Genomic epidemiology reveals multiple introductions of Zika virus into the United States

Zika virus (ZIKV) is causing an unprecedented epidemic linked to severe congenital abnormalities. In July 2016, mosquito-borne ZIKV transmission was reported in the continental United States; since then, hundreds of locally acquired infections have been reported in Florida. To gain insights into the timing, source, and likely route(s) of ZIKV introduction, we tracked the virus from its first detection in Florida by sequencing ZIKV genomes from infected patients and Aedes aegypti mosquitoes. We show that at least 4 introductions, but potentially as many as 40, contributed to the outbreak in Florida and that local transmission is likely to have started in the spring of 2016-several months before its initial detection. By analysing surveillance and genetic data, we show that ZIKV moved among transmission zones in Miami. Our analyses show that most introductions were linked to the Caribbean, a finding corroborated by the high incidence rates and traffic volumes from the region into the Miami area. Our study provides an understanding of how ZIKV initiates transmission in new regions

Shared genetic risk between eating disorder- and substance-use-related phenotypes:Evidence from genome-wide association studies

First published: 16 February 202

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

The Effectiveness of a Group Intervention to Improve Coping Skills for Emotion Regulation in Preadolescent and Adolescent Males with Attachment Difficulties

This study was designed to assess the effectiveness of a six session cognitive-behavioral group intervention to improve coping skills for emotional regulation in male preadolescents and adolescents with attachment difficulties. There is a lack of research in the area of group interventions with male adolescents as well as interventions for adolescents with attachment difficulties. A multiple probe across groups and a multiple baseline across groups design were used in this study. The measures assessed difficulties in emotion regulation, coping strategies, adolescent adjustment, anger control, negative behaviors, and level of distress. Although there were no substantial findings and no hypotheses were supported, the current study did find that the participants enjoyed the group interaction and some wished to continue the group

Paramedic-performed digital nerve block to facilitate field reduction of a dislocated finger

This short report describes the use of digital nerve block by a paramedic to facilitate the reduction of a dislocated finger in the prehospital setting. The finger was successfully reduced at the scene without requiring administration of parenteral opioids. The patient was reluctant to visit an emergency department, but was able to be referred to a local primary care practice for postreduction imaging and further care. Paramedic-performed local and regional anesthesia has not been previously described in the emergency medicine or emergency medical services literature. With appropriate training, prehospital digital nerve blocks may be a feasible option to supplement existing paramedic analgesic options

Airways in out-of-hospital cardiac arrest: systematic review and meta-analysis

Objective. To determine the differences in survival for out-of-hospital advanced airway intervention (AAI) compared with basic airway intervention (BAI) in cardiac arrest. Background. AAI is commonly utilized in cardiac arrest in the out-of-hospital setting as a means to secure the airway. Observational studies and clinical trials of AAI suggest that AAI is associated with worse outcomes in terms of survival. No controlled trials exist that compares AAI to BAI. Methods. We conducted a bias-adjusted meta-analysis on 17 observational studies. The outcomes were survival, short-term (return of spontaneous circulation and to hospital admission), and longer-term (to discharge, to one month survival). We undertook sensitivity analyses by analyzing patients separately: those who were 16 years and older, nontrauma only, and attempted versus successful AAI. Results. This meta-analysis included 388,878 patients. The short-term survival for AAI compared to BAI were overall OR 0.84(95% CI 0.62 to 1.13), for endotracheal intubation (ETI) OR 0.79 (95% CI 0.54 to 1.16), and for supraglottic airways (SGA) OR 0.59 (95% CI 0.39 to 0.89). Long-term survival for AAI were overall OR 0.49 (95% CI 0.37 to 0.65), for ETI OR 0.48 (95% CI 0.36 to 0.64), and for SGA OR 0.35 (95% CI 0.28 to 0.44). Sensitivity analyses shows that limiting analyses to adults, non-trauma victims, and instances where AAI was both attempted and successful did not alter results meaningfully. A third of all studies did not adjust for any other confounding factors that could impact on survival. Conclusions. This meta-analysis shows decreased survival for AAIs used out-of-hospital in cardiac arrest, but are likely biased due to confounding, especially confounding by indication. A properly conducted prospective study or a controlled trial is urgently needed and are possible to do