how such scenarios of changing waterfowl distribution may affect the potential for avian influenza transmission. Our results provide advance understanding of changing disease transmission threats by incorporating real-world data that predicts differences in habitat utilization by migratory birds over time.

We build an argument directed to agnostics who think there’s a realistic possibility some specific revelatory claim is true (for instance, the Christian, or Judaic, or Islamic claim) and who find that claim more plausible than its theistic competitors. Though such agnostics may have serious reservations about the claim, perhaps not even deeming the chance it’s true to be at least fifty-fifty, we contend that—surprisingly—it’s obligatory for them to assent to the claim if it provides a means for remediation of wrong-doing. Our focus is the Christian revelatory claim, but the argument’s template can be applied to other religions that, like Christianity, promise to fix the world’s ills in an afterlife.

The prevalence of heart failure (HF) with reduced (r) and preserved (p) ejection fraction (EF) continues to rise globally despite current advances in diagnostics and improvements to medical management [...]

Pathological sodium-water retention or edema/congestion is a primary cause of heart failure (HF) decompensation, clinical symptoms, hospitalization, reduced quality of life, and premature mortality. Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) based therapies reduce hospitalization due to HF, improve functional status, quality, and duration of life in patients with HF with reduced ejection fraction (HFrEF) independently of their glycemic status. The pathophysiologic mechanisms and molecular pathways responsible for the benefits of SGLT-2i in HFrEF remain inconclusive, but SGLT-2i may help HFrEF by normalizing salt-water homeostasis to prevent clinical edema/congestion. In HFrEF, edema and congestion are related to compromised cardiac function. Edema and congestion are further aggravated by renal and pulmonary abnormalities. Treatment of HFrEF patients with SGLT-2i enhances natriuresis/diuresis, improves cardiac function, and reduces natriuretic peptide plasma levels. In this review, we summarize current clinical research studies related to outcomes of SGLT-2i treatment in HFrEF with a specific focus on their contribution to relieving or preventing edema and congestion, slowing HF progression, and decreasing the rate of rehospitalization and cardiovascular mortality.

In permafrost regions, active layer thickness (ALT) observations measure the effects of climate change and predict hydrologic and elemental cycling. Often, ALT is measured through direct ground-based measurements. Recently, synthetic aperture radar (SAR) measurements from airborne platforms have emerged as a method for observing seasonal thaw subsidence, soil moisture, and ALT in permafrost regions. This study validates airborne SAR-derived ALT estimates in three regions of Alaska, USA using calibrated ground penetrating radar (GPR) geophysical data. The remotely sensed ALT estimates matched the field observations within uncertainty for 79% of locations. The average uncertainty for the GPR-derived ALT validation dataset was 0.14 m while the average uncertainty for the SAR-derived ALT in pixels coincident with GPR data was 0.19 m. In the region near Utqiaġvik, the remotely sensed ALT appeared slightly larger than field observations while in the Yukon-Kuskokwim Delta region, the remotely sensed ALT appeared slightly smaller than field observations. In the northern foothills of the Brooks Range, near Toolik Lake, there was minimal bias between the field data and remotely sensed estimates. These findings suggest that airborne SAR-derived ALT estimates compare well with in situ probing and GPR, making SAR an effective tool to monitor permafrost measurements.

Extensive Ossification of the Achilles Tendon (EOAT) is an uncommon condition characterized by the presence of heterotopic ossification within the substance of the Achilles Tendon and is distinct from other tendinopathies associated with tendon mineralization. The purpose of this scoping review of the literature on EOAT is to describe the pathogenesis, patient population, presentation, management, and outcomes of this rare condition. Fifty-four articles were included in the scoping review after screening and selection. According to the literature, EOAT often presents with pain and swelling around the Achilles Tendon and is frequently associated with acute trauma. EOAT is more common in men, and although the exact mechanisms of the pathology are not fully understood, EOAT may demonstrate specific molecular signaling patterns. The lack of knowledge regarding the molecular mechanism may be a significant hindrance to the management of the condition. Even though a standard treatment regimen for EOAT does not exist, conservative management for six months in patients without complications is recommended. Those who have an acute fracture of the ossification should be managed more aggressively and will often require surgical repair with autograft, although there is no standardized procedure at this time. Clinicians should be aware of the typical presentation, risk factors, and management options of patients with EOAT. Additionally, they should be cautious when selecting treatment strategies and conduct a thorough evaluation of long-term outcomes with various treatment modalities, which this review provides. Most important, this review highlights the need for further research to determine the best course of clinical treatment of EOAT injuries, in order to establish a standard treatment regimen.

Young adults enrolled in collegiate agricultural programs are a critical audience for agricultural health and safety training. Understanding the farm tasks that young adults engage in is necessary for tailoring health and safety education. The project analyzed evaluation survey responses from the Gear Up for Ag Health and Safety ™ program, including reported agricultural tasks, safety concerns, frequency of discussing health and safety concerns with healthcare providers, safety behaviors, and future career plans. The most common tasks reported included operation of machinery and grain-handling. Most participants intended to work on a family-owned agricultural operation or for an agribusiness/cooperative following graduation. Reported safety behaviors (hearing protection, eye protection, and sunscreen use when performing outdoor tasks) differed by gender and education type. Male community college and university participants reported higher rates of "near-misses" and crashes when operating equipment on the roadway. One-third of participants reported discussing agricultural health and safety issues with their medical provider, while 72% were concerned about the health and safety of their family and co-workers in agriculture. These findings provide guidance for better development of agricultural health and safety programs addressing this population-future trainings should be uniquely tailored, accounting for gender and educational differences., Competing Interests: Conflicts of Interest: Authors K.W., J.L.G., D.S., and C.S. perform work for the Ag Health and Safety Alliance™, a 501(c)(3) non-profit organization in the U.S. and Canada that focuses on health and safety for the next generation of agriculture through the delivery of the Gear Up for Ag Health and Safety™ program. This 2–5 h program targets students enrolled in agricultural production programs in the collegiate environment and operates through established partnerships with host institutions. The grant funding for this research was used for solely for the evaluation of this ongoing community education program. Authors K.W., J.L.G., D.S., and C.S. acknowledge that the research findings from the Gear Up for Ag™ training program is intended to serve as an example for other similar health and safety training programs—and that these findings are not intended to solely to benefit the Gear Up for Ag™ training program. The authors believe the findings from this example may be applicable to multiple other programs.

Bartonella henselae can cause various infections in humans, ranging from benign and self-limiting diseases to severe and life-threatening diseases as well as persistent infections that are difficult to treat. To develop more effective treatments for persistent Bartonella infections, in this study, we performed a high-throughput screen of an FDA-approved drug library against stationary phase B. henselae using the SYBR Green I/propidium iodide (PI) viability assay. We identified 110 drug candidates that had better activity against stationary phase B. henselae than ciprofloxacin, and among the top 52 drug candidates tested, 41 drugs were confirmed by microscopy to have higher activity than the current frontline antibiotic erythromycin. The identified top drug candidates include pyrvinium pamoate, daptomycin, methylene blue, azole drugs (clotrimazole, miconazole, sulconazole, econazole, oxiconazole, butoconazole, bifonazole), aminoglycosides (gentamicin and streptomycin, amikacin, kanamycin), amifostine (Ethyol), antiviral Lopinavir/ritonavir, colistin, nitroxoline, nitrofurantoin, verteporfin, pentamidine, berberine, aprepitant, olsalazine, clinafloxacin, and clofoctol. Pyrvinium pamoate, daptomycin, methylene blue, clotrimazole, and gentamicin and streptomycin at their respective maximum drug concentration in serum (C max ) had the capacity to completely eradicate stationary phase B. henselae after 3-day drug exposure in subculture studies. While the currently used drugs for treating bartonellosis, including rifampin, erythromycin, azithromycin, doxycycline, and ciprofloxacin, had very low minimal inhibitory concentration (MIC) against growing B. henselae , they had relatively poor activity against stationary phase B. henselae , except aminoglycosides. The identified FDA-approved agents with activity against stationary phase B. henselae should facilitate development of more effective treatments for persistent Bartonella infections.

Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat for effective treatment of several difficult-to-treat infections in humans. To identify potential new treatment options for MRSA infections, we screened a clinical compound library consisting of 1524 compounds using a growth inhibition assay in 96-well plates. We identified 34 agents which are either bacteriostatic or bactericidal against log-phase clinical MRSA strain USA300. Among them, 9 candidates (thonzonium, cetylpyridinium, trilocarban, benzododecinium, bithionol, brilliant green, chlorquinaldol, methylbenzethonium and green violet) are known antiseptics, 11 candidates are known antibiotics currently recommended for the treatment of MRSA. We identified 9 new drug candidates, 5 of which (thiostrepton, carbomycin, spiramycin, clofazimine and chloroxine) are antibiotics used for treating other infections than S. aureus infections; 4 of which (quinaldine blue, closantel, dithiazanine iodide and pyrvinium pamoate) are drugs used for treating parasitic diseases or cancer. We ranked these new drug candidates according to their MICs against the MRSA strain USA300. Our findings may have implications for more effective treatment of MRSA infections.

Lyme disease is a leading vector-borne disease in the United States. Although the majority of Lyme patients can be cured with standard 2-4 week antibiotic treatment, 10%-20% of patients continue to suffer from prolonged post-treatment Lyme disease syndrome (PTLDS). While the cause for this is unclear, persisting organisms not killed by current Lyme antibiotics may be involved. In our previous study, we screened an FDA drug library and reported 27 top hits that showed high activity against Borrelia persisters. In this study, we present the results of an additional 113 active hits that have higher activity against the stationary phase B. burgdorferi than the currently used Lyme antibiotics. Many antimicrobial agents (antibiotics, antivirals, antifungals, anthelmintics or antiparasitics) used for treating other infections were found to have better activity than the current Lyme antibiotics. These include antibacterials such as rifamycins (3-formal-rifamycin, rifaximin, rifamycin SV), thiostrepton, quinolone drugs (sarafloxacin, clinafloxacin, tosufloxacin), and cell wall inhibitors carbenicillin, tazobactam, aztreonam; antifungal agents such as fluconazole, mepartricin, bifonazole, climbazole, oxiconazole, nystatin; antiviral agents zanamivir, nevirapine, tilorone; antimalarial agents artemisinin, methylene blue, and quidaldine blue; antihelmintic and antiparasitic agents toltrazuril, tartar emetic, potassium antimonyl tartrate trihydrate, oxantel, closantel, hycanthone, pyrimethamine, and tetramisole. Interestingly, drugs used for treating other non-infectious conditions including verteporfin, oltipraz, pyroglutamic acid, pidolic acid, and dextrorphan tartrate, that act on the glutathione/γ-glutamyl pathway involved in protection against free radical damage, and also the antidepressant drug indatraline, were found to have high activity against stationary phase B. burgdorferi. Among the active hits, agents that affect cell membranes, energy production, and reactive oxygen species production are more active against the B. burgdorferi persisters than the commonly used antibiotics that inhibit macromolecule biosynthesis. Future studies are needed to evaluate and optimize the promising active hits in drug combination studies in vitro and also in vivo in animal models. These studies may have implications for developing more effective treatments of Lyme disease.

To identify effective compounds that are active against Staphylococcus aureus (S. aureus) persisters, we screened a clinical drug library consisting of 1524 compounds and identified six drug candidates that had anti-persister activity: tosufloxacin, clinafloxacin, sarafloxacin, doxycycline, thiostrepton, and chlorosalicylanilide. Among them, tosufloxacin had the highest anti-persister activity, which could completely eradicate S. aureus persisters within 2 days in vitro. Clinafloxacin ranked the second with very few persisters surviving the drug exposure. Interestingly, we found that both tosufloxacin and trovafloxacin that had high activity against persisters contained at the N-1 position the 2,4-difluorophenyl group, which is absent in other less active quinolones and may be associated with the high anti-persister activity. Further studies are needed to evaluate tosufloxacin in animal models and to explain its unique activity against bacterial persisters. Our findings may have implications for improved treatment of persistent bacterial infections.

Uropathogenic E. coli is a major cause of urinary tract infections (UTIs), but current antibiotics do not always effectively clear the persistent infection. To identify drugs that eliminate uropathogenic E. coli persisters, we screened a clinical drug library consisting of 1524 compounds using high throughput drug exposure assay in 96-well plates. Bacterial survival was assessed by growth on LB plates. We identified 14 drug candidates (tosufloxacin, colistin, sparfloxacin, moxifloxacin and gatifloxacin, enrofloxacin and sarafloxacin, octodrine, clofoctol, dibekacin, cephalosporin C, pazufloxacin, streptomycin and neomycin), which had high anti-persister activity. Among them, tosufloxacin and colistin had the highest anti-persister activity and could completely eradicate E. coli persisters in 3 days in vitro while the current UTI antibiotics failed to do so. Our findings may have implications for the development of a more effective treatment for UTIs.