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ABSTRACT IMPACT: Use of this novel murine model of inflammatory bowel disease (IBD) and C. difficile infection (CDI) will aid in developing new clinical approaches to predict, diagnose, and treat CDI in the IBD population. OBJECTIVES/GOALS: IBD is associated with intestinal inflammation and alterations of the gut microbiota, both of which can diminish colonization resistance to C. difficile. Here, we sought to determine if IBD is sufficient to render mice susceptible to C. difficile colonization and infection in the absence of other perturbations, such as antibiotic treatment. METHODS/STUDY POPULATION: C57BL/6 IL-10-/- mice were colonized with Helicobacter hepaticus to trigger colonic inflammation akin to human IBD. Control mice, not colonized with H. hepaticus, were pretreated with the antibiotic cefoperazone to render the gut microbiota susceptible to CDI. Mice were then gavaged with spores of the toxigenic C. difficile strain VPI 10463 and monitored for C. difficile colonization and disease. The fecal microbiota at the time of C. difficile exposure was profiled by 16S rRNA gene sequencing and analyzed using mothur. Statistical analyses were performed using R. RESULTS/ANTICIPATED RESULTS: Mice with IBD harbored significantly distinct intestinal microbial communities compared to non-IBD controls at the time of C. difficile spore exposure (14 days post-IBD trigger). Mice with IBD were susceptible to persistent C. difficile colonization, while genetically identical non-IBD controls were resistant to C. difficile colonization. Concomitant IBD and CDI was associated with significantly worse clinical and intestinal disease than unaccompanied IBD. DISCUSSION/SIGNIFICANCE OF FINDINGS: Patients with IBD who develop concurrent CDI experience increased morbidity and mortality. These studies in a novel mouse model of IBD and CDI emphasize the dual importance of host responses and alterations of the gut microbiota in susceptibility to C. difficile colonization and infection in the setting of IBD.
Benzobicyclon will be the first 4-hydroxyphenylpyruvate dioxygenase (HPPD)–inhibiting herbicide available in US rice production pending registration completion. An observation of benzobicyclon controlling weedy rice in two field trials prompted a greenhouse and field evaluation to determine if benzobicyclon would control weedy rice accessions from Arkansas, Mississippi, and southeastern Missouri. A total of 100 accessions were screened in the greenhouse and field. Percentage mortality was determined in the greenhouse, and percentage control was recorded in the field. Benzobicyclon at 371 g ai ha–1 caused at least 80% mortality of 22 accessions in the greenhouse and at least 80% control of 30 accessions in the field. For most accessions, individual plants within the accession varied in response to benzobicyclon. Based on these results, the sensitivity of weedy rice to benzobicyclon varies across accessions collected in the midsouthern United States, and it may provide an additional control option for weedy rice in some fields.
The financial system is governed not just by formal rules but also by social relationships that pervade the elite strata of society. Understanding such dynamics entails understanding complex relational ties between actors, a task that can be facilitated through the use of network analysis. We argue that a latent feature of interest to scholars of the political economy of finance is one of social distance, which is a measurable concept. Using new data from the financial sector, we measure the social distance between a range of financial firms and one key regulator, the U.S. Securities and Exchange Commission (SEC), over time to assess whether or not social distance is related to organizations’ advocacy behavior. We find a positive relationship between how close a given organization is to the SEC and how often it engages in advocacy. The result persists when we control for numerous factors related to organizational characteristics, firm size, and when we measure advocacy frequency in different ways.
The most effective dose of prehospital furosemide in acute decompensated heart failure (ADHF) has not yet been identified and concerns of worsening renal function have limited its use.
To assess if administering high-dose furosemide is associated with worsening renal function.
The authors conducted a 2-center chart review for patients who presented via a single Emergency Medical Service (EMS) from June 5, 2009 through May 17, 2013. Inclusion criteria were shortness of breath, primarily coded as ADHF, and the administration of furosemide prior to emergency department (ED) arrival. A total of 331 charts were identified. The primary endpoint was an increase in creatinine (Cr) of more than 0.3 mg/dL from admission to any time during hospital stay. Exploratory endpoints included survival, length-of-stay (LOS), disposition, urine output in the ED, change in BUN/Cr from admission to discharge, and change in Cr from admission to 72 hours and discharge.
When treated as a binary variable, there was no association observed between an increase in Cr of more than 0.3 mg/dL and prehospital furosemide dose. Baseline characteristics found to be associated with dose were included in the logistic regression model. Lowering the dose of prehospital furosemide was associated with higher odds of attaining a 0.3 mg/dL increase in Cr (adjusted OR = 1.49 for a 20 mg decrease; P = .019). There was no association found with any of the exploratory endpoints.
Patients who received higher doses of furosemide prehospitally were less likely to have an increase of greater than 0.3 mg/dL in Cr during the hospital course.
NievesLC, MehrtensGM, PoresN, PickrellC, TanisJ, SattyT, ChuangM, YoungTC, MerlinMA. The Effect of Furosemide Dose Administered in the Out-of-hospital Setting on Renal Function Among Patients with Suspected Acute Decompensated Heart Failure. Prehosp Disaster Med. 2015;30(1):1-8.
This chapter introduces and describes the process of medical evaluation, also termed medical screening, of the psychiatric patient in the emergency department (ED). It discusses the diagnosis of medical mimics, along with the utility of both the patient history and physical exam and laboratory evaluations. The evaluation that an emergency physician conducts is an extremely important and, albeit, limited chance for the patient to be treated for a medical condition that may be causing their symptoms. The chapter also discusses the use of standard screening algorithms, which have been shown in several studies to decrease testing costs for ED patients undergoing medical screening. Local processes, such as coordination of care, trust between providers, wait times for subsequent psychiatric admission, facility overcrowding, and subgroup demographics may play a strong role in acceptance and accuracy of the emergency medicine evaluation process.
The guinea-pig was previously reported as being sensitive to a niacin-deficient (ND), high-protein diet, suggesting that it is a suitable model for the low tryptophan to NAD+ conversion observed in human subjects. However, these studies were based on growth rates and mortality. The objective of the present study was to determine whether guinea-pigs are suitable for ND studies based on measurements of blood and bone marrow NAD+. Using a 20 % casein diet, ND decreased blood NAD+ after 4 weeks, but this parameter returned to normal after 9 weeks of feeding, while bone marrow was decreased by 35 % at this time point. Using a 15 % casein diet, 7 weeks of ND caused 44 and 42 % decreases in blood and bone marrow NAD+. Using a 10 % casein diet, ND decreased NAD+ by 32 % in blood and 62 % in bone marrow at 7 weeks. Growth rates were directly related to the dietary tryptophan content, with the lowest growth rates seen with the 10 % casein diet. Changes in guinea-pig NAD+ are comparable with the rat model at similar levels of dietary tryptophan, while mortality rates were dramatically higher in the guinea-pig model. The present study concludes that mortality in ND guinea-pigs is not indicative of poor tryptophan conversion, but is due to environmental stresses in guinea-pigs that are not observed with rats. We conclude that guinea-pigs are not suitable for research on niacin deficiency and they present challenges for any study requiring purified diets and wire-bottomed cages.
Field experiments were conducted across the north-central United States to determine the benefits of various weed control strategies in corn. Weed control, corn yield, and economic return increased when a preemergence (PRE) broad-spectrum herbicide was followed by (fb) postemergence (POST) herbicides. Weed control decisions based on field scouting after a PRE broad-spectrum herbicide application increased weed control and economic return. Application of a PRE grass herbicide fb a POST herbicide based on field scouting resulted in less control of velvetleaf and morningglory species, corn yield, and economic return compared with a PRE broad-spectrum herbicide application fb scouting. Cultivation after a PRE broad-spectrum herbicide application increased weed control and corn yield compared with the herbicide applied alone, but economic return was not increased. An early-postemergence herbicide application fb cultivation resulted in the highest level of broadleaf weed control, the highest corn yield, and the greatest economic return compared with all other strategies. Weed control based on scouting proved to be useful in reducing the effect of weed escapes on corn yield and increased economic return compared with PRE herbicide application alone. However, economic return was not greater than the PRE fb planned POST or total POST strategies.