Thermal tolerance for the tropical clawed frog, Xenopus tropicalis with comments on comparative methods for amphibian studies.

Thermal tolerance data are important for identifying the potential range of non-native species following introduction and establishment. Such data are particularly important for understanding invasion risks of tropical species introduced to temperate climates and identifying whether they can survive outside tropical regions. A breeding population of the tropical clawed frog (Xenopus tropicalis) was recently discovered in west-central Florida, U.S.A. This fully aquatic species is native to the rainforest belt of west Africa and has not been documented outside its native range. Because of the lack of invasion history, data are sparse on the thermal limits for this species. We used chronic lethal and critical thermal methodologies to investigate thermal tolerance on adult stages and critical thermal methods on tadpoles. Because of our use of both chronic and critical methodologies, we also examined the literature to reveal common methods used to investigate thermal minimum and maximum temperature in amphibians, which were found to be dominated by the critical maximum. Chronic lethal temperatures for adult X. tropicalis were 9.73 °C and 36.68 °C. Critical temperatures were affected by acclimation temperature and life stage; adults were more tolerant of extreme temperatures. Based on these critical thermal data and the fact that breeding tends to occur when temperatures are suitable for survival, tadpole stages are unlikely to be affected by extreme temperatures. Instead, range expansion in Florida will likely be limited by the adult stages. Our findings indicate that the tropical clawed frog could occupy much of southern Peninsular Florida and other tropical and subtropical regions worldwide.

Commonly collected thermal performance data can inform species distributions in a data-limited invader.

Predicting potential distributions of species in new areas is challenging. Physiological data can improve interpretation of predicted distributions and can be used in directed distribution models. Nonnative species provide useful case studies. Panther chameleons (Furcifer pardalis) are native to Madagascar and have established populations in Florida, USA, but standard correlative distribution modeling predicts no suitable habitat for F. pardalis there. We evaluated commonly collected thermal traits- thermal performance, tolerance, and preference-of F. pardalis and the acclimatization potential of these traits during exposure to naturally-occurring environmental conditions in North Central Florida. Though we observed temperature-dependent thermal performance, chameleons maintained similar thermal limits, performance, and preferences across seasons, despite long-term exposure to cool temperatures. Using the physiological data collected, we developed distribution models that varied in restriction: time-dependent exposure near and below critical thermal minima, predicted activity windows, and predicted performance thresholds. Our application of commonly collected physiological data improved interpretations on potential distributions of F. pardalis, compared with correlative distribution modeling approaches that predicted no suitable area in Florida. These straightforward approaches can be applied to other species with existing physiological data or after brief experiments on a limited number of individuals, as demonstrated here.

Dermatomycosis Caused by Paranannizziopsis australasiensis in Nonnative Panther Chameleons (Furcifer pardalis) Captured in Central Florida, USA.

Emergent fungal pathogens in herpetofauna are a concern in both wild and captive populations. We diagnosed dermatomycosis by Paranannizziopsis australasiensis in two panther chameleons (Furcifer pardalis) and suspected it in eight others captured from an established free-living nonnative population in Florida, USA. Chameleons developed skin lesions following recent exposure to cold weather conditions while housed in captivity, approximately 10 mo after capture and 12 wk after being placed in outdoor enclosures. Affected animals were treated with oral voriconazole and terbinafine until most cases resolved; however, medications were ultimately discontinued. Paranannizziopsis australasiensis has not previously been described in chameleons, nor in animals originating from a free-ranging population in the USA. Although the source of P. australasiensis infection is uncertain, we discuss several scenarios related to the pet trade and unique situation of chameleon "ranching" present in the USA.

The Quick Sepsis-Related Organ Failure Assessment Score Is Prognostic of Pancreatitis Severity in Patients With Alcohol-Induced Pancreatitis.

OBJECTIVES: The aim of this study was to determine if the quick Sepsis-Related Organ Failure Assessment (qSOFA) score assessed at and 48 hours after admission is prognostic for alcohol-induced acute pancreatitis (AAP) severity. METHODS: This is a retrospective cohort review study of 161 patients admitted to a single academic hospital in Houston, TX, with the diagnosis of AAP. Receiver operator characteristics analysis and logistic regression were used to assess the diagnostic accuracy and prognostic ability of the qSOFA score. RESULTS: A qSOFA score of 2 or higher at and 48 hours after admission had a specificity of 94% or greater and sensitivity of 33% or higher for pancreatitis severity and need for intensive care admission, intubation, or vasopressors. The qSOFA score at and 48 hours after admission was prognostic of intensive care unit admission by an adjusted odds ratio of 48.5 (95% confidence interval [CI], 6.4-1013.3; P < 0.001) and 18.8 (95% CI, 2.2-467.3; P < 0.05), respectively. The qSOFA score at admission was prognostic of severe pancreatitis by an adjusted odds ratio of 35.3 (95% CI, 7.2-224.3; P < 0.001). CONCLUSIONS: A qSOFA score of 2 or higher is highly specific and prognostic of multiple clinical outcomes both at and 48 hours after admission in patients with AAP.

Misapplying autonomy: why patient wishes cannot settle treatment decisions.

The principle of autonomy is widely recognized to be of utmost importance in bioethics; however, we argue that this principle is often misapplied when one fails to distinguish two different contexts in medicine. When a particular patient is offered treatment options, she has the ultimate say in whether to proceed with any of those treatments. However, when deciding whether a particular intervention should be regarded as a form of medical treatment in the first place, it is the medical community who has the ultimate say. Some argue that particular interventions should be allowed by virtue of the fact that they are autonomously requested. But making such an argument fails to distinguish between these two contexts and misapplies the principle of autonomy, ultimately having the potential to instigate problematic changes in the practice of medicine.

Association of serum lipid levels with psychotic symptoms in first-episode and drug naïve outpatients with major depressive disorder: a large-scale cross-sectional study.

Background Major depressive disorder (MDD) is a prevalent psychiatric disorder, with increasing evidence that patients with MDD display psychotic symptoms. Studies have shown the association between lipid levels and MDD, but few have explored the relationship between lipids and psychotic symptoms in MDD. The objective of this study was to compare the differences of lipid levels between patients with psychotic major depressive disorder (PMD) and those with non-psychotic major depressive disorder (NPMD) in first-episode and drug-naive (FEDN) MDD patients. Methods A total of 1718 outpatients with FEDN MDD were recruited. In addition to collecting basic information, their blood specimens were also collected to detect serum TC, HDL-C, TG, and LDL-C. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), and Positive and Negative Syndrome Scale (PANSS) were used to assess their depression, anxiety, and psychotic symptoms respectively. Results Compared to those with NPMD, those with PMD had higher scores on HAMD, HAMA, and more elevated serum TC, TG, and LDL-C levels, but lower HDL-C levels (all p < 0.05). Further logistic regression analysis showed that TG, the severity of depressive and anxiety symptoms were significantly associated with psychotic symptoms (p < 0.05). Limitations No causal relationship could be drawn due to the cross-sectional design. Conclusions Psychotic symptoms in patients with MDD may be predicted by lipid levels in the future. Our findings suggest that TG seems to predict the presence of current psychotic features among patients with FEDN MDD.

The Association of Drug-Use Characteristics and Active Coping Styles With Positive Affect in Patients With Heroin-Use Disorder and Methamphetamine-Use Disorder During the COVID-19 Pandemic.

Background: Positive affect (PA) is crucial for individuals to cope with the current pandemic and buffer the lingering fears after it, especially for patients with substance-use disorders (SUDs). The current study aimed to explore PA and its related factors during the COVID-19 pandemic in male patients with the heroin-use disorder (HUD) and patients with the methamphetamine-use disorder (MAUD), respectively. Methods: A total of 325 male patients with SUDs (106 with HUD and 219 with MAUD, all were single-substance users) in a compulsory rehabilitation center underwent semi-structured interviews during the pandemic. The demographic information, drug-use characteristics, active coping styles (ACSs, by Simple Coping Style Questionnaire), and PA (by the Positive and Negative Affect Scale) of participants were collected and recorded. Results: There were significant differences between the two groups in age, the proportion of full-time workers before the epidemic, duration of drug use, the proportion of patients with long-term withdrawal during the epidemic, cravings, ACS, and PA. Correlation and multiple linear regression analysis showed that duration of drug use, ACS, and stable jobs were significant predictive factors for PA in patients with HUD, while long-term withdrawal, ACS, and stable jobs during the epidemic were significant predictive factors for PA in patients with MAUD. Conclusions: Our study demonstrated the factors for PA in patients with HUD and MAUD during the pandemic. The results provided a basis for the comprehensive understanding of the PA of patients with SUDs and the development of targeted treatments.

Prevalence, clinical correlates and risk factors associated with Tardive Dyskinesia in Chinese patients with schizophrenia.

Tardive Dyskinesia (TD) is a serious, nonrhythmic and iatrogenic movement disorder, and is a common comorbidity in patients with schizophrenia (SZ). The main goal of this study was to investigate the prevalence, clinical correlates, and risk factors of TD in Chinese patients with chronic SZ, which has not been fully studied. This study adopted a cross-sectional design. A total of 901 Chinese inpatients with SZ were recruited between 2008 and 2011. We used the Abnormal Involuntary Movement Scale (AIMS) to measure the severity of TD, and the Positive and Negative Syndrome Scale (PANSS) was used to measure the psychopathological symptoms of SZ. Blood samples were also collected for routine blood tests, including the levels of triglyceride (TG), cholesterol (CHO), HDL-cholesterol (HDL-CHO), LDL-cholesterol (LDL-CHO), Apolipoprotein A1 (ApoA1), and Apolipoprotein B (ApoB). Overall, 36% of patients with SZ had TD. Compared with the non-TD patients, the TD patients were more likely to be men, had older age, lower education level, higher smoking rate, higher hospitalization frequency, and longer duration of illness (DOI). Further, compared with the non-TD patients, the TD patients had higher PANSS total, PANSS negative subscale, and cognitive subscale scores, but had lower depressive subscale scores and lower mean levels of metabolic biomarkers, including TG, CHO, HDL-CHO, LDL-CHO, ApoA1 and ApoB. Moreover, binary regression analysis showed that antipsychotic type, BMI, gender, age, HDL-CHO, and ApoB were associated with TD. Our findings indicate that TD is a common movement disorder in patients with chronic SZ, with certain demographic and clinical variables being risk factors for the development of TD.

Factors of Negative Affect in Elderly Patients With Substance Use Disorders During COVID-19 Pandemic.

Background: The outbreak of the novel coronavirus disease 2019 (COVID-19) has become the greatest public health emergency and has attracted global attention. During the COVID-19 pandemic, the negative affect (NA) of elderly patients with substance use disorders (SUDs) has also become a more serious public concern. The current study aims to clarify the NA and its influencing factors in elderly patients with SUDs during the pandemic. Methods: Two psychiatrists conducted semi-structured interviews with 77 SUD patients aged above 50 years to collect their demographical information and certain drug use characteristics. Barratt Impulse Scale and the Positive and Negative Affect Scale were used to obtain information about patients' self-reported impulsivity and NA. Results: Univariate linear regression analysis showed that NA was positively correlated with the frequency of drug use, type of SUDs, cravings during COVID-19, and impulsivity. Multiple linear regression analysis showed that being female, higher frequency of drug use, stronger cravings, and greater impulsiveness jointly accounted for the variation of NA in elderly patients with SUDs. Conclusions: This study confirmed that, during the COVID-19 pandemic, gender, frequency of drug use, cravings, and impulsivity were associated with NA in elderly patients with SUDs. This study provided a theoretical basis for clinicians to reduce the patients' NA.

Hypophosphatemia Is More Common and Is Prognostic of Poorer Outcomes in Severe Alcoholic Pancreatitis.

OBJECTIVES: The aim of this study was to determine if hypophosphatemia is more common in patients with severe alcohol-induced acute pancreatitis (AAP). METHODS: This is a retrospective, single institution, cohort study that analyzed 147 patients admitted to the hospital for AAP. Multivariate logistic regression was used to determine if hypophosphatemia would be related to clinical outcomes of disease severity. RESULTS: Hypophosphatemia was more common in patients with severe AAP at admission; in addition, all patients with severe AAP (100%) eventually developed hypophosphatemia during admission, relative to those with mild (43%) and moderately severe (54%) AAP. The magnitude of the lowest phosphate measurement obtained during admission was lower in patients with severe AAP (mean, 1.5 mg/dL, standard deviation [SD], 0.5 mg/dL) relative to those with mild (mean, 2.6 mg/dL; SD, 0.9 mg/dL) and moderately severe (mean, 2.3 mg/dL; SD, 0.9 mg/dL) AAP (P < 0.001). Finally, patients who developed hypophosphatemia during admission were more likely to require intensive care unit admission (P < 0.001), vasopressors (P = 0.01), or intubation (P = 0.003). CONCLUSIONS: Hypophosphatemia is more common and of greater magnitude in patients admitted to the hospital with severe AAP. In addition, patients with severe AAP who develop hypophosphatemia during admission are more likely to have poorer clinical outcomes.

Do free-ranging rattlesnakes use thermal cues to evaluate prey?

Rattlesnakes use infrared radiation to detect prey animals such as small mammals and lizards. Because ectotherm locomotor performance depends on temperature, rattlesnakes could use prey temperature to evaluate the potential of lizards to evade attacks. Here, we tested whether hunting rattlesnakes use infrared information to (1) detect and (2) evaluate prey before attack. We expected thermal contrast between prey and background to be the best predictor of predatory behaviour under the prey detection hypothesis, and absolute prey temperature under the prey evaluation hypothesis. We presented lizard carcasses of varying temperatures to free-ranging sidewinder rattlesnakes (Crotalus cerastes) and scored behavioural responses as a function of thermal contrast, absolute lizard temperature, and light level. Thermal contrast and light level were the most salient predictors of snake behaviour. Snakes were more likely to respond to lizards and/or respond at greater distances at night and when thermal contrast was high, supporting the known prey detection function of infrared sensing. Absolute lizard temperature was not an important predictor of snake behaviour; thus, we found no evidence for temperature-based prey evaluation. Infrared sensing is still poorly understood in ecologically relevant contexts; future research will test whether rattlesnakes learn to evaluate prey based on temperature with experience.

Patient Knowledge and Attitudes About Fecal Microbiota Therapy for Clostridium difficile Infection.

In a survey of patients with Clostridium difficile infection, physician recommendation seemed to be the largest factor affecting the likelihood of patients considering future fecal microbial therapy.