Viral and host factors associated with SARS-CoV-2 disease severity in Georgia, USA.

While SARS-CoV-2 vaccines have shown strong efficacy, their suboptimal uptake combined with the continued emergence of new viral variants raises concerns about the ongoing and future public health impact of COVID-19. We investigated viral and host factors, including vaccination status, that were associated with SARS-CoV-2 disease severity in a setting with low vaccination rates. We analyzed clinical and demographic data from 1,957 individuals in the state of Georgia, USA, coupled with viral genome sequencing from 1,185 samples. We found no difference in disease severity between individuals infected with Delta and Omicron variants among the participants in this study, after controlling for other factors, and we found no specific mutations associated with disease severity. Compared to those who were unvaccinated, vaccinated individuals experienced less severe SARS-CoV-2 disease, and the effect was similar for both variants. Vaccination within 270 days before infection was associated with decreased odds of moderate and severe outcomes, with the strongest association observed at 91-270 days post-vaccination. Older age and underlying health conditions, especially immunosuppression and renal disease, were associated with increased disease severity. Overall, this study provides insights into the impact of vaccination status, variants/mutations, and clinical factors on disease severity in SARS-CoV-2 infection when vaccination rates are low. Understanding these associations will help refine and reinforce messaging around the crucial importance of vaccination in mitigating the severity of SARS-CoV-2 disease.

Soft Tissue Infection of Immunocompetent Man with Cat-Derived Globicatella Species.

We report a novel Globicatella species causing extensive soft tissue infection in a man bitten by a stray domestic cat in the United Kingdom. We identified this bacterium by 16S rRNA gene sequencing, whole-genome sequencing, and biochemical profiling and determined antimicrobial drug susceptibility.

Verwey transition as evolution from electronic nematicity to trimerons via electron-phonon coupling.

Understanding the driving mechanisms behind metal-insulator transitions (MITs) is a critical step toward controlling material's properties. Since the proposal of charge order-induced MIT in magnetite Fe3O4 in 1939 by Verwey, the nature of the charge order and its role in the transition have remained elusive. Recently, a trimeron order was found in the low-temperature structure of Fe3O4; however, the expected transition entropy change in forming trimeron is greater than the observed value, which arises a reexamination of the ground state in the high-temperature phase. Here, we use electron diffraction to unveil that a nematic charge order on particular Fe sites emerges in the high-temperature structure of bulk Fe3O4 and that, upon cooling, a competitive intertwining of charge and lattice orders arouses the Verwey transition. Our findings discover an unconventional type of electronic nematicity in correlated materials and offer innovative insights into the transition mechanism in Fe3O4 via the electron-phonon coupling.

COVID-19 vaccination uptake and hesitancy reasons in food production workers.

BACKGROUND: Food production sites have been a high-risk location for SARS-CoV-2 outbreaks worldwide since early in the COVID-19 pandemic. Ireland has a high population rate of COVID-19 vaccination, but reports from food production sites suggest uptake is lower amongst workers despite prior outbreaks at these workplaces. AIMS: To study COVID-19 vaccination rates, intent to undertake future vaccination and hesitancy reasons in food production workers. METHODS: Data regarding vaccination status was collected via an online survey from workers at 8 food production sites in Ireland; those who were unvaccinated were asked for reasons for being unvaccinated and likelihood to future vaccination. Respondents were also asked for their usual trusted source of medical information. RESULTS: N = 355 responses were received. The crude vaccination rate is 86% (N = 306). Those employed in the general operative class are more likely to be unvaccinated (N = 30; 18%) when compared to unvaccinated in all other job classes (N = 16; 9%: p < 0.01). The rate of vaccination is lower in those not born in Ireland compared to those born in Ireland (N = 110, 73% vs N = 192; 98%: p < 0.001). N = 35 (76%) of unvaccinated workers report they are very unlikely or unlikely to undertake vaccination in the future. CONCLUSIONS: There is an observed lower-than-national vaccination rate in food production workers. Rates are lowest amongst those workers born overseas; targeting these groups with information responding to their concerns may increase uptake and reduce current and future health inequalities.

Bilateral Carpal Tunnel Syndrome Following COVID-19 Vaccination: A Case Report.

Coronavirus disease 2019 (COVID-19) continues to pose significant health challenges, with insights into long-term disease sequelae emerging. The post-viral effects resulting from COVID-19 are being investigated and 'long COVID-19' is now a recognised phenomenon. As part of the spectrum of comorbidities, acute-onset neuropathy is associated with infection. The public health response aimed at limiting morbidity and mortality is rooted in vaccination programmes. With the extensive roll-out of novel vaccinations, there has been careful monitoring of temporally associated health problems. Some of the documented associations include neuropathy and entrapment neuropathies. This case report details a patient presenting with bilateral carpal tunnel syndrome (CTS) post their second dose of AZD1222 (ChAdOx1 nCoV-19) vaccination. Though we do not claim causality, the emerging post-vaccination immune-mediated effects may ultimately be proven to include neuropathy exacerbation. Meticulous recording of such associations is required as it is of great relevance to the hand surgeon managing CTS. Level of Evidence: Level V (Therapeutic).

Effects of sleep on positive, negative and neutral valenced story and image memory.

During sleep, emotional memories are preferentially strengthened. However, most studies on sleep and emotional memory focus on comparing negative valence with neutral valence stimuli. This study compared the sleep-dependent memory effects for stories and images, each comprising negative, neutral, and positive stimuli. It was hypothesized that a sleep effect would be seen for negatively and positively valenced stimuli. A novel story memory task (comprising three stories), and photographs from the Nencki Affective Picture database were presented for learning to 61 healthy adults (ages 18-25). They were tested for memory on the two tasks immediately, and then again after either a 2-hr nap (n = 31; 17 women, 14 men) or 2-hr wake period (n = 30; 13 women, 17 men). At second testing, the sleep condition had significantly better recall compared to the wake condition on both tasks. There was a relationship with valence only for the story task, with better performance for the sleep condition on the negatively and positively valenced texts, but not on the neutral text. There were no significant relationships between memory measures and sleep-stage duration and EEG power variables. The story memory findings support the hypothesis that memory consolidation prioritizes emotional memory, whether positively or negatively valenced.

High anti-SARS-CoV-2 antibody seroprevalence in healthcare workers in an Irish university teaching hospital.

INTRODUCTION: Healthcare workers are at very high risk for SARS-CoV-2 exposure and infection. This study evaluated anti-SARS-CoV-2 seroprevalence in healthcare workers in a tertiary care hospital and then correlated seroprevalence with confirmed or suspected SARS-CoV-2 infection in this population since the onset of the COVID-19 pandemic. METHOD: The study was approved by our institution's Joint Research Ethics Committee in June 2020. All volunteers were provided with a consent form, an information leaflet and a questionnaire on the day before phlebotomy. Serum samples were collected from 1176 participants over a 3-month period and analysed using the Elecsys Anti-SARS-CoV-2 assay (Roche Diagnostics GmbH, Mannheim, Germany) which detects total antibodies against the nucleocapsid protein of SARs-COV-2. RESULTS: Overall anti-SARS-CoV-2 seroprevalence among participating healthcare workers was 17.9%. The rate of confirmed infection by real-time polymerase chain reaction molecular testing prior to participation was 12.2%. Of 211 participants who had a reactive antibody test result, 37% did not have COVID-19 infection confirmed at any point prior to participation in this study, either having had a swab which did not detect SARS-CoV-2 RNA or having never been tested. Seropositivity was the highest (30%) in the youngest quintile of age (20-29 years old). Staff with more patient contact had a higher seroprevalence of 19.5% compared to 13.4% in staff with less patient contact. CONCLUSION: This study demonstrates that a substantial proportion of SARS-CoV-2 infections in healthcare workers may be asymptomatic or subclinical and thus potentially represent a significant transmission risk to colleagues and patients.

The Virtual Nose: Assessment of Static Nasal Airway Obstruction Using Computational Simulations and 3D-Printed Models.

Background: The use of virtual noses to predict the outcome of surgery is of increasing interests, particularly, as detailed and objective pre- and postoperative assessments of nasal airway obstruction (NAO) are difficult to perform. The objective of this article is to validate predictions using virtual noses against their experimentally measured counterpart in rigid 3D-printed models. Methods: Virtual nose models, with and without NAO, were reconstructed from patients' cone beam computed tomography scans, and used to evaluate airflow characteristics through computational fluid dynamics simulations. Prototypes of the reconstructed models were 3D printed and instrumented experimentally for pressure measurements. Results: Correlation between the numerical predictions and experimental measurements was shown. Analysis of the flow field indicated that the NAO in the nasal valve increases significantly the wall pressure, shear stress, and incremental nasal resistance behind the obstruction. Conclusions: Airflow predictions in static virtual noses correlate well with detailed experimental measurements on 3D-printed replicas of patient airways.

Intramedullary Cannulated Compression Screws for Extra-Articular Phalangeal Fractures.

Background: There is no consensus as to which is the best way to fix unstable extra-articular phalangeal fractures. We performed a literature review to determine outcomes using intramedullary cannulated compression screws. Methods: PubMed, Medline and Embase databases were searched for English language articles reporting the use of one or more intramedullary screw(s) for fixation of an acute extra-articular phalangeal fracture in adults that reported outcome data. Results: A total of 62 abstracts were identified, of which 14 full-text articles were eligible for full-text screening for the inclusion criteria. Of these 14 articles, seven articles were included in the final study. Data on 146 phalangeal fractures were aggregated with an average patient age of 36 (18-84). 89% (130/146) fractures were of the proximal phalanx, the remainder of the middle phalanx. Surgical technique was mostly a minimally invasive technique under fluoroscopy guidance using an anterograde technique. One paper described a retrograde method. Screw diameter varied from 2.2 mm to 3.2 mm. Where the radiographic union was reported, all fractures united. Range of motion averaged 231° (range 95°-295°) in four studies. Return to work was reported as 6.4 weeks (range 0.9-16.7 weeks) in one study. Different quality-of-life scores were reported by the studies (DASH 3.52 (range 1-45), QuickDASH score of 3.9 and DASH score of 3.9). Complications rate was 5% (8/146) including 5 major complications and 3 minor in the pooled results. Conclusions: This literature review demonstrates that fixation of extra-articular fractures of the proximal and middle phalanges with cannulated compression screws is a safe and successful surgical treatment with faster mobilization and return to work with fewer complications, including stiffness, than have been reported with plates and screws and percutaneous K-wires. This application is limited to transverse and short oblique extra-articular fractures.

Rugby union referees' physical and physiological demands across different competitive levels.

BACKGROUND: The purpose of this study was to compare the match demands of officiating 15-a-side rugby union at different competitive levels. METHODS: Data was collected using Global Navigation Satellite Systems from 21 referees during 82 competitive rugby union matches across three different competitive levels: 1) professional; 2) semi-professional; 3) amateur. RESULTS: Compared with referees at the professional and semi-professional levels, referees at the amateur level covered less total distance (P=0.005). Additionally, these referees covered less distance jogging, and at low and medium intensity (all P<0.05), and had less time between repeated high-intensity efforts (P<0.001). Furthermore, compared with referees at the semi-professional and amateur levels, referees at the professional level had a higher sprint duration and covered more distance sprinting (all P<0.05), and achieved a higher maximal speed during the longest repeated high-intensity effort or "worst-case scenario" (P=0.026). The professional level referees also displayed a lower average heart rate (P<0.001), spent a higher percentage of time at <60% HRmax (P<0.001), and a lower percentage of time between 71% and 80% HRmax (P=0.004). Finally, external and internal load were strongly correlated for referees at the semi-professional level only (r=0.75, P<0.001). CONCLUSIONS: Overall, the findings demonstrate that refereeing 15-a-side rugby union is more physically demanding at higher competitive levels, particularly in terms of high-intensity efforts. The results provide important information for practitioners involved in the physical preparation and training of rugby union referees.

Femtosecond X-ray induced changes of the electronic and magnetic response of solids from electron redistribution.

Resonant X-ray absorption, where an X-ray photon excites a core electron into an unoccupied valence state, is an essential process in many standard X-ray spectroscopies. With increasing X-ray intensity, the X-ray absorption strength is expected to become nonlinear. Here, we report the onset of such a nonlinearity in the resonant X-ray absorption of magnetic Co/Pd multilayers near the Co L[Formula: see text] edge. The nonlinearity is directly observed through the change of the absorption spectrum, which is modified in less than 40 fs within 2 eV of its threshold. This is interpreted as a redistribution of valence electrons near the Fermi level. For our magnetic sample this also involves mixing of majority and minority spins, due to sample demagnetization. Our findings reveal that nonlinear X-ray responses of materials may already occur at relatively low intensities, where the macroscopic sample is not destroyed, providing insight into ultrafast charge and spin dynamics.

Atom-specific activation in CO oxidation.

We report on atom-specific activation of CO oxidation on Ru(0001) via resonant X-ray excitation. We show that resonant 1s core-level excitation of atomically adsorbed oxygen in the co-adsorbed phase of CO and oxygen directly drives CO oxidation. We separate this direct resonant channel from indirectly driven oxidation via X-ray induced substrate heating. Based on density functional theory calculations, we identify the valence-excited state created by the Auger decay as the driving electronic state for direct CO oxidation. We utilized the fresh-slice multi-pulse mode at the Linac Coherent Light Source that provided time-overlapped and 30 fs delayed pairs of soft X-ray pulses and discuss the prospects of femtosecond X-ray pump X-ray spectroscopy probe, as well as X-ray two-pulse correlation measurements for fundamental investigations of chemical reactions via selective X-ray excitation.

Femtosecond X-ray magnetic circular dichroism absorption spectroscopy at an X-ray free electron laser.

X-ray magnetic circular dichroism spectroscopy using an X-ray free electron laser is demonstrated with spectra over the Fe L(3,2)-edges. The high brightness of the X-ray free electron laser combined with high accuracy detection of incident and transmitted X-rays enables ultrafast X-ray magnetic circular dichroism studies of unprecedented sensitivity. This new capability is applied to a study of all-optical magnetic switching dynamics of Fe and Gd magnetic sublattices in a GdFeCo thin film above its magnetization compensation temperature.

Rates of self-reported 'burnout' and causative factors amongst urologists in Ireland and the UK: a comparative cross-sectional study.

OBJECTIVES: To determine the incidence of 'burnout' among UK and Irish urological consultants and non-consultant hospital doctors (NCHDs). The second objective was to identify possible causative factors and to investigate the impact of various vocational stressors that urologists face in their day-to-day work and to establish whether these correlate with burnout. The third objective was to develop a new questionnaire to complement the Maslach Burnout Inventory (MBI), more specific to urologists as distinct from other surgical/medical specialties, and to use this in addition to the MBI to determine if there is a requirement to develop effective preventative measures for stress in the work place, and develop targeted remedial measures when individuals are affected by burnout. SUBJECTS AND METHODS: A joint collaboration was carried out between the Irish Society of Urology (ISU) and the British Association of Urological Surgeons (BAUS). Anonymous voluntary questionnaires were sent to all current registered members of both governing bodies. The questionnaire comprised two parts: the first part encompassed sociodemographic data collection and identifying potential risk factors for burnout, and the second used the MBI to objectively assess for workplace burnout. To evaluate differences in burnout, 2 × 2 contingency tables and Fischer's exact probability tests were used. RESULTS: In all, 575 urologists responded to the online survey out of a total of 1380 invites, yielding a 42% response rate. All respondents were aged <75 years (median age 45 years), with men representing 87.5% of respondents. In all, 75% of respondents worked in England, followed by the Republic of Ireland (9%), Scotland (8%), Northern Ireland (4%), and Wales (3%). In all, 79% of respondents were consultants, with 13% representing training posts, and 40% of respondents held a professorship/clinical lead position. Respondents' countries of origin included England, Scotland, Ireland, India, Wales, Malaysia, Pakistan and Sri Lanka. Overall, the mean emotion exhaustion (EE) score was 23.5, representing a moderate level of EE. The mean depersonalisation (DP) score was 8.2, representing a moderate level of DP. The mean personal achievement (PA) score was 17.1, representing high levels of PA. In all, 86 respondents (15%) reported self-medication with non-prescription drugs or alcohol to combat signs and symptoms of burnout, while 46 (8%) sought professional help for symptoms of burnout. In all, 460 respondents (80%) felt that burnout should be evaluated amongst members of the ISU/BAUS, and 345 (60%) would avail of counselling if provided. CONCLUSIONS: This is the first study to address the issue of burnout across two separate health systems in the UK and Ireland. This study has shown previously undescribed high levels of burnout characterised by EE and DP, with associated significant levels of self-medication amongst a male-predominant cohort. Burnout was attributed to non-surgical administrative/institutional factors, with most respondents reporting support for staff evaluation and the provision of counselling services. This pilot study lends itself to the creation of risk stratification for urologists, and an opportunity to provide educational resources, training/development programmes, and collegial and administrative support pathways.

A metagenetic approach to determine the diversity and distribution of cyst nematodes at the level of the country, the field and the individual.

Distinct populations of the potato cyst nematode (PCN) Globodera pallida exist in the UK that differ in their ability to overcome various sources of resistance. An efficient method for distinguishing between populations would enable pathogen-informed cultivar choice in the field. Science and Advice for Scottish Agriculture (SASA) annually undertake national DNA diagnostic tests to determine the presence of PCN in potato seed and ware land by extracting DNA from soil floats. These DNA samples provide a unique resource for monitoring the distribution of PCN and further interrogation of the diversity within species. We identify a region of mitochondrial DNA descriptive of three main groups of G. pallida present in the UK and adopt a metagenetic approach to the sequencing and analysis of all SASA samples simultaneously. Using this approach, we describe the distribution of G. pallida mitotypes across Scotland with field-scale resolution. Most fields contain a single mitotype, one-fifth contain a mix of mitotypes, and less than 3% contain all three mitotypes. Within mixed fields, we were able to quantify the relative abundance of each mitotype across an order of magnitude. Local areas within mixed fields are dominated by certain mitotypes and indicate towards a complex underlying 'pathoscape'. Finally, we assess mitotype distribution at the level of the individual cyst and provide evidence of 'hybrids'. This study provides a method for accurate, quantitative and high-throughput typing of up to one thousand fields simultaneously, while revealing novel insights into the national genetic variability of an economically important plant parasite.

High-throughput diagnosis of potato cyst nematodes in soil samples.

Potato cyst nematode (PCN) is a damaging soilborne pest of potatoes which can cause major crop losses. In 2010, a new European Union directive (2007/33/EC) on the control of PCN came into force. Under the new directive, seed potatoes can only be planted on land which has been found to be free from PCN infestation following an official soil test. A major consequence of the new directive was the introduction of a new harmonized soil sampling rate resulting in a threefold increase in the number of samples requiring testing. To manage this increase with the same staffing resources, we have replaced the traditional diagnostic methods. A system has been developed for the processing of soil samples, extraction of DNA from float material, and detection of PCN by high-throughput real-time PCR. Approximately 17,000 samples are analyzed each year using this method. This chapter describes the high-throughput processes for the production of float material from soil samples, DNA extraction from the entire float, and subsequent detection and identification of PCN within these samples.

Management of occupational blood exposures: looking at progress.

Occupational blood exposure (OBE) is a well-recognised hazard in the healthcare setting. A 4-year review of OBE in a large Irish teaching hospital over 2008-2011 found encouraging results, but identified deficits in documentation, communication and follow-up. The process was repeated 1 year later to determine if improvements were achieved and recommendations implemented. In 2012, 110 OBEs were reported, of which 81% were reported within 72 hours of the injury. The administration of first aid was adequately documented in 85% of cases and confirmation of the provision of appropriate information and/or counselling in 72% of the cases. Attendance for follow-up was broadly in line with the previous review. The findings and recommendations contributed to improvements in practice. However, to ensure these are ongoing, the reinforcement of an educational strategy in a systematic way is fundamental.