Early respiratory viral infections in infants with cystic fibrosis

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Background Viral infections contribute to morbidity in cystic fibrosis (CF), but the impact of respiratory viruses on the development of airway disease is poorly understood. Methods Infants with CF identified by newborn screening were enrolled prior to 4 months of age to participate in a prospective observational study at 4 centers. Clinical data were collected at clinic visits and weekly phone calls. Multiplex PCR assays were performed on nasopharyngeal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent bronchoscopy with bronchoalveolar lavage (BAL) and a subset underwent pulmonary function testing. We present findings through 8.5 months of life. Results Seventy infants were enrolled, mean age 3.1 ± 0.8 months. Rhinovirus was the most prevalent virus (66%), followed by parainfluenza (19%), and coronavirus (16%). Participants had a median of 1.5 viral positive swabs (range 0–10). Past viral infection was associated with elevated neutrophil concentrations and bacterial isolates in BAL fluid, including recovery of classic CF bacterial pathogens. When antibiotics were prescribed for respiratory-related indications, viruses were identified in 52% of those instances. Conclusions Early viral infections were associated with greater neutrophilic inflammation and bacterial pathogens. Early viral infections appear to contribute to initiation of lower airway inflammation in infants with CF. Antibiotics were commonly prescribed in the setting of a viral infection. Future investigations examining longitudinal relationships between viral infections, airway microbiome, and antibiotic use will allow us to elucidate the interplay between these factors in young children with CF

A biophysical model of prokaryotic diversity in geothermal hot springs

Recent field investigations of photosynthetic bacteria living in geothermal hot spring environments have revealed surprisingly complex ecosystems, with an unexpected level of genetic diversity. One case of particular interest involves the distribution along hot spring thermal gradients of genetically distinct bacterial strains that differ in their preferred temperatures for reproduction and photosynthesis. In such systems, a single variable, temperature, defines the relevant environmental variation. In spite of this, each region along the thermal gradient exhibits multiple strains of photosynthetic bacteria adapted to several distinct thermal optima, rather than the expected single thermal strain adapted to the local environmental temperature. Here we analyze microbiology data from several ecological studies to show that the thermal distribution field data exhibit several universal features independent of location and specific bacterial strain. These include the distribution of optimal temperatures of different thermal strains and the functional dependence of the net population density on temperature. Further, we present a simple population dynamics model of these systems that is highly constrained by biophysical data and by physical features of the environment. This model can explain in detail the observed diversity of different strains of the photosynthetic bacteria. It also reproduces the observed thermal population distributions, as well as certain features of population dynamics observed in laboratory studies of the same organisms

Boundary Liouville theory at c=1

The c=1 Liouville theory has received some attention recently as the Euclidean version of an exact rolling tachyon background. In an earlier paper it was shown that the bulk theory can be identified with the interacting c=1 limit of unitary minimal models. Here we extend the analysis of the c=1-limit to the boundary problem. Most importantly, we show that the FZZT branes of Liouville theory give rise to a new 1-parameter family of boundary theories at c=1. These models share many features with the boundary Sine-Gordon theory, in particular they possess an open string spectrum with band-gaps of finite width. We propose explicit formulas for the boundary 2-point function and for the bulk-boundary operator product expansion in the c=1 boundary Liouville model. As a by-product of our analysis we also provide a nice geometric interpretation for ZZ branes and their relation with FZZT branes in the c=1 theory.Comment: 37 pages, 1 figure. Minor error corrected, slight change in result (1.6

Towards a new privacy: Totalitarianism, emotion and management discourse

This article reviews some leadership and management literature dealing with emotional demands in professional contexts. An image of the ‘real self’, requiring emotional privacy, is highly valued by individuals subjected to intense emotional demands. It is argued that the ‘real self’ and emotional privacy ought to be defended against emotional ‘totalitarianism’ at work in high performance education contexts. The writings of George Orwell are employed both to develop an understanding of totalitarianism and consider how it can be resisted. Orwell prized the ideal of the ‘real self’, and it is argued that recent management literature does not give sufficient consideration to understanding and protecting ‘private’ emotions. It is argued that management discourse, demanding increasing levels of ‘emotional labour’, might be working from an imperfect or incomplete understanding of emotional experience as it is actually lived. An analysis of an article from The Academy of Management Review exemplifies managerial preoccupation with emotional effectiveness, without considering how such effectiveness connects with other life contexts. Ideas taken from Orwell are proposed to develop and fortify an ideal of emotional privacy, making explicit links between emotions and the society in which emotions are nurtured and understood

The variance shared across forms of childhood trauma is strongly associated with liability for psychiatric and substance use disorders

Introduction: Forms of childhood trauma tend to co-occur and are associated with increased risk for psychiatric and substance use disorders. Commonly used binary measures of trauma exposure have substantial limitations. Methods: We performed multigroup confirmatory factor analysis (CFA), separately by sex, using data from the Childhood Trauma (CT) Study's sample of twins and siblings (N = 2594) to derive three first-order factors (childhood physical abuse, childhood sexual abuse, and parental partner abuse) and, as hypothesized, one higher order, childhood trauma factor (CTF) representing a measure of their common variance. Results: CFA produced a good-fitting model in the CT Study; we replicated the model in the Comorbidity and Trauma (CAT) Study's sample (N = 1981) of opioid-dependent cases and controls. In both samples, first-order factors are moderately correlated (indicating they measure largely unique, but related constructs) and their loadings on the CTF suggest it provides a reasonable measure of their common variance. We examined the association of CTF score with risk for psychiatric and substance use disorders in these samples and the OZ-ALC GWAS sample (N = 1538) in which CT Study factor loadings were applied. We found that CTF scores are strongly associated with liability for psychiatric and substance use disorders in all three samples; estimates of risk are extremely consistent across samples. Conclusions: The CTF is a continuous, robust measure that captures the common variance across forms of childhood trauma and provides a means to estimate shared liability while avoiding multicollinearity. Confirmatory factor analysis was used to derive a higher order, childhood trauma factor representing a measure of the common variance across three forms of trauma: childhood physical abuse, childhood sexual abuse, and parental partner abuse. We replicated the model in a second sample. We then examined the association of childhood trauma score with risk for psychiatric and substance use disorders in these samples and a third sample in which the primary sample's factor loadings were applied finding factor scores to be strongly and consistently associated with liability for psychiatric and substance use disorders in all three samples

First observations of high-temperature submarine hydrothermal vents and massive anhydrite deposits off the north coast of Iceland

High-temperature (250°C) hydrothermal vents and massive anhydrite deposits have been found in a shallow water, sediment-filled graben near 66°36′N in the Tjornes Fracture Zone north of Iceland. The site is located about 30 km offshore, near the small island of Grimsey. The main vent field occurs at a depth of 400 m and consists of about 20 large-diameter (up to 10 m) mounds and 1–3 m chimneys and spires of anhydrite and talc. A north–south alignment of the mounds over a 1-km strike length of the valley floor suggests that their distribution is controlled by a buried fault. Widespread shimmering water and extensive white patches of anhydrite in the sediment between the mounds indicates that the entire 1-km2 area occupied by the vents is thermally active. A 2-man research submersible JAGO was used to map the area and to sample vent waters, gases, and chimneys. Actively boiling hydrothermal vents occur on most of the mounds, and extensive two-phase venting indicates that the field is underlain by a large boiling zone (200×300 m). The presence of boiling fluids in shallow aquifers beneath the deposits was confirmed by sediment coring. The highest-temperature pore fluids were encountered in talc- and anhydrite-rich sedimentary layers that occur up to 7 m below the mounds. Baked muds underlie the talc and anhydrite layers, and pyrite is common in stockwork-like fractures and veins in the hydrothermally altered sediments. However, massive sulfides (pyrite–marcasite crusts) were found in only one relict mound. Subseafloor boiling has likely affected the metal-carrying capacity of the hydrothermal fluids, and deposition of sulfides may be occurring at greater depth. Although the mounds and chimneys at Grimsey resemble other deposits at sedimented ridges (e.g. Middle Valley, Escanaba Trough, Guaymas Basin), the shallow water setting and extensive boiling of the hydrothermal fluids represent a distinctive new type of seafloor hydrothermal system

Protocol: Health, social care and technological interventions to improve functional ability of older adults: Evidence and gap map

This is the final version. Available on open access from Wiley via the DOI in this frecordThis is a protocol for a Campbell Evidence and Gap Map. The objectives are to identify and assess the available evidence on health, social care and technological interventions to improve functional ability among older adults

Protocol for the development of a CONSORT-equity guideline to improve reporting of health equity in randomized trials.

BACKGROUND: Health equity concerns the absence of avoidable and unfair differences in health. Randomized controlled trials (RCTs) can provide evidence about the impact of an intervention on health equity for specific disadvantaged populations or in general populations; this is important for equity-focused decision-making. Previous work has identified a lack of adequate reporting guidelines for assessing health equity in RCTs. The objective of this study is to develop guidelines to improve the reporting of health equity considerations in RCTs, as an extension of the Consolidated Standards of Reporting Trials (CONSORT). METHODS/DESIGN: A six-phase study using integrated knowledge translation governed by a study executive and advisory board will assemble empirical evidence to inform the CONSORT-equity extension. To create the guideline, the following steps are proposed: (1) develop a conceptual framework for identifying "equity-relevant trials," (2) assess empirical evidence regarding reporting of equity-relevant trials, (3) consult with global methods and content experts on how to improve reporting of health equity in RCTs, (4) collect broad feedback and prioritize items needed to improve reporting of health equity in RCTs, (5) establish consensus on the CONSORT-equity extension: the guideline for equity-relevant trials, and (6) broadly disseminate and implement the CONSORT-equity extension. DISCUSSION: This work will be relevant to a broad range of RCTs addressing questions of effectiveness for strategies to improve practice and policy in the areas of social determinants of health, clinical care, health systems, public health, and international development, where health and/or access to health care is a primary outcome. The outcomes include a reporting guideline (CONSORT-equity extension) for equity-relevant RCTs and a knowledge translation strategy to broadly encourage its uptake and use by journal editors, authors, and funding agencies

Internet-based medical education: a realist review of what works, for whom and in what circumstances

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