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A retrospective study was conducted to describe the impact of a molecular assay to detect the most common carbapenemase genes in carbapenem-resistant Enterobacterales isolates recovered in culture. Carbapenemases were detected in 69% of isolates, and assay results guided treatment modifications or epidemiologic investigation in 20% and 4% of cases, respectively.
Callery pear (Pyrus calleryana Decne.) is rapidly spreading in the United States, gaining attention in the last two decades as a serious invasive pest. Recommended control methods include foliar, basal bark, cut stump, and hack-and-squirt application of herbicides, but there are few published studies with replicated data on efficacy. Four readily available herbicidal active ingredients and a combination of two active ingredients were tested for control efficacy against P. calleryana in old-field areas and loblolly pine (Pinus taeda L.) understory. Basal bark applications (triclopyr, triclopyr + aminopyralid), foliar applications (glyphosate, imazapyr), and a soil application (hexazinone) effectively killed P. calleryana with the exception of hexazinone at one site, where rainfall may not have been optimal. Foliar application of glyphosate provided the most consistent control. Our results demonstrate efficacy of registered herbicide formulations for P. calleryana control in two geographic locations and two habitat types. The need for development of integrated pest management programs for P. calleryana is discussed.
A survey of acute-care hospitals found that rapid molecular diagnostic tests (RMDTs) have been widely adopted. Although many hospitals use their antimicrobial stewardship team and/or guidelines to help clinicians interpret results and optimize treatment, opportunities to more fully achieve the potential benefits of RMDTs remain.
Households in the USA spend about $70 billion annually on pets. Dogs, the most common pet, can be found in nearly half of American households. An important shadow price in the analysis of policies affecting human mortality is the value of statistical life (VSL), which is imputed from how people make decisions involving tradeoffs between small mortality risks and other goods. The value of statistical dog life (VSDL) is also an important, but until now unavailable, shadow price for use in regulation of such goods as pet foods and environmental toxins. Additionally, an estimate of the VSDL would have uses outside the regulatory process in valuing programs involving zooeyia, in setting tort awards for wrongful dog death, and in property divisions in divorce settlements where joint custody of dogs is not feasible. In order to estimate the VSDL, we conducted a contingent valuation of a national sample of dog owners that elicited willingness-to-pay for changes in mortality risk for pet dogs. Specifically, respondents were asked about willingness-to-pay for a vaccine that would reduce the risk of canine influenza. The design included both quantity (different magnitudes of risk reduction from the offered vaccine) and quality (differences in nature of death from the influenza) treatments as scope tests. It also included treatments involving spillover effects to other dogs and a priming question about disposable income. Based on the analysis and consideration of its assumptions, we recommend $10,000 as the VSDL.
This volume has achieved a large coverage of the experimentally well-studied areas of the temperate and subtropical coasts of the world (see Figure 1.1) – venturing into the tropics in some regions (Chapter 14, South-East Asia) and including mangroves (Chapter 17). Coral reef systems have not been considered. Much of the emphasis has been on rocky habitats as this is where the majority of experimental work on interactions has been done (but see Chapter 6). As well as reviewing regions where there has been a long history of experimental research (e.g., Chapters 2–4, 6, 10, 11, 13, 15, 16), areas of emerging experimental research in the last twenty-five years (e.g., Chapter 8, western Mediterranean; Chapter 12, south-east Pacific) and understudied regions (e.g., Chapter 7, Argentina; Chapter 14, South-East Asia) have also been included, allowing more comprehensive insights into the processes important for shaping these communities. In this short synthesis chapter, we first consider the main processes determining patterns covered by the previous chapters. We then consider major human impacts in these regions. Finally, we identify gaps in knowledge and make some suggestions for the way forward. We make the case for combining phylogeographic studies with macro-ecology and biogeography, coupled with well-designed hypothesis testing experiments, to better understand processes generating patterns on micro-evolutionary (hundreds to thousands of years) and ecological (up to hundreds of years) time scales.
Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.
Carbohydrate foods with high glycaemic index (GI) and load (GL) may negatively influence cancer risk. We studied the association of dietary carbohydrates, GI, GL, intake of bread and pasta with risk of bladder cancer using data from an Italian case–control study. The study included 578 men and women with histologically confirmed bladder cancer and 608 controls admitted to the same hospitals as cases for acute, non-neoplastic conditions. OR were estimated by logistic regression models after allowance for relevant confounding factors. OR of bladder cancer for the highest v. the lowest quantile of intake were 1·52 (95 % CI 0·85, 2·69) for available carbohydrates, 1·18 (95 % CI 0·83, 1·67) for GI, 1·96 (95 % CI 1·16, 3·31, Ptrend<0·01) for GL, 1·58 (95 % CI 1·09, 2·29, Ptrend=0·03) for pasta and 1·92 (95 % CI 1·28, 2·86, Ptrend<0·01) for bread. OR for regular consumption of legumes and whole-grain products were 0·78 (95 % CI 0·60, 1·00) and 0·82 (95 % CI 0·63, 1·08), respectively. No heterogeneity in risks emerged across strata of sex. This case–control study showed that bladder cancer risk was directly associated with high dietary GL and with consumption of high quantity of refined carbohydrate foods, particularly bread. These associations were apparently stronger in subjects with low vegetable consumption.
Geochemical and related studies have been made of near-surface sediments from the River Clyde estuary and adjoining areas, extending from Glasgow to the N, and W as far as the Holy Loch on the W coast of Scotland, UK. Multibeam echosounder, sidescan sonar and shallow seismic data, taken with core information, indicate that a shallow layer of modern sediment, often less than a metre thick, rests on earlier glacial and post-glacial sediments. The offshore Quaternary history can be aligned with onshore sequences, with the recognition of buried drumlins, settlement of muds from quieter water, probably behind an ice dam, and later tidal delta deposits. The geochemistry of contaminants within the cores also indicates shallow contaminated sediments, often resting on pristine pre-industrial deposits at depths less than 1m. The distribution of different contaminants with depth in the sediment, such as Pb (and Pb isotopes), organics and radionuclides, allow chronologies of contamination from different sources to be suggested. Dating was also attempted using microfossils, radiocarbon and 210Pb, but with limited success. Some of the spatial distribution of contaminants in the surface sediments can be related to grain-size variations. Contaminants are highest, both in absolute terms and in enrichment relative to the natural background, in the urban and inner estuary and in the Holy Loch, reflecting the concentration of industrial activity.
Fatty acid ethanolamides (FAE), a group of lipid mediators derived from long-chain fatty acids (FA), mediate biological activities including activation of cannabinoid receptors, stimulation of fat oxidation and regulation of satiety. However, how circulating FAE levels are influenced by FA intake in humans remains unclear. The objective of the present study was to investigate the response of six major circulating FAE to various dietary oil treatments in a five-period, cross-over, randomised, double-blind, clinical study in volunteers with abdominal obesity. The treatment oils (60 g/12 552 kJ per d (60 g/3000 kcal per d)) provided for 30 d were as follows: conventional canola oil, high oleic canola oil, high oleic canola oil enriched with DHA, flax/safflower oil blend and corn/safflower oil blend. Two SNP associated with FAE degradation and synthesis were studied. Post-treatment results showed overall that plasma FAE levels were modulated by dietary FA and were positively correlated with corresponding plasma FA levels; minor allele (A) carriers of SNP rs324420 in gene fatty acid amide hydrolase produced higher circulating oleoylethanolamide (OEA) (P=0·0209) and docosahexaenoylethanolamide (DHEA) levels (P=0·0002). In addition, elevated plasma DHEA levels in response to DHA intake tended to be associated with lower plasma OEA levels and an increased gynoid fat mass. In summary, data suggest that the metabolic and physiological responses to dietary FA may be influenced via circulating FAE. Genetic analysis of rs324420 might help identify a sub-population that appears to benefit from increased consumption of DHA and oleic acid.
Having worked on several approaches to CO2 capture over the past decade, we have studied a great number of physical and chemical solvents as well as polymer and composite membranes. Initially, most of these materials were based upon ionic liquids (ILs), however due to challenges encountered in applying ILs to meet the demanding requirements in CO2 separation processes, there is a need to reconsider what role (if any) ILs might play in CO2 capture technologies. Ultimately, more promising and robust materials will not come from ILs themselves, but from retrosynthetic analysis and a reconsideration of which structural variables and properties are (and are not) important. The hybridization of the constituent parts into entirely new, yet seemingly familiar substances, can yield greatly improved properties and economics. This manuscript highlights recent work from our group based on lessons learned from ILs that have spurred the development of new amine solvents and polymer materials to better address the demanding process conditions and requirements of CO2 capture and related separations.
Ludwig’s Bustard Neotis ludwigii is globally ‘Endangered’ because of a projected population decline resulting from high collision mortality on power lines throughout its southern African range. Population monitoring is key to the effective conservation of threatened species, but there are no population trend data to confirm the impact of this mortality. We repeated extensive road and aerial census counts of Ludwig’s Bustards and other large terrestrial birds, previously conducted in the late 1980s, across the Karoo, South Africa. An aerial survey gave similar density patterns to a concurrent road count, suggesting that road counts are an adequate method for censusing Ludwig’s Bustards. In common with the 1980s surveys, there was a strong seasonal effect in the Succulent Karoo, with Ludwig’s Bustards abundant in winter and rare in summer. There was no evidence of a corresponding decline in the Nama Karoo in winter, but this probably relates to reduced detectability in the Nama Karoo in summer as there is evidence for large proportions of the population migrating between biomes. No relationship was found between the numbers of Ludwig’s Bustards and rainfall, perhaps because of larger scale rainfall patterns in the Karoo and/or because the species is not strictly nomadic. Compared with the 1980s, Ludwig’s Bustards were more strongly associated with transformed lands, which have increased marginally on road count transects. Using Distance, the current South African population is estimated at 114,000 (95% CI 87,000-148,000) birds, with no evidence for a population decline over the past two decades. Numbers of Blue Cranes Anthropoides paradiseus increased since the 1980s, corresponding with other data supporting this trend, but numbers of Karoo Korhaan Eupodotis vigorsii, Southern Black Korhaan Afrotis afra and Blue Korhaan E. caerulescens all decreased, raising concerns about the conservation status of these resident bustard species.
The Florida Children’s Medical Services (CMS) has a long-standing history of ensuring that providers of multiple paediatric subspecialties abide by the highest standards. The cardiac sub-committee has written quality standard documents that participating programmes must meet or exceed. These standards oversee paediatric cardiology services including surgery, catheterisations, and outpatient services. On April, 2012, the cardiac sub-committee decided to develop similar standards in paediatric electrophysiology. A task force was created and began this process. These standards include a catalogue of required and optional equipment, as well as staff and physician credentials. We sought to establish expectations of procedural numbers by practitioner and facility. The task force surveyed the members of the Pediatric and Congenital Electrophysiology Society. Finding no consensus, the task force is committed to generate the data by requiring that the CMS participating programmes enrol and submit data to the Multicenter Pediatric and Adult Congenital EP Quality (MAP-IT™) Initiative. This manuscript details the work of the Florida CMS Paediatric Electrophysiology Task Force.