Independent susceptibility markers for atrial fibrillation on chromosome 4q25

Background-: Genetic variants on chromosome 4q25 are associated with atrial fibrillation (AF). We sought to determine whether there is more than 1 susceptibility signal at this locus. Methods and results-: Thirty-four haplotype-tagging single-nucleotide polymorphisms (SNPs) at the 4q25 locus were genotyped in 790 case and 1177 control subjects from Massachusetts General Hospital and tested for association with AF. We replicated SNPs associated with AF after adjustment for the most significantly associated SNP in 5066 case and 30 661 referent subjects from the German Competence Network for Atrial Fibrillation, Atherosclerosis Risk In Communities Study, Cleveland Clinic Lone AF Study, Cardiovascular Health Study, and Rotterdam Study. All subjects were of European ancestry. A multimarker risk score composed of SNPs that tagged distinct AF susceptibility signals was constructed and tested for association with AF, and all results were subjected to meta-analysis. The previously reported SNP, rs2200733, was most significantly associated with AF (minor allele odds ratio 1.80, 95% confidence interval 1.50 to 2.15, P=1.2×10) in the discovery sample. Adjustment for rs2200733 genotype revealed 2 additional susceptibility signals marked by rs17570669 and rs3853445. A graded risk of AF was observed with an increasing number of AF risk alleles at SNPs that tagged these 3 susceptibility signals. Conclusions-: We identified 2 novel AF susceptibility signals on chromosome 4q25. Consideration of multiple susceptibility signals at chromosome 4q25 identifies individuals with an increased risk of AF and may localize regulatory elements at the locus with biological relevance in the pathogenesis of AF

Diving into the vertical dimension of elasmobranch movement ecology

Knowledge of the three-dimensional movement patterns of elasmobranchs is vital to understand their ecological roles and exposure to anthropogenic pressures. To date, comparative studies among species at global scales have mostly focused on horizontal movements. Our study addresses the knowledge gap of vertical movements by compiling the first global synthesis of vertical habitat use by elasmobranchs from data obtained by deployment of 989 biotelemetry tags on 38 elasmobranch species. Elasmobranchs displayed high intra- and interspecific variability in vertical movement patterns. Substantial vertical overlap was observed for many epipelagic elasmobranchs, indicating an increased likelihood to display spatial overlap, biologically interact, and share similar risk to anthropogenic threats that vary on a vertical gradient. We highlight the critical next steps toward incorporating vertical movement into global management and monitoring strategies for elasmobranchs, emphasizing the need to address geographic and taxonomic biases in deployments and to concurrently consider both horizontal and vertical movements

Potential impact of annual vaccination with reformulated COVID-19 vaccines: Lessons from the US COVID-19 scenario modeling hub

Background AU Coronavirus Disease 2019 (COVID-19) continues to cause :significant hospitalizations and deaths in the United States. Its continued burden and the impact of annually reformulated vaccines remain unclear. Here, we present projections of COVID-19 hospitalizations and deaths in the United States for the next 2 years under 2 plausible assumptions about immune escape (20% per year and 50% per year) and 3 possible CDC recommendations for the use of annually reformulated vaccines (no recommendation, vaccination for those aged 65 years and over, vaccination for all eligible age groups based on FDA approval). Methods and findings The COVID-19 Scenario Modeling Hub solicited projections of COVID-19 hospitalization and deaths between April 15, 2023 and April 15, 2025 under 6 scenarios representing the intersection of considered levels of immune escape and vaccination. Annually reformulated vaccines are assumed to be 65% effective against symptomatic infection with strains circulating on June 15 of each year and to become available on September 1. Age- and state-specific coverage in recommended groups was assumed to match that seen for the first (fall 2021) COVID-19 booster. State and national projections from 8 modeling teams were ensembled to produce projections for each scenario and expected reductions in disease outcomes due to vaccination over the projection period. From April 15, 2023 to April 15, 2025, COVID-19 is projected to cause annual epidemics peaking November to January. In the most pessimistic scenario (high immune escape, no vaccination recommendation), we project 2.1 million (90% projection interval (PI) [1,438,000, 4,270,000]) hospitalizations and 209,000 (90% PI [139,000, 461,000]) deaths, exceeding pre-pandemic mortality of influenza and pneumonia. In high immune escape scenarios, vaccination of those aged 65+ results in 230,000 (95% confidence interval (CI) [104,000, 355,000]) fewer hospitalizations and 33,000 (95% CI [12,000, 54,000]) fewer deaths, while vaccination of all eligible individuals results in 431,000 (95% CI: 264,000–598,000) fewer hospitalizations and 49,000 (95% CI [29,000, 69,000]) fewer deaths. Conclusions COVID-19 is projected to be a significant public health threat over the coming 2 years. Broad vaccination has the potential to substantially reduce the burden of this disease, saving tens of thousands of lives each year

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Field establishment of Santalum album L. – the effect of the time of introduction of a pot host (Alternanthera nana R. Br.)

Field establishment of the root hemi-parasite Santalum album L. under large-scale plantation conditions, until recently, has been largely unsuccessful. In this experiment, the growth of S. album seedlings grown with the herbaceous pot host Alternanthera nana R. Br. for 134, 109, 84, 60 and 35 days in a nursery container prior to field establishment was examined after 11, 16 and 23 weeks in the field. S. album survival and growth was greater, and root:shoot ratio was lower for the 23 weeks for S. album seedlings grown with A. nana compared with seedlings grown without a host. Seedlings grown with A. nana for 134 days in the nursery prior to field establishment had greater stem diameter, height and root, shoot and total plant dry weight (DW) over the 23 Weeks in the field than all other treatments. Seedlings grown with A. nana for 109 days in the nursery prior to field establishment had greater field survival than all other treatments. A: nana survival in the field remained high when grown with S. album for 134 and 109 days in the nursery prior to field establishment whereas survival within remaining treatments declined significantly and A. nana growth was significantly less. S. album grown with A. nana for 134 days in the nursery prior to field establishment had a lower root:shoot ratio than all other treatments at all assessments. A strong negative linear relationship exists between S. album root:shoot ratio and A. nana DW, whereas a positive linear relationship exists between S. album DW and A. nana DW. Foliar phosphorus and sodium concentrations for S. album were lower and foliar potassium concentration higher when seedlings were grown with A. nana for 134 days in the nursery prior to field establishment compared with the remaining treatments at the 16-week assessment. The period of the S. album:A. nana association in the nursery significantly influenced S. album survival and growth following field planting

Potential for irrigated tropical forestry in northern Western Australia

Several high value exotic tropical timber trees have been screened in irrigated species selection experiments, on both predominant soil types (the Cununurra clay and Cockatoo sand), as potential plantation species for the Ord River Irrigation Area (ORIA), northern Western Australia, over the past ten years. Santalum album (Indian sandalwood) has demonstrated potential as a plantation species on the flood irrigated Cununurra clay sites. S. album, a root hemi-parasite, requires a range of host species over its entire rotation length. Consequently, a relatively complex multi-species plantation system has been developed to maintain high plantation productivity. Wood quality issues, plantation policy and environmental implications of irrigated ORIA S. album plantations are also discussed. Damage from Mastotermes darwiniensis prevents long term survival of S. album and many other hardwoods on light textured soils in the region. The re-investigation into the reforestation of these soils has commenced with a range of previously untested species. The early performance of a species selection experiment on a trickle irrigated Cockatoo sand site is presented. At seven months of age Tectona grandis (teak), Pterocarpus macrocarpus (Burma padauk) and Khaya senegalenesis (African mahogany) exhibit good survival and growth