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In order to maximize the utility of future studies of trilobite ontogeny, we propose a set of standard practices that relate to the collection, nomenclature, description, depiction, and interpretation of ontogenetic series inferred from articulated specimens belonging to individual species. In some cases, these suggestions may also apply to ontogenetic studies of other fossilized taxa.
Background: Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, California (SHIELD OC) was a CDC-funded regional decolonization intervention from April 2017 through July 2019 involving 38 hospitals, nursing homes (NHs), and long-term acute-care hospitals (LTACHs) to reduce MDROs. Decolonization in NH and LTACHs consisted of universal antiseptic bathing with chlorhexidine (CHG) for routine bathing and showering plus nasal iodophor decolonization (Monday through Friday, twice daily every other week). Hospitals used universal CHG in ICUs and provided daily CHG and nasal iodophor to patients in contact precautions. We sought to evaluate whether decolonization reduced hospitalization and associated healthcare costs due to infections among residents of NHs participating in SHIELD compared to nonparticipating NHs. Methods: Medicaid insurer data covering NH residents in Orange County were used to calculate hospitalization rates due to a primary diagnosis of infection (counts per member quarter), hospital bed days/member-quarter, and expenditures/member quarter from the fourth quarter of 2015 to the second quarter of 2019. We used a time-series design and a segmented regression analysis to evaluate changes attributable to the SHIELD OC intervention among participating and nonparticipating NHs. Results: Across the SHIELD OC intervention period, intervention NHs experienced a 44% decrease in hospitalization rates, a 43% decrease in hospital bed days, and a 53% decrease in Medicaid expenditures when comparing the last quarter of the intervention to the baseline period (Fig. 1). These data translated to a significant downward slope, with a reduction of 4% per quarter in hospital admissions due to infection (P < .001), a reduction of 7% per quarter in hospitalization days due to infection (P < .001), and a reduction of 9% per quarter in Medicaid expenditures (P = .019) per NH resident. Conclusions: The universal CHG bathing and nasal decolonization intervention adopted by NHs in the SHIELD OC collaborative resulted in large, meaningful reductions in hospitalization events, hospitalization days, and healthcare expenditures among Medicaid-insured NH residents. The findings led CalOptima, the Medicaid provider in Orange County, California, to launch an NH incentive program that provides dedicated training and covers the cost of CHG and nasal iodophor for OC NHs that enroll.
Disclosures: Gabrielle M. Gussin, University of California, Irvine, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.
To propose a new anthropometric index that can be employed to better predict percent body fat (PBF) among young adults and to compare with current anthropometric indices.
All measurements were taken in a controlled laboratory setting in Seoul (South Korea), between 1 December 2015 and 30 June 2016.
Eighty-seven young adults (18–35 years) who underwent dual-energy x-ray absorptiometry (DXA) were used for analysis. Multiple regression analyses were conducted to develop a body fat index (BFI) using simple demographic and anthropometric information. Correlations of DXA measured PBF (DXA_PBF) with previously developed anthropometric indices and the BFI were analysed. Receiver operating characteristic curve analyses were conducted to compare the ability of anthropometric indices to identify obese individuals.
BFI showed a strong correlation with DXA_PBF (r = 0·84), which was higher than the correlations of DXA_PBF with the traditional (waist circumference, r = 0·49; waist to height ratio, r = 0·68; BMI, r = 0·36) and alternate anthropometric indices (a body shape index, r = 0·47; body roundness index, r = 0·68; body adiposity index, r = 0·70). Moreover, the BFI showed higher accuracy at identifying obese individuals (area under the curve (AUC) = 0·91), compared with the other anthropometric indices (AUC = 0·71–0·86).
The BFI can accurately predict DXA_PBF in young adults, using simple demographic and anthropometric information that are commonly available in research and clinical settings. However, larger representative studies are required to build on our findings.
As part of the ongoing effort to improve the Northern Hemisphere radiocarbon (14C) calibration curve, this study investigates the period of 856 BC to 626 BC (2805–2575 yr BP) with a total of 403 single-year 14C measurements. In this age range, IntCal13 was constructed largely from German and Irish oak as well as Californian bristlecone pine 14C dates, with most samples measured with a 10-yr resolution. The new data presented here is the first atmospheric 14C single-year record of the older end of the Hallstatt plateau based on an absolutely dated tree-ring chronology. The data helped reveal a major solar proton event (SPE) which caused a spike in the production rate of cosmogenic radionuclides around 2610/2609 BP. This production event is thought to have reached a magnitude similar to the 774/775 AD production event but has remained undetected due to averaging effects in the decadal calibration data. The record leading up to the 2610/2609 BP event reveals a 11-yr solar cycle with varying cyclicity. Features of the new data and the benefits of higher resolution calibration are discussed.
Poor physical health in severe mental illness (SMI) remains a major issue for clinical practice.
To use electronic health records of routinely collected clinical data to determine levels of screening for cardiometabolic disease and adverse health outcomes in a large sample (n = 7718) of patients with SMI, predominantly schizophrenia and bipolar disorder.
We linked data from the Glasgow Psychosis Clinical Information System (PsyCIS) to morbidity records, routine blood results and prescribing data.
There was no record of routine blood monitoring during the preceding 2 years for 16.9% of the cohort. However, monitoring was poorer for male patients, younger patients aged 16–44, those with schizophrenia, and for tests of cholesterol, triglyceride and glycosylated haemoglobin. We estimated that 8.0% of participants had diabetes and that lipids levels, and use of lipid-lowering medication, was generally high.
Electronic record linkage identified poor health screening and adverse health outcomes in this vulnerable patient group. This approach can inform the design of future interventions and health policy.
The status of Asian populations of the Eurasian otter Lutra lutra is largely unknown. Since its designation as a Natural Monument (in 1983) and as Endangered (in 1997) in South Korea the authorities there have been trying to conserve and recover the species. We conducted a national otter survey by standard methods in 2017 and compared the current otter distribution to those recorded in a previous survey (2010). We found otter signs in 84.5% of 1,105 10 × 10 km grid cells, with the highest sprainting intensity in the south-west in the Yeongsan River Basin and on the south coast, where we recorded 7.05 and 6.26 spraints/site, respectively. Despite relatively low spraint densities, the otter has expanded its range since 2010 by colonizing urban areas. This trend suggests that South Korea could be a source area for the recovery of the Eurasian otter in East Asia.
Pollinator declines coupled with increasing demand for insect pollinated crops have the potential to cause future pollinator shortages for our most nutritious and valuable crops. Ensuring adequate crop pollination may necessitate a shift in pollination management, from one that primarily relies on the managed European honeybee (Apis mellifera L.) to one that integrates alternative pollinators. While a growing body of scientific evidence supports significant contributions made by naturally occurring, native bees for crop pollination, translating research to practice requires buy-in from growers. The intention of agricultural extension is to address grower needs and concerns; however, few studies have assessed grower knowledge, perceptions and attitudes about native pollinators. Here we present findings from questionnaire-based surveys of over 600 apple growers in New York State and Pennsylvania, coupled with ecological data from bee surveys. This hybrid sociological and biological survey allows us to compare grower knowledge and perceptions to an actual pollinator census. While up to 93% of respondents highly valued importance of native bees, 20% growers did not know how much native bees actually contribute to their orchard pollination. Despite the uncertainty, a majority of growers were open to relying on native bees (up to 60% in NY and 67% in PA) and to making low-cost changes to their farm's management that would benefit native pollinators (up to 68 in NY and 85% in PA). Growers consistently underestimated bee diversity, but their estimates corresponded to major bee groups identifiable by lay persons, indicating accurate local knowledge about native bees. Grower reliance on honeybees increased with farm size; because native bee abundance did not measurably decrease with farm size, renting honeybees may be motivated by risk avoidance rather than grower perception of lower native bee activity. Demonstrated effectiveness of native pollinators and clear guidelines for their management were the most important factors influencing grower decision to actively manage orchards for native bees. Our results highlight a pressing need for an active and research-based extension program to support diversification of pollination strategies in the region.
The emergence of a drive to reduce restrictive interventions has been accompanied particularly in the UK by a debate focussing on restraint positions. Any restraint intervention delivered poorly can potentially lead to serious negative outcomes. More research is required to reliably state the risk attached to a particular position in a particular clinical circumstance.
Declaration of interest
F.S. is a consultant psychiatrist in Psychiatric Intensive Care at the Maudsley Hospital, London. He is on the Executive Committee of the National Association of Psychiatric Intensive Care and Low Secure Units, and was a member of the National Institute for Health and Care Excellence Guideline Development Group for the Short-Term Management of Aggression and Violence (2015). J.P. is a senior lecturer at the Faculty of Health and Life Sciences, Coventry University. E.B. is a consultant and expert witness in violence reduction and the use of physical interventions, independent expert to the High Secure Hospitals Violence Reduction Manual Steering Group and a member of the College of Policing Guideline Committee Steering Group and Mental Health Restraint Expert Reference Group. B.P. is the clinical director for Crisis and Aggression Limitation and Management (CALM) Training and formerly a senior lecturer for the Faculty of Health, University of Stirling. He is a nurse and psychotherapist and presently chairs the European Network for Training in the Management of Aggression. A.O'B. is a consultant psychiatrist, the Director of Educational Programmes for the National Association of Psychiatric Intensive Care and Low Secure Units, and the Dean for Students at St George's University of London.
Neuroticism, a ‘Big Five’ personality trait, has been associated with sub-clinical traits of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The objective of the current study was to examine whether causal overlap between ASD and ADHD traits can be accounted for by genetic and environmental risk factors that are shared with neuroticism. We performed twin-based structural equation modeling using self-report data from 12 items of the Neo Five-Factor Inventory Neuroticism domain, 11 Social Responsiveness Scale items, and 12 Adult ADHD Self-Report Scale items obtained from 3,170 young adult Australian individual twins (1,081 complete pairs). Univariate analysis for neuroticism, ASD, and ADHD traits suggested that the most parsimonious models were those with additive genetic and unique environmental components, without sex limitation effects. Heritability of neuroticism, ASD, and ADHD traits, as measured by these methods, was moderate (between 40% and 45% for each respective trait). In a trivariate model, we observed moderate phenotypic (between 0.45 and 0.62), genetic (between 0.56 and 0.71), and unique environmental correlations (between 0.37and 0.55) among neuroticism, ASD, and ADHD traits, with the highest value for the shared genetic influence between neuroticism and self-reported ASD traits (rg = 0.71). Together, our results suggest that in young adults, genetic, and unique environmental risk factors indexed by neuroticism overlap with those that are shared by ASD and ADHD.
Since the AD 775 and AD 994 Δ14C peak (henceforth M12) was first measured by Miyake et al. (2012, 2013), several possible production mechanisms for these spike have been suggested, but the work of Mekhaldi et al. (2015) shows that a very soft energy spectrum was involved, implying that a strong solar energetic particle (SEP) event (or series of events) was responsible. Here we present Δ14C values from AD 721–820 Sequoiadendron giganteum annual tree-ring samples from Sequoia National Park in California, USA, together with Δ14C in German oak from 650–670 BC. The AD 721–820 measurements confirm that a sharp Δ14C peak exists at AD 775, with a peak height of approximately 15‰ and show that this spike was preceded by several decades of rapidly decreasing Δ14C. A sharp peak is also present at 660 BC, with a peak height of about 10‰, and published data (Reimer et al. 2013) indicate that it too was preceded by a multi-decadal Δ14C decrease, suggesting that solar activity was very strong just prior to both Δ14C peaks and may be causally related. During periods of strong solar activity there is increased probability for coronal mass ejection (CME) events that can subject the Earth’s atmosphere to high fluencies of solar energetic particles (SEPs). Periods of high solar activity (such as one in October–November 2003) can also often include many large, fast CMEs increasing the probability of geomagnetic storms. In this paper we suggest that the combination of large SEP events and elevated geomagnetic activity can lead to enhanced production of 14C and other cosmogenic isotopes by increasing the area of the atmosphere that is irradiated by high solar energetic particles.
Host–parasite associations are complex interactions dependent on aspects of hosts (e.g. traits, phylogeny or coevolutionary history), parasites (e.g. traits and parasite interactions) and geography (e.g. latitude). Predicting the permissive host set or the subset of the host community that a parasite can infect is a central goal of parasite ecology. Here we develop models that accurately predict the permissive host set of 562 helminth parasites in five different parasite taxonomic groups. We developed predictive models using host traits, host taxonomy, geographic covariates, and parasite community composition, finding that models trained on parasite community variables were more accurate than any other covariate group, even though parasite community covariates only captured a quarter of the variance in parasite community composition. This suggests that it is possible to predict the permissive host set for a given parasite, and that parasite community structure is an important predictor, potentially because parasite communities are interacting non-random assemblages.
Haun saussy opens his influential discussion of past and present conceptions of comparative literature, “exquisite cadavers Stitched from Fresh Nightmares,” by linking them in an apparently historic claim to victory: “Comparative literature has, in a sense, won its battles” (3). The ambiguous nature of that claim, and the real subject of Saussy's ensuing discussion, is indicated, however, by the qualifying phrase “in a sense.” In another sense, Saussy implies, the achievements of comparative literature remain open to debate. For, despite the widespread adoption by national-literature departments of comparative literature's theoretical methods of inquiry, comparative approaches to literature continue to be considered inessential or secondary to the defining aim of national-literature departments—investigating and describing the reality of historically grounded national traditions and identities. Saussy's “sense” of victory is thus snatched from the jaws of an unapologetic sense of defeat:
What needs propagating is the comparative reflex, the comparative way of thinking, not the departmental name; and if those are to spread at the cost of identity and institutional reward, so much the worse for identity.
—It so happens that identity is the pivot of our triumph—and our wraithlikeness. (5)
We evaluated the effect of tree genotype on the resistance of balsam fir, Abies balsamea (Linnaeus) Miller (Pinaceae), to damage from the balsam twig aphid, Mindarus abietinus Koch (Hemiptera: Aphididae), by visually assessing aphid damage in clonal seed orchards located in New Brunswick and Nova Scotia, Canada, during four consecutive years. Estimates of clone mean heritability were moderate, suggesting that heritability of resistance is influenced by genetic factors. In New Brunswick, positive phenotypic and genetic correlations of clone-mean damage among years indicate that clones rank similarly each year. Our results suggest that selectively breeding for increased resistance could result in genetic gains.