Morphological and Habitat Quality of Salmonid Streams and their Relationship with Fish-Based Indices in Aotearoa New Zealand and Ontario (Canada).

Habitat degradation is one of the major reasons for freshwater species decline. Hydrogeomorphological processes (such as sediment transport, bank erosion, and flooding) operate at the catchment scale and determine habitat features in river reaches. However, habitat quality indices and restoration for freshwater fish species are often implemented at small spatial scales of a few hundred metres. The Morphological Quality Index (MQI) considers fluvial processes at larger scales as well as channel forms, human impacts, and historical changes, but few studies have assessed its relevance for ecosystem health. We investigated relationships between the MQI, habitat quality (using the Qualitative Habitat Evaluation Index, QHEI), land cover, and fish metrics (number of fish species, index of biotic integrity (IBI), and trout biomass) in 26 salmonid streams in Aotearoa New Zealand and Southern Ontario, Canada. We found a significant correlation between the MQI and QHEI, and both metrics were correlated with urban and native forest proportion in the catchment. However, we found no relation between the MQI and the proportion of agricultural land in the catchment, while the QHEI was correlated with agricultural land in the riparian zone, highlighting the importance of vegetated riparian buffers in providing fish habitat. Establishing a strong correlation with fish metrics remains challenging. Nevertheless, a modified MQI targeting ecological health could be used as an effective management tool for aquatic conservation.

Risk and protective factors of mental health in children in residential care: A nationwide study from Luxembourg.

BACKGROUND: Children who grow up in residential care are at high risk for mental health problems. Existing studies have focused on negative mental health indicators and risk factors. There has been less emphasis on identifying protective factors, particularly those associated with positive mental health outcomes. OBJECTIVE: This study explores positive and negative dimensions of mental health and their links to risk and protective factors in children who have experienced early adversity and trauma and have been placed in residential care. PARTICIPANTS AND SETTINGS: Children aged 11 to 18 (N = 264) were recruited from residential care homes in Luxembourg, a small, high-income European country. METHODS: The children completed self-report questionnaires on mental health, perceived stress, school pressure, and participation. Residential care workers provided information on demographic factors, developmental and care history, and pre-care experiences of early adversity and trauma. RESULTS: Confirmatory factor analysis indicated that subjective well-being, internalising problems, and externalising problems are separate yet interconnected components of mental health. Multiple Indicators Multiple Causes models showed that individual, contextual, and psychosocial predictors contribute differentially to positive and negative mental health outcomes. CONCLUSIONS: Using a national sample of children in residential care in Luxembourg, this research indicates that subjective well-being, internalising problems, and externalising problems are distinct but related aspects of mental health. 'Child participation' and 'school pressure' displayed strong links with positive mental health outcomes and may serve as a potential path for improving public health interventions for children in care.

Trends in Hepatitis C Virus and HIV Care Outcomes Among People With HIV in Georgia, United States, 2014-2019.

OBJECTIVE: If untreated, hepatitis C virus (HCV) leads to poor health outcomes, including liver disease and death, particularly among people with HIV (PWH). We describe trends over time in incidence rates of HCV diagnoses among PWH in the state of Georgia. METHODS: We constructed a retrospective cohort of PWH in Georgia by using matched HIV and HCV case surveillance data from people diagnosed with HCV infection from January 1, 2014, through December 31, 2019. We calculated annual incidence rates per 1000 person-years and estimated trends over time in HCV diagnoses among the cohort of PWH by demographic characteristics and HIV care outcomes using Poisson regression analysis, with α = .05 considered significant. RESULTS: From 2014 through 2019, among 49 530 PWH in Georgia, 1945 (3.9%) were diagnosed with HCV infection. During this period, overall incidence per 1000 person-years of newly diagnosed HCV infection among PWH decreased from 8.7 to 4.5 (P for trend < .001). However, from 2014 through 2019, the annual incidence rates of PWH who were newly diagnosed with HCV infection increased from 4.6 to 7.1 (P for trend = .003) among people born from 1980 through 1989 and from 3.3 to 12.8 (P for trend < .001) among people born in 1990 or later. CONCLUSION: Strategies are needed to increase prevention, diagnosis, and treatment of HIV/HCV coinfection, particularly among PWH born in 1980 and later. Routine linkage of state surveillance data can inform prioritization of PWH at highest risk of HCV infection.

HIV and HCV testing at clinical encounters among people who inject drugs, 2013-2018-Opportunities for increased testing and prevention.

People who inject drugs (PWID) with unsafe injection practices have substantial risk for HIV and hepatitis C virus (HCV) infections. We describe frequency of, and factors associated with, HIV and HCV testing during clinical encounters with PWID. Inpatient and Emergency Department clinical encounters at an Atlanta hospital were abstracted from medical records spanning January 2013-December 2018. We estimated frequency of HIV and HCV testing during injection drug use (IDU)-related encounters among PWID without previous diagnoses. We assessed associations between patient factors and testing using generalized estimating equations models. HIV testing occurred in 39.3% and HCV testing occurred in 17.1% of eligible IDU-related encounters. Testing was more likely in IDU-related encounters during 2017-2018 than in encounters during 2013-2014; (HIV, AOR = 2.14, 95% CI, 1.32-3.49, p < .01). Testing was less likely among Black/African American patients compared to White patients (adjusted odds ratio [AOR]: HIV, AOR = 0.48, 95% confidence interval [CI], 0.33-0.72, p < .01); HCV, AOR = 0.41, 95% CI, 0.24-0.70, p < .01). This difference may be attributable to recent testing among Black patients in non-IDU related encounters. HIV and HCV testing improved over time; however, missed opportunities for testing still existed. Strategies should aim to improve equitable HIV and HCV testing among PWID.

SARS-CoV-2 infection in adult liver transplantation recipients: a systematic review of risk factors for mortality and immunosuppression role.

OBJECTIVE: Data on mortality, immunosuppression, and vaccination role regarding liver transplant (LT) recipients affected by COVID-19 are still under debate. This study aims to identify risk factors for mortality and the role of immunosuppression in COVID-19 LT recipients. MATERIALS AND METHODS: A systematic review of SARS-CoV-2 infection in LT recipients was performed. The primary outcomes were risk factors for mortality, the role of immunosuppression and vaccination. A meta-analysis was not performed as there was a different metric of the same outcome (mortality) and a lack of a control group in most studies. RESULTS: Overall, 1,343 LT recipients of 1,810 SOT were included, and data on mortality were available for 1,110 liver transplant recipients with SARS-CoV-2 infection. Mortality ranged between 0-37%. Risk factors of mortality were age >60 years, Mofetil (MMF) use, extra-hepatic solid tumour, Charlson Comorbidity Index, male sex, dyspnoea at diagnosis, higher baseline serum creatinine, congestive heart failure, chronic lung disease, chronic kidney disease, diabetes, BMI >30. Only 51% of 233 LT patients presented a positive response after vaccination, and older age (>65y) and MMF use were associated with lower antibodies. Tacrolimus (TAC) was identified as a protective factor for mortality. CONCLUSIONS: Liver transplant patients present additional risk factors of mortality related to immunosuppression. Immunosuppression role in the progression to severe infection and mortality may correlate with different drugs. Moreover, fully vaccinated patients have a lower risk of developing severe COVID-19. The present research suggests safely using TAC and reducing MMF use during the COVID-19 pandemic.

Missed opportunities for prevention: prevalence and incidence of human immunodeficiency virus and hepatitis C virus diagnoses among a cohort of individuals discharged from an urban hospital with injection drug-related diagnoses, 2012-2019.

PURPOSE: Risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections has increased due to the ongoing opioid epidemic and unsafe injection practices. We estimated the prevalence and incidence of HIV and HCV diagnoses among people who inject drugs from hospital-based clinical encounters. METHODS: We linked clinical encounters at an Atlanta hospital during 2012-2018 with state HIV and HCV surveillance records to examine the prevalence of infections at discharge and incidence of infections post clinical encounter. RESULTS: At discharge, 32.9% and 28.6% of patients with injection drug use-related clinical encounters had an HIV or HCV diagnosis, respectively. HIV and HCV diagnoses at the time of discharge were mostly among 40-64 years old patients, males, and Black/African Americans. Post clinical encounter, 3.8% of patients were later diagnosed with HIV, and 16.5% were later diagnosed with HCV, translating to incidence rates of 9.3 per 1000 person-years and 41.5 per 1000 person-years, respectively. The majority of HIV and HCV diagnoses post clinical encounter occurred among Black/African Americans and males. Of patients with HIV and HCV diagnoses post clinical encounter, 27.3% and 11.9% had been tested during their clinical encounter, respectively. CONCLUSIONS: Targeted interventions for HIV/HCV prevention, screening, diagnosis, and linkage to treatment are needed to reduce the incidence of new infections among people who inject drugs.

Assessing the artificially intelligent workplace: an ethical framework for evaluating experimental technologies in workplace settings.

Experimental technologies, including AI and robots, are revolutionising many types of work. For example, the logistics warehouse sector is witnessing a wave of new technologies, such as automated picking tools, collaborative robots and exoskeletons, affecting jobs and employees. Notably, it is not always possible to predict the effects of such new technologies, since they have inherent uncertainties and unintended consequences. Hence, their introduction into workplaces can be conceived as a social experiment. This paper aims to sketch a set of ethical guidelines for introducing experimental technologies into workplaces. It builds on Van de Poel's general framework for assessing new experimental technologies and translates that framework into a more specific context of work. We discuss its five principles: non-maleficence, beneficence, responsibility, autonomy, and justice. Each of these principles is applied to workplaces in general, and specifically to the logistics warehouse setting as a case study. A particular focus in our discussion is put on the distinctive potential harms and goods of work.

Impact of multi-agent systemic therapy on all-cause and disease-specific survival for people living with HIV who are diagnosed with non-Hodgkin lymphoma: population-based analyses from the state of Georgia.

For people living with HIV (PLWH) who are subsequently diagnosed with non-Hodgkin lymphoma (NHL), we investigate the impact of standard-of-care (SoC) cancer treatment on all-cause, NHL-specific, and HIV-specific survival outcomes. The focus is on a registry-derived, population-based sample of HIV + adults diagnosed with NHL within 2004-2012 in the state of Georgia. SoC treatment is defined as receipt of multi-agent systemic therapy (MAST). In multivariable survival analyses, SoC cancer treatment is significantly associated with better all-cause and NHL-specific survival, but not better HIV-specific survival across 2004-2017. Having a CD4 count <200 near the time of cancer diagnosis and Ann Arbor stage III/IV disease are associated with worse all-cause and HIV-specific survival; the effects on NHL survival trend negative but are not significant. Future work should expand the geographic base and cancers examined, deepen the level of clinical detail brought to bear, and incorporate the perspectives and recommendations of patients and providers.

Investigating the Origin of Mycobacterium chimaera Contamination in Heater-Cooler Units: Integrated Analysis with Fourier Transform Infrared Spectroscopy and Whole-Genome Sequencing.

Mycobacterium chimaera is ubiquitously spread in the environment, including factory and hospital water systems. Invasive cases of M. chimaera infection have been associated with aerosols produced by the use of heater-cooler units (HCU) during cardiac surgery. The aim of this study was to evaluate for the first time the performance of IR-Biotyper system on a large number of M. chimaera isolates collected from longitudinal environmental HCUs samples and water sources from hospitals located in three Italian provinces. In addition, IR-Biotyper results were compared with whole-genome sequencing (WGS) analysis, the reference method for molecular epidemiology, to investigate the origin of M. chimaera contamination of HCUs. From November 2018 to May 2021, 417 water samples from 52 HCUs (Stockert 3T, n = 41 and HCU40, n = 11) and 23 hospital taps (used to fill the HCU tanks) were concentrated, decontaminated, and cultured for M. chimaera. Positive cultures (n = 53) were purified by agar plate subcultures and analyzed by IR-Biotyper platform and Ion Torrent sequencing system. IR-Biotyper spectra results were analyzed using a statistical approach of dimensionality reduction by linear discriminant analysis (LDA), generating three separate clusters of M. chimaera, ascribable to each hospital. Furthermore, the only M. chimaera-positive sample from tap water clustered with the isolates from the HCUs of the same hospital, confirming that the plumbing system could represent the source of HCU contamination and, potentially, of patient infection. According to the genome-based phylogenies and following the classification proposed by van Ingen and collaborators in 2017, three distinct M. chimaera groups appear to have contaminated the HCU water systems: subgroups 1.1, 2.1, and branch 2. Most of the strains isolated from HCUs at the same hospital share a highly similar genetic profile. The nonrandom distribution obtained with WGS and IR-Biotyper leads to the hypothesis that M. chimaera subtypes circulating in the local plumbing colonize HCUs through the absolute filter, in addition with the current hypothesis that contamination occurs at the HCU production site. This opens the possibility that other medical equipment, such as endoscope reprocessing device or hemodialysis systems, could be contaminated by M. chimaera. IMPORTANCE Our manuscript focuses on interventions to reduce waterborne disease transmission, improve sanitation, and control infection. Sanitary water can be contaminated by nontuberculous Mycobacteria, including M. chimaera, a causative agent of invasive infections in immunocompromised patients. We found highly similar genetic and phenotypic profiles of M. chimaera isolated from heater-cooler units (HCU) used during surgery to thermo-regulate patients' body temperature, and from the same hospital tap water. These results lead to the hypothesis that M. chimaera subtypes circulating in the local plumbing colonize HCUs through the absolute filter, adding to the current hypothesis that contamination occurs at the HCU production site. In addition, this opens the possibility that other medical equipment using sanitized water, such as endoscope reprocessing devices or hemodialysis systems, could be contaminated by nontuberculous Mycobacteria, suggesting the need for environmental surveillance and associated control measures.

Intracerebroventricular dosing of N-sulfoglucosamine sulfohydrolase in mucopolysaccharidosis IIIA mice reduces markers of brain lysosomal dysfunction.

Mucopolysaccharidosis type IIIA (MPS IIIA) is a lysosomal storage disorder caused by N-sulfoglucosamine sulfohydrolase (SGSH) deficiency. SGSH removes the sulfate from N-sulfoglucosamine residues on the nonreducing end of heparan sulfate (HS-NRE) within lysosomes. Enzyme deficiency results in accumulation of partially degraded HS within lysosomes throughout the body, leading to a progressive severe neurological disease. Enzyme replacement therapy has been proposed, but further evaluation of the treatment strategy is needed. Here, we used Chinese hamster ovary cells to produce a highly soluble and fully active recombinant human sulfamidase (rhSGSH). We discovered that rhSGSH utilizes both the CI-MPR and LRP1 receptors for uptake into patient fibroblasts. A single intracerebroventricular (ICV) injection of rhSGSH in MPS IIIA mice resulted in a tissue half-life of 9 days and widespread distribution throughout the brain. Following a single ICV dose, both total HS and the MPS IIIA disease-specific HS-NRE were dramatically reduced, reaching a nadir 2 weeks post dose. The durability of effect for reduction of both substrate and protein markers of lysosomal dysfunction and a neuroimmune response lasted through the 56 days tested. Furthermore, seven weekly 148 µg doses ICV reduced those markers to near normal and produced a 99.5% reduction in HS-NRE levels. A pilot study utilizing every other week dosing in two animals supports further evaluation of less frequent dosing. Finally, our dose-response study also suggests lower doses may be efficacious. Our findings show that rhSGSH can normalize lysosomal HS storage and markers of a neuroimmune response when delivered ICV.

Subjective Well-Being of Adolescents in Luxembourg, Germany, and Brazil During the COVID-19 Pandemic.

PURPOSE: This study explores adolescent well-being during the first wave of the COVID-19 pandemic in two high-income countries from Europe and one middle-income country from South America. The aim is to investigate the correlates of different dimensions of subjective well-being in 10- to 16-year-olds from different cultural contexts. METHODS: An online, self-report questionnaire was completed by 1,613 adolescents in Luxembourg, Germany, and Brazil between May and July 2020. The outcome variables were measures of life satisfaction and emotional well-being during the COVID-19 pandemic. The study included a range of sociodemographic, interpersonal, and intrapersonal covariates. Data were analyzed using descriptive statistics and latent variable structural equational modeling. RESULTS: A two-factor model of subjective well-being, consisting of life satisfaction and emotional well-being latent constructs, fitted well with this sample data for Luxembourg, Germany, and Brazil. Results showed that gender, socioeconomic status, intrapersonal factors, quantity and type of schoolwork, and relationships with adults were important common predictors of individual differences in subjective well-being during COVID-19. Fear of illness emerged as the strongest correlate of emotional well-being across the three countries. CONCLUSIONS: This study indicates that girls and adolescents from low-income homes may be especially vulnerable to negative secondary impacts of COVID-19 that can affect mental health. It identified several common correlates of subjective well-being in adolescents from different cultural settings, including factors that may be changeable, such as the following: the way adults listen to adolescents, schoolwork during distant learning, and fear of illness. Findings can inform the development of quality interventions for promoting the well-being of adolescents during a global pandemic.

Practices and experiences of distant education during the COVID-19 pandemic: The perspectives of six- to sixteen-year-olds from three high-income countries.

The paper explores children's perspectives of distance education, their learning experiences and school satisfaction in Luxembourg, Germany and Switzerland during the first wave of the COVID-19 pandemic. The data stem from an online questionnaire completed by 1773 primary and secondary school children aged 6-16. While the paper uses quantitative and qualitative data, it aligns with the qualitative research tradition and predominantly uses an inductive approach. The findings show that teachers offered varied types of distance education and that parents supported children. The children's contact time with teachers and their time spent on schoolwork varied within and between countries. Their school satisfaction dropped in the three countries. The paper calls for training and development on distant education.

Effects of an Early Literacy Intervention for Linguistically Diverse Children: A Quasi-Experimental Study.

Phonological awareness and letter-sound knowledge underpin children's early literacy acquisition. Promoting these foundational skills in kindergarten should therefore lead to a better response to formal literacy instruction once started. The present study evaluated a 12-week early literacy intervention for linguistically diverse children who are learning to read in German. The study was set in Luxembourg where kindergarten education is in Luxembourgish and children learn to read in German in Grade 1 of primary school. One hundred and eighty-nine children (mean age = 5;8 years) were assigned to an early literacy intervention in Luxembourgish or to a business as usual control group. Trained teachers delivered the intervention to entire classes, four times a week, during the last year of kindergarten. The early literacy program included direct instruction in phonological awareness and letter-knowledge, while promoting print and book awareness and literacy engagement. Children were assessed pre-intervention, immediately post-intervention and at a 9 months delayed follow-up using measures in Luxembourgish and in German. At the end of the intervention, children in the intervention group performed significantly better than the control group on phonological awareness and letter-knowledge measures in Luxembourgish and the gains in phonological awareness were maintained at 9 months follow-up. The effects generalized to measures of phonological awareness, word-level reading comprehension and spelling in German (effect sizes d > 0.25), but not to German single word/pseudoword reading, at delayed follow-up. Intervention programs designed to support foundational literacy skills can be successfully implemented by regular teachers in a play-based kindergarten context. The findings suggest that early literacy intervention before school entry can produce educationally meaningful effects in linguistically diverse learners.

Do Exercises Prevent Falls Among Older Adults: Where Are We Now? A Systematic Review.

OBJECTIVE: To determine whether single interventions (SI), multifactorial interventions (MI), or multiple component interventions (MCI) including vitamin D supplementation prevent the incidence of falls and fall risk factors among older adults who are community-dwelling or living in long-term care facilities. DESIGN: Systematic review. METHODS: PubMed, Scopus, MEDLINE, and Cochrane were searched with restrictions applied to publication year (2015‒2019) and language (limited to studies published in English). After duplicate removal and title and abstract screening, 2 authors independently identified eligible studies on the basis of inclusion criteria. Risk of bias and quality of evidence were assessed. RESULTS: Thirty-four studies were included after screening titles and abstracts from 855 citations and 129 full-text articles. Thirteen randomized-controlled trials and clinical trials (5 on MI, 1 on MCI, and 7 on SI) including 2232 participants and 21 systematic reviews (assessing SI, MI, MCI, or all) were extracted for qualitative synthesis. Fifteen out of 20 studies that reported outcomes on falls rate found a significant reduction. Seventeen out of 23 studies with outcomes on fall risk factors concluded a significant improvement. Five studies found no significant differences in falls incidence, and 5 studies found no significant differences in fall risks. One study reported worsened outcomes, including poorer balance. CONCLUSION AND IMPLICATIONS: Although results are inconclusive, SI, MI, and MCI involving exercises may prevent falls. Vitamin D supplementation may be beneficial alongside exercise; however, whether vitamin D use consistently reduces falls incidence or fall risks remains uncertain. Exercises that are individually tailored to participants' capabilities and risks may be the most effective falls prevention interventions. Implementation may reduce medical costs and improve quality of life for older adults who are community-dwelling or are living in long-term care facilities.

Barriers Driving Racial Disparities in Colorectal Cancer Screening in African Americans.

PURPOSE OF REVIEW: Colorectal cancer screening has been shown to decrease mortality from colorectal cancer. Screening disparities continue to exist among ethnic minorities, particularly for African Americans. We herein review the barriers of colorectal cancer screening in this population. RECENT FINDINGS: At its foundation are patient barriers, which are further compounded by physician-related barriers and the idiosyncrasies of the healthcare system. Interventions to address the barriers include patient outreach, provider education, and healthcare legislation addressing financial barriers. Recent research has focused on factors predicting intentions to undergo colorectal cancer screening. Underlying all of the barriers is the systemic racism that affects and influences the healthcare system as much as all other institutions and contributes to inequities in the delivery of effective cancer prevention efforts. Perpetual disparities in CRC screening within the African American community are due to multifactorial barriers from the individual patient to provider and healthcare system and societal influences. An awareness of the behavioral and systemic factors that affect African Americans must underpin efforts to reach full equity in delivering CRC screening to this often medically underserved segment of our society.

Infective vegetative endocarditis of the mitral, aortic, and pulmonary valves due to Enterococcus hirae in a cat with a ventricular septal defect.

A 2.5-year-old female intact British Shorthair was presented for progressive complaints of abdominal distention, increased respiratory effort, lethargy and hyporexia. Based on the clinical presentation and a loud heart murmur, a cardiac cause was suspected. An echocardiogram was performed and the presumptive diagnosis of infective endocarditis of the aortic, mitral and pulmonic valves was made. Antemortem blood culture and postmortem valve biopsy confirmed bacterial endocarditis with Enterococcus hirae as etiological agent. To the authors' best knowledge, this case report is the first to describe an infective endocarditis with vegetative lesions on three cardiac valves associated with a ventricular septal defect in a cat, and Enterococcus hirae as causative agent for endocarditis in small animals.