Baiting and Feeding Revisited: Modeling Factors Influencing Transmission of Tuberculosis Among Deer and to Cattle

Although tuberculosis caused by Mycobacterium bovis (bTB) is endemic in white-tailed deer (Odocoileus virginianus) in northeastern Michigan, USA, baiting and feeding of deer continue despite a regulatory ban. Previous modeling suggests aggregation at bait sites slows the rates at which harvest and/or vaccination decrease bTB prevalence, prolongs time to eradication, and increases the likelihood that once eradicated, bTB will re-establish following an incursion. However, the extent to which specific factors such as food density, attractiveness to deer, and persistence on the landscape influence bTB transmission is unknown. We used an individual-based, spatially-explicit stochastic simulation model of bTB in deer and cattle to investigate effects of feed density, attractiveness, and spatial and temporal persistence on bTB prevalence in deer and the probability of breakdowns in adjacent cattle herds. Because hunter harvest remains key to controlling bTB in deer, and harvest rates are in long term decline, we modeled these feeding-associated factors at harvest rates prevailing both when the model was developed (2003–2007) and in 2018. Food placement at randomized locations vs. fixed sites had little effect on bTB prevalence in deer, whereas increasing the probability that deer move to food piles (attractiveness) had the greatest effect of factors studied on both prevalence and herd breakdowns. Reducing food pile density reduced prevalence, but decreased herd breakdowns only modestly. Consistent availability of food over longer periods of time, as would occur with supplemental winter feeding or persistent recreational feeding, increased both prevalence in deer and cattle herd breakdowns dramatically. Though perhaps implausible to the public, altering how bait and feed for deer are used can reduce cattle herd breakdowns. Baiting and feeding bans have contributed to declining bTB prevalence, but non-compliance and continued legal sales of feed impede eradication. Requiring hunters to move food piles is unlikely to mitigate effects on transmission and is not a useful management tool. Compared to baiting, winter supplemental feeding or extended recreational feeding is likely to magnify bTB transmission by prolonging temporal availability. Because attractiveness of feed is influenced both by type of feed and deer behavior, research to quantify factors influencing deer movement to food should be a priority

Are all beliefs equal? Implicit belief attributions recruiting core brain regions of theory of mind

Humans possess efficient mechanisms to behave adaptively in social contexts. They ascribe goals and beliefs to others and use these for behavioural predictions. Researchers argued for two separate mental attribution systems: an implicit and automatic one involved in online interactions, and an explicit one mainly used in offline deliberations. However, the underlying mechanisms of these systems and the types of beliefs represented in the implicit system are still unclear. Using neuroimaging methods, we show that the right temporo-parietal junction and the medial prefrontal cortex, brain regions consistently found to be involved in explicit mental state reasoning, are also recruited by spontaneous belief tracking. While the medial prefrontal cortex was more active when both the participant and another agent believed an object to be at a specific location, the right temporo-parietal junction was selectively activated during tracking the false beliefs of another agent about the presence, but not the absence of objects. While humans can explicitly attribute to a conspecific any possible belief they themselves can entertain, implicit belief tracking seems to be restricted to beliefs with specific contents, a content selectivity that may reflect a crucial functional characteristic and signature property of implicit belief attribution

The assessment of vascular risk in men with erectile dysfunction: the role of the cardiologist and general physician.

Erectile dysfunction (ED) and cardiovascular disease (CVD) share risk factors and frequently coexist, with endothelial dysfunction believed to be the pathophysiologic link. ED is common, affecting more than 70% of men with known CVD. In addition, clinical studies have demonstrated that ED in men with no known CVD often precedes a CVD event by 2-5 years. ED severity has been correlated with increasing plaque burden in patients with coronary artery disease. ED is an independent marker of increased CVD risk including all-cause and especially CVD mortality, particularly in men aged 30-60 years. Thus, ED identifies a window of opportunity for CVD risk mitigation. We recommend that a thorough history, physical exam (including visceral adiposity), assessment of ED severity and duration and evaluation including fasting plasma glucose, lipids, resting electrocardiogram, family history, lifestyle factors, serum creatinine (estimated glomerular filtration rate) and albumin:creatinine ratio, and determination of the presence or absence of the metabolic syndrome be performed to characterise cardiovascular risk in all men with ED. Assessment of testosterone levels should also be considered and biomarkers may help to further quantify risk, even though their roles in development of CVD have not been firmly established. Finally, we recommend that a question about ED be included in assessment of CVD risk in all men and be added to CVD risk assessment guidelines

Updated Guidance Regarding The Risk ofAllergic Reactions to COVID-19 Vaccines and Recommended Evaluation and Management: A GRADE Assessment, and International Consensus Approach

This guidance updates 2021 GRADE (Grading of Recommendations Assessment, Development and Evaluation) recommendations regarding immediate allergic reactions following coronavirus disease 2019 (COVID-19) vaccines and addresses revaccinating individuals with first-dose allergic reactions and allergy testing to determine revaccination outcomes. Recent meta-analyses assessed the incidence of severe allergic reactions to initial COVID-19 vaccination, risk of mRNA-COVID-19 revaccination after an initial reaction, and diagnostic accuracy of COVID-19 vaccine and vaccine excipient testing in predicting reactions. GRADE methods informed rating the certainty of evidence and strength of recommendations. A modified Delphi panel consisting of experts in allergy, anaphylaxis, vaccinology, infectious diseases, emergency medicine, and primary care from Australia, Canada, Europe, Japan, South Africa, the United Kingdom, and the United States formed the recommendations. We recommend vaccination for persons without COVID-19 vaccine excipient allergy and revaccination after a prior immediate allergic reaction. We suggest against \u3e 15-minute postvaccination observation. We recommend against mRNA vaccine or excipient skin testing to predict outcomes. We suggest revaccination of persons with an immediate allergic reaction to the mRNA vaccine or excipients be performed by a person with vaccine allergy expertise in a properly equipped setting. We suggest against premedication, split-dosing, or special precautions because of a comorbid allergic history

The Gene Ontology knowledgebase in 2023

The Gene Ontology (GO) knowledgebase (http://geneontology.org) is a comprehensive resource concerning the functions of genes and gene products (proteins and noncoding RNAs). GO annotations cover genes from organisms across the tree of life as well as viruses, though most gene function knowledge currently derives from experiments carried out in a relatively small number of model organisms. Here, we provide an updated overview of the GO knowledgebase, as well as the efforts of the broad, international consortium of scientists that develops, maintains, and updates the GO knowledgebase. The GO knowledgebase consists of three components: (1) the GO-a computational knowledge structure describing the functional characteristics of genes; (2) GO annotations-evidence-supported statements asserting that a specific gene product has a particular functional characteristic; and (3) GO Causal Activity Models (GO-CAMs)-mechanistic models of molecular "pathways" (GO biological processes) created by linking multiple GO annotations using defined relations. Each of these components is continually expanded, revised, and updated in response to newly published discoveries and receives extensive QA checks, reviews, and user feedback. For each of these components, we provide a description of the current contents, recent developments to keep the knowledgebase up to date with new discoveries, and guidance on how users can best make use of the data that we provide. We conclude with future directions for the project

Trends in Obesity and Overweight in Oregon Children With Down Syndrome

Background . Although obesity is a commonly discussed issue in the medical management of children with Down syndrome, there have been no large studies published on its prevalence in the United States or associations with other common comorbidities in this population. Methods . Using a database of children from a single medical center Down syndrome specialty clinic and the standard Centers for Disease Control and Prevention definitions, we calculated rates of obesity and overweight by age group and examined possible associations with common comorbidities including cardiac disease, thyroid disease, sleep apnea, autism, and visual and hearing impairment. We also examined mean body mass index (BMI) percentile and change in BMI percentile by age. Results . Data were obtained from 823 visits from 412 unique patients ranging in age from 2 years to 23 years of age. A total of 1.2% were underweight, 55.2% were normal weight, 23% were overweight, and 20.6% were obese. BMI percentile increased with female gender, age, and height percentile for age. Sleep apnea was associated with higher BMI percentile, while autism was associated with lower BMI percentile. Conclusions . Children with Down syndrome have higher rates of obesity than the general population, with especially high risk for girls. Much of the increase in obesity occurs between ages 2 and 6 years. Further research needs to target interventions for prevention in this vulnerable population, particularly in young girls

Prevalence of malnutrition, obesity and nutritional risk of Australian paediatric inpatients: A national one-day snapshot

Aim Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric Australian hospitals. The current study is the first to measure the prevalence of malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout Australia. Methods Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across Australia on a single day. Malnutrition and obesity prevalence was determined using z-scores and body mass index (BMI) percentiles. High nutritional risk was determined as a Paediatric Yorkhill Malnutrition Score of 2 or more. Results The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as Aboriginal and Torres Strait Islander were more likely to have lower height-for-age z-scores (P < 0.01); however, BMI and weight-for-age z-scores were not significantly different. Children who were younger, from regional hospitals or with a primary diagnosis of cardiac disease or cystic fibrosis had significantly lower anthropometric z-scores (P = 0.05). Forty-four per cent of patients were identified as at high nutritional risk and requiring further nutritional assessment. Conclusions The prevalence of malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less

Prognostic utility of erectile dysfunction for cardiovascular disease in younger men and those with diabetes

Multiple published studies have established erectile dysfunction (ED) as an independent risk marker for cardiovascular disease (CVD). In fact, incident ED has a similar or greater predictive value for cardiovascular events than traditional risk factors including smoking, hyperlipidemia, and family history of myocardial infarction. Here, we review evidence that supports ED as a particularly significant harbinger of CVD in 2 populations: men &lt;60 years of age and those with diabetes. Although addition of ED to the Framingham Risk Score only modestly improved the 10-year predictive capacity of the Framingham Risk Score for myocardial infarction or coronary death data in men enrolled in the Massachusetts Male Aging Study, other epidemiologic studies suggest that the predictive value of ED is quite strong in younger men. Indeed, in the Olmstead County Study, men 40 to 49 years of age with ED had a 50-fold higher incidence of new-incident coronary artery disease than those without ED. However, ED had less predictive value (5-fold increased risk) for coronary artery disease in men 70 years and older. Several studies, including a large analysis of more than 6300 men enrolled in the ADVANCE study, suggest that ED is a particularly powerful predictor of CVD in diabetic men as well. Based on the literature reviewed here, we encourage physicians to inquire about ED symptoms in all men more than 30 years of age with cardiovascular risk factors. Identification of ED, particularly in men &lt;60 years old and those with diabetes, represents an important first step toward CVD risk detection and reduction. (Am Heart J 2012;164:21-8.

A simple nutrition screening tool for paediatric inpatients

Background:\ud \ud Pediatric nutrition risk screening tools are not routinely implemented throughout many hospitals, despite prevalence studies demonstrating malnutrition is common in hospitalized children. Existing tools lack the simplicity of those used to assess nutrition risk in the adult population. This study reports the accuracy of a new, quick, and simple pediatric nutrition screening tool (PNST) designed to be used for pediatric inpatients. \ud \ud Materials and Methods:\ud \ud The pediatric Subjective Global Nutrition Assessment (SGNA) and anthropometric measures were used to develop and assess the validity of 4 simple nutrition screening questions comprising the PNST. Participants were pediatric inpatients in 2 tertiary pediatric hospitals and 1 regional hospital. \ud \ud Results:\ud \ud Two affirmative answers to the PNST questions were found to maximize the specificity and sensitivity to the pediatric SGNA and body mass index (BMI) z scores for malnutrition in 295 patients. The PNST identified 37.6% of patients as being at nutrition risk, whereas the pediatric SGNA identified 34.2%. The sensitivity and specificity of the PNST compared with the pediatric SGNA were 77.8% and 82.1%, respectively. The sensitivity of the PNST at detecting patients with a BMI z score of less than -2 was 89.3%, and the specificity was 66.2%. Both the PNST and pediatric SGNA were relatively poor at detecting patients who were stunted or overweight, with the sensitivity and specificity being less than 69%. \ud \ud Conclusion:\ud \ud The PNST provides a sensitive, valid, and simpler alternative to existing pediatric nutrition screening tools such as Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), Screening Tool Risk on Nutritional status and Growth (STRONGkids), and Paediatric Yorkhill Malnutrition Score (PYMS) to ensure the early detection of hospitalized children at nutrition risk