bluuebunny/crossref_metadata_2025 huggingface dataset:
Interactions between dingoes and introduced wild ungulates: concepts, evidence and knowledge gaps
Authors: Forsyth David M. , Latham A. David M. , Davis Naomi E. , Caley Peter , Letnic Mike , Moloney Paul D. , Woodford Luke P. , Woolnough Andrew P.
Published: March 2018

The dingo (Canis dingo or C. familiaris, including hybrids with feral dogs) is the apex carnivore on mainland Australia. Fifteen non-native ungulate species have established wild populations in Australia. Dingoes are managed to reduce impacts on domestic ungulates, and introduced wild ungulates are managed to reduce impacts on natural ecosystems and to minimise competition with domestic ungulates. There is speculation about the extent to which (1) dingoes limit the abundances of introduced wild ungulates, and (2) introduced wild ungulates sustain dingo populations. We reviewed the literature to identify potential ecological interactions between dingoes and introduced wild ungulates, and to synthesise evidence for interactions between dingoes and each ungulate species (including the percentage frequency occurrence (%FO) of ungulates in dingo diets). Eleven of the 15 ungulate species were recorded in the diet of dingoes, with the highest %FO occurrences reported for feral goats (73%) and cattle (60%). Two studies concluded that dingoes reduced ungulate abundances (feral goat (Capra hircus) and feral donkey (Equus asinus)), and two studies concluded that dingoes did not regulate feral pig (Sus scrofa) abundances. A fifth study concluded that dingoes exhibited a Type III functional response to increasing sambar deer (Cervus unicolor) abundances. A sixth study concluded that dingoes made relatively little use of hunter-shot sambar deer carcasses. We propose that interactions between dingoes and introduced wild ungulates depend on the sex–age classes vulnerable to dingo predation, dingo pack sizes, the availability of escape terrain for ungulates and the availability of alternative foods for dingoes. The interplay between environmental conditions and the population growth rate of ungulates, and hence their ability to sustain losses from predation, could also be important. We predict that dingoes will have most impact on the abundance of smaller ungulate species and neonates.
Quantitative trait loci for sensory and textural properties of Chinese white noodles from a population of recombinant inbred lines of winter wheat
Authors: Zhang Xiaocun , Fu Yanwu , Xu Yiru , Guo Ying
Published: March 2018

In this paper, we detected quantitative trait loci (QTLs) for two of the most important quality factors of Chinese white noodles (CWN), sensory quality and textural properties, using a recombinant inbred line (RIL) population containing 184 lines derived from the cross between two Chinese winter wheat (Triticum aestivum L.) varieties, Linmai6 and Tainong18. Twenty-six QTLs for eight sensory quality traits were identified on chromosomes 1A, 2A, 3A, 4A, 5A, 6A, 2B, 3B 4B, 5B, 6B 7B, 2D, 4D, 5D and 6D that explained 7.0–16.84% of the phenotypic variance. Fourteen QTLs associated with textural quality traits were identified on chromosomes 1B, 2D, 3A, 3B, 4A, 5B, 5D and 7D that explained 5.94–13.15% of the phenotypic variance. Six QTLs associated with hardness, adhesiveness, cohesiveness, gumminess, resilience and appearance were mapped to chromosome 4A, indicating that this chromosome was important for textural and sensory properties of CWN. This study furthers understanding of the genetic basis for sensory quality and textural properties of CWN and provides the basis for gene mapping of these traits.
Improved leaf nitrogen reutilisation and Rubisco activation under short-term nitrogen-deficient conditions promotes photosynthesis in winter wheat (Triticum aestivum L.) at the seedling stage
Authors: Gao Jingwen , Wang Feng , Hu Hang , Jiang Suyu , Muhammad Abid , Shao Yuhang , Sun Chuanjiao , Tian Zhongwei , Jiang Dong , Dai Tingbo
Published: March 2018

Excess N input results in low N use efficiency and environmental crisis, so nitrogenous fertiliser applications must be reduced. However, this can lead to low-N stress. Previous studies on low N have not explored the unique adjustment strategy to N deficiency in the short term, which is important for developing long-term N deficiency tolerance. In this case, two wheat (Triticum aestivum L.) cultivars with different tolerances to low N, Zaoyangmai (sensitive) and Yangmai158 (tolerant), were exposed to 0.25 mM N as a N-deficient condition with 5.0 mM N as a control. Under long-term N-deficient conditions, a significant decrease in Rubisco content resulted in decreased Rubisco activity and net photosynthetic rate (Pn) in both cultivars. However, the NO3– : soluble protein ratio decreased, and nitrate reductase and glutamine synthetase activity increased under short-term N deficiency, especially in Yangmai158. As a result, Rubisco content was not decreased in Yangmai158, while total N content decreased significantly. Moreover, increased Rubisco activase activity promoted Rubisco activation under short-term N deficiency. In sequence, Rubisco activity and Pn improved under short-term N deficiency. In conclusion, N deficiency-tolerant cultivars can efficiently assimilate N to Rubisco and enhance Rubisco activation to improve photosynthetic capabilities under short-term N deficiency conditions.
Spiders as potential bioindicators of mountain grasslands health: the Argentine tarantula Grammostola vachoni (Araneae, Theraphosidae)
Authors: Schwerdt Leonela , Elena de Villalobos Ana , Miles Fernando Pérez
Published: March 2018

Context
Bioindicators are used for conservation prioritisation by means of spatial comparisons of a site value, or monitoring of ecosystem recovery or response to management. Spiders are characterised by their selection of quality habitats and guild responses to environmental change. However, they have only occasionally been used as bioindicators. Grammostola vachoni is an endemic tarantula that only occurs in the grasslands of the mountainous system in central Argentina and it is included in the Red List of the IUCN as Vulnerable.

Aims
In this study, we performed a characterisation of the microhabitat of G. vachoni at sites with different disturbance regimes and we analysed the potential use of this species as a bioindicator of mountain grassland health.

Methods
We determined the microhabitat characteristics around their refuges by mean of the soil parameters, as well as the composition and structure of vegetation and amount of refuge available.

Key results
We found significant differences in the number of individuals and the percentage of occupation between sites. No significant differences were recorded in the soil characteristics and occupation of G. vachoni but we found that the composition of vegetation, and the heterogeneity and diversity of plants are influenced by different disturbance regimes, altering the distribution of spiders.

Conclusions
Our results are consistent with those of other studies where the spiders have proved to be good bioindicators of different disturbances and we propose for the first time a Theraphosidae species for evaluating the state or health of a natural grassland.

Implications
The information reported in this study is very important to provide data for a future re-categorisation of G. vachoni for the Red List of IUCN. Also, we add new component of ecosystems for to use as indicator, open up the possibility for new research for the same and other species of a grasslands of the mountainous system.
Predation pressure on the hatching of the Kentish plover (Charadrius alexandrinus) in clutch protection projects: a case study in north Portugal
Authors: Ferreira-Rodríguez Noé , Pombal Manuel A.
Published: March 2018

Context
The decline of Kentish plover (Charadrius alexandrinus) populations is related to a great variety of factors, including habitat loss, predators and human activities. In particular, predators have been identified as the main factor of low hatching success in many areas. However, few manipulative experiments have addressed this issue.

Aims
This study was designed to analyse the advantages, but also threats, of the protection measures commonly adopted in clutch protection programs.

Methods
Through camera traps, monitoring animal tracks and opportunistic observation we identified potential predators. Additionally, predation risk was assessed through simulated clutches. To improve hatching success, antipredator measures were adopted and their effectiveness analysed.

Key results
Our results show that under natural conditions, most simulated clutches will not complete the incubation period. Primary causes of hatching failure are predation, flooding, desertion and mechanical cleaning of the beaches, but another cause is accidental trampling. In this regard, protection measures greatly increased hatching success.

Conclusions
The use of clutch protection measures greatly increases hatching success in Kentish plovers. Nevertheless, protection measures are related to an increasing harassment of incubating adults, which could result in clutch desertion or adult predation.

Implications
Altogether, current results suggest that the efficiency of protection measures needs to be tested and adapted to each particular area; this is because there are a high number of correlated factors that might drastically affect the results in each case.
Intermedia visual agenda setting
Authors: Lough Kyser
Published: March 2018

This study combines and extends two existing aspects of agenda setting: intermedia and visual agenda setting. It defines and explores intermedia visual agenda setting by comparing the Associated Press’ top photos to what appears on the front pages of top-circulation U.S. newspapers. Only 25.88% of Associated Press photos used on the front pages came from the Associated Press’ top visual agenda, but findings indicate top general news photos are more likely to be used and top sports photos are less likely to be used. Additionally, photos from the Associated Press’ top visual agenda are more likely to be in non-dominant positions on the front page. These findings indicate that some intermedia visual agenda setting takes place and calls for more research in this area.
Democratization or censorship?
Authors: De Maio Mariana
Published: March 2018

Using second-level agenda setting, this paper examines the coverage of Argentina’s 2009 media reform. To investigate the attributes the media used, data were collected from three national newspapers’ online publications (Clarín, La Nación, andPágina/12). Results from the analysis suggest that the newspapers used different attributes and tone based on their political leanings. Content analysis before and after selected court’s rulings on the new media law demonstrate thatLa NaciónandClaríntended to converge in the way they used attributes and tone. When the rulings went against the interests ofClarínandLa Nación, both newspapers reacted negatively, in tone and attribute, relative toPágina/12.
Ultra-high-density silicon nanocone arrays with sharp tips by Ar+ sputtering at low temperature
Authors: Wang Hongjun , Li Qintao , Wu Xiujuan
Published: March 2018

Ultra-high-density silicon nanocone arrays with sharp tips have been fabricated by Ar+ sputtering at low temperatures. The investigation of SEM and AFM indicates that with an increasing substrate temperature from room temperature, 200 to 400°C, the density of silicon nanocone increases from 1–2 × 109, 3–4 × 109 to 1–2 × 1010 cm−2, respectively. The rooter diameter of the cones decreases from 120–150 to 40–50 nm and the tip angle of cones decreases from 32–36° to 20–26°. As predicted by the Bradley–Harper theory, the ripple wavelength decreases with substrate temperature during the carbon ripple formation process, which leads to an increase in the silicon nanocone density and a decrease in the silicon nanocone rooter diameter.
Implementing Single-Item Screening for Drug use in a Veterans Health Administration Outpatient Setting
Authors: Hodgkin Dominic , Gao Wenwu , Merrick Elizabeth L. , Drebing Charles E. , Larson Mary Jo , Horgan Constance M. , Sharma Monica , Petry Nancy M. , Saitz Richard
Published: March 2018

Background: Unhealthy drug use is a concern in many settings, including military and veteran populations. In 2013, the Veterans Health Administration (VHA) medical center in Bedford, Massachusetts, started requiring routine screening for unhealthy drug use in outpatient primary care and mental health settings, using a validated single question. Methods: This study used descriptive and multivariable analyses of VHA electronic records for patients eligible for the screening program ( N = 16,118). The study assessed first-year rates and predictors of screening and of positive screens, both for drug use and for unhealthy alcohol use, for which screening was already required. Results: During the first year, 70% of patients were screened for unhealthy drug use and 84% were screened for unhealthy alcohol use. In multivariable analyses, screening for drug use was more likely for patients who had 8 or more days with VHA visits or were aged 40 or over. Patients with a prior drug use disorder diagnosis were much less likely to be screened. Three percent of patients screened for unhealthy drug use had a positive screen, and 14% of those screened for unhealthy alcohol use had a positive screen. Strong predictors of a positive drug use screen included a prior-year diagnosis of drug use disorder, any mental health clinic visits, younger age, or being unmarried. Conclusions: The drug screening initiative was relatively successful in its first-year implementation, having screened 70% of eligible subjects. However, it failed to screen many of those most likely to screen positive, thereby missing many opportunities to address unhealthy drug use. Future refinements should include better training clinicians in how to ask sensitive questions and how to address positive screens.
Lessons Learned from the Implementation of a Medically Enhanced Residential Treatment (MERT) Model Integrating Intravenous Antibiotics and Residential Addiction Treatment
Authors: Englander Honora , Wilson Talitha , Collins Devin , Phoutrides Elena , Weimer Melissa , Korthuis P. Todd , Calcagni Jessica , Nicolaidis Christina
Published: March 2018

Background

Hospitalizations for severe infections associated with substance use disorder (SUD) are increasing. People with SUD often remain hospitalized for many weeks instead of completing intravenous antibiotics at home; often, they are denied skilled nursing facility admission. Residential SUD treatment facilities are not equipped to administer intravenous antibiotics. We developed a medically enhanced residential treatment (MERT) model integrating residential SUD treatment and long-term IV antibiotics as part of a broader hospital-based addiction medicine service. MERT had low recruitment and retention, and ended after six months. The goal of this study was to describe the feasibility and acceptability of MERT, to understand implementation factors, and explore lessons learned.

Methods

We conducted a mixed-methods evaluation. We included all potentially eligible MERT patients, defined by those needing ≥2 weeks of intravenous antibiotics discharged from February 1 to August 1, 2016. We used chart review to identify diagnoses, antibiotic treatment location, and number of recommended and actual IV antibiotic-days completed. We audio-recorded and transcribed key informant interviews with patients and staff. We conducted an ethnographic analysis of interview transcripts and implementation field notes.

Results

Of the 45 patients needing long-term intravenous antibiotics, 18 were ineligible and 20 declined MERT. 7 enrolled in MERT and three completed their recommended intravenous antibiotic course. MERT recruitment barriers included patient ambivalence towards residential treatment, wanting to prioritize physical health needs, and fears of untreated pain in residential. MERT retention barriers included high demands of residential treatment, restrictive practices due to PICC lines, and perceptions by staff and other residents that MERT patients “stood out” as “different.” Despite the challenges, key informants felt MERT was a positive construct.

Conclusions

Though MERT had many possible advantages; it proved more challenging to implement than anticipated. Our lessons may be applicable to future models integrating post-hospital intravenous antibiotics and SUD care.
Article Commentary: Medications for Opioid use Disorder in the Department of Veterans Affairs (VA) Health Care System: Historical Perspective, Lessons Learned, and Next Steps
Authors: Wyse Jessica J. , Gordon Adam J. , Dobscha Steven K. , Morasco Benjamin J. , Tiffany Elizabeth , Drexler Karen , Sandbrink Friedhelm , Lovejoy Travis I.
Published: March 2018

The US Department of Veterans Affairs (VA), the largest health care system in the US, has been confronted with the health care consequences of opioid disorder (OUD). Increasing access to quality OUD treatment, including pharmacotherapy, is a priority for the VA. We examine the history of medications (e.g., methadone, buprenorphine, injectable naltrexone) used in the treatment of OUD within VA, document early and ongoing efforts to increase access and build capacity, primarily through the use of buprenorphine, and summarize research examining barriers and facilitators to prescribing and medication receipt. We find that there has been a slow but steady increase in the use of medications for OUD and, despite system-wide mandates and directives, uneven uptake across VA facilities and within patient sub-populations, including some of those most vulnerable. We conclude with recommendations intended to support the greater use of medication for OUD in the future, both within VA as well as other large health care systems.
Establish a special conservation zone for the captive giant panda
Authors: Chen Yi-ping , Ellison Aaron M. , Lu Yong-long
Published: March 2018

The giant panda (
Ailuropoda melanoleuca
) is recognized worldwide as an icon for wildlife conservation. Since the introduction in 1992 of reliable methods for artificial insemination, the population of captive pandas has grown to approximately 350 individuals in 2013. However, captive panda populations are harmed by environmental pollution, diseases transmitted from domestic animals, and other anthropologenic activities. Although the Chinese government has proposed the creation of a Giant Panda National Park, there are at least three reasons that suggest that it is premature to reintroduce captive pandas into this proposed national park. First, habitat fragmentation remains the greatest threat to survival of giant pandas; second, most captive pandas are hybrids of the Sichuan and Qinling subspecies and release of hybrids may lead to further introgression between the two subspecies; and third, captive pandas may be competitively inferior to wild pandas in the region, and may not survive fights for food or mates. As an alternative, we suggest establishing a special conservation zone in the Shennongjia National Nature Reserve for wild training of captive pandas prior to their reintroduction into the National Park.
Analysis of Compositions and Physical Characteristics of Different Rice From Heilongjiang China
Authors: Chen Fenglian , Li Xinming , Lv Mingshou , Shi Yanguo
Published: March 2018

Diversity and correlation between composition, texture characteristics and sensory features of twenty kinds of purebred rice from Heilongjiang China were studied. Experimental results showed significant differences in content of fat, amylose and protein, however those differences were not extended to perceived taste evaluation by sensory evaluation. More protein led to lower viscosity but better hardness and springiness, higher amylose content resulted lower taste but higher springiness. Moisture content was significantly negatively correlated with resilience; the content of protein was significantly positively correlated with resilience. The adhesiveness of texture characteristic and the viscosity of taste showed significant positive correlation.
Reconstruction of Cyber and Physical Software Using Novel Spread Method
Authors: Ma Wubin , Deng Su , Huang Hongbin
Published: March 2018

Cyber and Physical software has been concerned for many years since 2010. Actually, many researchers would disagree with the deployment of traditional Spread Method for reconstruction of Cyber and physical software, which embodies the key principles reconstruction of cyber physical system. NSM(novel spread method), our new methodology for reconstruction of cyber and physical software, is the solution to all of these challenges.
Torsion and K-theory for Some Free Wreath Products
Authors: Freslon Amaury , Martos Rubén
Published: March 2018

We classify torsion actions of free wreath products of arbitrary compact quantum groups by $S_{N}^{+}$ and use this to prove that if $\mathbb{G}$ is a torsion-free compact quantum group satisfying the strong Baum–Connes property then $\mathbb{G}\wr _{\ast }S_{N}^{+}$ also satisfies the strong Baum–Connes property. We then compute the K-theory of free wreath products of classical and quantum free groups by $SO_{q}(3)$.
Six-vertex Models and the GUE-corners Process
Authors: Dimitrov Evgeni
Published: March 2018

We consider a class of probability distributions on the six-vertex model, which originates from the higher spin vertex models of [13]. We define operators, inspired by the Macdonald difference operators, which extract various correlation functions, measuring the probability of observing different arrow configurations. For the class of models we consider, the correlation functions can be expressed in terms of multiple contour integrals, which are suitable for asymptotic analysis. For a particular choice of parameters we analyze the limit of the correlation functions through the steepest descent method. Combining this asymptotic statement with some new results about Gibbs measures on Gelfand–Tsetlin cones and patterns, we show that the asymptotic behavior of our six-vertex model near the boundary is described by the Gaussian Unitary Ensemble-corners process.
A novel long non-coding RNA Myolinc regulates myogenesis through TDP-43 and Filip1
Authors: Militello Giuseppe , Hosen Mohammed Rabiul , Ponomareva Yuliya , Gellert Pascal , Weirick Tyler , John David , Hindi Sajedah Mahmoud , Mamchaoui Kamel , Mouly Vincent , Döring Claudia , Zhang Lidan , Nakamura Miki , Kumar Ashok , Fukada So-ichiro , Dimmeler Stefanie , Uchida Shizuka
Published: March 2018

Myogenesis is a complex process required for skeletal muscle formation during embryonic development and for regeneration and growth of myofibers in adults. Accumulating evidence suggests that long non-coding RNAs (lncRNAs) play key roles in regulating cell fate decision and function in various tissues. However, the role of lncRNAs in the regulation of myogenesis remains poorly understood. In this study, we identified a novel muscle-enriched lncRNA called ‘Myolinc (AK142388)’, which we functionally characterized in the C2C12 myoblast cell line. Myolinc is predominately localized in the nucleus, and its levels increase upon induction of the differentiation. Knockdown of Myolinc impairs the expression of myogenic regulatory factors and formation of multi-nucleated myotubes in cultured myoblasts. Myolinc also regulates the expression of Filip1 in a cis-manner. Similar to Myolinc, knockdown of Filip1 inhibits myogenic differentiation. Furthermore, Myolinc binds to TAR DNA-binding protein 43 (TDP-43), a DNA/RNA-binding protein that regulates the expression of muscle genes (e.g. Acta1 and MyoD). Knockdown of TDP-43 inhibits myogenic differentiation. We also show that Myolinc−TDP-43 interaction is essential for the binding of TDP-43 to the promoter regions of muscle marker genes. Finally, we show that silencing of Myolinc inhibits skeletal muscle regeneration in adult mice. Altogether, our study identifies a novel lncRNA that controls key regulatory networks of myogenesis.
Home Environmental Contamination Is Associated with Community-associated Methicillin-resistant Staphylococcus aureus Re-colonization in Treated Patients
Authors: Davis Meghan , Morris Daniel , Cluzet Valerie , Bilker Warren , Tolomeo Pam , Julian Kathleen G , Baron Patrick , Brazil Amy , Ferguson Jacqueline , Iverson Sally Ann , Shahbazian Jonathan , Ludwig Shanna , Hu Baofeng , Rankin Shelley , Nachamkin Irving , Lautenbach Ebbing ,   CDC Prevention Epicenters Network
Published: March 2018

Background

Strategies to interrupt household transmission of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) that target human colonization show mixed results. Our aim was to determine whether home environmental contamination and pet carriage with MRSA were associated with re-colonization or persistent colonization of index patients diagnosed with CA-MRSA skin or soft-tissue infection (SSTI).

Methods

Index patients from a randomized controlled trial (NCT00966446) that tested household-wide decolonization of people were eligible to participate in this substudy. Before randomization, eight environmental sites and all pets were sampled in the home. Patients were treated by their physician for the initial SSTI between diagnosis (visit 0) and the home visit (visit 1). They provided swabs every 2 weeks for 3 months (7 visits). After broth-enrichment culture, MRSA isolates were PCR-confirmed and spa-typed.

Results

Of 88 index patients recruited from the main trial, 64 (73%) provided swabs for ≥3 visits and were included in this analysis. At visit 1, 41 (64%) households were MRSA contaminated and 6 (9%) had MRSA-positive pet(s). All MRSA-positive pets lived in homes with MRSA environmental contamination. After visit 1, 42 (66%) index patients and their household members were block-randomized to nasal mupirocin and chlorhexidine body wash decolonization. Thirty-seven (58%) index patients had two consecutive negative swabs (de-colonized); 13 (35%) of these later were MRSA-positive (re-colonized). Patients with home contamination had higher rates of re-colonization than those without (Cox proportional hazard ratio 6.0 [95% CI: 1.2, 30.6], P < 0.03). Persistent colonization (all or all but one swab positive) was identified in 6 (9%) of index patients and was associated with identification of matching spa-types in environmental and subsequent human MRSA isolates (P < 0.05).

Conclusion

In patients with MRSA SSTI, MRSA-contaminated homes, and potentially MRSA-positive pets, are associated with re-colonization and persistent colonization. Future studies are needed to determine whether environmental decontamination can improve the success of household decolonization interventions.

Disclosures

All authors: No reported disclosures.
How Do Advanced Molecular Tests Compare to Routine Clinical Laboratory Evaluation of CSF in Meningoencephalitis? A Study in 10 Urban Emergency Departments Across the USA
Authors: Merlin Toby L , Chancey Scott , Zheng Yueli , Bowzard Brad , Fischer Leah , Parker Todd , Pillai Satish , Talan David , Moran Gregory , Krishnadasan Anusha , Santibanez Scott ,   The EMERGEncy ID Net Study Group
Published: March 2018

Background

The EMERGEncy ID Net Study Group is investigating whether advanced molecular tests (AMT) increase the detection of causative agents in the CSF of patients presenting with meningoencephalitis (ME). We report findings from a pilot study using AMT on 18 CSF samples from 10 US Urban Emergency Departments. The purpose of the pilot was to compare the performance of these four AMT to established clinical laboratory methods.

Methods

We investigated four AMT: (1) BioFire FilmArray ME Panel targeting 14 causative agents; (2) an in-house target-directed next generation sequencing assay targeting 25 agents; (3) a microarray capable of detecting >2,500 agents; and (4) deep metagenomic next generation sequencing. For targeted sequencing, loci from 12 DNA-based and 13 RNA-based pathogens were amplified from the extracts by multiplex PCR. All sequencing was performed on an Illumina MiSeq using 500 cycle v2 Reagent Kits. Reads from the targeted sequencing were aligned to the 25 specific reference target sequences using Bowtie2 while metagenomics reads were processed with the taxonomic sequence classifying software Kraken. For microarray analysis, Lawrence Livermore Microbial Detection Array v2 arrays were hybridized with Cy3-labeled DNA or cDNA. Scanned images of arrays were analyzed by CLiMax 3.1.

Results

Eight CSF samples had results positive for well-established causes of ME from prior testing (Table). The pilot study demonstrated none of the four AMT detected all causative agents in the eight CSF samples known to have well-established causes of ME. BioFire and targeted sequencing performed best, both detecting 6/8, metagenomics deep sequencing detected 3/8, and microarray detected 1/8.

Conclusion

Despite the sophistication of AMT, they cannot detect pathogens they do not target, that are present in small numbers, or that have been eliminated from the CSF by the immune response. Despite the theoretical potential for microarray and metagenomic sequencing to detect thousands of different agents, the agents probably must be present at high levels for detection.

Disclosures

All authors: No reported disclosures.
Utility and Challenges of a Multi-pathogen Diagnostic Platform for Characterizing Public Health Threats of Severe Acute Respiratory Infections in Six Countries
Authors: Milucky Jennifer ,   International TAC Working Group
Published: March 2018

Background

Pneumonia causes significant morbidity and mortality worldwide. Comprehensive etiology studies of pneumonia in adults are limited; however, new diagnostics enable simultaneous detection of multiple pathogens in respiratory specimens. Characterizing the public health threat of severe acute respiratory infection (SARI) may enhance global health security. We studied potential etiologies of SARI among adults in six countries over a 12-month period using multi-pathogen diagnostics.

Methods

We enrolled SARI cases (acute onset of fever and cough, requiring hospitalization, in an adult) from Global Disease Detection sites in Bangladesh, China, Egypt, Guatemala, Kenya, and Thailand and healthy frequency-matched controls (2 controls: 5 cases) by time (onset), age group (18–49, 50–64, 65+ years), and catchment area. Demographics, clinical data, and nasopharyngeal and oropharyngeal specimens were collected from cases and controls. Specimens were tested for 16 viruses and 14 bacteria using Taqman® Array Card, which uses real-time reverse transcriptase polymerase chain reaction.

Results

We enrolled 2,388 cases and 1,135 controls from Oct 2013 through Oct 2015. Age distribution (Figure) and seasonality varied by site: enrollment peaked in summer months in Bangladesh, Thailand, and China, and in winter months in Egypt, but was stable throughout the year in Guatemala and Kenya. Case fatality rate across all study locations was 2.3% (range 0–7.0%). One or more pathogens was detected in 76% of cases and in 67% of controls; ≥2 pathogens were detected in 42% of cases and 37% of controls. Pathogens more commonly detected among cases than controls included influenza A (OR 13.3, CI 7.0–25.2; 12.8% of cases vs. 1.1% of controls), influenza B (OR: 27.0, CI 8.6–84.8; 8.1% vs. 0.3%), and respiratory syncytial virus (RSV) (OR: 9.4, CI 3.4–25.8; 4.0% vs. 0.4%).

Conclusion

In this SARI study, frequent detection of multiple pathogens in the oro- and nasopharynx of both cases and controls made etiology attribution difficult. Influenza and RSV, however, were likely to be causes of SARI. Because upper respiratory tract specimens may not accurately reflect disease in the lung, better specimens are needed to determine pneumonia etiology, particularly for bacteria.

Disclosures

All authors: No reported disclosures.
Pertussis-Associated Persistent Cough in Previously Vaccinated Children
Authors: Principi Nicola , Litt David , Terranova Leonardo , Picca Marina , Malvaso Concetta , Vitale Cettina , Fry Norman , Esposito Susanna ,   Italian Pertussis Group for Persistent Cough in Children
Published: March 2018

Background

Persistent cough is a very distressing condition. It may be due to infectious agents, including Bodetella pertussis. In this case, associated symptoms are frequently different from typical pertussis (PT) cases and diagnosis is difficult and delayed. In this study, the role of B. pertussis infection as cause of persistent cough in school-children and adolescents and the protective role of previously administered PT vaccine doses was evaluated.

Methods

Healthy 7- to 17-year-old children with cough lasting from 2 to 8 weeks were enrolled. Excluded were the patients who had received the preschool booster (PSB) PT vaccine less than one year before the cough onset. At enrollment, a nasopharyngeal swab and an oral fluid sample were obtained to seek pertussis infection by detection of B. pertussis DNA in the nasopharynx using PCR and/or an elevated titer of anti-pertussis toxin IgG in oral fluid using an IgG antibody-capture enzyme-linked immunosorbent assay. Saliva determination of anti-PT toxin IgG was used because it acts as a surrogate for anti-PT toxin IgG serology.

Results

Among 96 patients, pertussis was diagnosed in 18 (18.7%; 95% CI 11.5–28.0). In 2 children with cough lasting 2 weeks, confirmation was based on the detection of B. pertussis; in 13 cases, with cough lasting 4–7 weeks, PT was diagnosed because there were high anti-PT IgG titers in oral fluid; and in 3 cases, with cough lasting 3 weeks, PT was diagnosed due to positivity for both tests. In 15 children, the disease occurred despite PSB administration. In 2 cases, PT diagnosis was made only 16 and19 months after booster injection, whereas in other 13 cases infection emerged after a longer period. However, in eight cases disease occurred less than 5 years after vaccine administration.

Conclusion

This study demonstrates that about 20% of persistent cough in children is due to PT. In case of persistent cough, this has to be considered to prescribe an effective therapy. Moreover, the study confirms that protection evoked by PT vaccine rapidly wanes and that schoolchildren may return to be PT susceptible after few year of the officially recommended PSB dose. If confirmed, these findings might lead to anticipate presently recommended PT vaccine dose for adolescents.

Disclosures

All authors: No reported disclosures.
Segmentation Analysis of Susceptibility to Cybercrime: Exploring Individual Differences in Information Security Awareness and Personality Factors
Authors: Hadlington Lee , Chivers Sally
Published: March 2018

The present article aimed to explore if susceptibility to cybercrime can be linked to information security awareness and personality factors. A total of 1,054 participants aged between 18 and 84 years took part in an online survey consisting of a recently developed segmentation analysis tool designed to explore an individual’s susceptibility to cybercrime. Alongside this, two other scales measuring information security awareness and the personality trait of impulsivity were also included. In total, 60% of the population surveyed presented as being in the higher risk categories for susceptibility to cybercrime. Furthermore, individuals in the higher risk categories for susceptibility to cybercrime also presented poorer information security awareness, as well as having higher levels of trait impulsivity. It was also noted that certain demographic factors also linked to susceptibility to cybercrime, including age and current employment status, with the unemployed and student populations being less well represented in lower risk categories. This work is seen as being critical while designing effective intervention strategies that are designed to target specific at-risk populations, as well as presenting a key tool that could be widely used by organizations to examine risk within their own specific populations.
How to predict and improve prognosis of food allergy
Authors: Dahdah Lamia , Pecora Valentina , Riccardi Carla , Fierro Vincenzo , Valluzzi Rocco , Mennini Maurizio
Published: March 2018

Purpose of review

The prevalence of food allergy is increasing. More children are being diagnosed with food allergies, and it is taking longer to outgrow them, among those who develop tolerance. The aim of this review is to draw the profile of the persistent food allergic, so that prevention strategies can be developed and active treatment set up.

Recent findings

Many determinants are involved in food allergy prognosis: ethnicity and sex, type of food, innate immune system, eliciting dose, sensitization status and other biomarkers determination, gut microbiome composition, and the presence of comorbidities. Once identified, a persistent food allergy could be conveyed to active treatments, such as oral immunotherapy or the use of biologics, always taking into account their experimental nature.

A better understanding of prognostic factors and phenotypes of food allergy is crucial in decision-making when it comes to food allergy prevention and management. A good classification of the allergic patient allows to determine the degree of exclusion diets and the timing of the reintroduction of avoided food when possible. In the cases of persistent and severe food allergy, many promising interventions are emerging which could improve prognosis and quality of care.
An Observational Cohort Study Examining the Effect of the Duration of Skin-to-Skin Contact on the Physiological Parameters of the Neonate in a Neonatal Intensive Special Care Unit
Authors: Jones Hannah , Santamaria Nick
Published: March 2018

Background:

Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses.

Purpose:

This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature.

Method:

An observational cohort study was conducted at The Royal Women's Hospital NISC Unit in Melbourne, Australia. For each neonate participant, 1 SSC with their parent was studied (parent convenience) and neonatal physiological parameters recorded, with a bivariate correlation used to explore the relationship between the duration of SSC and the percentage of time during SSC that the neonate's physiological variables remained within a target range.

Findings:

No correlation existed between the duration of SSC and the neonatal physiological variables of oxygen saturation, HR, RR, and temperature. However, neonatal oxygen requirement was more often reduced across the duration of SSC.

Implications for Practice and Future Research:

Due to previously documented benefits to neonates physiologically from SSC, and our supportive finding that SSC reduces neonatal oxygen requirement, we believe that this study adds to the evidence to support promotion of SSC in NISC Units. The duration of SSC does not appear to negatively impact the physiological effects to the neonate. Thus, SSC should be encouraged in all NISC Units to be conducted for the length of time the parent is able. This study should be repeated with a larger sample size.
Early discharge after posterior spinal fusion for adolescent idiopathic scoliosis is possible using an optimized postoperative pathway: a case-control study
Authors: Fletcher Nicholas D. , Lazarus David E. , Bruce Robert W. , Owen Robert J. , Geddes Benjamin J. , Schmitz Michael
Published: March 2018

Background:

Patients with adolescent idiopathic scoliosis (AIS) are typically healthy and yet hospital stay after posterior spinal fusion (PSF) remains lengthy.

Methods:

A review of patients undergoing PSF for AIS by four pediatric orthopaedic surgeons was performed. Patients were divided based on their surgery occurring before or after the implementation of an accelerated discharge pathway (AD). Patients treated prior to the AD pathway were managed using a less standardized traditional (TD) pathway.

Results:

Four surgeons performed 99 PSF for AIS using the TD pathway and 81 PSF after implementation of the AD pathway. Length of stay was 20% shorter in patients managed under the AD pathway (3.29±0.61 days vs. 4.11±0.97 days, P<0.0001) There was no difference in age, sex, preoperative main thoracic thoracolumbar curve magnitudes between groups. There was no difference in groups with regards to the use of osteotomies, number of levels fused, or total number of screws placed. Patients managed in the AD cohort had shorter surgical times (TD 4.55±0.9 hr vs. AD 4.19±1.11 hr, P=0.02) and lower estimated blood loss (TD 688±395 cc vs. AD 453±327 cc; P<0.0001). Multivariate regression analysis revealed a 0.82 day reduction in length of stay when controlling for estimated blood loss and length of surgery. There was no statistical difference between groups with regards to any complications.

Conclusions:

The use of a coordinated discharge pathway helped to reduce length of stay in patients undergoing PSF for AIS without an increase in complications. This hospital stay of 3 days represents a dramatic decrease over previously published averages.
How to survive your first night on pediatric call
Authors: Wells Daniel
Published: March 2018

Providing orthopaedic care for children is most likely the greatest responsibility an orthopaedic resident will face during residency. As growing individuals, children’s bones are much softer and pliable than bones in adults and therefore they break and heal differently, requiring different treatment. If the break includes the physis, which is unique to children, it must be treated in a way that will avoid growth problems. If not treated early or correctly, fractures or deformities, either congenital or mechanical, can result in significant disability in adulthood. Although this rotation may seem daunting at first, treating children is extremely fulfilling. This article shares some practical tips for surviving your first night on pediatric orthopaedic call.
Top ten journal articles for residents beginning a pediatric orthopaedic rotation
Authors: Walker Kent
Published: March 2018

Starting a new rotation during orthopaedic residency can be stressful, especially if that rotation is in pediatrics, as treatment often is quite different in children than adults. Knowing what to expect on this rotation can help alleviate some of the concern. With the overwhelming amount of literature covering pediatric orthopaedics, finding out where to begin often is frustratingly time consuming. The goal of this article is to offer a starting point in reading for junior residents before they enter their pediatric orthopaedic rotation. It reviews the top ten articles this author found to be the most helpful. The reading list provided is by no means a complete list but rather a foundation upon which to build a solid knowledge base within this discipline.
The Development of a Machine Learning Inpatient Acute Kidney Injury Prediction Model*
Authors: Koyner Jay L. , Carey Kyle A. , Edelson Dana P. , Churpek Matthew M.
Published: March 2018

Objectives:

To develop an acute kidney injury risk prediction model using electronic health record data for longitudinal use in hospitalized patients.

Design:

Observational cohort study.

Setting:

Tertiary, urban, academic medical center from November 2008 to January 2016.

Patients:

All adult inpatients without pre-existing renal failure at admission, defined as first serum creatinine greater than or equal to 3.0 mg/dL, International Classification of Diseases, 9th Edition, code for chronic kidney disease stage 4 or higher or having received renal replacement therapy within 48 hours of first serum creatinine measurement.

Interventions:

None.

Measurements and Main Results:

Demographics, vital signs, diagnostics, and interventions were used in a Gradient Boosting Machine algorithm to predict serum creatinine–based Kidney Disease Improving Global Outcomes stage 2 acute kidney injury, with 60% of the data used for derivation and 40% for validation. Area under the receiver operator characteristic curve (AUC) was calculated in the validation cohort, and subgroup analyses were conducted across admission serum creatinine, acute kidney injury severity, and hospital location. Among the 121,158 included patients, 17,482 (14.4%) developed any Kidney Disease Improving Global Outcomes acute kidney injury, with 4,251 (3.5%) developing stage 2. The AUC (95% CI) was 0.90 (0.90–0.90) for predicting stage 2 acute kidney injury within 24 hours and 0.87 (0.87–0.87) within 48 hours. The AUC was 0.96 (0.96–0.96) for receipt of renal replacement therapy (n = 821) in the next 48 hours. Accuracy was similar across hospital settings (ICU, wards, and emergency department) and admitting serum creatinine groupings. At a probability threshold of greater than or equal to 0.022, the algorithm had a sensitivity of 84% and a specificity of 85% for stage 2 acute kidney injury and predicted the development of stage 2 a median of 41 hours (interquartile range, 12–141 hr) prior to the development of stage 2 acute kidney injury.

Conclusions:

Readily available electronic health record data can be used to predict impending acute kidney injury prior to changes in serum creatinine with excellent accuracy across different patient locations and admission serum creatinine. Real-time use of this model would allow early interventions for those at high risk of acute kidney injury.
Identification and Management of Acute Cardiac Tamponade
Authors: York Nancy L. , Kane Christy , Smith Carol S.
Published: March 2018

Although incidence is rare, acute cardiac tamponade (CT) is a cardiovascular condition often resulting in a high mortality rate. In acute CT, rapid accumulation of fluid occurs in the pericardial sac and prevents the heart’s chambers from adequately filling with blood, leading to reduced diastolic filling, diminished stroke volumes, and subsequent hemodynamic instability. Health care providers should be aware of at-risk patients and the earliest signs and symptoms because an acute CT is considered a medical emergency.
Informant Report of Financial Capacity for Individuals With Chronic Acquired Brain Injury: An Assessment of Informant Accuracy
Authors: Sunderaraman Preeti , Cosentino Stephanie , Lindgren Karen , James Angela , Schultheis Maria
Published: March 2018

Objective:

Primarily, to investigate the association between informant report and objective performance on specific financial capacity (FC) tasks by adults with chronic, moderate to severe acquired brain injury, and to examine the nature of misestimates by the informants.

Design:

Cross-sectional design.

Setting:

A postacute, community-based rehabilitation center.

Participants:

Data were obtained from 22 chronic acquired brain injury (CABI) adults, mean age of 46.6 years (SD = 8.67), mean years of education of 13.45 years (SD = 2.15), with moderate to severe acquired brain injury (86% had traumatic brain injury), with a mean postinjury period of 17.14 years (SD = 9.5). Whereas the CABI adults completed the Financial Competence Assessment Inventory interview—a combination of self-report and performance-based assessment, 22 informants completed a specifically designed parallel version of the interview.

Results:

Pearson correlations and 1-sample t tests based on the discrepancy scores between informant report and CABI group's performance were used. The CABI group's performance was not associated with its informant's perceptions. One-sample t tests revealed that informants both underestimated and overestimated CABI group's performance.

Conclusions:

Results indicate lack of correspondence between self- and informant ratings. Further investigation revealed that misestimations by informants occurred in contrary directions with CABI adults' performance being inaccurately rated. These findings raise critical issues related to assuming that the informant report can be used as a “gold standard” for collecting functional data related to financial management, and the idea that obtaining objective data on financial tasks may represent a more valid method of assessing financial competency in adults with brain injury.