In this multicenter cross-sectional study of two different approaches to universal SARS-CoV-2 admission testing, hybrid testing (SARS-CoV-2 for asymptomatic and multiplex for symptomatic) resulted in increased isolation days due to ordering errors among symptomatic patients. Universal multiplex testing minimized such errors while detection of asymptomatic non-SARS-CoV-2 viruses remained infrequent.

In test-negative study of residents exposed to viral respiratory infection (VRI), odds of VRI (excluding SARS-CoV-2) was higher with shared room (OR = 2.28, 95% CI, 1.53–3.40) and shared adjoining washroom (OR = 1.65, 95% CI, 1.03–2.64) than neighboring rooms. Measures recommended for exposed residents in shared rooms should be considered for shared washrooms.

Aims: ADHD is commonly comorbid with depression and this comorbidity is associated with increased symptom severity and worse outcomes than either condition alone. Depression is highly heterogeneous and may present differently in populations with ADHD. This study aimed to explore different symptom presentations of depression and associated clinical correlates in a clinical ADHD sample.

Methods: We analysed data from the Study of ADHD Genes and Environment (SAGE). Parents completed semi-structured questionnaires about their child’s psychopathology at baseline (mean age 10.9 years) and the Mood and Feelings Questionnaire to capture their child’s depression symptoms approximately 5 years later (mean age = 14.6 years, N=249). Depression symptom presentations were derived by latent profile analysis.

Results: Analyses found three presentations of depression symptoms: a ‘low symptoms’ (48.5% of the sample) class, a ‘high symptoms’ class (15.5%) with consistently high depression symptoms, particularly for suicidality and poor self-esteem items, and an ‘irritable/poor sleep’ class (36.1%) with intermediate levels of depression symptoms and high scores for irritability and poor sleep. All three classes had elevated irritability and symptoms that overlap with ADHD. Behavioural problems were associated with an increased likelihood of being in the high symptoms compared with low symptoms class, and higher autism symptoms were associated with being in the intermediate ‘irritable/poor sleep’ compared with low class.

Conclusion: Our findings suggest that while young people with ADHD often have elevated depression symptoms, there is notable heterogeneity. Young people with ADHD and behavioural disorders may be particularly at risk of more severe depression symptom presentations characterised by high suicidal cognitions, whilst those with ADHD and autistic traits may present with more irritability and poor sleep.

Access to clean and reliable water is critically important for health, well-being, and economic development. The natural, built, and social systems – which interact with each other and comprise the water system-of-systems – are threatened by intensifying hazards and stressors like crumbling infrastructure, floods, droughts, storms, wildfires, sea level rise, population growth, cyber threats, and pollution. Marginalized communities, including disadvantaged and rural communities and Tribal nations with insufficient access to clean water or regenerative sources of water, are often the most impacted. Responses to these issues are hampered by fragmented and uncoordinated governance and management. A multi-stakeholder structured engagement process at the SWIM conference and workshop held in December 2023 identified the most critical current and future issues facing the water sector and what needs to change to find solutions. This paper synthesized these issues. Highlighted issues were the vulnerability and lack of resilience of water systems to hazards and stressors, inequities associated with water scarcity, and water quality problems – all affected by climate change, land-use change, and socio-economic changes. The Smart One Water (S1W) vision provided an important context for the conference. This paper expands the S1W vision with a synthesis of discussions about S1W-related fundamental concepts, practices, and implementation barriers.

Low vitamin D associated with high parathyroid hormone (PTH) is common in HIV infection. We determined the association between total 25(OH)D and PTH in adolescents living with HIV, in Zambia and Zimbabwe. Adolescents (11–19 years) perinatally infected with HIV and established on antiretroviral therapy for ≥ 6 months were recruited into a cross-sectional study. Socio-demographic and clinical characteristics were recorded, anthropometry measured and fasted serum concentrations of 1,25(OH)2D, total 25(OH)D and intact PTH measured. The association between total 25(OH)D and PTH was examined using natural cubic spline regression. 842 participants (female: 53·2%) with a median age of 15·5 (IQR: 13·2–17·9) years were enrolled. Median antiretroviral therapy duration was 9·8 (IQR: 6·3–12·3) years, and 165/841 had an HIV viral-load >60 copies/ml. Stunting (height-for-age z-score <–2) and underweight (weight-for-age z-score <–2) were observed in 29·9 and 30·0%, respectively. Three-quarters reported daily Ca intakes <150 mg/d. The mean (sd) concentrations of total 25(OH)D and 1,25(OH)2D were 66·1(16·5) nmol/l and 210·6 (70·4) pmol/l, respectively, and median PTH level was 4·3 (IQR: 3·3–5·5) pmol/l. There was an inverse non-linear relationship between total 25(OH)D and PTH, 25(OH)D levelling off at 74·6 nmol/l (95 % CI: 74·5, 75·2). Results were consistent in those taking tenofovir disoproxil fumarate and virally unsuppressed participants. In this population with extremely low habitual Ca intakes, the lack of association between 25(OH)D and PTH when 25(OH)D exceeded 75 nmol/l potentially suggests that levels of 25(OH)D >75 nmol/l may need to be achieved to improve bone health; investigation is needed in future research studies.

A daily prompt to offer vaccination to inpatients awaiting transfer to rehabilitation resulted in increased SARS-CoV-2 (OR 5.64, 95% CI 3.3–10.15; P < 0.001) and influenza (OR 3.80, 95% CI 2.45–6.06; P < 0.001) vaccination. Compared to baseline, this intervention was associated with reduced incidence of viral respiratory infection during subsequent admission to rehabilitation.

Background: The prevalence of carbapenemase-producing Enterobacteriaceae (CPE) is increasing worldwide. In Canada, where rates of healthcare-associated (HA) transmission of CPE remains relatively low, there is a need to share early experience of universal screening programs and risk factors for HA acquisition. Method: In 2018, universal screening was introduced throughout our large Canadian tertiary care hospital across, all critical care and oncology units. Additionally, risk-factor based screening was applied in all other inpatient units, with further targeted screening of roommate exposures or all inpatients on unit following identification of a single HA case. A retrospective cohort study was carried out on CPE cases detected between January 2018 and December 2023. We assessed the proportion of HA CPE cases, defined as CPE identified in patients with prior admission to our facility or after >72 hours after admission. HA cases were examined for relevant risk factors, including known roommate with CPE, the presence of other CPE on the unit, exposure to outbreak units, prior travel history, travel by a family member, and antibiotic exposure within the past 90 days. Result: A total of 150 CPE cases were identified, with 66 (44%) classified as HA. Among these HA cases, 14 (21%) were associated with presence of known case on the unit. The remaining 52 (79%) represented sporadic nosocomial cases without a known exposure or further transmission on the unit. Upon further retrospective review, 6 (9.2%) HA cases had documented travel history or exposure to a family member with recent travel to China, India, Sri Lanka, or the United States within the past year. Nearly all HA cases (62, 95.4%) had antibiotic exposure within 90 days of CPE detection; specifically, 47 (72.3%) received beta-lactams, 42 (64.6%) cephalosporin, 25 (38.5%) glycopeptide, 20 (30.8%) carbapenem, and 8 (12.3%) macrolide. Conclusion: HA CPE acquisition identified during the first 5-years of universal screening were mostly sporadic and not associated with known exposures or other risk factors. Receipt of prior antibiotics was present in nearly all cases.

Asymptomatic screening for SARS-CoV-2 is recommended in healthcare settings during periods of increased incidence, yet studies in rehabilitation settings are lacking. Routine weekly post-admission asymptomatic testing in a rehabilitation facility offered marginal gain beyond syndromic and targeted unit testing and was not associated with a reduced risk of healthcare-associated COVID-19.

Wastewater-based epidemiology (WBE) has proven to be a powerful tool for the population-level monitoring of pathogens, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). For assessment, several wastewater sampling regimes and methods of viral concentration have been investigated, mainly targeting SARS-CoV-2. However, the use of passive samplers in near-source environments for a range of viruses in wastewater is still under-investigated. To address this, near-source passive samples were taken at four locations targeting student hall of residence. These were chosen as an exemplar due to their high population density and perceived risk of disease transmission. Viruses investigated were SARS-CoV-2 and its variants of concern (VOCs), influenza viruses, and enteroviruses. Sampling was conducted either in the morning, where passive samplers were in place overnight (17 h) and during the day, with exposure of 7 h. We demonstrated the usefulness of near-source passive sampling for the detection of VOCs using quantitative polymerase chain reaction (qPCR) and next-generation sequencing (NGS). Furthermore, several outbreaks of influenza A and sporadic outbreaks of enteroviruses (some associated with enterovirus D68 and coxsackieviruses) were identified among the resident student population, providing evidence of the usefulness of near-source, in-sewer sampling for monitoring the health of high population density communities.

Changes in abundance and distribution of marine top predators can indicate environmental change or anthropogenic pressure requiring management response. Here, we used an extensive dataset (21 years) to conduct a spatial and temporal analysis of grey seal strandings in Cornwall and the Isles of Scilly, close to the southern edge of the breeding range of the species. A total of 2007 strandings were reported from 2000 to 2020, increasing by 474% from 35 to 201 individuals per year during this period. The continued rise in strandings was consistent across all life stages and timeframes (5, 10 and 20 years), underpinning the suggestion of increasing abundance in the region. The observed seasonality differed by life stage, coinciding with the increased presence of animals near the coast for key life phases such as breeding, moulting and pupping. Strandings are widely distributed across the coast of Cornwall and the Isles of Scilly; however, most strandings were recorded on the north coast of Cornwall (70%) where major pupping and haul out sites are found. Despite hosting several pupping and haul out sites, a small proportion was recorded on the Isles of Scilly (5%) where it is thought that strandings are particularly underreported. Describing baselines in magnitude of strandings and life-stage compositions across space and time allows future deviations in frequency, demographic composition or spatial distribution to be detected and investigated. We demonstrate the utility of long-term citizen science data to provide valuable and cost-effective information on the distribution and abundance of a highly mobile marine mammal.

Weed management is consistently ranked among the top priorities of the United States sweetpotato industry. To provide additional weed and insect management strategies for sweetpotato, we initiated development of insect-resistant germplasm that also has weed tolerance by breeding and selecting for sweetpotato clones that are fast growing and have semi-erect to erect canopy architecture. Field studies were conducted in 2018 and 2019 in Charleston, South Carolina, to quantify the effects of weed-free interval and sweetpotato clone on weed counts for naturally occurring weed species, storage root yield, and insect resistance to the major pests of sweetpotato. Weed-free intervals included plots that were weedy all season and weed-free for 2, 3, and 4 wk after transplanting. Sweetpotato clones evaluated included ‘Beauregard’, ‘Covington’, ‘Monaco’, and six advanced selections with semi-erect to erect plant habit. Significant weed-free interval and sweetpotato clone main effects were observed for all variables measured, but not for their interaction. Two sweetpotato clones, USDA-17-037 and USDA-17-077, were consistent across both years and had the lowest weed counts, exhibited enhanced insect resistance, and were the highest yielding entries. These results demonstrate the potential for development of insect-resistant sweetpotato germplasm with a vigorous, erect plant habit that may be less susceptible to weed interference than cultivars with spreading shoot growth. The combination of germplasm that is both resistant to insect pests and competitive with weeds can provide organic and subsistence sweetpotato growers solutions to these critical issues related to sweetpotato production.