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Methane (CH4) production is a ubiquitous, apparently unavoidable side effect of fermentative fibre digestion by symbiotic microbiota in mammalian herbivores. Here, a data compilation is presented of in vivo CH4 measurements in individuals of 37 mammalian herbivore species fed forage-only diets, from the literature and from hitherto unpublished measurements. In contrast to previous claims, absolute CH4 emissions scaled linearly to DM intake, and CH4 yields (per DM or gross energy intake) did not vary significantly with body mass. CH4 physiology hence cannot be construed to represent an intrinsic ruminant or herbivore body size limitation. The dataset does not support traditional dichotomies of CH4 emission intensity between ruminants and nonruminants, or between foregut and hindgut fermenters. Several rodent hindgut fermenters and nonruminant foregut fermenters emit CH4 of a magnitude as high as ruminants of similar size, intake level, digesta retention or gut capacity. By contrast, equids, macropods (kangaroos) and rabbits produce few CH4 and have low CH4 : CO2 ratios for their size, intake level, digesta retention or gut capacity, ruling out these factors as explanation for interspecific variation. These findings lead to the conclusion that still unidentified host-specific factors other than digesta retention characteristics, or the presence of rumination or a foregut, influence CH4 production. Measurements of CH4 yield per digested fibre indicate that the amount of CH4 produced during fibre digestion varies not only across but also within species, possibly pointing towards variation in microbiota functionality. Recent findings on the genetic control of microbiome composition, including methanogens, raise the question about the benefits methanogens provide for many (but apparently not to the same extent for all) species, which possibly prevented the evolution of the hosting of low-methanogenic microbiota across mammals.
In the last decade, the exponential increase in migration studies focusing on the mobility of groups and single individuals—mostly based on aDNA and strontium isotope analyses—has provided an important extra layer of information regarding past social dynamics. The current relatively large quantity of data and their constant increase provide an opportunity to examine human mobility in unprecedented detail. In short, the course of academic dialogue is changing from producing evidence for movement to examining differences or similarities in human mobilities across temporal and geographical barriers. Moreover, the amount and type of new data are beginning to provide new kinds of information that can help us grasp why that movement first came about. We present the first potential mobility model focusing on single individuals during different life stages based on in vivo movement patterns. We draw on previous studies in recent mobility research that provide a variety of case studies to illustrate the model. We hope that this model will prove valuable for future discussions regarding human mobility by integrating the present archaeological contextual discourse with the increasing body of data being produced.
OBJECTIVES/SPECIFIC AIMS: Macrolides, linezolid, imipenem-cilastatin, fluoroquinolones, penicillin combinations, and ceftriaxone are known to be associated with Torsade de pointes/QT prolongation (TdP/QTP). Other antibiotics may also lead to TdP/QTP, but no study has systemically compared TdP/QTP risks of different antibiotics using recent data. Therefore, the objective of this study was to evaluate the association between TdP/QTP and antibiotics in recent years using the FDA Adverse Event Report System (FAERS). METHODS/STUDY POPULATION: FAERS reports from January 1, 2015 to December 31, 2017 were analyzed. The Medical Dictionary for Regulatory Activities (MedDRA) was used to identify TdP/QTP cases. We calculated the Reporting Odds Ratios (RORs) and corresponding 95% confidence intervals (95%CI) for the association between antibiotics and TdP/QTP. An association was considered to be statistically significant when the lower limit of the 95%CI was greater than 1. RESULTS/ANTICIPATED RESULTS: A total of 2,042,801 reports (including 5,221 TdP/QTP reports) were considered, after inclusion criteria were applied. Macrolides had the greatest proportion of TdP/QTP reports, representing 2.9% of all macrolide reports. TdP/QTP RORs (95%CI) for the antibiotics were (in descending order): macrolides 11.73 (9.74-14.12), linezolid 9.39 (6.45-13.68), amikacin 8.94 (4.22-18.92), imipenem-cilastatin 5.01 (2.38-10.56), fluoroquinolones 4.67 (3.96-5.52), penicillin combinations 3.52 (2.56-4.86), cephalosporins 1.90 (1.14-3.16), metronidazole 1.49 (0.74-2.99), vancomycin 1.26 (0.70-2.28), clindamycin 0.83 (0.27-2.58), trimethoprim-sulfamethoxazole 0.82 (0.31-2.18), and amoxicillin 0.57 (0.18-1.78). DISCUSSION/SIGNIFICANCE OF IMPACT: This study confirms prior evidence for TdP-QTP risks with macrolides, linezolid, imipenem-cilastatin, fluoroquinolones, penicillin combinations, and cephalosporins. This study provides new evidence for TdP-QTP risks with amikacin. Macrolides had the highest TdP/QTP ROR among the antibiotics evaluated in this study.
Introduction: Motor vehicle collisions (MVCs) resulting in injuries and death disproportionately involve impaired drivers. Those under the influence of alcohol also have a higher rate of presentation and admission to hospital for traumatic injuries. In an attempt to decrease impaired driving and alcohol-related MVCs and injuries, the government of Alberta introduced stricter impaired driving legislation in the summer of 2012. It has yet to be determined what impact this new legislation has had on traumatic injuries secondary to MVCs and alcohol impairment. The objective of this study was to assess the relationship between the implementation of the new legislation and the proportion of alcohol-related MVC trauma presenting to the emergency department of a Level I Trauma Centre. Methods: A retrospective single centre cross-sectional chart review examining adult patients presenting to the ED of a major trauma centre who: a) require trauma team activation or consultation and b) have a MVC related injury. Of those charts meeting these criteria, the proportion of patients with positive blood alcohol concentration (BAC) was compared between the year before and the four years after implementation of the new legislation. Patients were identified using electronic medical record logs. We compared the proportion of impaired drivers by year using the SPSS software package and conducted an interrupted time series analysis in order to determine whether the implementation of the law directly affected the measured outcomes. Results: 1470 total MVC related trauma patients were identified during the study period (468 prior to legislation implementation [2010-2012] and 1002 after [2012-2016]). The proportion of drivers with BAC defined as legally impaired decreased significantly over this time period (p=0.003). Based on preliminary interrupted time series analysis we cannot conclude that the implementation of the new laws led to this significant change (p=0.524). When analyzing drivers between 16 to 25 years old, we noted a non-significant but notable decrease in the proportion of impaired drivers from 45.9% in 2011 to 21.1% in 2016 (p=0.173). Conclusion: While an impact was not seen immediately following the implementation of Alberta’s new impaired driving legislation, the proportion of impaired drivers requiring trauma team activation has decreased significantly since enactment of the new legislation from 28.9% in 2011 to 16.9% in 2016. However, based on interrupted time series analysis we cannot conclude the new legislation independently influenced this change. The impact of other factors including public education, societal preferences and generational changes cannot be excluded. There continues to be a dramatic decrease in the proportion of impaired drivers presenting with MVC related trauma under 25 years old This has not yet reached statistical significance probably due to small sample size but the trend is most prominent in this age group.
One of the most certain ways to determine star formation rate in galaxies is based on far infrared (FIR) measurements. To decide the origin of the observed FIR emission, subtracting the Galactic foreground is a crucial step. We utilized Herschel photometric data to determine the hydrogen column densities in three galactic latitude regions, at b = 27°, 50° and −80°. We applied a pixel-by-pixel fit to the spectral energy distribution (SED) for the images aquired from parallel PACS-SPIRE observations in all three sky areas. We determined the column densities with resolutions 45” and 6’, and compared the results with values estimated from the IRAS dust maps. Column densities at 27° and 50° galactic latitudes determined from the Herschel data are in a good agreement with the literature values. However, at the highest galactic latitude we found that the column densities from the Herschel data exceed those derived from the IRAS dust map.
In hierarchical structure formation scenarios, merging galaxies are expected to be seen in different phases of their coalescence. Simulations suggest that simultaneous activity of the supermassive black holes (SMBHs) in the centres of the merging galaxies may be expected at kpc-scale separations. Currently, there are no direct observational methods which allow the selection of a large number of such dual active galactic nuclei (AGN) candidates. SDSS J142507.32+323137.4 was reported as a promising candidate source based on its optical spectrum. Here we report on our sensitive e-MERLIN observations performed at 1.6 and at 5 GHz, which show that the optical spectrum of the source can be more straightforwardly explained with jet–cloud interactions instead of the dual AGN scenario.
Accidental hypothermia can lead to untoward cardiac manifestations and arrest. This report presents a case series of severe accidental hypothermia with cardiac complications in three emergency patients who were treated with extracorporeal membrane oxygenation (ECMO) and survived after re-warming. The aim of this discussion was to encourage more clinicians to consider ECMO as a re-warming therapy for severe hypothermia with circulatory collapse and to prompt discussion about decreasing the barriers to its use.
NiehausMT, PechulisRM, WuJK, FreiS, HongJJ, SandhuRS, GreenbergMR. Extracorporeal Membrane Oxygenation (ECMO) for Hypothermic Cardiac Deterioration: A Case Series. Prehosp Disaster Med. 2016;31(5):570–571.
Skin and soft tissue infections (SSTIs) due to Staphylococcus aureus have become increasingly common in the outpatient setting; however, risk factors for differentiating methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) SSTIs are needed to better inform antibiotic treatment decisions. We performed a case-case-control study within 14 primary-care clinics in South Texas from 2007 to 2015. Overall, 325 patients [S. aureus SSTI cases (case group 1, n = 175); MRSA SSTI cases (case group 2, n = 115); MSSA SSTI cases (case group 3, n = 60); uninfected control group (control, n = 150)] were evaluated. Each case group was compared to the control group, and then qualitatively contrasted to identify unique risk factors associated with S. aureus, MRSA, and MSSA SSTIs. Overall, prior SSTIs [adjusted odds ratio (aOR) 7·60, 95% confidence interval (CI) 3·31–17·45], male gender (aOR 1·74, 95% CI 1·06–2·85), and absence of healthcare occupation status (aOR 0·14, 95% CI 0·03–0·68) were independently associated with S. aureus SSTIs. The only unique risk factor for community-associated (CA)-MRSA SSTIs was a high body weight (⩾110 kg) (aOR 2·03, 95% CI 1·01–4·09).
Surface digital elevation models (DEMs) and slope-related estimates of glacier thickness enable modelling of glacier-bed topographies over large ice-covered areas. Due to the erosive power of glaciers, such bed topographies can contain numerous overdeepenings, which when exposed following glacier retreat may fill with water and form new lakes. In this study, the bed overdeepenings for ~28 000 glaciers (40 775 km2) of the Himalaya-Karakoram region are modelled using GlabTop2 (Glacier Bed Topography model version 2), in which ice thickness is inferred from surface slope by parameterizing basal shear stress as a function of elevation range for each glacier. The modelled ice thicknesses are uncertain (±30%), but spatial patterns of ice thickness and bed elevation primarily depend on surface slopes as derived from the DEM and, hence, are more robust. About 16 000 overdeepenings larger than 104m2 were detected in the modelled glacier beds, covering an area of ~2200 km2 and having a volume of ~120km3 (3-4% of present-day glacier volume). About 5000 of these overdeepenings (1800 km2) have a volume larger than 106m3. The results presented here are useful for anticipating landscape evolution and potential future lake formation with associated opportunities (tourism, hydropower) and risks (lake outbursts).
A comprehensive study based on U–Pb and Hf isotope analyses of zircons from gneisses has been conducted along the western part (Babina area) of the E–W-trending Bundelkhand Tectonic Zone in the central part of the Archaean Bundelkhand Craton. 207Pb–206Pb zircon ages and Hf isotopic data indicate the existence of a felsic crust at ~ 3.59 Ga, followed by a second tectonothermal event at ~ 3.44 Ga, leading to calc-alkaline magmatism and subsequent crustal growth. The study hence suggests that crust formation in the Bundelkhand Craton occurred in a similar time-frame to that recorded from the Singhbhum and Bastar cratons of the North Indian Shield.
The observance of possible somatic and environmental causes is essential to improve safety and efficacy in the treatment of agitated states. Severe agitation is considered a medical emergency requiring immediate psychopharmacologic intervention.
To establish a clinically applicable consensus statement based on evidence- as well as eminence-based medicine with respect to schizophrenia and mania.
The recommendations given are based on information from psychopharmacologic treatment studies as well as logistic and practical factors intrinsic to clinical settings.
Atypical antipsychotics given orally together with Lorazepam are considered the first-line treatment of agitated states in psychotic patients. Adequate communication with the patient is considered essential for effective oral administration. A novel alternative, Loxapine 4.5 mg or 9.1 mg (approved by the EMA 2013), is administered via an inhaler and exerts its sedative effects within 10 minutes. Inhalation may carry the benefit of greater patient acceptance. In contrast, intramuscular administration of antipsychotics is typically perceived by patients to be more invasive and persuasion or coercion may be necessary in severely ill patients. On the other hand, Aripiprazole, Haloperidole, Olanzapine and Ziprasidone show clinical efficacy within 15-30 minutes in psychopharmacologic trials when administered intramuscularly (i.m.). When taking extrapyramidal symptoms, QTc-prolongation and potential for combination with benzodiazepines into account, Aripiprazole i.m. carries the highest recommendation grade. Lorazepam may be administered intravenously. Currently, no antipsychotics are approved for intravenous administration.
This project gives recommendations which consider risk-benefit ratios and patient compliance.
Although discussed controversially, coercive practices during involuntary admission are common in mental health services. The impact of physical restraints on patients has not been sufficiently studied.
To investigate the subjective perception of patients during and after physical restraint.
47 patients in a psychiatric intermediate care facility experiencing belt fixation were interviewed and filled out self-assessment forms at 4 visits.
The median duration of restraint was 99 hours. Median VAS scores indicated moderate levels of anxiety. With increasing time span from the fixation, memory regarding this event decreased and patients experienced a regain of self-control. Consistently, 50% perceived high levels of coercion at admission, PTSD could be supposed in 25% of the patients.
Despite a considerable restraint of freedom, distress related to belt-fixation seems acceptable in our sample. Patients’ disapproval concerning restraint measures seems to diminish with time, probably related to decreasing memory regarding the fixation practice.
Prior studies to determine the economic consequences of schizophrenia have largely been undertaken in clinical settings with a small number of cases and have been unable to analyze effects across different age cohorts. The aim of this study is to investigate the burden of schizophrenia in Germany.
Costs, service utilization, and premature mortality attributable to schizophrenia were estimated for the year 2008 using a retrospective matched cohort design. Therefore, 26,977 control subjects as well as 9411 individuals with a confirmed diagnosis of schizophrenia were drawn from a sickness fund claims database. To reduce conditional bias, the non-parametric genetic matching method was employed.
The final study population comprised 8224 matched pairs. The annual cost attributable to schizophrenia was €11,304 per patient from the payers’ perspective and €20,609 from the societal perspective with substantial variations among age groups: direct medical expenses were highest among patients aged > 65 years, whereas younger individuals (< 25 years) incurred the greatest non-medical costs. The annual burden of schizophrenia from the perspective of German society ranges between €9.63 billion and €13.52 billion.
There are considerable differences in the distribution of costs and service utilization for schizophrenia. Because schizophrenia is characterized by an early age of onset and a long duration, research efforts should be targeted at particular populations to obtain the most beneficial outcomes, both clinically and economically.
We use a WISE-2MASS-Pan-STARRS1 galaxy catalog to search for a supervoid in the direction of the Cosmic Microwave Background Cold Spot. We obtain photometric redshifts using our multicolor data set to create a tomographic map of the galaxy distribution. The radial density profile centred on the Cold Spot shows a large low density region, extending over 10's of degrees. Motivated by previous Cosmic Microwave Background results, we test for underdensities within two angular radii, 5°, and 15°. Our data, combined with an earlier measurement by Granett et al. 2010, are consistent with a large Rvoid=(192 ± 15)h−1 Mpc (2σ) supervoid with δ ≃ −0.13 ± 0.03 centered at z=0.22 ± 0.01. Such a supervoid, constituting a ∼3.5 σ fluctuation in the ΛCDM model, is a plausible cause for the Cold Spot.
We observed an area of sky located within the SDSS Stripe 82 field at 1.6 GHz with the European VLBI Network (EVN). There are fifteen mJy/sub-mJy radio sources within the primary beam of a typical 30-m class EVN radio telescope. Our aim was to obtain information on compact radio structures of all VLBI-detectable sources within this primary beam area. The source of particular interest is the recently identified radio quasar J222843.54+011032.2 (J2228+0110) at z = 5.95. The data correlation was performed at the EVN software correlator at JIVE (SFXC). Three targets (J2228+0110, J222851.45+011203.4, J222941.76+011428.5) were detected, all three with position offsets not exceeding the 3σ accuracy of the original low-resolution radio surveys. The detection rate of 20% is consistent with other wide-field VLBI experiments carried out recently (e.g. Middelberg et al. 2013). The project presented here demonstrates the ability of EVN in multiple-phase-centre experiments and paves the way for future large-scale EVN surveys of compact structures in extragalactic radio sources using the multiple-phase-centre VLBI technique.