Is the daily use of public transport facilities an enhanced epidemiological risk for diagnosing COVID-19 among healthcare workers with mild respiratory symptoms?

Introduction: Many people in Switzerland think that the daily use of the public transport facilities, during a pandemic peak wave, could be associated with an enhanced risk for Covid-19. Objectives: To investigate the association between the daily use of the public transport and acquisition of Covid-19 in Zurch during a peak wave of the pandemics. Methods: Retrospective cohort analysis of hospital-own databases at the Balgrist University Hospital in Zurich, between 1 October and 31 December 2020. We specifically interviewed our healthcare workers (HCW) about the use of public transport (with mandatory masking). Results: During the three most intensive months of the 2nd wave, we investigated 376 episodes of Covid-19-compatible respiratory symptoms and exposures among our HCW (median age 37 years), of which 94 (25%) revealed a positive PCR result for Covid-19. Overall, 225 HCW (225/376;60%) reportedly used the public transport (train, bus, tramway). In group comparison, the HCWs using the public transport system acquired no more Covid-19 than using a private transport (58/225 vs. 36/151;Pearson-chi2-test;p = 0.67). We added a logistic regression model with the outcome “Covid-19 infection” to adjust for the case-mix of different localizations or opportunities of potential contamination such as a documented exposure in the hospital, among the team members, in the family, or after a close contact to a PCR-confirmed case. In the multivariate results, using the public transport was irrelevant concerning the acquisition of Covid- 19 (odds ratio (OR) 0.98, 95%CI 0.59-1.62), in contrast, for example, to being exposed to a sick team member (OR 2.28, 95%CI 1.20-4.34). Conclusion: In Zurich, the daily use of public transport was not associated with an additional risk of being diagnosed with Covid-19 among the young population of HCWs, not even during the peak of a pandemic wave. Other factors are more relevant

Red-giant and main-sequence solar-like oscillators in binary systems revealed by ESA Gaia Data Release 3 -- Reconstructing stellar and orbital evolution from binary-star ensemble seismology

Binary systems constitute a valuable astrophysics tool for testing our understanding of stellar structure and evolution. Systems containing a oscillating component are interesting as asteroseismology offers independent parameters for the oscillating component that aid the analysis. About 150 of such systems are known in the literature. To enlarge the sample of these benchmark objects, we crossmatch the Two-Body-Orbit Catalogue (TBO) of Gaia DR3, with catalogs of confirmed solar-like oscillators on the main-sequence and red-giant phase from NASA Kepler and TESS. We obtain 954 new binary system candidates hosting solar-like oscillators, of which 45 and 909 stars are on the main sequence and red-giant, resp., including 2 new red giants in eclipsing systems. 918 oscillators in potentially long-periodic systems are reported. We increase the sample size of known solar-like oscillators in binary systems by an order of magnitude. We present the seismic properties of the full sample and conclude that the grand majority of the orbital elements in the TBO is physically reasonable. 82% of all TBO binary candidates with multiple times with APOGEE are confirmed from radial-velocity measurement. However, we suggest that due to instrumental noise of the TESS satellite the seismically inferred masses and radii of stars with $\nu_\textrm{max}$$\lesssim$30$\mu$Hz could be significantly overestimated. For 146 giants the seismically inferred evolutionary state has been determined and shows clear differences in their distribution in the orbital parameters, which are accounted the accumulative effect of the equilibrium tide acting in these evolved binary systems. For other 146 systems hosting oscillating stars values for the orbital inclination were found in the TBO. From testing the TBO on the SB9 catalogue, we obtain a completeness factor of 1/3.Comment: under review for publication in A&A (22 pages + 4 pages of appendix, 21 figures, 33 pages of tables in the Appendix

Action observation can prime visual object recognition

Observing an action activates action representations in the motor system. Moreover, the representations of manipulable objects are closely linked to the motor systems at a functional and neuroanatomical level. Here, we investigated whether action observation can facilitate object recognition using an action priming paradigm. As prime stimuli we presented short video movies showing hands performing an action in interaction with an object (where the object itself was always removed from the video). The prime movie was followed by a (briefly presented) target object affording motor interactions that are either similar (congruent condition) or dissimilar (incongruent condition) to the prime action. Participants had to decide whether an object name shown after the target picture corresponds with the picture or not (picture–word matching task). We found superior accuracy for prime–target pairs with congruent as compared to incongruent actions across two experiments. Thus, action observation can facilitate recognition of a manipulable object typically involving a similar action. This action priming effect supports the notion that action representations play a functional role in object recognition

Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Antimicrobial protein and Peptide concentrations and activity in human breast milk consumed by preterm infants at risk of late-onset neonatal sepsis

Objective: We investigated the levels and antimicrobial activity of antimicrobial proteins and peptides (AMPs) in breast milk consumed by preterm infants, and whether deficiencies of these factors were associated with late-onset neonatal sepsis (LOS), a bacterial infection that frequently occurs in preterm infants in the neonatal period. Study design: Breast milk from mothers of preterm infants (≤32 weeks gestation) was collected on days 7 (n = 88) and 21 (n = 77) postpartum. Concentrations of lactoferrin, LL-37, beta-defensins 1 and 2, and alpha-defensin 5 were measured by enzyme-linked immunosorbent assay. The antimicrobial activity of breast milk samples against Staphylococcus epidermidis, Staphylococcus aureus, Escherichia coli, and Streptococcus agalactiae was compared to the activity of infant formula, alone or supplemented with physiological levels of AMPs. Samples of breast milk fed to infants with and without subsequent LOS were compared for levels of AMPs and inhibition of bacterial growth. Results: Levels of most AMPs and antibacterial activity in preterm breast milk were higher at day 7 than at day 21. Lactoferrin was the only AMP that limited pathogen growth >50% when added to formula at a concentration equivalent to that present in breast milk. Levels of AMPs were similar in the breast milk fed to infants with and without LOS, however, infants who developed LOS consumed significantly less breast milk and lower doses of milk AMPs than those who were free from LOS. Conclusions: The concentrations of lactoferrin and defensins in preterm breast milk have antimicrobial activity against common neonatal pathogens