The long-term inflammatory impact of diet could potentially elevate the risk of periodontal disease through modification of systemic inflammation. The aim of the present study was to prospectively investigate the associations between a food based, reduced rank regression (RRR) derived, empirical dietary inflammatory pattern (EDIP) and incidence of periodontitis. The study population was composed of 34,940 men from the Health Professionals Follow-Up Study, who were free of periodontal disease and major illnesses at baseline (1986). Participants provided medical and dental history through mailed questionnaires every 2 years, and dietary data through validated semi-quantitative food frequency questionnaires every 4 years. We used Cox proportional hazard models to examine the associations between EDIP scores and validated self-reported incidence of periodontal disease over a 24-year follow-up period. No overall association between EDIP and the risk of periodontitis was observed; the hazard ratio comparing the highest EDIP quintile (most proinflammatory diet) to the lowest quintile was 0.99 (95% confidence interval: 0.89 -1.10, p-value for trend = 0.97). A secondary analysis showed that among obese non-smokers (i.e. never and former smokers at baseline), the hazard ratio for periodontitis comparing the highest EDIP quintile to the lowest was 1.39 (95% confidence interval: 0.98 -1.96, p-value for trend = 0.03). In conclusion, no overall association was detected between EDIP and incidence of self-reported periodontitis in the study population. From the subgroups evaluated EDIP was significantly associated with increased risk of periodontitis only among nonsmokers who were obese. Hence, this association must be interpreted with caution.

Background: Detection of unusual carbapenemase-producing organisms (CPOs) in a healthcare facility may signify broader regional spread. During investigation of a VIM-producing Pseudomonas aeruginosa (VIM-CRPA) outbreak in a long-term acute-care hospital in central Florida, enhanced surveillance identified VIM-CRPA from multiple facilities, denoting potential regional emergence. We evaluated infection control and performed screening for CPOs in skilled nursing facilities (SNFs) across the region to identify potential CPO reservoirs and improve practices. Methods: All SNFs in 2 central Florida counties were offered a facility-wide point-prevalence survey (PPS) for CPOs and a nonregulatory infection control consultation. PPSs were conducted using a PCR-based screening method; specimens with a carbapenemase gene detected were cultured to identify the organisms. Infection control assessments focused on direct observations of hand hygiene (HH), environmental cleaning, and the sink splash zone. Thoroughness of environmental cleaning was evaluated using fluorescent markers applied to 6 standardized high-touch surfaces in at least 2 rooms per facility. Results: Overall, 21 (48%) SNFs in the 2-county region participated; 18 conducted PPS. Bed size ranged from 40 to 391, 5 (24%) facilities were ventilator-capable SNFs (vSNFs), and 12 had short-stay inpatient rehabilitation units. Of 1,338 residents approached, 649 agreed to rectal screening, and 14 (2.2%) carried CPOs. CPO-colonized residents were from the ventilator-capable units of 3 vSNFs (KPC-CRE=7; KPC-CRPA=1) and from short-stay units of 2 additional facilities (VIM-CRPA, n = 5; KPC-CRE, n = 1). Among the 5 facilities where CPO colonization was identified, the prevalence ranged from 1.1% in a short-stay unit to 16.1% in a ventilator unit. All facilities had access to soap and water in resident bathrooms; 14 (67%) had alcohol-based hand rubs accessible. Overall, mean facility HH adherence was 52% (range, 37%–66%; mean observations per facility = 106) (Fig. 1). We observed the use of non–EPA-registered disinfectants and cross contamination from dirty to clean areas during environmental cleaning; the overall surface cleaning rate was 46% (n = 178 rooms); only 1 room had all 6 markers removed. Resident supplies were frequently stored in the sink splash zone. Conclusions: A regional assessment conducted in response to emergence of VIM-CRPA identified a relatively low CPO prevalence at participating SNFs; CPOs were primarily identified in vSNFs and among short-stay residents. Across facilities, we observed low adherence to core infection control practices that could facilitate spread of CPOs and other resistant organisms. In this region, targeting ventilator and short-stay units of SNFs for surveillance and infection control efforts may have the greatest prevention impact.

Funding: None

Disclosures: None

Understanding the effects of predicted rising sea levels, combined with changes in precipitation and freshwater inflow on key estuarine ecosystem engineers such as the eastern oyster would provide critical information to inform restoration design and predictive models. Using oyster ladders with shell bags placed at three heights to capture a range of inundation levels, oyster growth of naturally recruited spat was monitored over the course of 6 months. Oyster numbers and shell heights were consistently highest in bottom and mid bags experiencing greater than 50% inundation (mid: 63 ± 7%; bottom: 95 ± 3%). Identifying thresholds for optimal oyster growth and survival to enhance restoration engineering would require finer scale evaluation of inundation levels.

Many plant bugs (Miridae) are generalist herbivores that feed on multiple host species. The reasons these bugs move across hosts and the behavioural mechanisms responsible for their retention at specific hosts remain elusive. Green mirids (Creontiades dilutus) are endemic to Australia. These insects are important pests of cotton (Gossypium hirsutum) and even in low numbers can cause substantial damage to crops. These bugs are also present in relatively much higher numbers on pigeon pea (Cajanus cajan) planted alongside cotton fields, and evidence shows they move across these crops in both directions. Observations of these highly mobile insects in the field are challenging, but indirect evidence suggests that they may be nocturnal. This study evaluated: (1) the diel (24 h) period in which C. dilutus adults were most active, (2) whether they respond to plant volatiles immediately prior to landing on host substrates, and (3) if their presence on a host is in response to attraction or arrestment cues. The results suggest that C. dilutus bugs are typically most active early in the evenings, after remaining motionless during the day (unless disturbed). Their movement (at night) was arrested by hosts prior to touching plant tissues. There was no evidence to suggest that these bugs are attracted by volatiles beyond 2 cm. These outcomes demonstrate that insect behaviours need to be investigated within their typical activity periods, and that arrestment cues possibly play a central role in the host finding process of generalist C. dilutus and probably, therefore, other mirid species.

Cognitive behavioural therapy (CBT) is an important treatment in conjunction with psychopharmacotherapy in schizophrenia. However, there is only very little research on the effects of such interventions on brain function.

Recent studies have suggested that jumping to conclusions and a specific attributional bias is a predominant cognitive style in patients which might lead to the development of delusions. In this multi-centre fMRI trial, we investigated the effect of nine months of CBT on neural correlates of “jumping to conclusions” and the “attributional style” in patients with psychosis. Eighty patients and 80 control subjects were recruited in six centres and measured with 3-Tesla functional magnetic imaging (fMRI) before and after CBT.

It could be shown that CBT ameliorates differences in brain activations between patients and controls after nine months.

These results support the feasibility of fMRI multicenter trials and sheds further light into the mechanisms relating psychotherapy to brain function in Schizophrenia.

There is evidence that patients with persecutory delusions tend to attribute excessively hypothetical positive events to internal causes and hypothetical negative events to external causes, arrive at hasty conclusions and fail in gathering and assessing adequate feedback, particularly when emotionally salient material is involved. Research on the neural correlates of the corresponding neural correlates and even more so on the potential effects of cognitive behavioral therapy (CBT) on the associated cerebral networks is almost unavailable.

The first and preliminary results of a multicentre fMRI study will be presented.

In this study eighty schizophrenia patients from the POSITIVE clinical trial and eighty healthy subjects were recruited at six German university hospitals (Bonn, Duisburg-Essen, Düsseldorf, Frankfurt, Cologne, Tubingen). After nine months of therapy (either with CBT or Supportive Therapy) patients and controls were re-examined enabling the study correlates of cerebral reorganization processes.

We found reliable differences in brain activation relating to phenomena of decision making under uncertainty, and biased attribution (self- vs. external reference of emotional events).

The comparison of both groups revealed significant decreased activation in key areas for decision making, self-reflection, self-relevance and agency attribution of patients with schizophrenia.

The preliminary data analysis of the still blinded treatment arms shows significantly increased activations in these areas after nine months of CBT. This suggest neuroplasitic changes according to relearning strategies in psychotic patients with schizophrenia and will hopefully give rise to a more widespread application of CBT in treatment of schizophrenia.

This case report describes a patient on tranylcypromine who erroneously received a single dose of imipramine and subsequently developed a fatal serotonin syndrome. Both the clinical features and the pathophysiology of the serotonin syndrome are discussed.

When open-cut mines are eventually abandoned, they leave a large hole with sloping sides. The hole fills with rain water, and there is also contaminated run-off from surrounding land, that moves through the rock and eventually through the sloping sides of the abandoned mine. This paper considers a two-dimensional unsteady model motivated by this leaching flow through the rock and into the rain-water reservoir. The stability of the interface between the two fluids is analysed in the inviscid limit. A viscous Boussinesq model is also presented, and a closed-form solution is presented to this problem, after it has been linearized in a manner consistent with Boussinesq theory. That solution suggests that the interfacial zone is effectively neutrally stable as it evolves in time. However, an asymptotic theory in the interfacial region shows the interface to be unstable. In addition, the nonlinear Boussinesq model is solved using a spectral method. Interfacial travelling waves and roll-up are observed and discussed, and compared against the predictions of asymptotic Boussinesq theory.

Rayleigh–Taylor instability occurs when a heavier fluid overlies a lighter fluid, and the two seek to exchange positions under the effect of gravity. We present a linearized theory for arbitrary three-dimensional (3D) initial disturbances that grow in time, and calculate the evolution of the interface for early times. A new spectral method is introduced for the fully 3D nonlinear problem in a Boussinesq fluid, where the interface between the light and heavy fluids is approximated with a smooth but rapid density change in the fluid. The results of large-scale numerical calculation are presented in fully 3D geometry, and compared and contrasted with the early-time linearized theory.

Species distribution models (SDMs) are statistical tools used to develop continuous predictions of species occurrence. ‘Integrated SDMs’ (ISDMs) are an elaboration of this approach with potential advantages that allow for the dual use of opportunistically collected presence-only data and site-occupancy data from planned surveys. These models also account for survey bias and imperfect detection through the use of a hierarchical modelling framework that separately estimates the species–environment response and detection process. This is particularly helpful for conservation applications and predictions for rare species, where data are often limited and prediction errors may have significant management consequences. Despite this potential importance, ISDMs remain largely untested under a variety of scenarios. We performed an exploration of key modelling decisions and assumptions on an ISDM using the endangered Baird’s tapir (Tapirus bairdii) as a test species. We found that site area had the strongest effect on the magnitude of population estimates and underlying intensity surface and was driven by estimates of model intercepts. Selecting a site area that accounted for the individual movements of the species within an average home range led to population estimates that coincided with expert estimates. ISDMs that do not account for the individual movements of species will likely lead to less accurate estimates of species intensity (number of individuals per unit area) and thus overall population estimates. This bias could be severe and highly detrimental to conservation actions if uninformed ISDMs are used to estimate global populations of threatened and data-deficient species, particularly those that lack natural history and movement information. However, the ISDM was consistently the most accurate model compared to other approaches, which demonstrates the importance of this new modelling framework and the ability to combine opportunistic data with systematic survey data. Thus, we recommend researchers use ISDMs with conservative movement information when estimating population sizes of rare and data-deficient species. ISDMs could be improved by using a similar parameterization to spatial capture–recapture models that explicitly incorporate animal movement as a model parameter, which would further remove the need for spatial subsampling prior to implementation.

We consider fluid in a channel of finite height. There is a circular hole in the channel bottom, through which fluid of a lower density is injected and rises to form a plume. Viscous boundary layers close to the top and bottom of the channel are assumed to be so thin that the viscous fluid effectively slips along each of these boundaries. The problem is solved using a novel spectral method, in which Hankel transforms are first used to create a steady-state axisymmetric (inviscid) background flow that exactly satisfies the boundary conditions. A viscous correction is then added, so as to satisfy the time-dependent Boussinesq Navier–Stokes equations within the fluid, leaving the boundary conditions intact. Results are presented for the “lazy” plume, in which the fluid rises due only to its own buoyancy, and we study in detail its evolution with time to form an overturning structure. Some results for momentum-driven plumes are also presented, and the effect of the upper wall of the channel on the evolution of the axisymmetric plume is discussed.

The coastal waters of east Lewis from the Butt of Lewis to Loch Erisort are a proposed Marine Protected Area (MPA) for Risso's dolphins (Grampus griseus). A total of 100.4 h (2006.4 km) of active search effort (Beaufort sea states ≤3) was collected during 72 dedicated boat surveys between 2010 and 2017 (primarily in August and September) in the southern part of the MPA and south to the Shiant Isles. Forty Risso's dolphin sightings and 24.1 h of encounter effort were recorded, predominantly along the southern and eastern Eye Peninsula in 20–40 m water depths and at distances <1 km from shore. Group size ranged from one to 50 animals (mean = 11.8 dolphins) and calves occurred in 37.5% of sightings. A total of 2404 shore-based scans (Beaufort sea states ≤3) carried out from Tiumpan Head between September 2011 and December 2017 resulted in 271 (11.3%) ‘dolphin-present’ scans. Dolphins were present year-round, with a seasonal increase between May and October. ‘Calf-present’ scans only occurred between April and October. Photo-identification images from 28 boat surveys produced a minimum population size of 117 animals. There was evidence of high inter- and intra-annual site fidelity, with individual dolphins photographically captured in up to six of the eight survey years, and between two and seven capture dates being recorded for over 45% of individuals within most years. The combined datasets support the importance of east Lewis for Risso's dolphins, and recommendations are made for ongoing monitoring of dolphin occurrence throughout the wider MPA.