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The majority of paediatric Clostridioides difficile infections (CDI) are community-associated (CA), but few data exist regarding associated risk factors. We conducted a case–control study to evaluate CA-CDI risk factors in young children. Participants were enrolled from eight US sites during October 2014–February 2016. Case-patients were defined as children aged 1–5 years with a positive C. difficile specimen collected as an outpatient or ⩽3 days of hospital admission, who had no healthcare facility admission in the prior 12 weeks and no history of CDI. Each case-patient was matched to one control. Caregivers were interviewed regarding relevant exposures. Multivariable conditional logistic regression was performed. Of 68 pairs, 44.1% were female. More case-patients than controls had a comorbidity (33.3% vs. 12.1%; P = 0.01); recent higher-risk outpatient exposures (34.9% vs. 17.7%; P = 0.03); recent antibiotic use (54.4% vs. 19.4%; P < 0.0001); or recent exposure to a household member with diarrhoea (41.3% vs. 21.5%; P = 0.04). In multivariable analysis, antibiotic exposure in the preceding 12 weeks was significantly associated with CA-CDI (adjusted matched odds ratio, 6.25; 95% CI 2.18–17.96). Improved antibiotic prescribing might reduce CA-CDI in this population. Further evaluation of the potential role of outpatient healthcare and household exposures in C. difficile transmission is needed.
Ten compounds are found in the Ba0-Y203-CuOx system. High temperature (≈950-1000°C) phases identified as Ba4Y2O7 , Ba2Y2O5 , Ba3Y4O9 , BaY2O4 , Y2Cu2O5 , BaCuO2+x, Ba3YCu2OZ BaY2Cu05 and BazYCu306+x are formed in this temperature range. In addition, a new compound with composition of 2BaO:CuO, which possibly has a melting point below 950°C, was prepared at 850°C. A summary o£ the crystallographic data of these 10 phases is given. In particular, results of x-ray studies pertaining to four compounds, BazYCu306+x, which is currently the most promising high To' superconductor material, Ba2Cu03 , BaY2Cu05 , and Ba3YCu20Z are reviewed.
A new ESCA (electron spectroscopy for chemical analysis) instrument has been developed to provide high sensitivity and efficient operation for laboratory analysis of composition and chemical bonding in very thin surface layers of solid samples. High sensitivity is achieved by means of the high-intensity, efficient X-ray source described by Davies and Herglotz at the 1968 Denver X-Ray Conference, in combination with the new electron energy analyzer described by Lee at the 1972 Pittsburgh Conference on Analytical Chemistry and Applied Spectroscopy. A sample chamber designed to provide for rapid introduction and replacement of samples has adequate facilities for various sample treatments and conditioning followed immediafely by ESCA analysis of the sample.
Examples of application are presented, demonstrating the sensitivity and resolution achievable with this instrument. Its usefulness in trace surface analysis is shown and some “chemical shifts” measured by the instrument are compared with those obtained by X-ray spectroscopy.
Most studies underline the contribution of heritable factors for psychiatric disorders. However, heritability estimates depend on the population under study, diagnostic instruments, and study designs that each has its inherent assumptions, strengths, and biases. We aim to test the homogeneity in heritability estimates between two powerful, and state of the art study designs for eight psychiatric disorders.
We assessed heritability based on data of Swedish siblings (N = 4 408 646 full and maternal half-siblings), and based on summary data of eight samples with measured genotypes (N = 125 533 cases and 208 215 controls). All data were based on standard diagnostic criteria. Eight psychiatric disorders were studied: (1) alcohol dependence (AD), (2) anorexia nervosa, (3) attention deficit/hyperactivity disorder (ADHD), (4) autism spectrum disorder, (5) bipolar disorder, (6) major depressive disorder, (7) obsessive-compulsive disorder (OCD), and (8) schizophrenia.
Heritability estimates from sibling data varied from 0.30 for Major Depression to 0.80 for ADHD. The estimates based on the measured genotypes were lower, ranging from 0.10 for AD to 0.28 for OCD, but were significant, and correlated positively (0.19) with national sibling-based estimates. When removing OCD from the data the correlation increased to 0.50.
Given the unique character of each study design, the convergent findings for these eight psychiatric conditions suggest that heritability estimates are robust across different methods. The findings also highlight large differences in genetic and environmental influences between psychiatric disorders, providing future directions for etiological psychiatric research.
Palaeoecology has been prominent in studies of environmental change during the Holocene epoch in Scotland. These studies have been dominated by palynology (pollen, spore and related bio-and litho-stratigraphic analyses) as a key approach to multi- and inter-disciplinary investigations of topics such as vegetation, climate and landscape change. This paper highlights some key dimensions of the pollen- and vegetation-based archive, with a focus upon woodland dynamics, blanket peat, human impacts, biodiversity and conservation. Following a brief discussion of chronological, climatic, faunal and landscape contexts, the migration, survival and nature of the woodland cover through time is assessed, emphasising its time-transgressiveness and altitudinal variation. While agriculture led to the demise of woodland in lowland areas of the south and east, the spread of blanket peat was especially a phenomenon of the north and west, including the Western and Northern Isles. Almost a quarter of Scotland is covered by blanket peat and the cause(s) of its spread continue(s) to evoke recourse to climatic, topographic, pedogenic, hydrological, biotic or anthropogenic influences, while we remain insufficiently knowledgeable about the timing of the formation processes. Humans have been implicated in vegetational change throughout the Holocene, with prehistoric woodland removal, woodland management, agricultural impacts arising from arable and pastoral activities, potential heathland development and afforestation. The viability of many current vegetation communities remains a concern, in that Scottish data show reductions in plant diversity over the last 400 years, which recent conservation efforts have yet to reverse. Palaeoecological evidence can be used to test whether conservation baselines and restoration targets are appropriate to longer-term ecosystem variability and can help identify when modern conditions have no past analogues.
Introduction: In Ontario, Advanced Care Paramedics (ACPs) are required to perform a minimum of 24 educational credits per year of Continuing Medical Education (CME). Of these 24 credits, 12 are chosen by the paramedic, while 12 credits are mandated by the Base Hospital. The combined mandatory and optional CME frame is used so paramedics can target their personal needs appropriately, while ensuring new medical directives and global knowledge deficits identified by Quality Assurance (QA) means can be addressed by the Base Hospital. Objective: To determine if there is a difference between what ACPs identify as their knowledge deficits and what CME they complete. Methods: Methods: Request for participation in a written survey was delivered to all ACPs in an Ontario Base Hospital, prior to the CME cycle for the year. Respondents were asked to identify deficits from a 37-point, organ systems-based list, with free-text option for any deficits not itemized. Following the annual cycle, CME credits were evaluated by the Regional Base Hospital education coordinator, and Base Hospital medical directors for content. The deficits identified prior to the CME cycle were then compared to the CME attended for each respondent. In order to best represent the individual ACP response to their perceived deficits, a percentage of deficits identified and addressed was chosen. Respondents were not aware that their responses would be compared to the credits obtained for the year, to minimize bias in CME selection. Results: Of the 140 ACPs in the region, 42 (30%) completed the survey. From the 37-point list, the median number of perceived deficits identified was 7.00 (IQR 3.00-10.00). The median number of CME events that addressed perceived deficits was 2.00 (IQR 1.00-3.00). The median number of perceived deficits addressed by either paramedic-chosen or mandatory CME were identical at 1.00 (IQR 0.00-2.00). The percentage of perceived deficits identified and addressed via CME was 35.07% (range 0-100%). Paramedic-chosen CME covered 22.48% (range 0-100%) of perceived deficits, while mandatory CME covered 20.14% (range 0-100%) of perceived deficits. Conclusion: In the current system, only 35.07% of perceived deficits were addressed through mandatory and paramedic-chosen CME. Further information regarding barriers to paramedics obtaining CME that meets their perceived deficits needs to be elucidated.
Introduction: To determine trends in identified self-perceived knowledge deficits of paramedics, training barriers and desired methods of self-directed education. Methods: A written survey was delivered to all paramedics in an Ontario base-hospital. Respondents were asked to identify deficits from a 37-point, anatomic systems-based list. Preferred educational modalities to address knowledge deficits and factors taken into consideration when choosing self-directed education were captured. Top 5 perceived deficit topics, number of perceived deficits, top 5 factors associated with training modality chosen and factors taken into consideration for choosing training modalities, were compared against paramedic age, training (Advanced Care Paramedic; ACP, or Primary Care Paramedic; PCP) and primary location of practice (urban, rural, mixed setting). Results: Of 1262 paramedics, 746 (59.11%) completed the survey. PCPs had a higher report of deficit in both neonatal resuscitation and arrhythmia than ACPs (48.3% vs 58.8%, p=0.015; 40.3% vs 58.5%, p<0.001). Paramedics who listed rural as their primary practice location were more likely to report a deficit in pediatric respiratory disorder than those with a mixed urban/rural and primary urban practice (65.9% vs 46.3%, p=0.000; 65.9% vs 45.9%, p=0.001;) as well as a higher median number of listed deficits (9.00 vs 6.00 vs 6.00, p<0.001). ACPs were more likely to consider scheduling, location/ease of attending and cost as barriers than PCPs (85.4% vs 63.8%, p=0.000; 69.5% vs 51.4%, p=0.002; 69.5% vs 39.5%, p=0.000) while reporting an increased desire for webinar material than PCPs (56.1% vs 40.4%, p=0.007). There were no significant differences found by age. Conclusion: Targeted educational needs-based assessments can help ensure appropriate topics are delivered in a fashion that overcomes identified barriers to self-directed learning. From our analysis, increased awareness of ease of attending sessions and preferred modalities, such as webinars may be beneficial; especially for ACPs who require more annual continuing educational hours. Paramedics in rural locations may require increased continuing education, especially for rarely encountered, high risk situations, such as pediatric critical care. These findings can help direct future education in our system and others.
Introduction: Objective: To identify self-perceived knowledge deficits of paramedics, barriers to training and desired methods of self-directed continuing education. Methods: A written 58 question survey was delivered to all 1262 paramedics under the jurisdiction of a single base-hospital in Ontario, Canada. Respondents were asked to select deficit, no deficit or not applicable from a 37-point, anatomic systems-based list. They were then asked to identify from a 15-point list which educational modalities they would choose to address any knowledge deficits. Finally, they were asked which factors they took into consideration when choosing their self-directed continuing education. Results: Seven hundred forty-six of 1262 paramedics (59.11%) completed the surveys. Of these respondents, 82 (10.99%) were advanced care paramedics, while 664 (89.01%) were primary care paramedics. Of the 645 who responded with their primary geographical setting: 136 (21.09%) listed a primary urban practice, 126 (19.53%) listed a primary rural practice and 287 (44.50%) reported a split urban and rural practice. The most common perceived deficits (respondent number, percentage); were electrolyte disturbance (418, 56.03%), neonatal resuscitation (386, 51.74%), pediatric respiratory disorder (381, 51.07%), arrhythmia (377, 50.53%), and pediatric cardiac arrest (317, 42.49%). The top 5 educational opportunities they were most likely to choose included online module (464, 62.20%), in-class lecture (423, 56.70%), web-based review (403, 54.02%), webinar (301, 40.35%) and peer consult (237, 31.77%). The top 3 barriers to choosing continuing education were work scheduling (479, 64.21%), location/ease of attending (382, 51.21%), and cost (305, 40.88%). Conclusion: Paramedics in this base hospital system identified pediatric critical care situations, electrolyte abnormalities and cardiac arrhythmia as self-perceived deficits. The most commonly selected educational opportunities included online learning, in-person training and peer consult. These preferred modalities are consistent with the identified barriers of work scheduling, ease of attending and cost. Targeted educational needs based assessments can help ensure that appropriate topics are delivered in a fashion that help overcome identified barriers to self-directed learning.
Pressure transducer technology to measure gas production from microbial ecosystems has been utilized in a number of ways but predominantly for food evaluation. The approach also has considerable potential to increase our understanding of, and ability to manipulate, the rumen microbial ecosystem, but most research to date has concentrated on measurement of total gas production and not composition. The aim of this study was to extend the scope of the gas production technique to the quantitation of component gases, whilst investigating ruminal gas production in the presence and absence of methanogens.
The properties of the acoustic modes are sensitive to magnetic activity. The unprecedented long-term Kepler photometry, thus, allows stellar magnetic cycles to be studied through asteroseismology. We search for signatures of magnetic cycles in the seismic data of Kepler solar-type stars. We find evidence for periodic variations in the acoustic properties of about half of the 87 analysed stars. In these proceedings, we highlight the results obtained for two such stars, namely KIC 8006161 and KIC 5184732.
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.
Grazing experiments have shown that using a ryegrass (Lolium perenne L.) variety bred by conventional techniques for high water-soluble carbohydrate (WSC) concentrations can improve liveweight gain in pre-weaned lambs (Lee et al., 2001) and increase milk yields and reduce N excretion in dairy cows (Miller et al., 2001) compared to conventional ryegrass. The aim of this study was to determine the effects of using reseeded upland pastures, sown with either a ryegrass variety bred for elevated levels of WSC or a control ryegrass on the production performance of grazing steers when compared to steers grazing permanent ryegrass/white clover pastures.
Perennial ryegrass varieties bred to express high water-soluble carbohydrate (WSC) concentrations have been shown to improve liveweight gain in pre-weaned lambs of grazing ewes (Lee et al., 2001) compared to conventional ryegrass. Studies have shown that the largest differential in WSC between ryegrass varieties bred for high WSC concentrations and control ryegrasses occurs 5-6 weeks after the plant is allowed to re-grow following cutting or grazing (Miller et al., 2001). Therefore, the benefits, in terms of lamb performance, of using these grasses with high WSC concentrations may be best achieved when they are rotationally rather than continuously grazed. The aim of this experiment was to compare lambs rotationally or continuously grazing either a ryegrass variety bred for high WSC concentrations or a control ryegrass.
The majority of market lamb produced in UK results from crossing terminal sire rams with crossbred ewes. The selection of terminal sire breeds over the past 15 years for improved carcass composition has shown positive benefits on carcass quality of their crossbred progeny (Simm et al. 2001). However, faster rates of genetic improvement would be achieved if information from these terminal sire crossbred lambs could be used in the genetic evaluation of terminal sire breeds. Incorporating crossbred information into purebred selection programmes has been modelled and the results show that it is an effective way of improving carcass quality (Jones et al. 1999). However, this is currently compromised by limitations on how individual carcass data can be collected for incorporation into breeding programmes. An innovative technology based on Video Image Analysis (VIA) of lamb carcasses is being evaluated for introduction into UK lamb abattoirs. VIA systems can provide an objective, automatic, consistent and accurate way of measuring carcass composition. However, little is known of genetic parameters for VIA measurements of lamb carcasses. Therefore the aim of the present research project was to estimate the genetic parameters of VIA carcass measurements in crossbred lamb population.
Progressive inefficacy of chemoprophylactic therapy to control gastro-intestinal (GI) nematode infection in sheep has been a major contributory factor in stimulating research into the development of alternative means of internal parasite control. This research aims to investigate the possibilities for selecting UK sheep for increased genetic resistance to naturally acquired GI nematode parasite infections.
Genetic potential for milk production has increased rapidly in the Holstein-Friesian breed and there is concern that this might be causing an increased incidence of health problems. We have recently (Ingvartsen et al., 2002) reviewed the inter-relationships between lactation performance and health, demonstrating the importance of considering effects on/of body reserves as well as effects on/of milk production. Whilst we identified mechanisms whereby body reserves can have a direct effect on susceptibility to disease, disease also affects body reserves making it difficult to study their inter-relationships. The dry period is a particularly interesting period in this regard, because additional nutrients are directed towards reserves, whilst it is followed by a period (early lactation) of high disease incidence. The objective of this study was to investigate the effects of body condition score (BCS) at calving, as well as the effects of dry period diets designed to alter BCS, on disease incidences in the first 100 days of lactation.
Ortles mountain (3905 m a.s.l.), South Tyrol, Italy, is the highest mountain of the Eastern European Alps, and its upper glacier, Alto dell’Ortles, presents a unique opportunity to obtain the first paleoenvironmental record from an ice core in this area. To study the suitability of this glacier as a drilling site, in 2009 we performed the first preliminary study of its glaciological characteristics at ˜3830 m a.s.l. The maximum thickness is ˜75 m, and lamination of the exposed ice layers is excellent down to bedrock. Firn and ice lenses were observed in a 10 m shallow core, and the firn/ice transition was below ˜24m. The seasonal chemical signal is clearly preserved only within the uppermost 2008 and 2009 snow/firn. A simple mass-balance model, the incipient ‘smoothing’ of the chemical record, and the observed ice lenses provide evidence that melting, infiltration and refreezing cycles occurred within the firn layers formed before 2008. Nevertheless, the mass balance of the upper part of Alto dell’Ortles was positive (˜800mma_1) during the last few years. We suggest that an environmental history is likely to be well preserved only within the ice layers formed before ˜1980, when summer air temperature was ˜2°C colder than today in this area. Clearly the continued warming trend predicted to occur over the next few decades, and the consequent increase in frequency and/or intensity of infiltration processes, will endanger the preservation of the glacial archive conserved in the deep ice layers of Ortles mountain.