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The objective of the study was to assess mortality rates in COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) who also requiring mechanical ventilation. The predictors of mortality in this cohort were analysed, and the clinical characteristics recorded.

Through the process of enteric fermentation, cattle produce methane (CH4), a potent greenhouse gas (GHG). Growing public concern about climate change has increased the need for accurate methods of measuring CH4 emissions from cattle directly to improve emission inventories and evaluate emissions mitigation techniques. The present study evaluated a ventilated head box system capable of measuring CH4 and carbon dioxide (CO2) emissions, and oxygen (O2) consumption from cattle. Six Holstein heifers were used to measure CH4 and CO2 emissions and O2 consumption from 2 ad libitum intake measurement periods (ADAPT and ADLIB) and 1 measurement period (RESTRICT) with intake restricted to 2% of BW on a DM basis. Methane emissions during RESTRICT were significantly lower (P < 0.0001) than both ad libitum periods. Daily CH4 emission rates per animal were 235.0 ± 6.19 L/d, 228.3 ± 6.18 L/d, and 193.2 ± 8.88 L/d for the periods ADAPT, ADLIB, and RESTRICT, respectively. Carbon dioxide emission rates were 3627 ± 90.72 L/d, 3632 ± 90.47, and 3184 ± 104.79 L/d for the ADAPT, ADLIB, and RESTRICT periods, respectively. Oxygen consumption rates were 3391 ± 99.77 L/d, 3454 ± 99.57 L/d, and 3002 ± 111.36 L/d for the periods ADAPT, ADLIB, and RESTRICT, respectively. The head box system evaluated provides an accurate method of measuring emissions from cattle and can provide information about daily variations and peaks in emissions. [ABSTRACT FROM AUTHOR]

RATIONALE: Tuberculosis (TB) remains a major cause of mortality. A better understanding of the immune responses to mycobacterial antigens may be helpful to develop improved vaccines and diagnostics. OBJECTIVES: The mycobacterial antigen heparin-binding hemagglutinin (HBHA) induces strong IFN-[gamma] responses by circulating lymphocytes from subjects latently infected with Mycobacterium tuberculosis, and low responses associated with CD4(+) regulatory T (Treg) cells in patients with TB. Here, we investigated HBHA-specific IFN-[gamma] responses at the site of the TB disease. METHODS: Bronchoalveolar lavages, pleural fluids, and blood were prospectively collected from 61 patients with a possible diagnosis of pulmonary or pleural TB. HBHA-specific IFN-[gamma] production was analyzed by flow cytometry and ELISA. The suppressive effect of pleural Treg cells was investigated by depletion experiments. MEASUREMENTS AND MAIN RESULTS: The percentages of HBHA-induced IFN-[gamma](+) alveolar and pleural lymphocytes were higher for pulmonary (P < 0.0001) and for pleural (P < 0.01) TB than for non-TB controls. Local CD4(+) and CD8(+) T cells produced the HBHA-specific IFN-[gamma]. This local secretion was not suppressed by Treg lymphocytes, contrasting with previously reported data on circulating lymphocytes. CONCLUSIONS: Patients with TB display differential effector and regulatory T-cell responses to HBHA in local and circulating lymphocytes with a predominant effector CD4(+) and CD8(+) response locally, compared with a predominant Treg response among circulating lymphocytes. These findings may be helpful for the design of new vaccines against TB, and the detection of HBHA-specific T cells at the site of the infection may be a promising tool for the rapid diagnosis of active TB. [ABSTRACT FROM AUTHOR]

Environmental concerns involving the dairy industry are shifting from an exclusive focus on water quality to encompass climate change and air quality issues. The dairy industry's climate change air emissions of concern are the greenhouse gases methane and nitrous oxide. With regard to air quality, the dairy industry's major emission contributions are particulate matter, volatile organic compounds, and ammonia. The emissions of these compounds from dairies can be variable because of a number of factors including weather conditions, animal type, management, and nutrition. To evaluate and compare emissions across the diverse operations that comprise the US dairy industry, emissions should be reported per unit of output (e.g., per kg of 3.5% fatcorrected milk). Accurately modeling emissions with models that can predict the complex bio-geochemical processes responsible for emissions is critical to assess current emissions inventories and develop mitigation strategies. Improving the dairy industry's production efficiency (e.g., improvements in management, nutrition, reproduction, and cow comfort) is an effective way to reduce emissions per unit of milk. With accurate process-based models, emissions reductions due to improved production efficiency could be reported per unit of milk and predicted on a farm-to-farm basis. [ABSTRACT FROM AUTHOR]

Temperament measures have been correlated to ADG and DMI in feedlot cattle. However, most of these experiments evaluate intake at the pen level, rather than within the individual animal. Moreover, some of these relationships are often investigated using an average temperament score (either over time or numerous measures) rather than a single measure of temperament. The objective of this experiment was to examine relationships between temperament measures and performance in individual beef steers based on initial temperament scores. Steers from one source (n = 105) were randomly allocated to 4 pens in 2 weight blocks. Steers were fed a common TMR 3 times each day at approximately 0700, 1000, and 1400 for 70 d. Individual feed and water intake (WI) were measured daily using an Insentec feeding system. Body weights, exit velocity (EV), and chute score (CS) were measured every 14 d. Exit velocity was measured over 1.5 m; CS was measured by the same trained observer and reported on a 1-4 scale, where 1 is calm and 4 is wild. Animals were assigned an EV and CS ranking based on initial measures. Chute score ranking was assigned according to the first measure. Animals 1 SD above the EV mean were ranked as a 2 and animals 1 SD below the mean were a 0, with animals between ranking a 1. Lower ranks are indicative of calmer temperament. Dry matter intake, ADG, G:F, and WI were split into 5 periods (d 0-14, 14-28, 0-28, 28-70, and 0-70). Data were analyzed using the MIXED procedure of SAS where the model included main effects of EV and CS; block was used as a random effect. There was no effect of EV or CS on DMI or WI for any period (P ≥ 0.90). There were no treatment effects for periods d 0-14, 14-28, or 0-70 (P ≥ 0.72). From d 0-28, steers with a CS of 2 or 3 had a increased ADG and G:F (P = 0.04) compared to steers with CS of 1 or 4. From d 28-70, steers with an EV of 1 had decreased ADG and G:F (P ≤ 0.05) compared to steers with EV of 0 or 2. Chute score may be more important for measures during early periods in the feedlot. Additionally, because each temperament measure related to performance in a different manner, this data supports the concept that CS and EV measure different underlying traits. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the effect of energy/monensin supplementation on CH4 emissions and performance of stocker calves grazing winter wheat (Triticum aestivum). Eight steers (BW = 261 ± 33 kg) and 8 heifers (BW = 240 ± 21 kg) were grazed in a 9-ha pasture with a GreenFeed CH4 measurement system (GEM; C-Lock Inc., Rapid City, SD) after initial adaptation in a dry lot. For 2 wk prior to treatments, baseline CH4 was measured for each animal. Calves were randomly assigned within sex to receive 0, 0.21, 0.43, 0.64, 0.86, or 1.07 kg/d of a supplement (primarily ground corn and wheat midds with mineral supplements and 150 mg/kg monensin.) The GEM bait feed was pelleted wheat midds. Calves were fed 3 d per wk in individual stalls and orts were weighed, so that actual supplement intake was used for analysis. It was assumed that some calves may not consume all available supplement, therefore two calves were assigned to the first 5 supplement levels and 6 assigned to the 1.07 kg/d treatment. This resulted in a relatively uniform distribution of actual supplement intakes in the range of 0.53 to 1.46 kg/d, when GEM bait intake was included. Forage intake was estimated by bolusing TiO2 for 14 days then collecting feces for 5 d, at the end of the experiment, using TiO2 and iADF as external and internal markers. Because several predictor variables were available, dependent variables of interest were subjected to backwards stepwise regression (PROC GLMSELECT in SAS) with baseline CH4, total supplement intake, forage intake, initial BW, sex, and monensin dose in the model. Animal performance increased linearly with total supplement intake and forage intake (P ≤ 0.02; R2 = 0.45). Supplement intake quadratically reduced forage intake (P = 0.01; R2 = 0.47). Methane production increased with increasing forage intake and initial BW, but the heifers produced less CH4 than steers (P = 0.01; R2= 0.74). Methane yield (g CH4/ kg of intake) decreased with increasing DMI and decreasing BW, and heifers yielded less CH4 than steers (P ≤ 0.01; R2 = 0.84). Supplement intake reduced CH4 emission intensity (g CH4/kg BW gain; P = 0.03). These results suggest that supplementing cattle grazing wheat pasture with an energy/monensin supplement improves sustainability. [ABSTRACT FROM AUTHOR]

Reactive nitrogen (Nr) emissions from beef cattle production can contribute to both air and water pollution. However, Nr (biologically available N) is also essential for the growth of plants and animals. Feed N intake is the major driver of total Nr excretion by beef cattle and most feed N is in the form of dietary protein. Beef cattle excrete Nr into the environment in 2 main ways: the feces and urine. Most fecal N is excreted in an organic form and sources can include undigested feed N, microbial N, and endogenous N. Urinary N is excreted mostly as urea, but also includes compounds such as purine derivatives and creatinine. As N intake of cattle increases, both fecal N and urinary N excretion will increase; however, urinary N is excreted at an increasing rate as compared to fecal N. Once excreted from the animal, urinary N, and especially urea-N, can undergo several transformations that can lead to an increase in Nr in the environment. Specifically, urinary urea-N can be converted to ammonium/ammonia and then be emitted to the atmosphere as ammonia gas through volatilization. Ammonia can lead to particulate matter formation, acidification of terrestrial and aquatic ecosystems, and eutrophication of water bodies once deposited. Alternatively, ammonium can undergo the biological process of nitrification in soil leading to the production of nitrate (NO3-), which may be used by plants or microorganisms or leached into groundwater. Nitrate can undergo the biological process of denitrification, thereby leading to the production of nitrogen gas (N2). During the denitrification process, nitric oxide (NO) and nitrogen dioxide (NO2) can be emitted (collectively known as NOx) as can the potent greenhouse gas nitrous oxide (N2O). Emissions of NOx can lead to particulate matter formation and can drive the production of tropospheric ozone. In addition to being a greenhouse gas 265 times more potent than carbon dioxide at trapping heat in the Earth's atmosphere on a 100-yr time scale, N2O emissions can also lead to the destruction of stratospheric ozone. Thus, feeding dietary protein at concentrations above animal requirements can lead to an increase Nr emissions from beef cattle production and negative environmental sustainability outcomes. [ABSTRACT FROM AUTHOR]

The objective of this experiment was to determine the effect of whole cottonseed (WCS) supplementation on average daily gain (ADG) and enteric methane (CH4) production of steers grazing native range during spring. Steers (n = 18; body weight = 317 ± 5.5 kg) were adapted to an in-pasture CH4 measurement device (GreenFeed (GF); C-Lock Inc., Rapid City, South Dakota) for one week. Steers were stratified by adaptation-period use of GF and randomly assigned to treatments within stratifications. Treatments were either 0, 0.9, 1.8, 2.7, 3.6, or 4.5 kg of WCS (as-fed) per day offered in individual feeding stanchions. Orts were measured and actual WCS intake was used in the analysis. Unshrunk body weight was measured weekly before feeding for the duration of the experiment. Mean supplement intake per animal ranged from 0.89 to 2.86 kg per day. Total fat content of the diet (WCS + forage) at the greatest WCS intake was estimated to be 6.4%. Animal performance increased linearly as WCS intake increased (P = 0.02). Two of the three steers assigned to the 0 WCS treatment refused to use GF, and therefore CH4 emissions were unavailable. Because only one observation was available at 0 WCS, and the Cook's Distance of this point was greater than one (Di ≥ 7.48), the 0 WCS observation was excluded from further analysis. There tended to be a quadratic relationship between daily methane production (g of CH4 per animal per day) and WCS intake (P = 0.057), and there was a significant quadratic relationship between emission intensity (g of CH4 per kg of ADG) and WCS intake (P = 0.011) indicating minimum CFP at 2.0 kg WCS intake. The increased animal performance associated with WCS supplementation decreased emission intensity at moderate levels of supplementation. If ranchers choose to feed WCS to minimize emission intensity of steers grazing spring native range, they should feed approximately 2.0 kg per day of WCS. [ABSTRACT FROM AUTHOR]

Investigates the response of heat shock protein (HSP) on notothenoid fish by researchers from Santa Barbara, California. Significance of the cellular protection system in providing different species protection against the catastrophic effects of heat damage; Reasons behind failure of the researchers to elicit a heat shock response after exposing the liver cells extracted from the fish to stressful conditions; Use of HSP to protect the fish from the permanent threat of cold protein damage in its natural habitat on the icy waters around Antarctica.

The objective of this experiment was to demonstrate the effectiveness of a commercially available tannin product (Silvafeed ® ByPro, 70% tannic acid) as an enteric methane (CH 4 ) mitigation and preventative animal health strategy in Holstein heifers (BW = 219 ± 17 kg; 9 mo), reared under organic production system requirements. Twenty heifers were randomly assigned to one of four commercial tannin supplementation treatments as follows: 0% (0 g/hd/d; CON), 0.075% (~5 g/hd/d; LOW), 0.15% (~10 g/hd/d; MED), and 0.30% (~21 g/hd/d; HIG) of dry matter intake (DMI). Heifers received their treatment in individual animal feeding stanchions and were fed a basal total mixed ration (TMR) through four SmartFeed Pro intake measurement bunk systems (C-Lock Inc., Rapid City, SD, USA) for 45 d. An automatic head chamber system (AHCS; i.e., GreenFeed, C-Lock Inc., Rapid City, SD, USA) was used to continuously evaluate enteric CH 4 production. No effect was observed among the treatments for CH 4 emissions ( p ≥ 0.55), animal performance ( p ≥ 0.38), or oxidative stress biomarker concentration ( p ≥ 0.55). Superoxide dismutase (SOD) and reduced glutathione (GSH) concentrations exhibited a linear response to increasing tannin dose ( p = 0.003), indicating a potential tannin effect on the antioxidant status of dairy heifers. This observation may encourage future tannin research relating to animal health, which may be of particular interest to organic dairy systems. The results of this study suggest that tannin supplementation at 0%, 0.075%, 0.15%, and 0.30% of DMI, did not alter CH 4 emissions, animal performance, or oxidative stress biomarker concentration in organic Holstein heifers when assessed under an on-farm research approach. Further, the results of this study affirm the challenges associated with on-farm research and the development of climate-smart strategies that are capable of mitigating climate impacts in less controlled environments under standard working conditions.

The purpose of this study was to: (1) understand heat mitigation strategies currently used and recommended by feedyard operators, veterinarians, and nutritionists, (2) understand their perceptions of heat mitigation strategies related to cattle health, performance, welfare, and carcass quality, (3) quantify the frequency of extreme heat events, and (4) understand industry needs associated with heat stress mitigation strategies. An online survey was shared via 11 industry association listservs. Descriptive statistics were performed on 56 responses (n = 22 operators, 26 veterinarians and eight nutritionists). Thematic analysis was performed on free-response questions. Sixteen (72.7%) operators, 23 (88.5%) veterinarians and eight (100%) nutritionists utilized at least one heat mitigation strategy. "Changing processing and shipping hours" (n = 42, 75%) had the most "strongly agree" responses when asked about strategy effectiveness. The majority of respondents agreed that heat stress negatively impacts cattle health, performance, and welfare (Mean ± SD; ≥7.8 ± 2.6 for all roles). Forty-two (75%) respondents experienced cattle death loss from extreme heat events. Thematic analysis indicated that respondents perceived pen infrastructure and water/feed management as important considerations for better mitigating heat stress impacts. When asked what resources would be helpful, respondents indicated research and data regarding the effectiveness of various strategies.

The US dairy industry has made substantial gains in reducing the greenhouse gas emission intensity of a gallon of milk. At the same time, consumer and investor interest for improved environmental benefits or reduced environmental impact of food production continues to grow. Following a trend of increasing greenhouse gas emission commitments for businesses across sectors of the economy, the US dairy industry has committed to a goal of net zero greenhouse gas emissions by 2050. The Paris Climate Accord's goal is to reduce warming of the atmosphere to less than 1.5 to 2°C based on preindustrial levels, which is different from emission goals of historic climate agreements that focus on emission reduction targets. Most of the emissions that account for the greenhouse gas footprint of a gallon of milk are from the short-lived climate pollutant CH 4 , which has a half-life of approximately 10 yr. The relatively new accounting system Global Warming Potential Star and the unit CO 2 warming equivalents gives the industry the appropriate metrics to quantify their current and projected warming impact on future emissions. Incorporating this metric into potential future emissions pathways can allow the industry to understand the magnitude of emissions reductions needed to no longer contribute additional warming. Deterministic modeling was performed across the dairy industry's emission areas of enteric fermentation, manure management, feed production, and other upstream emissions necessary for dairy production. By reducing farm-level absolute emissions by 23% based on current levels, there is the opportunity for the US dairy industry to realize climate neutrality within the next few decades., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Infectious sacroiliitis is a rare disease that can occur in conjunction with other osteoarticular infections. Furthermore, it is very unusual for Listeria monocytogenes to be identified in an osteoarticular infection, with spondylodiscitis being the most frequent such infection. We report a case of spondylodiscitis with infectious sacroiliitis due to infection with L. monocytogenes treated successfully with meropenem as salvage therapy., Learning Points: It is very unusual for Listeria monocytogenes to be identified in an osteoarticular infection. L. monocytogenes can cause infectious sacroiliitis, which is a rare disease.Meropenem has been proposed as salvage therapy and was successful in our case., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2022.)

Aims. Health care workers (HCWs) are at risk of acquiring the Severe Acute Respiratory Syndrome Coronavirus 2 Infection (SARS-CoV-2). The aim of the study is to determine the SARS-CoV-2 positivity rates during the first epidemiologic peak among HCWs of a south Belgian hospital and to identify risks factors for infection. Methods. All hospital staff who worked during the first epidemiological peak were asked to answer a questionnaire regarding demographical data, function, type of working unit, type of contact with patients, eventual symptomatology, and the positivity of reverse transcription-polymerase chain reaction (RT-PCR) testing or immunoassay. Results . A total of 235 questionnaires were collected; 90 (38%) HCWs tested positive for SARS-CoV-2 from either RT-PCR or immunoassay testing. The positivity rate of HCWs between wards was statistically different ( p = 0.004) and was higher in COVID-19 wards than Intensive Care Unit (ICU) and Emergency Department (ED). A total of 114 (49%) HCWs presented SARS-CoV-2-compatible symptomatology; 79 (88%) were positive on either RT-PCR or immunoassay testing; 74 (37%) HCWs were unable to work during the studied period; 5 were hospitalized. No deaths were reported. Multivariate logistic regression modeling showed that having symptoms was highly associated with test positivity (OR 23.3, CI 11.1, 53.1, p -value < 0.001). Working in a COVID-19 ward against working in ICU or ED was also predictive of positivity among HCWs (OR 3.25, CI 1.50, 7.28, p -value = 0.003). Discussion and Conclusions. This study shows a higher positivity rate compared to already reported positivity rates among HCWs. Reported differences in positivity rates depend on many factors, such as local crisis intensity, screening strategy, training in use of self-protective equipment, and study selection bias. HCWs working in COVID-19 wards, in comparison to ED and ICU, seemed at greater risk of being infected in this study. This could be explained by the disparity of HCWs' experience in handling self-protective equipment and knowledge in infection prevention. Hence, care should be taken in proper training for less-experienced HCWs during hospital epidemics. The latter could increase HCWs' protection and consequently decrease work absenteeism, ensuring enhanced continuity of patient care during hospital crisis. Rapid quarantine of symptomatic HCWs could reduce contamination rates, as having symptoms was highly associated with test positivity in this study.

Aim: The objective of the study was to assess mortality rates in COVID-19 patients suffering from acute respiratory distress syndrome (ARDS) who also requiring mechanical ventilation. The predictors of mortality in this cohort were analysed, and the clinical characteristics recorded., Material and Method: A single centre retrospective study was conducted on all COVID-19 patients admitted to the intensive care unit of the Epicura Hospital Center, Province of Hainaut, Belgium, between March 1st and April 30th 2020., Results: Forty-nine patients were included in the study of which thirty-four were male, and fifteen were female. The mean (SD) age was 68.8 (10.6) and 69.5 (12.6) for males and females, respectively. The median time to death after the onset of symptoms was eighteen days. The median time to death, after hospital admission was nine days. By the end of the thirty days follow-up, twenty-seven patients (55%) had died, and twenty-two (45%) had survived. Non-survivors, as compared to those who survived, were similar in gender, prescribed medications, COVID-19 symptoms, with similar laboratory test results. They were significantly older (p = 0.007), with a higher co-morbidity burden (p = 0.026) and underwent significantly less tra-cheostomy (p < 0.001). In multivariable logistic regression analysis, no parameter significantly predicted mortality., Conclusions: This study reported a mortality rate of 55% in critically ill COVID-19 patients with ARDS who also required mechanical ventilation. The results corroborate previous findings that older and more comorbid patients represent the population at most risk of a poor outcome in this setting., Competing Interests: Conflict of interest None to declare., (© 2021 Christophe de Terwangne, Antonio Sorgente, Redente Tortora, Diana Cheung, Frederic Duprez, Sammy Place, Jerome R. Lechien, Lucio Capulzini, Michael De Cubber, Sven Saussez, Fabio Silvio Taccone, Shahram Mashayekhi, published by Sciendo.)

Assess the predictive accuracy of the WHO COVID-19 severity classification on COVID-19 hospitalized patients. The secondary aim was to compare its predictive power with a new prediction model, named COVID-19 EPI-SCORE, based on a Bayesian network analysis. Methods : We retrospectively analyzed a population of 295 COVID-19 RT-PCR positive patients hospitalized at Epicura Hospital Center, Belgium, admitted between March 1st and April 30th, 2020. Results: Our cohort's median age was 73 (62-83) years, and the female proportion was 43%. All patients were classified following WHO severity classification at admission. In total, 125 (42.4%) were classified as Moderate , 69 (23.4%) as Severe , and 101 (34.2%) as Critical . Death proportions through these three classes were 11.2%, 33.3%, and 67.3%, respectively, and the proportions of critically ill patients (dead or needed Invasive Mechanical Ventilation) were 11.2%, 34.8%, and 83.2%, respectively. A Bayesian network analysis was used to create a model to analyze predictive accuracy of the WHO severity classification and to create the EPI-SCORE. The six variables that have been automatically selected by our machine learning algorithm were the WHO severity classification, acute kidney injury, age, Lactate Dehydrogenase Levels (LDH), lymphocytes and activated prothrombin time (aPTT). Receiver Operation Characteristic (ROC) curve indexes hereby obtained were 83.8% and 91% for the models based on WHO classification only and our EPI-SCORE, respectively. Conclusions: Our study shows that the WHO severity classification is reliable in predicting a severe outcome among COVID-19 patients. The addition to this classification of a few clinical and laboratory variables as per our COVID-19 EPI-SCORE has demonstrated to significantly increase its accuracy.

Hydroxychloroquine has been used worldwide as a first-line treatment for patients hospitalized with COVID-19. Little is known about COVID-19 and its effects on patients with congenital red blood cell disorders. We report a case of haemolytic anaemia in a 32-year-old patient and a fortuitous highlighting of G6PD deficiency. We reviewed the literature to assess the risk of hydroxychloroquine use in this context., Learning Points: A rapid drop in haemoglobin in COVID-19 patients should alert physicians to test for haemolytic anaemia and enzymopathies.Our review of the literature shows that use of hydroxychloroquine is safe in G6PD-deficient patients., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)

Background: Advances in mobile health (mHealth) technology have made it possible for patients and health care providers to monitor and track behavioral health symptoms in real time. Ideally, mHealth apps include both passive and interactive monitoring and demonstrate high levels of patient engagement. Digital phenotyping, the measurement of individual technology usage, provides insight into individual behaviors associated with mental health., Objective: Researchers at a Veterans Affairs Medical Center and Cogito Corporation sought to explore the feasibility and acceptability of an mHealth app, the Cogito Companion., Methods: A mixed methodological approach was used to investigate the feasibility and acceptability of the app. Veterans completed clinical interviews and self-report measures, at baseline and at a 3-month follow-up. During the data collection period, participants were provided access to the Cogito Companion smartphone app. The mobile app gathered passive and active behavioral health indicators. Data collected (eg, vocal features and digital phenotyping of everyday social signals) are analyzed in real time. Passive data collected include location via global positioning system (GPS), phone calls, and SMS text message metadata. Four primary model scores were identified as being predictive of the presence or absence of depression or posttraumatic stress disorder (PTSD). Veterans Affairs clinicians monitored a provider dashboard and conducted clinical outreach when indicated., Results: Findings suggest that use of the Cogito Companion app was feasible and acceptable. Veterans (n=83) were interested in and used the app; however, active use declined over time. Nonetheless, data were passively collected, and outreach occurred throughout the study period. On the Client Satisfaction Questionnaire-8, 79% (53/67) of the sample reported scores demonstrating acceptability of the app (mean 26.2, SD 4.3). Many veterans reported liking specific app features (day-to-day monitoring) and the sense of connection they felt with the study clinicians who conducted outreach. Only a small percentage (4/67, 6%) reported concerns regarding personal privacy., Conclusions: Feasibility and acceptability of the Cogito Corporation platform to monitor mental health symptoms, behaviors, and facilitate follow-up in a sample of veterans were supported. Clinically, platforms such as the Cogito Companion system may serve as useful methods to promote monitoring, thereby facilitating early identification of risk and mitigating negative psychiatric outcomes, such as suicide., (©Lisa M Betthauser, Kelly A Stearns-Yoder, Suzanne McGarity, Victoria Smith, Skyler Place, Lisa A Brenner. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.08.2020.)

Objective: We investigate the prevalence of the self-reported and objective sudden loss of smell (SLS) in patients with severe coronavirus disease 2019 (COVID-19)., Methods: Severe COVID-19 patients with self-reported SLS were recruited at hospitalization discharge. Epidemiological and clinical data were collected. The Sino-nasal Outcome Test-22 (SNOT-22) was used to evaluate rhinological complaints. Subjective olfactory and gustatory functions were assessed with the National Health and Nutrition Examination Survey (NHNES). Objective SLS was evaluated using psychophysical tests. Potential associations between olfactory evaluation and the clinical outcomes (duration of hospitalization; admission biology; one month serology (IgG), and chest computed tomography findings) were studied., Results: Forty-seven patients completed the study (25 females). Subjectively, eighteen (38.3%) individuals self-reported subjective partial or total SLS. Among them, only three and four were anosmic and hyposmic, respectively (38.9%). Considering the objective evaluation in the entire cohort, the prevalence of SLS was 21.3%. Elderly patients and those with diabetes had lower objective olfactory evaluation results than young and non-diabetic individuals., Conclusions: The prevalence of SLS in severe COVID-19 patients appears to be lower than previously estimated in mild-to-moderate COVID-19 forms. Future comparative studies are needed to explore the predictive value of SLS for COVID-19 severity.

Background: S arcoidosis is a multisystemic disease producing non-caseating granulomas. The aetiology and pathogenesis are unknown. We herewith report an atypical case of cutaneous sarcoidosis., Case Presentation: A 50-year-old female presented with an onset of multiple subcutaneous nodules on her 4 limbs. These nodules appeared concomitantly with the initiation of radioactive iodine therapy for papillary thyroid cancer. These nodules were not obvious on inspection of the skin, but easily felt on palpation.The biopsy of the subcutaneous nodules revealed hypodermic non-caseating granulomas consistent with sarcoidosis. The patient underwent an 18F-fluorodeoxyglucose positron emission tomography (PET) scan study that revealed, besides the subcutaneous nodules, multiple hypermetabolic mediastinal lymphadenopathies and cervical adenopathies. Biopsy of the mediastinal lymphadenopathy showed neither granulomas nor neoplastic cells. Cervical biopsy revealed neoplastic cells of thyroid origin. Laboratory tests were normal. Bronchoalveolar lavage showed a normal CD4/CD8 T-cell ratio.A diagnosis of cutaneous sarcoidosis was established, as well as a recurrence of the cancerous disease. The subcutaneous nodules regressed spontaneously in the absence of any treatment., Discussion and Conclusion: S arcoidosis is a multisystemic disease of unknown origin. This case illustrates an uncommon occurrence of sarcoidosis, triggered by radioactive iodine therapy. Radioiodine may lead to immunological changes, especially affecting the Th1/Th2 ratio, which may promote the emergence of sarcoidosis in genetically predisposed patients. There is still much to discover to fully understand the pathogenesis of sarcoidosis., Learning Points: The immunopathogenesis of sarcoidosis is poorly understood, as well as the environmental factors involved.Radioactive iodine therapy for thyroid cancer treatment may be an environmental trigger.The immunological changes induced by radioiodine, especially with respect to the Th1/Th2 ratio, may promote occurrence of sarcoidosis in genetically predisposed patients., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)

The aim of this study was to assess if women with a low first trimester maternal pregnancy-associated plasma protein-A (PAPP-A) level are at increased risk of emergency cesarean (EmCS) for intrapartum fetal compromise (IFC) and/or adverse neonatal outcomes. This was a retrospective cohort study performed at Mater Mother's Hospital, Brisbane, Australia, between 2016 and 2018. All women with a singleton, euploid, non-anomalous fetus with a documented PAPP-A level measured between 10 +0 and 13 +6 weeks gestation during the study period were included. Data were extracted from the institution's perinatal database and dichotomized according to PAPP-A level (≤0.4 Multiples of Medium (MoM) vs. >0.4 MoM). The primary outcomes were EmCS-IFC and a composite of severe adverse neonatal outcomes (SCNO). Nine thousand sixty-one pregnancies were included, 3.3% with a PAPP-A ≤ 0.4 MoM. Low maternal PAPP-A was not associated with an increased risk of EmCS-IFC (adjusted odds ratio (aOR) 0.77, 95% confidence interval (CI) 0.24-2.46, p = 0.66) or SCNO (aOR 0.65, 95% CI 0.39-1.07, p = 0.09). Low PAPP-A was associated with increased odds of pre-eclampsia, preterm birth and birthweight < 10th centile. In conclusion, low maternal PAPP-A level is not associated with an increased risk of EmCS IFC or adverse neonatal outcomes despite greater odds of low-birthweight infants and preterm birth.

A new methodology is presented using well known electrical characterization techniques on dedicated single devices in order to investigate backside interface contribution to the measured pixel dark current in BSI CMOS image sensors technologies. Extractions of interface states and charges within the dielectric densities are achieved. The results show that, in our case, the density of state is not directly the source of dark current excursions. The quality of the passivation of the backside interface appears to be the key factor. Thanks to the presented new test structures, it has been demonstrated that the backside interface contribution to dark current can be investigated separately from other sources of dark current, such as the frontside interface, DTI (deep trench isolation), etc.

We describe a 66-year old patient with a recurrent ulcer on her right ankle. Biopsy revealed medium-vessel vasculitis consistent with cutaneous polyarteritis nodosa. There were no signs or symptoms suggestive of systemic vasculitis, but a 18FDG-PET scan showed areas of increased uptake around the large arteries and the pelvic and shoulder girdles. These findings suggested polymyalgia rheumatica in the setting of large-vessel vasculitis. This case thus supports the statement from the Chapel-Hill consensus conference that classification of systemic vasculitis by vessel size is based on the vessels predominantly involved, but vessels of other sizes may also be affected., Learning Points: The classification of vasculitis needs further refinement as some patients may not easily fit into just one category.Conditions that include aspects of different vasculitis also exist and cannot be classified using the Chapel Hill nomenclature.The role of PET scan in the assessment of PAN needs further evaluation., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interest, (© EFIM 2019.)

We examined the dose-dependent effects of feeding lactating dairy cows a standard diet supplemented with monensin at 175, 368, or 518 mg cow -1 day -1 on the rumen microbiota. For each dosage, 3 animals were randomly assigned into groups and fed the same basal total mixed ration diet supplemented with monensin, at the respective dose. After 20 days, rumen samples were taken and the effect on the microbiota was examined by 16S rRNA gene sequence analysis and qPCR. At the lowest dose no significant change in 16S rRNA gene sequences associated with any bacterial phyla was observed; however, at the medium and high dosages, we observed significant reductions in sequences associated with gram-positive bacteria and significant increases in those associated with gram-negative bacteria that were dosage dependent. All dosages reduced the levels of sequences associated with methanogenic archaea in the rumen, with the medium dosage showing the largest decline. No significant difference was observed for the 18S rRNA gene sequences associated with protozoa in any of the libraries. Our results indicate that with this diet the medium dosage of monensin was most efficacious for the reduction in methanogenic archaea in the rumen of lactating dairy., (© 2018 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Background: There is a critical need for real-time tracking of behavioral indicators of mental disorders. Mobile sensing platforms that objectively and noninvasively collect, store, and analyze behavioral indicators have not yet been clinically validated or scalable., Objective: The aim of our study was to report on models of clinical symptoms for post-traumatic stress disorder (PTSD) and depression derived from a scalable mobile sensing platform., Methods: A total of 73 participants (67% [49/73] male, 48% [35/73] non-Hispanic white, 33% [24/73] veteran status) who reported at least one symptom of PTSD or depression completed a 12-week field trial. Behavioral indicators were collected through the noninvasive mobile sensing platform on participants' mobile phones. Clinical symptoms were measured through validated clinical interviews with a licensed clinical social worker. A combination hypothesis and data-driven approach was used to derive key features for modeling symptoms, including the sum of outgoing calls, count of unique numbers texted, absolute distance traveled, dynamic variation of the voice, speaking rate, and voice quality. Participants also reported ease of use and data sharing concerns., Results: Behavioral indicators predicted clinically assessed symptoms of depression and PTSD (cross-validated area under the curve [AUC] for depressed mood=.74, fatigue=.56, interest in activities=.75, and social connectedness=.83). Participants reported comfort sharing individual data with physicians (Mean 3.08, SD 1.22), mental health providers (Mean 3.25, SD 1.39), and medical researchers (Mean 3.03, SD 1.36)., Conclusions: Behavioral indicators passively collected through a mobile sensing platform predicted symptoms of depression and PTSD. The use of mobile sensing platforms can provide clinically validated behavioral indicators in real time; however, further validation of these models and this platform in large clinical samples is needed., (©Skyler Place, Danielle Blanch-Hartigan, Channah Rubin, Cristina Gorrostieta, Caroline Mead, John Kane, Brian P Marx, Joshua Feast, Thilo Deckersbach, Alex “Sandy” Pentland, Andrew Nierenberg, Ali Azarbayejani. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 16.03.2017.)