Does fish oil during pregnancy help prevent asthma in kids?

Does fish oil during pregnancy help prevent asthma in kids? The evidence on fish oil has been mixed, but this study affirms its benefits--in certain women. PRACTICE CHANGER: Fish oil supplementation taken by women in the third trimester of pregnancy can reduce the risk of persistent wheeze, asthma, and infections of the lower respiratory tract in their children.Authors: Dana Neutze, MD, PhD; Kelly Lacy Evans, MD; Marianne Koenig, PharmD, BCPS; Gregory Castelli, PharmD, BCPS, BC-ADM; Anne Mounsey, MD Department of Family Medicine, University of North Carolina at Chapel Hill (Drs. Neutze, Evans, and Mounsey); UPMC St. Margaret Family Medicine Residency Program, Pittsburgh, Pa (Drs. Koenig and Castelli)

A Refined QSO Selection Method Using Diagnostics Tests: 663 QSO Candidates in the LMC

We present 663 QSO candidates in the Large Magellanic Cloud (LMC) selected using multiple diagnostics. We started with a set of 2,566 QSO candidates from our previous work selected using time variability of the MACHO LMC lightcurves. We then obtained additional information for the candidates by crossmatching them with the Spitzer SAGE, the MACHO UBVI, the 2MASS, the Chandra and the XMM catalogs. Using this information, we specified six diagnostic features based on mid-IR colors, photometric redshifts using SED template fitting, and X-ray luminosities in order to further discriminate high confidence QSO candidates in the absence of spectra information. We then trained a one-class SVM (Support Vector Machine) model using the diagnostics features of the confirmed 58 MACHO QSOs. We applied the trained model to the original candidates and finally selected 663 high confidence QSO candidates. Furthermore, we crossmatched these 663 QSO candidates with the newly confirmed 144 QSOs and 275 non-QSOs in the LMC fields. On the basis of the counterpart analysis, we found that the false positive rate is less than 1%.Comment: 13 pages, 17 figures. accepted for publication in Ap

Cosmic Evolution of Star Formation In SDSS Quasar Hosts Since z=1

We present Spitzer IRS observations of a complete sample of 57 SDSS type-1 quasars at z~1. Aromatic features at 6.2 and/or 7.7 um are detected in about half of the sample and show profiles similar to those seen in normal galaxies at both low- and high-redshift, indicating a star-formation origin for the features. Based on the ratio of aromatic to star-formation IR (SFIR) luminosities for normal star-forming galaxies at z~1, we have constructed the SFIR luminosity function (LF) of z~1 quasars. As we found earlier for low-redshift PG quasars, these z~1 quasars show a flatter SFIR LF than do z~1 field galaxies, implying the quasar host galaxy population has on average a higher SFR than the field galaxies do. As measured from their SFIR LF, individual quasar hosts have on average LIRG-level SFRs, which mainly arise in the circumnuclear regions. By comparing with similar measurements of low-redshift PG quasars, we find that the comoving SFIR luminosity density in quasar hosts shows a much larger increase with redshift than that in field galaxies. The behavior is consistent with pure density evolution since the average SFR and the average SFR/BH-accretion-rate in quasar hosts show little evolution with redshift. For individual quasars, we have found a correlation between the aromatic-based SFR and the luminosity of the nuclear radiation, consistent with predictions of some theoretical models. We propose that type 1 quasars reside in a distinct galaxy population that shows elliptical morphology but that harbors a significant fraction of intermediate-age stars and is experiencing intense circumnuclear star formation.Comment: Accepted for publication in ApJ, 20 pages, 11 figure

QSO Selection Algorithm Using Time Variability and Machine Learning: Selection of 1,620 QSO Candidates from MACHO LMC Database

We present a new QSO selection algorithm using a Support Vector Machine (SVM), a supervised classification method, on a set of extracted times series features including period, amplitude, color, and autocorrelation value. We train a model that separates QSOs from variable stars, non-variable stars and microlensing events using 58 known QSOs, 1,629 variable stars and 4,288 non-variables using the MAssive Compact Halo Object (MACHO) database as a training set. To estimate the efficiency and the accuracy of the model, we perform a cross-validation test using the training set. The test shows that the model correctly identifies ~80% of known QSOs with a 25% false positive rate. The majority of the false positives are Be stars. We applied the trained model to the MACHO Large Magellanic Cloud (LMC) dataset, which consists of 40 million lightcurves, and found 1,620 QSO candidates. During the selection none of the 33,242 known MACHO variables were misclassified as QSO candidates. In order to estimate the true false positive rate, we crossmatched the candidates with astronomical catalogs including the Spitzer Surveying the Agents of a Galaxy's Evolution (SAGE) LMC catalog and a few X-ray catalogs. The results further suggest that the majority of the candidates, more than 70%, are QSOs.Comment: 17 pages, 11 figures; accepted for the publication in Ap

A concise guide to developing and using quantitative models in conservation management

Quantitative models are powerful tools for informing conservation management and decision-making. As applied modeling is increasingly used to address conservation problems, guidelines are required to clarify the scope of modeling applications and to facilitate the impact and acceptance of models by practitioners. We identify three key roles for quantitative models in conservation management: (a) to assess the extent of a conservation problem; (b) to provide insights into the dynamics of complex social and ecological systems; and, (c) to evaluate the efficacy of proposed conservation interventions. We describe 10 recommendations to facilitate the acceptance of quantitative models in conservation management, providing a basis for good practice to guide their development and evaluation in conservation applications. We structure these recommendations within four established phases of model construction, enabling their integration within existing workflows: (a) design (two recommendations); (b) specification (two); (c) evaluation (one); and (d) inference (five). Quantitative modeling can support effective conservation management provided that both managers and modelers understand and agree on the place for models in conservation. Our concise review and recommendations will assist conservation managers and modelers to collaborate in the development of quantitative models that are fit-for-purpose, and to trust and use these models appropriately while understanding key drivers of uncertainty.Pablo García‐Díaz, Thomas A.A. Prowse, Dean P. Anderson, Miguel Lurgi Rachelle N. Binny, Phillip Casse

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Hospital admission and emergency care attendance risk for SARS-CoV-2 delta (B.1.617.2) compared with alpha (B.1.1.7) variants of concern: a cohort study

Background: The SARS-CoV-2 delta (B.1.617.2) variant was first detected in England in March, 2021. It has since rapidly become the predominant lineage, owing to high transmissibility. It is suspected that the delta variant is associated with more severe disease than the previously dominant alpha (B.1.1.7) variant. We aimed to characterise the severity of the delta variant compared with the alpha variant by determining the relative risk of hospital attendance outcomes. Methods: This cohort study was done among all patients with COVID-19 in England between March 29 and May 23, 2021, who were identified as being infected with either the alpha or delta SARS-CoV-2 variant through whole-genome sequencing. Individual-level data on these patients were linked to routine health-care datasets on vaccination, emergency care attendance, hospital admission, and mortality (data from Public Health England's Second Generation Surveillance System and COVID-19-associated deaths dataset; the National Immunisation Management System; and NHS Digital Secondary Uses Services and Emergency Care Data Set). The risk for hospital admission and emergency care attendance were compared between patients with sequencing-confirmed delta and alpha variants for the whole cohort and by vaccination status subgroups. Stratified Cox regression was used to adjust for age, sex, ethnicity, deprivation, recent international travel, area of residence, calendar week, and vaccination status. Findings: Individual-level data on 43 338 COVID-19-positive patients (8682 with the delta variant, 34 656 with the alpha variant; median age 31 years [IQR 17–43]) were included in our analysis. 196 (2·3%) patients with the delta variant versus 764 (2·2%) patients with the alpha variant were admitted to hospital within 14 days after the specimen was taken (adjusted hazard ratio [HR] 2·26 [95% CI 1·32–3·89]). 498 (5·7%) patients with the delta variant versus 1448 (4·2%) patients with the alpha variant were admitted to hospital or attended emergency care within 14 days (adjusted HR 1·45 [1·08–1·95]). Most patients were unvaccinated (32 078 [74·0%] across both groups). The HRs for vaccinated patients with the delta variant versus the alpha variant (adjusted HR for hospital admission 1·94 [95% CI 0·47–8·05] and for hospital admission or emergency care attendance 1·58 [0·69–3·61]) were similar to the HRs for unvaccinated patients (2·32 [1·29–4·16] and 1·43 [1·04–1·97]; p=0·82 for both) but the precision for the vaccinated subgroup was low. Interpretation: This large national study found a higher hospital admission or emergency care attendance risk for patients with COVID-19 infected with the delta variant compared with the alpha variant. Results suggest that outbreaks of the delta variant in unvaccinated populations might lead to a greater burden on health-care services than the alpha variant. Funding: Medical Research Council; UK Research and Innovation; Department of Health and Social Care; and National Institute for Health Research