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Toxoplasma gondii is a globally distributed zoonotic protozoan parasite. Infection with T. gondii can cause congenital toxoplasmosis in developing fetuses and acute outbreaks in the general population, and the disease burden is especially high in South America. Prior studies found that the environmental stage of T. gondii, oocysts, is an important source of infection in Brazil; however, no studies have quantified this risk relative to other parasite stages. We developed a Bayesian quantitative risk assessment (QRA) to estimate the relative attribution of the two primary parasite stages (bradyzoite and oocyst) that can be transmitted in foods to people in Brazil. Oocyst contamination in fruits and greens contributed significantly more to overall estimated T. gondii infections than bradyzoite-contaminated foods (beef, pork, poultry). In sensitivity analysis, treatment, i.e., cooking temperature for meat and washing efficiency for produce, most strongly affected the estimated toxoplasmosis incidence rate. Due to the lack of regional food contamination prevalence data and the high level of uncertainty in many model parameters, this analysis provides an initial estimate of the relative importance of food products. Important knowledge gaps for oocyst-borne infections were identified and can drive future studies to improve risk assessments and effective policy actions to reduce human toxoplasmosis in Brazil.

Oocyst shedding in domestic and wild felids is a critical yet understudied topic in Toxoplasma gondii ecology and epidemiology that shapes human and animal disease burden. We synthesized published literature dating from the discovery of felids as the definitive hosts of T. gondii in the 1960s through March 2021 to examine shedding prevalence, oocyst genotypes, and risk factors for shedding. Oocyst shedding prevalence in many geographic regions exceeded the commonly accepted 1% reported for domestic cats; crude prevalence from cross-sectional field studies of domestic cat shedding ranged from 0% in Australia to 18.8% in Africa, with greater variation in reports of oocyst shedding in free-ranging, wild felids. Shedding in wild felid species has primarily been described in captive animals, with attempted detection of oocyst shedding reported in at least 31 species. Differences in lifestyle and diet play an important role in explaining shedding variation between free-ranging unowned domestic cats, owned domestic cats, and wild felids. Additional risk factors for shedding include the route of infection, diet, age, and immune status of the host. It is widely reported that cats only shed oocysts after initial infection with T. gondii, but experimental studies have shown that repeat oocyst shedding can occur. Factors associated with repeat shedding are common amongst free-ranging felids (domestic and wild), which are more likely to eat infected prey, be exposed to diverse T. gondii genotypes, and have coinfections with other parasites. Repeat shedding events could play a significant yet currently ignored role in shaping environmental oocyst loading with implications for human and animal exposure. Oocyst presence in the environment is closely linked to climate variables such as temperature and precipitation, so in quantifying risk of exposure, it is important to consider the burden of T. gondii oocysts that can accumulate over time in diverse environmental matrices and sites, as well as the spatial heterogeneity of free-ranging cat populations. Key directions for future research include investigating oocyst shedding in under-sampled regions, genotyping of oocysts detected in feces, and longitudinal studies of oocyst shedding in free-ranging felids. This article is protected by copyright. All rights reserved.

Post-acute sequelae of COVID-19, also known as "long COVID," is used to describe the long-term symptoms that might be experienced weeks to months after primary infection with SARS-CoV-2, the virus that causes COVID-19. Among persons with a previous COVID-19 diagnosis, estimates of the prevalence of sequelae range from 5% among nonhospitalized persons to 80% among hospitalized persons (1,2). Studies have analyzed the aftereffects of COVID-19, but few have assessed the demographic characteristics associated with long COVID (3,4). Health disparities resulting from pervasive structural and socioeconomic barriers in the U.S. health care system might contribute to differences in these effects and might continue to exacerbate existing inequities (5). To identify trends in post-acute sequelae, the Long Beach Department of Health and Human Services (LBDHHS) interviewed a random sample of 366 persons aged ≥18 years who received a positive SARS-CoV-2 test result during April 1-December 10, 2020. One third of the persons interviewed reported having at least one symptom 2 months after their positive test result, with higher odds of sequelae among persons aged 40-54 years, females, and those with preexisting conditions. Black or African American (Black) participants had higher odds of reporting dyspnea and myalgia/arthralgia compared with other racial/ethnic groups. Persons who were aged ≥40 years, female, Black, or who reported known preexisting conditions also reported higher numbers of distinct sequelae. As the number of recovered COVID-19 patients increases, monitoring the prevalence of post-acute sequelae among larger cohorts in diverse populations will be necessary to understand and manage this condition. Identification of groups disproportionately affected by post-acute COVID-19 sequelae can help develop efforts to prioritize preventions and treatment strategies, including vaccination of groups at higher risk for these long-term sequelae, and access to testing and care for post-acute sequelae.

For a positive real number $\alpha$, let $\mathbb{N}_0[\alpha,\alpha^{-1}]$ be the semiring of all real numbers $f(\alpha)$ for $f(x)$ lying in $\mathbb{N}_0[x,x^{-1}]$, which is the semiring of all Laurent polynomials over the set of nonnegative integers $\mathbb{N}_0$. In this paper, we study various factorization properties of the additive structure of $\mathbb{N}_0[\alpha, \alpha^{-1}]$. We characterize when $\mathbb{N}_0[\alpha, \alpha^{-1}]$ is atomic. Then we characterize when $\mathbb{N}_0[\alpha, \alpha^{-1}]$ satisfies the ascending chain condition on principal ideals in terms of certain well-studied factorization properties. Finally, we characterize when $\mathbb{N}_0[\alpha, \alpha^{-1}]$ satisfies the unique factorization property and show that, when this is not the case, $\mathbb{N}_0[\alpha, \alpha^{-1}]$ has infinite elasticity., Comment: 16 pages

White-tailed deer Odocoileus virginianus are the most popular big game animal in the United States. Recreational harvest of these animals is a critical tool in population management, as well as an important financial resource for state economies and wildlife agencies. Thus, herd health evaluations can provide information to wildlife managers tasked with developing sustainable harvest practices while monitoring for emergent problems. The purpose of our study was to document causes of illness and natural mortality in New York white-tailed deer submitted for post mortem evaluation. Animals were presented by members of the public and wildlife management personnel due to abnormal behavior or unexplained death. We describe demographic and seasonal associations among gross and histologic evaluation and diagnostic testing. Post mortem examinations were performed on 735 white-tailed deer submitted for necropsy in New York from January 2011 to November 2017. Causes of euthanasia or mortality were classified into nine categories. The most common findings were bacterial infections, trauma not evident at time of collection, and nutritional issues, primarily starvation. Using a multinomial logistic regression model, we looked for associations between the mortality categories and age, sex and season. Compared to the baseline of bacterial deaths, adults were less likely to have died from nutritional and parasitic causes, males were less likely to have died from other causes, and risk of death from nutritional reasons decreased from season to season, with lowest risk in winter. These methods can help wildlife biologists track changes in disease dynamics over time.

Purpose The purpose of this systematic review is to characterize the complications associated with superior capsule reconstruction (SCR) for the treatment of functionally irreparable rotator cuff tears (FIRCTs). Methods This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two independent reviewers completed a search of PubMed, Embase, and Medline databases. Studies were deemed eligible for inclusion if they reported postoperative outcomes of arthroscopic SCR for FIRCTs and considered at least 1 postoperative complication. Statistical heterogeneity was quantified via the I2 statistic. Due to marked heterogeneity, pooled proportions were not reported. All complications and patient-reported outcomes were described qualitatively. Results Fourteen studies met the inclusion/exclusion criteria. The overall complication rate post-SCR ranged from 5.0% to 70.0% (I2 = 84.9%). Image-verified graft retear ranged from 8% to 70%, I2 = 79.4%), with higher rates reported when SCR was performed using allograft (19%-70%, I2 76.6%) compared to autograft (8%-29%, I2 = 66.1%). Reoperation (0%-36%, I2 = 73.4%), revision surgeries (0%-21%, I2 = 81.2%), medical complications (0%-5%, I2 = 0.0%), and infections (0%-5%, I2 = 0.0%) were also calculated. Conclusions SCR carries a distinct complication profile when used for the treatment of FIRCTs. The overall rate of complications ranged from 5.0% to 70.0%. The most common complication is graft retear with higher ranges in allografts (19%-70%) compared to autografts (8%-29%). The majority of studies reported at least 1 reoperation (range, 0%-36%), most commonly for revision to reverse shoulder arthroplasty. Level of Evidence Level IV, systematic review of Level IV or better investigations.

Neurofilaments (NFs) are structural proteins of neurons that are released in significant quantities in the cerebrospinal fluid and blood as a result of neuronal degeneration or axonal damage. Therefore, NFs have potential as biomarkers for neurologic disorders. Neural degeneration increases with age and has the potential to confound the utility of NFs as biomarkers in the diagnosis of neurologic disorders. We investigated this relationship in horses with and without neurological diagnosis. While controlling for horse type (draft, pleasure, and racing), we evaluated the relationship between serum heavy-chain phosphorylated neurofilaments (pNF-H) and age, sex, and serum vitamin E concentrations. Serum pNF-H concentrations increased by 0.002 ng/ml for each year increase in age. There were significant differences in the serum pNF-H concentration among the type of activity performed by the horse. The highest serum pNF-H concentration was found in horses performing heavy work activity (racehorse) and with lower serum pNF-H concentration found among light (pleasure riding) and moderate (draft) activity. There was no significant association between the pNF-H concentration and sex or vitamin E concentration. Serum pNF-H concentration was elevated among horses afflicted with EMND and EPM when compared with control horses without evidence of neurologic disorders. Accordingly, serum pNF-H concentration can serve as a useful biomarker to complement the existing diagnostic work-up of horses suspected of having EPM or EMND.

Dromedary, or one-humped, camels Camelus dromedarius are an almost exclusively domesticated species that are common in arid areas as both beasts of burden and production animals for meat and milk. Currently, there are approximately 30 million dromedary camels, with highest numbers in Africa and the Middle East. The hardiness of camels in arid regions has made humans more dependent on them, especially as a stable protein source. Camels also carry and may transmit disease-causing agents to humans and other animals. The ability for camels to act as a point source or vector for disease is a concern due to increasing human demands for meat, lack of biosafety and biosecurity protocols in many regions, and a growth in the interface with wildlife as camel herds become sympatric with non-domestic species. We conducted a literature review of camel-borne zoonotic diseases and found that the majority of publications (65%) focused on Middle East respiratory syndrome (MERS), brucellosis, Echinococcus granulosus, and Rift Valley fever. The high fatality from MERS outbreaks during 2012–2016 elicited an immediate response from the research community as demonstrated by a surge of MERS-related publications. However, we contend that other camel-borne diseases such as Yersinia pestis, Coxiella burnetii, and Crimean–Congo hemorrhagic fever are just as important to include in surveillance efforts. Camel populations, particularly in sub-Saharan Africa, are increasing exponentially in response to prolonged droughts, and thus, the risk of zoonoses increases as well. In this review, we provide an overview of the major zoonotic diseases present in dromedary camels, their risk to humans, and recommendations to minimize spillover events.

Introduction There has been a resurgence of popularity in performing bicruciate-retaining (BCR) total knee arthroplasty (TKA) as opposed to the more common posterior-stabilized (PS). BCR may be better for young and active patients since it restores knee kinematics better than other prosthetic designs. However, there is a belief in the community that BCR results in stiffer knees. There is not yet any study that shows clear clinical differences between BCR and PS TKAs. This study aims to clarify this point of contention. Materials and methods A prospective randomized control trial was conducted where patients were randomized to have either BCR or PS TKA implanted using a spacer-based gap balancing technique. A total of 32 BCR and 34 PS knees were evaluated (54 patients). Results were obtained at the preoperative visit and the subsequent postoperative visits up to 2 years and above. In this study, knee range of motion measurements, Knee injury and Osteoarthritis Outcome Score (KOOS), as well as Knee Society (KS) knee and function scores were compared between groups and visits. Resultats There was a significant difference in maximum knee flexion between BCR and PS patients at 6 weeks (BCRmean 94.8°, PSmean 113.6°, P Discussion The results confirm the suspicion that BCR TKA results in stiffer knees than PS TKA during the early postoperative period. However the difference in maximum flexion decreased and tended to resolve by the 2-year postoperative visit. The difference also did not seem to have an impact on the various clinical and functional outcome measurements that were collected after 6 weeks. Conclusion BCR TKA does not result in stiffer knees than PS TKA after 2 years. There appears to be a stiffening phenomenon that occurs after BCR TKA compared to PS TKA but it seems to resolve over time. Further investigation on the causes of this phenomenon is warranted. Further follow-up of this patient cohort will provide additional relevant information.