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Posttraumatic stress disorder (PTSD) has been associated with advanced epigenetic age cross-sectionally, but the association between these variables over time is unclear. This study conducted meta-analyses to test whether new-onset PTSD diagnosis and changes in PTSD symptom severity over time were associated with changes in two metrics of epigenetic aging over two time points.
Methods
We conducted meta-analyses of the association between change in PTSD diagnosis and symptom severity and change in epigenetic age acceleration/deceleration (age-adjusted DNA methylation age residuals as per the Horvath and GrimAge metrics) using data from 7 military and civilian cohorts participating in the Psychiatric Genomics Consortium PTSD Epigenetics Workgroup (total N = 1,367).
Results
Meta-analysis revealed that the interaction between Time 1 (T1) Horvath age residuals and new-onset PTSD over time was significantly associated with Horvath age residuals at T2 (meta β = 0.16, meta p = 0.02, p-adj = 0.03). The interaction between T1 Horvath age residuals and changes in PTSD symptom severity over time was significantly related to Horvath age residuals at T2 (meta β = 0.24, meta p = 0.05). No associations were observed for GrimAge residuals.
Conclusions
Results indicated that individuals who developed new-onset PTSD or showed increased PTSD symptom severity over time evidenced greater epigenetic age acceleration at follow-up than would be expected based on baseline age acceleration. This suggests that PTSD may accelerate biological aging over time and highlights the need for intervention studies to determine if PTSD treatment has a beneficial effect on the aging methylome.
In December 2018, an outbreak of Salmonella Enteritidis infections was identified in Canada by whole-genome sequencing (WGS). An investigation was initiated to identify the source of the illnesses, which proved challenging and complex. Microbiological hypothesis generation methods included comparisons of Salmonella isolate sequence data to historical domestic outbreaks and international repositories. Epidemiological hypothesis generation methods included routine case interviews, open-ended centralized re-interviewing, thematic analysis of open-ended interview data, collection of purchase records, a grocery store site visit, analytic comparison to healthy control groups, and case–case analyses. Food safety hypothesis testing methods included food sample collection and analysis, and traceback investigations. Overall, 83 cases were identified across seven provinces, with onset dates from 6 November 2018 to 7 May 2019. Case ages ranged from 1 to 88 years; 60% (50/83) were female; 39% (22/56) were hospitalized; and three deaths were reported. Brand X profiteroles and eclairs imported from Thailand were identified as the source of the outbreak, and eggs from an unregistered facility were hypothesized as the likely cause of contamination. This study aims to describe the outbreak investigation and highlight the multiple hypothesis generation methods that were employed to identify the source.
Patients with Fontan failure are high-risk candidates for heart transplantation and other advanced therapies. Understanding the outcomes following initial heart failure consultation can help define appropriate timing of referral for advanced heart failure care.
Methods:
This is a survey study of heart failure providers seeing any Fontan patient for initial heart failure care. Part 1 of the survey captured data on clinical characteristics at the time of heart failure consultation, and Part 2, completed 30 days later, captured outcomes (death, transplant evaluation outcome, and other interventions). Patients were classified as “too late” (death or declined for transplant due to being too sick) and/or “care escalation” (ventricular assist device implanted, inotrope initiated, and/or listed for transplant), within 30 days. “Late referral” was defined as those referred too late and/or had care escalation.
Results:
Between 7/2020 and 7/2022, 77 Fontan patients (52% inpatient) had an initial heart failure consultation. Ten per cent were referred too late (6 were too sick for heart transplantation with one subsequent death, and two others died without heart transplantation evaluation, within 30 days), and 36% had care escalation (21 listed ± 5 ventricular assist device implanted ± 6 inotrope initiated). Overall, 42% were late referrals. Heart failure consultation < 1 year after Fontan surgery was strongly associated with late referral (OR 6.2, 95% CI 1.8–21.5, p=0.004).
Conclusions:
Over 40% of Fontan patients seen for an initial heart failure consultation were late referrals, with 10% dying or being declined for transplant within a month of consultation. Earlier referral, particularly for those with heart failure soon after Fontan surgery, should be encouraged.
Hitler's Machtergreifung, or seizure of power, on January 30, 1933, marked the end of the Weimar Republic and the beginning of the Third Reich, and German film scholarship has generally accepted this date as the break between Weimar and Nazi-era film as well. This collection of essays interrogates the continuities and discontinuities in German cinema before and after January 1933 and theirrelationship to the various crises of the years 1928 to 1936 in seven areas: politics, the economy, concepts of race and ethnicity, the making of cinema stars, genre cinema, film technologies and aesthetics, and German-international film relations. Focusing both on canonical and lesser-known works, the essays analyze a representative sample of films and genres from the period. This book will be ofinterest to scholars and students of Weimar and Third Reich cinema and of the sociopolitical, economic, racial, artistic, and technological spheres in both late Weimar and the early Third Reich, as well as to film scholars in general.
Contributors: Paul Flaig, Margrit Frölich, Barbara Hales, Anjeana Hans, Bastian Heinsohn, Brook Henkel, Kevin B. Johnson, Owen Lyons, Richard W. McCormick, Kalani Michell, Mihaela Petrescu, Christian Rogowski, Valerie Weinstein, Wilfried Wilms.
Barbara Hales is Associate Professor of History at the University of Houston-Clear Lake. MihaelaPetrescu is Visiting Lecturer at the University of Pittsburgh. Valerie Weinstein is Assistant Professor of Women's, Gender, and Sexuality Studies and German Studies at the University of Cincinnati.
The role of the Eurasian badger (Meles meles) as a wildlife host has complicated the management of bovine tuberculosis (bTB) in cattle. Badger ranging behaviour has previously been found to be altered by culling of badgers and has been suggested to increase the transmission of bTB either among badgers or between badgers and cattle. In 2014, a five-year bTB intervention research project in a 100 km2 area in Northern Ireland was initiated involving selective removal of dual path platform (DPP) VetTB (immunoassay) test positive badgers and vaccination followed by release of DPP test negative badgers (‘Test and Vaccinate or Remove’). Home range sizes, based on position data obtained from global positioning system collared badgers, were compared between the first year of the project, where no DPP test positive badgers were removed, and follow-up years 2–4 when DPP test positive badgers were removed. A total of 105 individual badgers were followed over 21 200 collar tracking nights. Using multivariable analyses, neither annual nor monthly home ranges differed significantly in size between years, suggesting they were not significantly altered by the bTB intervention that was applied in the study area.
In this paper, we address how the COVID-19 pandemic has impacted informed consent for clinical research through examining experiences within Clinical and Translation Science Award (CTSA) institutions. We begin with a brief overview of informed consent and the challenges that existed prior to COVID-19. Then, we discuss how informed consent processes were modified or changed to address the pandemic, consider what lessons were learned, and present research and policy steps to prepare for future research and public health crises. The experiences and challenges for CTSA institutions offer an important perspective for examining what we have learned about informed consent and determining the next steps for improving the consent process.
UNAIDS established fast-track targets of 73% and 86% viral suppression among human immunodeficiency virus (HIV)-positive individuals by 2020 and 2030, respectively. The epidemiologic impact of achieving these goals is unknown. The HIV-Calibrated Dynamic Model, a calibrated agent-based model of HIV transmission, is used to examine scenarios of incremental improvements to the testing and antiretroviral therapy (ART) continuum in South Africa in 2015. The speed of intervention availability is explored, comparing policies for their predicted effects on incidence, prevalence and achievement of fast-track targets in 2020 and 2030. Moderate (30%) improvements in the continuum will not achieve 2020 or 2030 targets and have modest impacts on incidence and prevalence. Improving the continuum by 80% and increasing availability reduces incidence from 2.54 to 0.80 per 100 person-years (−1.73, interquartile range (IQR): −1.42, −2.13) and prevalence from 26.0 to 24.6% (−1.4 percentage points, IQR: −0.88, −1.92) from 2015 to 2030 and achieves fast track targets in 2020 and 2030. Achieving 90-90-90 in South Africa is possible with large improvements to the testing and treatment continuum. The epidemiologic impact of these improvements depends on the balance between survival and transmission benefits of ART with the potential for incidence to remain high.
Water samples from eight locations, ranging in pH from 7.1 to 8.5, were tested to determine the effect of carbon dioxide (CO2) pressurization on pH. After pressurization with CO2 the pH of the water decreased 1.8 to 4.1 pH units. An increase of 0.4 to 1.2 pH units occurred after the CO2 pressurized water exited a spray nozzle. The use of N2 or air as a pressurizing gas had very little effect on pH. The addition of diammonium phosphate, urea-ammonium nitrate (UAN)3, or ammonium sulfate had only minor effects on water pH. The addition of monoammonium phosphate reduced water pH to 4.6 to 5.5. The physical/chemical properties and activity of a herbicide may be altered with the change in spray solution pH by using CO2 to pressurize the spray solution.
Traditionally, Weimar cinema has been equated with the work of a handful of auteurist filmmakers and a limited number of canonical films. Often a single, limited phenomenon, "expressionist film," has been taken as synonymous with the cinema of the entire period. But in recent decades, such reductive assessments have been challenged by developments in film theory and archival research that highlight the tremendous richness and diversity of Weimar cinema. This widening of focus has brought attention to issues such as film as commodity; questions of technology and genre; transnational collaborations and national identity; effects of changes in socioeconomics and gender roles on film spectatorship; and connections between film and other arts and media. Such shifts have been accompanied by archival research that has made a cornucopia of new information available, now augmented by the increased availability of films from the period on DVD. This wealth of new source material calls fora re-evaluation of Weimar cinema that considers the legacies of lesser-known directors and producers, popular genres, experiments of the artistic avant-garde, and nonfiction films, all of which are aspects attended to by the essays in this volume.
Contributors: Ofer Ashkenazi, Jaimey Fisher, Veronika Fuechtner, Joseph Garncarz, Barbara Hales, Anjeana Hans, Richard W. McCormick, Nancy P.Nenno, Elizabeth Otto, Mihaela Petrescu, Theodore F. Rippey, Christian Rogowski, Jill Smith, Philipp Stiasny, Chris Wahl, Cynthia Walk, Valerie Weinstein, Joel Westerdale.
Christian Rogowski is Professor of German at Amherst College.