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In March 2017, the New Jersey Department of Health received reports of 3 patients who developed septic arthritis after receiving intra-articular injections for osteoarthritis knee pain at the same private outpatient facility in New Jersey. The risk of septic arthritis resulting from intra-articular injection is low. However, outbreaks of septic arthritis associated with unsafe injection practices in outpatient settings have been reported.
An infection prevention assessment of the implicated facility’s practices was conducted because of the ongoing risk to public health. The assessment included an environmental inspection of the facility, staff interviews, infection prevention practice observations, and a medical record and office document review. A call for cases was disseminated to healthcare providers in New Jersey to identify patients treated at the facility who developed septic arthritis after receiving intra-articular injections.
We identified 41 patients with septic arthritis associated with intra-articular injections. Cultures of synovial fluid or tissue from 15 of these 41 case patients (37%) recovered bacteria consistent with oral flora. The infection prevention assessment of facility practices identified multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, unsafe injection practices, and poor cleaning and disinfection practices. No additional cases were identified after infection prevention recommendations were implemented by the facility.
Aseptic technique is imperative when handling, preparing, and administering injectable medications to prevent microbial contamination.
This investigation highlights the importance of adhering to infection prevention recommendations. All healthcare personnel who prepare, handle, and administer injectable medications should be trained in infection prevention and safe injection practices.
Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.
Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.
Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.
An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.
There is community concern about the treatment of farm animals post-farm gate, particularly animal transport and slaughter. Relationships between lamb behavioural and physiological variables on farm, stockperson, dog and lamb behavioural variables pre-slaughter and plasma cortisol, glucose and lactate in lambs post-slaughter were studied in 400 lambs. The lambs were observed in three behavioural tests, novel arena, flight distance to a human and temperament tests, before transport for slaughter. Closed-circuit television video footage was used to record stockperson, dog and lamb behaviour immediately before slaughter. Blood samples for cortisol, glucose and lactate analyses were collected on farm following the three behavioural tests and immediately post-slaughter. The regression models that best predicted plasma cortisol, glucose and lactate concentrations post-slaughter included a mixture of stockperson and dog behavioural variables as well as lamb variables both on-farm and pre-slaughter. These regression models accounted for 33%, 34% and 44% of the variance in plasma cortisol, glucose and lactate concentrations post-slaughter, respectively. Some of the stockperson and dog behaviours pre-slaughter that were predictive of the stress and metabolic variables post-slaughter included the duration of negative stockperson behaviours such as fast locomotion and lifting/pulling lambs, and the duration of dog behaviours such as lunging and barking at the lamb, while some of the predictive lamb behaviour variables included the durations of jumping and fleeing. Some of the physiological and behavioural responses to the behavioural tests on farm were also predictive of the stress and metabolic variables post-slaughter. These relationships support the well-demonstrated effect of handling on fear and stress responses in livestock, and although not direct evidence of causal relationships, highlight the potential benefits of training stockpeople to reduce fear and stress in sheep at abattoirs.
Producers are interested in utilising farrowing systems with reduced confinement to improve sow welfare. However, concerns of increased mortality may limit commercial uptake. Temporary confinement systems utilise a standard crate which is opened 3 to 7 days postpartum, providing protection for neonatal piglets at their most vulnerable age and later increased freedom of movement for sows. However, there is anecdotal evidence that piglet mortality increases immediately after the temporary crate is opened. The current study aims were to determine if piglet mortality increases post-opening, to trial different opening techniques to reduce post-opening piglet mortality and to identify how the different opening techniques influence sow behaviour. Three opening treatments were implemented across 416 sows: two involved opening crates individually within each farrowing house when each litter reached 7 days of age, in either the morning or afternoon (AM or PM), with a control of the standard method used on the farm to open all crates in each farrowing house simultaneously once the average litter age reached 7 days (ALL). Behavioural observations were performed on five sows from each treatment during the 6 h after crate opening, and during the same 6 h period on the previous and subsequent days. Across all treatments, piglet mortality was significantly higher in the post-opening than pre-opening period (P<0.0005). Between opening treatments, there were significant differences in piglet mortality during the 2 days after crate opening (P<0.05), whilst piglet mortality also tended to differ from crate opening until weaning (P=0.052), being highest in ALL and lowest in PM. Only sows in the PM treatment showed no increase in standing behaviour but did show an increased number of potentially dangerous posture changes after crate opening (P=0.01), which may be partly attributed to the temporal difference in observation periods. Sow behaviour only differed between AM and ALL on the day before crate opening, suggesting the AM treatment disrupted behaviour pre-opening. Sows in AM and PM treatments showed more sitting behaviour than ALL, and therefore may have been more alert. In conclusion, increases in piglet mortality after crate opening can be reduced by opening crates individually, more so in the afternoon. Sow habituation to disturbance before crate opening may have reduced post-opening piglet mortality, perhaps by reducing the difference in pre- and post-opening sow behaviour patterns.
Global interest in alternative indoor farrowing systems is increasing, leading to a growing number of farms utilising such systems alongside standard crates. There is evidence that interchanging sows between different farrowing systems affects maternal behaviour, whilst the subsequent effect of this on piglet mortality is unknown. The current study hypothesised that second parity piglet mortality would be higher if a sow farrowed in a different farrowing system to that of her first parity. Retrospective farm performance records were used from 753 sows during their first and second parities. Sows farrowed in either standard crates (crates), temporary crates (360s) or straw-bedded pens (pens), with mortality recorded as occurring either pre- or post-processing. Inter- and intra-parity sow consistency in performance were also investigated. Overall, total piglet mortality reduced from the first to the second parity, being significantly higher in the crates and higher in the 360s during the first or second parity, respectively. In the second parity, an interaction of the current and previous farrowing systems resulted in the lowest incidence of crushing for sows housed in the same system as their first parity for the crates and pens, but not the 360s. Post-processing mortality was significantly higher in the crates if a sow previously farrowed in the 360s and vice versa. Sows which previously farrowed in a pen had a significantly larger litter size and lower pre-processing mortality from crushing in their second parity than sows previously housed in the crates or the 360s. No inter-parity consistency of sow performance was found, whilst intra-parity consistency was found in the first but not second parity. In conclusion, returning sows to the same farrowing system appears to reduce piglet mortality, whilst farrowing in a pen during the first parity significantly increased second parity litter size without increasing piglet mortality.
The development of adverse behaviour in group–housed growing/ finishing pigs with intact tails was studied in a straw–flow housing system and in a part–slatted system with a commercial enrichment object. Food intake, body weight and behaviour were monitored over the finishing period, with tail biting outbreaks defined as an occasion where three or more pigs within a group had freshly damaged tails and tail biting behaviour was ongoing. Data from the two systems were analysed to identify tail–biting outbreaks and behavioural changes over time. Levels of pig manipulation were higher in the part–slatted system. Over time, pigs in both systems showed reduced interest in the enrichment provided, but not in each other. Despite the presence of the enrichment device, tail biting occurred in all groups in the part–slatted system, but only 1/12 groups in the straw–flow system. The amount of time occupied by manipulation of the enrichment provided was very significantly higher for straw than for the commercial object. Better design of enrichment strategies is therefore needed and should be based on species–relevant requirements.
The Neotoma Paleoecology Database is a community-curated data resource that supports interdisciplinary global change research by enabling broad-scale studies of taxon and community diversity, distributions, and dynamics during the large environmental changes of the past. By consolidating many kinds of data into a common repository, Neotoma lowers costs of paleodata management, makes paleoecological data openly available, and offers a high-quality, curated resource. Neotoma’s distributed scientific governance model is flexible and scalable, with many open pathways for participation by new members, data contributors, stewards, and research communities. The Neotoma data model supports, or can be extended to support, any kind of paleoecological or paleoenvironmental data from sedimentary archives. Data additions to Neotoma are growing and now include >3.8 million observations, >17,000 datasets, and >9200 sites. Dataset types currently include fossil pollen, vertebrates, diatoms, ostracodes, macroinvertebrates, plant macrofossils, insects, testate amoebae, geochronological data, and the recently added organic biomarkers, stable isotopes, and specimen-level data. Multiple avenues exist to obtain Neotoma data, including the Explorer map-based interface, an application programming interface, the neotoma R package, and digital object identifiers. As the volume and variety of scientific data grow, community-curated data resources such as Neotoma have become foundational infrastructure for big data science.
Recent estimates of total pre-weaning piglet mortality range between 16-19% (MLC 2006). With environmental modification using the farrowing crate reaching its potential to decrease mortality, as well as raising serious welfare concerns, a different approach to effectively address piglet survival is needed. Genetic breeding programmes implemented in alternative farrowing systems could prove a viable option.
UK legislation dictates that all pigs shall have access to straw or other material or object suitable to satisfy their behavioural needs (Welfare of Livestock Regulations, 1994). However, it is unknown how much straw must be provided to be behaviourally rewarding, and whether pigs’ prior experience of straw can impact upon their subsequent behavioural needs. Therefore, the aim of the current experiment was to investigate these issues by exposing pigs which did, or did not, have prior experience of straw to four levels of straw bed depth.
Providing environmental enrichment to farmed animals such as pigs is very important to safeguard their welfare. Current legislation specifies that all pigs must have permanent access to a sufficient quantity of material to enable proper investigation and manipulation activities. Straw has always been regarded as a functional form of enrichment for pigs, but can be difficult to use in slatted housing systems. Alternative enrichment objects might be acceptable substitutes, provided they are designed according to characteristics which pigs find important (Van de Weerd et al., 2003), as pigs may lose interest in simple devices. Most enrichment studies have focussed on immediate effects on behaviour, but it is also important to find out whether there are critical periods where providing enrichment will have effects later in life. The aim of the present study was to investigate whether early life enrichment had an effect on the behavioural development of pigs. To assess this, pigs were tested on an Elevated Plus Maze (EPM) at 10 weeks of age. The EPM is a well-validated anxiety model in rodents, which has more recently been used in pigs. It provides a way to separate fear of novelty (avoidance of open arms) and activity-related elements (entries into closed arms) (Anderson et al., 2000).
Legislation in the United Kingdom states that all pigs should have access to straw or other material or object suitable to satisfy their behavioural needs (Welfare of Livestock Regulations, 1994). However, the use of straw bedding has not been universally adopted as its use is incompatible with housing systems which contain perforated flooring, and 76% of pig producers in the UK currently employ fully- or part-slatted finishing housing systems. The aim of this study was to investigate whether different lengths of chopped straw would achieve enhancements in pig welfare, by exploring the possibility that small quantities of chopped straw, in preference to unchopped straw, could constitute adequate provision in part- and fully-slatted systems, thus avoiding the blockage of perforated flooring.
The general well-being of growing pigs is known to be affected by both the quantity/quality of stockperson input invested and the complexity of their housing environment (Pearce et. al., 1989). However, the nature of the interactions which exist between these two factors is still largely unknown. The aim of this experiment was to investigate the separate and interactive effects of handling and environmental enrichment on the welfare and performance of growing pigs.
Quantification of lean body mass and fat mass can provide important insight into epidemiological research. However, there is no consensus on generalisable anthropometric prediction equations to validly estimate body composition. We aimed to develop and validate practical anthropometric prediction equations for lean body mass, fat mass and percent fat in adults (men, n 7531; women, n 6534) from the National Health and Nutrition Examination Survey 1999–2006. Using a prediction sample, we predicted each of dual-energy X-ray absorptiometry (DXA)-measured lean body mass, fat mass and percent fat based on different combinations of anthropometric measures. The proposed equations were validated using a validation sample and obesity-related biomarkers. The practical equation including age, race, height, weight and waist circumference had high predictive ability for lean body mass (men: R2=0·91, standard error of estimate (SEE)=2·6 kg; women: R2=0·85, SEE=2·4 kg) and fat mass (men: R2=0·90, SEE=2·6 kg; women: R2=0·93, SEE=2·4 kg). Waist circumference was a strong predictor in men only. Addition of other circumference and skinfold measures slightly improved the prediction model. For percent fat, R2 were generally lower but the trend in variation explained was similar. Our validation tests showed robust and consistent results with no evidence of substantial bias. Additional validation using biomarkers demonstrated comparable abilities to predict obesity-related biomarkers between direct DXA measurements and predicted scores. Moreover, predicted fat mass and percent fat had significantly stronger associations with obesity-related biomarkers than BMI did. Our findings suggest the potential application of the proposed equations in various epidemiological settings.
The Arctic marine environment is undergoing a transition from thick multi-year to first-year sea-ice cover with coincident lengthening of the melt season. Such changes are evident in the Baffin Bay-Davis Strait-Labrador Sea (BDL) region where melt onset has occurred ~8 days decade−1 earlier from 1979 to 2015. A series of anomalously early events has occurred since the mid-1990s, overlapping a period of increased upper-air ridging across Greenland and the northwestern North Atlantic. We investigate an extreme early melt event observed in spring 2013. (~6σ below the 1981–2010 melt climatology), with respect to preceding sub-seasonal mid-tropospheric circulation conditions as described by a daily Greenland Blocking Index (GBI). The 40-days prior to the 2013 BDL melt onset are characterized by a persistent, strong 500 hPa anticyclone over the region (GBI >+1 on >75% of days). This circulation pattern advected warm air from northeastern Canada and the northwestern Atlantic poleward onto the thin, first-year sea ice and caused melt ~50 days earlier than normal. The episodic increase in the ridging atmospheric pattern near western Greenland as in 2013, exemplified by large positive GBI values, is an important recent process impacting the atmospheric circulation over a North Atlantic cryosphere undergoing accelerated regional climate change.
Several different types of laterally extensive debris bands occur along the western terminus region of the Matanuska Glacier, Alaska, U.S.A. An ice-bed process, which to our knowledge has not previously been recognized and described, forms the most common and most prominent type of debris band at Matanuska Glacier’s terminus. The debris bands are composed of one or several millimeter-thick laminations of silt-rich ice having much higher sediment content than that of the surrounding ice. Samples of these bands and their surrounding englacial ice have been analyzed for anthropogenic tritium (3H), oxygen-18 (δ18O), and deuterium (δD).We interpreted the laminated, silt-rich debris bands as basal fractures, along which silt-laden, glaciohydraulically supercooled and pressurized waters flowed, healing the fractures by ice growth. This process is analogous to the inward growth of hydrothermal quartz from the sides of an open fracture.
The numerous debris bands in the terminus region of Matanuska Glacier, Alaska, U.S.A., were formed by injection of turbid meltwaters into basal crevasses. The debris bands are millimeter(s)-thick layers of silt-rich ice cross-cutting older, debris-poor englacial ice. The sediment grain-size distribution of the debris bands closely resembles the suspended load of basal waters, and of basal and proglacial ice grown from basal waters, but does not resemble supraglacial debris, till or the bedload of subglacial streams. Most debris bands contain anthropogenic tritium (3H) in concentrations similar to those of basal meltwater and ice formed from that meltwater, but cross-cut englacial ice lacking tritium. Stable-isotopic ratios (δ18O and δD) of debris-band ice are consistent with freezing from basal waters, but are distinct from those in englacial ice. Ice petrofabric data along one debris band lack evidence of active shearing. High basal water pressures and locally extensional ice flow associated with overdeepened subglacial basins favor basal crevasse formation.
An antenna in geostationary orbit was used for VLBI observations at 2.3 GHz, in combination with ground antennas in Australia and Japan. 23 of the 25 observed sources were detected on orbiter-ground baselines, with baseline lengths as large as 2.15 earth diameters. Brightness temperatures between 1012 K and 4 × 1012 K were measured for 10 sources.
The contribution to sea level to 2200 from the grounded, mainland Antarctic Peninsula ice sheet (APIS) was calculated using an ice-sheet model initialized with a new technique computing ice fluxes based on observed surface velocities, altimetry and surface mass balance, and computing volume response using a linearized method. Volume change estimates of the APIS resulting from surface mass-balance anomalies calculated by the regional model RACMO2, forced by A1B and E1 scenarios of the global models ECHAM5 and HadCM3, predicted net negative sea-level contributions between −0.5 and −12 mm sea-level equivalent (SLE) by 2200. Increased glacier flow due to ice thickening returned ∼15% of the increased accumulation to the sea by 2100 and ∼30% by 2200. The likely change in volume of the APIS by 2200 in response to imposed 10 and 20 km retreats of the grounding line at individual large outlet glaciers in Palmer Land, southern Antarctic Peninsula, ranged between 0.5 and 3.5 mm SLE per drainage basin. Ensemble calculations of APIS volume change resulting from imposed grounding-line retreat due to ice-shelf break-up scenarios applied to all 20 of the largest drainage basins in Palmer Land (covering ∼40% of the total area of APIS) resulted in net sea-level contributions of 7–16 mm SLE by 2100, and 10–25 mm SLE by 2200. Inclusion of basins in the northern peninsula and realistic simulation of grounding-line movement for AP outlet glaciers will improve future projections.