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Background and Aim: Food access is an important social determinant of health and refers to geographical and infrastructural aspects of food availability. Using publicly available data on food access from the United States Department of Agriculture (USDA), geospatial analyses can identify regions with variable food access, which may impact acute pancreatitis (AP), an acute inflammatory condition characterized by unpredictable outcomes and substantial mortality. This study aimed to investigate the association of clinical outcomes in patients with AP with geospatial food access. Methods: We examined AP-related hospitalizations at a tertiary center from January 2008 to December 2018. The physical addresses were geocoded through ArcGIS Pro2.7.0 (ESRI, Redlands, CA). USDA Food Access Research Atlas defined low food access as urban areas with 33% or more of the population residing over one mile from the nearest food source. Regression analyses enabled assessment of the association between AP outcomes and food access. Results: The study included 772 unique patients with AP residing in Massachusetts with 931 AP-related hospitalizations. One hundred and ninety-eight (25.6%) patients resided in census tracts with normal urban food access and 574 (74.4%) patients resided in tracts with low food access. AP severity per revised Atlanta classification [OR 1.88 (95%CI 1.21–2.92); p = 0.005], and 30-day AP-related readmission [OR 1.78(95%CI 1.11–2.86); p = 0.02] had significant association with food access, despite adjustment for demographics, healthcare behaviors, and comorbidities (Charlson Comorbidity Index). However, food access lacked significant association with AP-related mortality (p = 0.40) and length of stay (LOS: p = 0.99). Conclusion: Low food access had a significant association with 30-day AP-related readmissions and AP severity. However, mortality and LOS lacked significant association with food access. The association between nutrition, lifestyle, and AP outcomes warrants further prospective investigation. [ABSTRACT FROM AUTHOR]

Background: Sjögren's disease (SjD) is a common systemic autoimmune disease that affects mainly women. Key pathologic features include the infiltration of exocrine glands by lymphocytes and the activation of B lymphocytes with the production of autoantibodies. We aimed to analyze the transcriptome of circulating B cells from patients with SJD and healthy controls to decipher the B-cell-specific contribution to SJD. Methods: RNA from peripheral blood B cells of five untreated female patients with SjD and positive ANA, positive anti-SSA (both Ro-52 and Ro-60), positive anti-SSB and positive rheumatoid-factor, and five healthy controls was subjected to whole-transcriptome sequencing. A false discovery rate of < 0.1 was applied to define differentially expressed genes (DEG). Results: RNA-sequencing identified 56 up and 23 down DEG. Hierarchal clustering showed a clear separation between the two groups. Ingenuity pathway analysis revealed that these genes may play a role in interferon signaling, chronic mycobacterial infection, and transformation to myeloproliferative disorders. Conclusions: We found upregulated expression of type-I and type-II interferon (IFN)-induced genes, as well as genes that may contribute to other concomitant conditions, including infections and a higher risk of myeloproliferative disorders. This adds insight into the autoimmune process and suggests potential targets for future functional and prognostic studies. [ABSTRACT FROM AUTHOR]

Vegetables are an essential component of a healthy dietary pattern in children; however, their consumption is often insufficient due to lack of preference. To address this, the influence of combining vegetables (mixed peas and carrots—MPACs) with potatoes, a generally liked food, on overall vegetable consumption among children aged 7–13 years was explored. The research involved a cross-over study design with 65 participants who completed five lunchtime meal conditions, each with different combinations of MPACs and potatoes versus a control (MPACs with a wheat roll). The meals were provided in a cafeteria setting, and plate waste was used to measure vegetable consumption. Anthropometric data and other variables were also measured. Notably, self-reported hunger did not significantly differ between conditions. Meal condition was a significant predictor of MPACs (F = 5.20; p = 0.0005), with MPAC consumption highest when combined with shaped potato faces in the same bowl (+8.77 g compared to serving MPACs and shaped potato faces in separate bowls) and lowest when combined with diced potatoes in the same bowl (−2.85 g compared to serving MPACs and diced potatoes in separate bowls). The overall model for MPAC consumption was influenced by age, height z-score, body fat percentage z-score, and condition (likelihood ratio = 49.1; p < 0.0001). Age had the strongest correlation with vegetable consumption (r = 0.38), followed by male gender, height z-score (r = 0.30), and body fat z-score (r = −0.15). The results highlight the positive impact of combining potatoes with vegetables in school meals, particularly when using shaped potato faces. These findings emphasize the potential of potatoes as a valuable vegetable option in promoting healthier eating habits among children. Additionally, future research could explore the impact of different potato combinations and investigate other factors influencing meal consumption in school settings. [ABSTRACT FROM AUTHOR]

Background: As marijuana use is rising among patients with inflammatory bowel disease (IBD), so is interest in its potential use as a therapeutic agent. We sought to survey IBD patients regarding marijuana use, self-reported impact on IBD symptoms, and perceptions of safety. Methods: A multicenter anonymous survey was administered to patients with IBD between October 2020 and June 2021. The 70-question survey collected demographic variables, clinical variables, attitudes about marijuana, and perceptions of its safety and efficacy in IBD. Participants were classified by their marijuana use: "rarely/never," "current," and "former". Percentage and chisquare tests were used to compare categorical variables between the 3 groups, and means and 2-group ANOVA were used for continuous variables. Results: Of 181 patients surveyed, 166 were eligible for the study. Of these, 70 (42.2%) participants were rare/never marijuana users, 44 (26.5%) were current users, and 52 (31.3%) were former users. Fifty-three percent thought marijuana would help with IBD inflammation and 80% thought it would help with IBD pain. Over 70% of patients from all groups thought marijuana had a low-tomoderate risk of harm, and 69.6% of the participants who never or rarely used marijuana thought marijuana was addictive, compared to 20.5% of the current users and 44% of the former marijuana users. Conclusions: While many patients thought marijuana use helps with IBD-related pain and inflammation, many expressed concerns about addiction to marijuana and a possible risk of harm. Further studies are needed to examine the benefit and harm of marijuana in IBD. [ABSTRACT FROM AUTHOR]

Sperm cells must undergo a complex maturation process after ejaculation to be able to fertilize an egg. One component of this maturation is hyperpolarization of the membrane potential to a more negative value. The ion channel responsible for this hyperpolarization, SLO3, was first cloned in 1998, and since then much progress has been made to determine how the channel is regulated and how its function intertwines with various signaling pathways involved in sperm maturation. Although Slo3 was originally thought to be present only in the sperm of mammals, recent evidence suggests that a primordial form of the gene is more widely expressed in some fish species. Slo3, like many reproductive genes, is rapidly evolving with low conservation between closely related species and different regulatory and pharmacological profiles. Despite these differences, SLO3 appears to have a conserved role in regulating sperm membrane potential and driving large changes in response to stimuli. The effect of this hyperpolarization of the membrane potential may vary among mammalian species just as the regulation of the channel does. Recent discoveries have elucidated the role of SLO3 in these processes in human sperm and provided tools to target the channel to affect human fertility. [ABSTRACT FROM AUTHOR]

While acute pancreatitis (AP) contributes significantly to hospitalizations and costs, most cases are mild with minimal complications. In 2016, we piloted an observation pathway in the emergency department (ED) for mild AP and showed reduced admissions and length of stay (LOS) without increased readmissions or mortality. After 5 years of implementation, we evaluated outcomes of the ED pathway and identified predictors of successful discharge. We reviewed a prospectively enrolled cohort of patients with mild AP presenting to a tertiary care center ED between 10/2016 and 9/2021, evaluating LOS, charges, imaging, and 30-day readmission, and assessed predictors of successful ED discharge. Patients were divided into two main groups: successfully discharged via the ED pathway ("ED cohort") and admitted to the hospital ("admission cohort"), with subgroups to compare outcomes, and multivariate analysis to determine predictors of discharge. Of 619 AP patients, 419 had mild AP (109 ED cohort, 310 admission cohort). The ED cohort was younger (age 49.3 vs 56.3,p < 0.001), had lower Charlson Comorbidity Index (CCI) (1.30 vs 2.43, p < 0.001), shorter LOS (12.3 h vs 116 h, p < 0.001), lower charges (mean $6768 vs $19886, p < 0.001) and less imaging, without differences in 30-day readmissions. Increasing age (OR: 0.97; p < 0.001), increasing CCI (OR: 0.75; p < 0.001) and biliary AP (OR: 0.10; p < 0.001) were associated with decreased ED discharge, while idiopathic AP had increased ED discharge (OR: 7.8; p < 0.001). After appropriate triage, patients with mild AP (age <50, CCI <2, idiopathic AP) can safely discharge from the ED with improved outcomes and cost savings. [ABSTRACT FROM AUTHOR]

Interstitial macrophages (IMs) reside in the lung tissue surrounding key structures including airways, vessels, and alveoli. Recent work has described IM heterogeneity during homeostasis, however, there are limited data on IMs during inflammation. We sought to characterize IM origin, subsets, and transcriptomic profiles during homeostasis and lipopolysaccharide (LPS) induced acute lung inflammation. During homeostasis, we used three complementary methods, spectral flow cytometry, single-cell RNA-sequencing, and gene regulatory network enrichment, to demonstrate that IMs can be divided into two core subsets distinguished by surface and transcriptional expression of folate receptor β (Folr2/FRβ). These subsets inhabited distinct niches within the lung interstitium. Within FRβ+ IMs we identified a subpopulation marked by coexpression of LYVE1. During acute LPS-induced inflammation, lung IM numbers expand. Lineage tracing revealed IM expansion was due to recruitment of monocyte-derived IMs. At the peak of inflammation, recruited IMs were comprised two unique subsets defined by expression of genes associated with interferon signaling and glycolytic pathways. As recruited IMs matured, they adopted the overall transcriptional state of FRβ− resident IMs but retained expression in several origin-specific genes, such as IL-1β. FRβ+ IMs were of near-pure resident origin. Taken together our data show that during LPS-induced inflammation, there are distinct populations of IMs that likely have unique functions. FRΒ+ IMs comprise a stable, resident population, whereas FRβ− ΙΜs represent a mixed population of resident and recruited IMs. [ABSTRACT FROM AUTHOR]

Vegetative filter strip characteristics such as perenniality drive hydrology and subsequent ecosystem services. However, the extent and the potential for forage–biomass crops to improve water quality, provide fodder, and optimize nutrient cycling in multifunctional systems is unknown. We evaluated (a) how species, perenniality, and plant community composition are linked to water quality; and (b) the multiuse forage–biomass potential of filter strips. Whole plots were species [eastern gamagrass (Tripsacum dactyloides), Kernza [or intermediate wheatgrass (Thinopyrum intermedium)], silphium (Silphium integrifolium), switchgrass (Panicum virgatum), and winter wheat (Triticum aestivum)], with split‐plots receiving 0 or 5.6 Mg ha−1 broiler litter. Rainfall simulations were conducted at 5 cm h−1 (until 30 min of continuous runoff) in summer and fall of 2019 and 2021 with dual forage and biomass harvests occurring 2019–2021. Kernza and silphium had the lowest biomass regrowth after forage harvests relative to native grasses, suggesting they would not be ideal multifunctional forage–bioenergy crops. Among all soil–plant–water variables, canonical correlations indicate poultry litter (.97), and soil phosphorus saturation (.77) were the most influential variables for water quality. Water quality score, FWQ, which is inversely related to runoff water quality, was lowest for switchgrass (0.03) and greatest (P ≥.05) for eastern gamagrass and wheat (1.77 and 3.33, respectively), but not different from Kernza (0.98) and silphium (0.31). Therefore, switchgrass resulted in the best water quality scores and highest forage–biomass yields, with Kernza and silphium also showing promise for reducing sediment and nutrient loads following poultry litter applications in multifunctional filter strip systems. Core Ideas: Filter strip characteristics drive surface hydrology and subsequent ecosystem services. Greatest multiuse (forage–biomass filter strip) yields occurred for switchgrass. Poultry litter applications and soil P saturation were most correlated with water quality. Perennial crops (excluding eastern gamagrass) improved water quality. Switchgrass had the highest water quality and biomass yields, indicating greatest multiuse filter strip potential. [ABSTRACT FROM AUTHOR]

Purpose: To study patient satisfaction with new patient telehealth visits in a reproductive endocrinology and infertility (REI) office. Methods: A cross-sectional study in a university-based fertility clinic was completed including all new patients seen via telehealth between March 1, 2021, and August 19, 2021. Primary outcomes were perceived patient satisfaction, access, and preferences to telehealth visits. Results: A total of 351 participants were contacted, 61.8% (n = 217) agreed to participate in the study, and 28.8% (n = 101) completed the survey. There were no significant differences in age, BMI, distance from clinic, or length of infertility with response to survey. Ninety-three percent of responders would use telehealth services again and were satisfied with the telehealth system. Telehealth improved access to healthcare for 88% and travel time for 96%. The median distance from clinic was 24 miles, and there was no significance difference in preference for telehealth visits over in person visits (p = 0.696). Conclusions: In the era of COVID-19, healthcare implementation has dramatically changed with a drastic increase in telehealth services. Based on our survey, majority of patients were satisfied with telehealth visits and believed it saved travel time while improving access to REI care. Despite no differences in patient preference for in person versus telehealth depending on their distance from clinic, this is reassuring because patients are satisfied with telehealth for reasons other than distance from clinic. [ABSTRACT FROM AUTHOR]

The Mulberry River in Arkansas is one of America's National Wild and Scenic Rivers and has been listed as impaired for low pH since 2008. Stream chemistry is directly related to land use and changes in land use can result in degradation of surface waters. Growth of conifers, through afforestation or conversion of native hardwood stands, has been attributed to basin acidification in several regions and may be contributing acid to the Mulberry River basin. The objective of this study was to examine the relationship between land use (i.e., coniferous forest, deciduous forest, mixed forest, and pasture) and stream chemistry of 11 tributaries of the Mulberry River over a 2‐year period. Coniferous forest land use was not correlated with stream pH, neither was stream pH predicted by coniferous forest land use. Acid neutralizing capacity (ANC) was negatively correlated with, and partially predicted by coniferous land use. Total organic carbon was negatively correlated with coniferous land use and positively correlated with deciduous land use. Deciduous land use was positively correlated with SO4 and negatively correlated with total N and NO3. Spearman's rank correlation and principal component analysis identified significant inverse relationships between stream pH and NO3 and between ANC and NO3, which may suggest that HNO3 may be the primary source of acidity within the Mulberry River basin. Although no relationships were observed between coniferous land use and pH, conifer growth may be affecting the stream buffering capacity of the basin which would increase the susceptibility of the river to acidification. [ABSTRACT FROM AUTHOR]

Adding aluminum sulfate or alum to poultry litter is a best management practice (BMP) that reduces ammonia emissions and P runoff and leaching, although its long‐term effects on forage growth and P uptake are largely unknown. The objective was to determine if reducing soluble P in litter with alum would result in forage P deficiencies or reduce yields. A 20‐yr study was conducted to determine effects of four rates of alum‐treated litter, untreated litter, and ammonium nitrate (NH4NO3), as well as an unfertilized control on tall fescue (Festuca arundinacea Schreb.) yield and P uptake. Phosphorus uptake increased as litter rates increased for both sources but was greater (P ≤.05) for untreated litter, likely owing to high water‐extractable P in soil. Over 20 yr, both litter sources had greater P uptake than NH4NO3. Average annual yields by fertilizer source across rates were 6.92, 6.64, 5.10, and 3.38 Mg ha–1 for alum‐treated litter, untreated litter, NH4NO3, and the control, respectively. Forage yields increased with litter application rate, but there was no difference due to litter source, whereas yields were 34% lower with NH4NO3 due to soil acidification and forage P deficiency (≤0.2% P). Multiple regression indicated tall fescue P uptake was affected by total P application rate and water‐extractable phosphorus (WEP), whereas yields were influenced by N rates, Mehlich III P levels, soil pH, and precipitation. These results indicate that amending soils with alum‐treated litter does not adversely affect tall fescue yields or P utilization, therefore alum is a sustainable BMP in pasture systems. Core Ideas: Treating poultry litter with alum is a best management practices for reducing NH3 emissions and nonpoint source P pollution.Phosphorus uptake increased over time and was greatest for untreated litter and lowest for NH4NO3.Ammonium nitrate had 34% yield reductions compared with poultry litter sources due to soil acidification.Alum is a best management practice for improving air and water quality without causing tall fescue P deficiencies. [ABSTRACT FROM AUTHOR]

The acute respiratory distress syndrome (ARDS) is a major healthcare problem, accounting for significant mortality and long-term disability. Approximately 25% of patients with ARDS will develop an overexuberant fibrotic response, termed fibroproliferative ARDS (FP-ARDS) that portends a poor prognosis and increased mortality. The cellular pathological processes that drive FP-ARDS remain incompletely understood. We have previously shown that the transmembrane receptor-type tyrosine phosphatase protein tyrosine phosphatase-a (PTPα) promotes pulmonary fibrosis in preclinical murine models through regulation of transforming growth factor-b (TGF-α) signaling. In this study, we examine the role of PTPα in the pathogenesis of FP-ARDS in a preclinical murine model of acid (HCl)-induced acute lung injury. We demonstrate that although mice genetically deficient in PTPα (Ptpra-/-) are susceptible to early HCl-induced lung injury, they exhibit markedly attenuated fibroproliferative responses. In addition, early profibrotic gene expression is reduced in lung tissue after acute lung injury in Ptpra-/- mice, and stimulation of naïve lung fibroblasts with the BAL fluid from these mice results in attenuated fibrotic outcomes compared with wild-type littermate controls. Transcriptomic analyses demonstrate reduced extracellular matrix (ECM) deposition and remodeling in mice genetically deficient in PTPα. Importantly, human lung fibroblasts modified with a CRISPR-targeted deletion of PTPRA exhibit reduced expression of profibrotic genes in response to TGF-b stimulation, demonstrating the importance of PTPα in human lung fibroblasts. Together, these findings demonstrate that PTPα is a key regulator of fibroproliferative processes following acute lung injury and could serve as a therapeutic target for patients at risk for poor long-term outcomes in ARDS. [ABSTRACT FROM AUTHOR]

We present a landmark success of a pilot study in the noninvasive, topical hormonal stimulation of reproduction of salamanders using Texas blind salamanders (Eurycea rathbuni) as a model species. Improved reproduction is a critical milestone in the conservation of imperiled species. Captive reproduction of amphibians is often challenging due to specific and ambiguous environmental cues for each species. The Texas blind salamander is a federally listed troglobitic amphibian found only in the Edwards Aquifer beneath San Marcos, Texas. This species is long‐lived, paedomorphic, and obligately aquatic. As with other cave‐dwelling organisms, Texas blind salamanders exhibits delayed reproductive maturity and low reproductive output. The US Fish & Wildlife San Marcos Aquatic Resources Center maintains a captive assurance population of wild individuals to supplement natural populations in the case of a catastrophic impacts on the wild population. Despite housing this species since the 1980s, unassisted reproductive events remain infrequent and unpredictable. In 2020, we developed the noninvasive use of the topical application of GnRH‐A to stimulate reproduction in 12 females combined with 12 males during a pilot study, that resulted in 11 clutches over a five‐month period. These findings mark a significant increase from normally low production of 4.5 clutches annually (average from 2007 to 2019) and represent a landmark success for captive propagation of this species. [ABSTRACT FROM AUTHOR]

Cardiovascular risk stratification is often performed in patients considered for renal transplantation. In a single center, we sought to examine the association between abnormal stress testing with imaging and post-renal transplant major adverse cardiovascular events (MACE) using multivariable logistic regression. From January 2006 to May 2016 232 patients underwent renal transplantation and 59 (25%) had an abnormal stress test result. Compared to patients with a normal stress test, patients with an abnormal stress test had a higher prevalence of dyslipidemia, diabetes mellitus, obesity, coronary artery disease (CAD), and heart failure. Among those with an abnormal result, 45 (76%) had mild, 10 (17%) moderate, and 4 (7%) severe ischemia. In our cohort, 9 patients (3.9%) had MACE at 30-days post-transplant, 5 of whom had an abnormal stress test. The long-term MACE rate, at a median of 5 years, was 32%. After adjustment, diabetes (OR 2.37, 95% CI 1.12–5.00, p = 0.02), CAD (OR: 3.05, 95% CI 1.30–7.14, p = 0.01) and atrial fibrillation (OR: 5.86, 95% CI 1.86–18.44, p = 0.002) were independently associated with long-term MACE, but an abnormal stress test was not (OR: 0.83, 95% CI 0.37–1.92, p = 0.68). In conclusion, cardiac stress testing was not an independent predictor of long-term MACE among patients undergoing renal transplant. [ABSTRACT FROM AUTHOR]

Background: Regeneration of complex patterned structures is well described among, although limited to a small sampling of, amphibians. This limitation impedes our understanding of the full range of regenerative competencies within this class of vertebrates, according to phylogeny, developmental life stage, and age. To broaden the phylogenetic breath of this research, we characterized the regenerative capacity of the Texas blind salamander (Eurycea rathbuni), a protected salamander native to the Edwards Aquifer of San Marcos, Texas and colonized by the San Marcos Aquatic Resource Center. As field observations suggested regenerative abilities in this population, the forelimb stump of a live captured female was amputated in the hopes of restoring the structure, and thus locomotion in the animal. Tails were clipped from two males to additionally document tail regeneration. Results: We show that the Texas blind salamander exhibits robust limb and tail regeneration, like all other studied Plethodontidae. Regeneration in this species is associated with wound epithelium formation, blastema formation, and subsequent patterning and differentiation of the regenerate. Conclusions: The study has shown that the Texas blind salamander is a valuable model to study regenerative processes, and that therapeutic surgeries offer a valuable means to help maintain and conserve this vulnerable species. Key Findings: For the first time it has been shown that the Texas blind salamander exhibits robust limb and tail regeneration.Similar to other regenerating amphibians, the Texas blind salamander generates a blastema to regenerate a missing structure.Amputation surgeries can facilitate direct therapeutic rehabilitation and improved quality of life of wild captured Texas blind salamanders.This manuscript provides novel insight into the growth rates, courtship and husbandry of this species. [ABSTRACT FROM AUTHOR]

Eurycea pterophila is a fully aquatic paedomorphic salamander species classified as under review for federal listing and distributed in restricted sections of the Comal River (Comal CO., TX). Unlike Eurycea sosorum, which constitutes the only documented wild sightings of Eurycea eggs in the region, no eggs of Eurycea pterophila have been documented in the wild. During a routine collection of Eurycea pterophila for a captive assurance population, two eggs were found in the Comal River, TX near Spring Island, and successfully raised in captivity. Captive Eurycea pterophila eggs were laid at the same time the wild eggs were found; thus, data are presented here for a comparison. [ABSTRACT FROM AUTHOR]

Idiopathic pulmonary fibrosis (IPF) is a progressive, often fatal, fibrosing lung disease for which treatment remains suboptimal. Fibrogenic cytokines, including transforming growth factor-β (TGF-β), are central to its pathogenesis. Protein tyrosine phosphatase-α (PTPα) has emerged as a key regulator of fibrogenic signaling in fibroblasts. We have reported that mice globally deficient in PTPα (Ptpra−/−) were protected from experimental pulmonary fibrosis, in part via alterations in TGF-β signaling. The goal of this study was to determine the lung cell types and mechanisms by which PTPα controls fibrogenic pathways and whether these pathways are relevant to human disease. Immunohistochemical analysis of lungs from patients with IPF revealed that PTPα was highly expressed by mesenchymal cells in fibroblastic foci and by airway and alveolar epithelial cells. To determine whether PTPα promotes profibrotic signaling pathways in lung fibroblasts and/or epithelial cells, we generated mice with conditional (floxed) Ptpra alleles (Ptpraf/f). These mice were crossed with Dermo1-Cre or with Sftpc-CreERT2 mice to delete Ptpra in mesenchymal cells and alveolar type II cells, respectively. Dermo1-Cre/Ptpraf/f mice were protected from bleomycin-induced pulmonary fibrosis, whereas Sftpc-CreERT2/Ptpraf/f mice developed pulmonary fibrosis equivalent to controls. Both canonical and noncanonical TGF-β signaling and downstream TGF-β-induced fibrogenic responses were attenuated in isolated Ptpra−/− compared with wild-type fibroblasts. Furthermore, TGF-β-induced tyrosine phosphorylation of TGF-β type II receptor and of PTPα were attenuated in Ptpra−/− compared with wild-type fibroblasts. The phenotype of cells genetically deficient in PTPα was recapitulated with the use of a Src inhibitor. These findings suggest that PTPα amplifies profibrotic TGF-β-dependent pathway signaling in lung fibroblasts. [ABSTRACT FROM AUTHOR]

In 2008, the Mulberry River, a National Wild and Scenic River, was listed as impaired due to low pH (below pH 6.0). Over the last 50 years, the volume of conifers in the Ozark region has increased 115% since 1978 which may result in the acidification of nearby aquatic ecosystems. The objective of this study was to determine if differences exist in soil and litter chemical properties between deciduous and coniferous tree stands. Aboveground litter (n = 200) and soil (n = 400) at 0- to 5- and 5- to 15-cm depths were collected at paired deciduous and coniferous stands at 10 locations within the Mulberry River watershed and analyzed for a suite of chemical parameters. There were no differences (P > 0.05) in several measures of soil acidity between deciduous and coniferous stands. Litter collected from the coniferous stands was more acidic than deciduous litter (4.4 vs 4.7; P < 0.05). Cation exchange capacity, exchangeable Ca and Mg, and water-soluble P and Mg contents differed (P < 0.05) by stand and depth. Cation exchange capacity and exchangeable Ca and Mg were greatest in the 0- to 5-cm depth interval of the coniferous stands. Water-soluble P and Mg contents were greatest within the 0- to 5-cm depth interval which did not differ (P > 0.05) between stand but were greater than the 5- to 15-cm depth interval. Although limited to the top 15-cm of soil, the similarity in soil acidity between stands suggests that conifer growth may not be a substantial source of acidity to the Mulberry River. [ABSTRACT FROM AUTHOR]

In Latin America (LA), HIV prevalence among MSM is estimated at thirty times greater than in the general male population. Little is known about the role of social support or disclosure status in relation to the HIV care continuum among LA MSM. Using multivariable logistic generalized estimation equations, we assessed the impact of social support satisfaction and disclosure status on engagement in HIV care, ART initiation, and ART adherence with data from an online, multinational sample of HIV infected MSM in Latin America (N = 2,350). 80.0% were engaged in HIV care, 71% initiated ART, and among those, 37% reported missing at least one dose in the past month. In multivariable models, compared to being very satisfied with social support, being somewhat satisfied (aOR = 0.73, 95% CI 0.56, 0.95) or somewhat dissatisfied (aOR = 0.83, 95% CI 0.70, 0.98) were associated with reduced odds of reporting 100% ART adherence. Disclosure of status was associated with a greater odds of HIV care engagement (OR = 1.63, 95% CI 1.28, 2.07) and ART initiation (OR = 1.55, 95% CI 1.30, 1.84). Greater satisfaction with social support and comfort disclosing HIV status to these sources were associated with improved engagement in HIV care and greater initiation of ART among MSM in LA. [ABSTRACT FROM AUTHOR]

The article presents a study which explores the ways that media influences individuals and society includes investigations of all forms of news and entertainment mass media, including film, radio, television, newspapers, websites, books, video games, music, and magazines. Information on the method used in the study, the results and conclusion are discussed.

Background: Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality.Methods: This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h. CoNS was considered a pathogen if recovered from ≥ 2 cultures, or 1 culture if treated for ≥ 5 days and signs of sepsis were present. Logistic regression was used to examine factors associated with morbidity and mortality.Results: Of 2242 VLBW infants, 285 (12.7%) had late-onset sepsis. CoNS (125, 44%), Staphylococcus aureus (52, 18%), and Escherichia coli (36, 13%) were the most commonly recovered organisms. In multivariate analysis, CoNS sepsis was not associated with mortality [OR 0.6 (95% CI 0.2-2.6)), but sepsis with other organisms was [OR 4.5 (95% CI 2.6-8.0)]. CoNS sepsis was associated with longer hospitalization but not risk for bronchopulmonary dysplasia, intraventricular hemorrhage, or retinopathy of prematurity.Conclusion: CoNS sepsis was not associated with mortality or morbidities other than length of stay. These findings support vancomycin-reduction strategies in the NICU. [ABSTRACT FROM AUTHOR]

Many aquatic species produce chemical alarm cues that serve as a warning to nearby conspecifics. In mixed-species aggregations, individuals may also benefit by 'eavesdropping' on the chemical alarm cues of other species that are in the same prey guild. Rainbow Darters ( Etheostoma caeruleum) are benthic fish that co-occur with native Ozark Minnows ( Notropis nubilus), recently introduced Western Mosquitofish ( Gambusia affinis), and native Oklahoma Salamanders ( Eurycea tyrnerensis), all of whom are vulnerable to the same predators. We tested the responses of darters to the damage-released alarm cues of conspecifics (positive control), minnows, and mosquitofish; alarm cues from Bumblebee Gobies ( Brachygobius doriae) served as a negative (allopatric) control. We also tested the response of sympatric and allopatric darters to the damage-released alarm cues of Oklahoma Salamander. Darters exhibited a fright response to conspecific and minnow alarm cues, but not to cues from mosquitofish or gobies. Lack of response to mosquitofish cues could be because they are introduced or because they typically occur higher in the water column than darters. Darters that were sympatric with the salamander exhibited a fright response to the alarm cues of the salamander, while allopatric darters did not. Rainbow Darters can develop responses to the alarm cues of syntopic species (minnows and Oklahoma Salamander) within their prey guild. [ABSTRACT FROM AUTHOR]

Pediatr Crit Care Med J Soc Crit Care Med World Fed Pediatr Intensive Crit Care Soc. 2016; 17: e309 - e316. Lastly, this study used prospectively collected data on intubations in the NICU and DR with an innovative database named NEAR4NEOs, a multi-centre, prospective registry to improve intubation safety in the NICU. The development of tracheal intubation proficiency outside the operating suite during pediatric critical care medicine fellowship training: a retrospective cohort study using cumulative sum analysis. [Extracted from the article]

Background The Palliative Care and Rapid Emergency Screening (P-Ca RES) Project is an initiative intended to improve access to palliative care ( PC) among emergency department ( ED) patients with life-limiting illness by facilitating early referral for inpatient PC consultations. In the previous two phases of this project, we derived and validated a novel PC screening tool. This paper reports on the third and final preimplementation phase. Objectives Examine the acceptability of the P-Ca RES tool among PC and ED providers as well as test its reliability on case vignettes. Compare variations in reliability and acceptability of the tool based on ED providers' roles (attendings, residents, and nurses) and lengths of experience. Methods A two-part electronic survey was distributed to ED providers at multiple sites across the United States. We tested the reliability of the tool in the first part of the survey, through a series of case vignettes. A criterion standard of correct responses was first defined by consensus input from expert PC physicians' interpretations of the vignettes. The experts' input was validated using the Gwet's AC1 coefficient for inter-rater reliability. ED providers were then presented with the case vignettes and asked to use the P-Ca RES tool to correctly identify which patients had unmet PC needs. ED provider responses were compared both against the criterion standard and against different subsets of respondents (divided both by role and by level of experience). The second part of the survey assessed acceptability of the P-Ca RES tool among ED providers using responses to questions from a modified Ottawa Acceptability of Decision Rules Instrument, based on a 1-5 Likert rating scale. Descriptive statistics were used to report all outcomes. Results In total, 213 ED providers employed in three different regions across the country responded to the survey (39.4%) and 185 (86.9%) of those completed it. The majority of providers felt that the tool would be useful in their practice (80.5%), agreed that the tool was clear and unambiguous (87.1%), thought that use of the tool would likely benefit patients (87.5%), and thought that it would result in improved use of resources to help severely ill patients (83.6%). Over three-quarters of ED providers (78.5%) also self-reported that they refer patients with unmet PC needs less than 10% of the time, and only 10.8% of respondents believed that they are already utilizing an effective strategy to screen or refer patients to PC. Applying our P-Ca RES tool to case vignettes, ED providers generated PC referrals in concordance with PC experts over 88.7% of the time (95% confidence interval = 86.4% to 90.6%), with an overall sensitivity of more than 90%. These results varied minimally regardless of the respondent's role in the ED or their level of experience. Conclusion Screening by emergency medicine providers for unmet PC needs using a brief, novel, content-validated screening tool is acceptable and is also reliable when applied to case vignettes-regardless of provider role or experience. Clinical trial and further study are warranted and are currently under way. [ABSTRACT FROM AUTHOR]

Background: Worksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness. We examined the effects of a multifaceted health promotion campaign on organizational capacity to meet requirements to become CEO Cancer Gold Standard Accredited. Methods: We conducted an online survey to assess perceived organizational values and support for the five CEO Cancer Gold Standard Pillars for cancer prevention: tobacco cessation; physical activity; nutrition; cancer screening and early detection; and accessing information on cancer clinical trials. Baseline and follow-up surveys were sent 6-months apart to faculty, staff, and students at a school of public health to test the impact of a multifaceted health promotion campaign on perceived organizational change. Descriptive analyses were used to characterize percent improvement. Multivariate logistic regression analyses were used to control for participants' university status. Results: The current organizational culture highly supported tobacco cessation at both time points. Significant improvements (p < .05) from baseline to follow-up were observed for questions measuring organizational values for 'prevention, screening, and early detection of cancer' and 'accessing cancer treatment and clinical trials'. Conclusions: Health promotion and education efforts using multiple approaches were effective to improve perceived organizational values and support for cancer prevention and early detection, and increase access to information about cancer clinical trials. Future studies are needed to examine broader impacts of implementing worksite health promotion initiatives. [ABSTRACT FROM AUTHOR]

Background: Worksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness. We examined the effects of a multifaceted health promotion campaign on organizational capacity to meet requirements to become CEO Cancer Gold Standard Accredited. Methods: We conducted an online survey to assess perceived organizational values and support for the five CEO Cancer Gold Standard Pillars for cancer prevention: tobacco cessation; physical activity; nutrition; cancer screening and early detection; and accessing information on cancer clinical trials. Baseline and follow-up surveys were sent 6-months apart to faculty, staff, and students at a school of public health to test the impact of a multifaceted health promotion campaign on perceived organizational change. Descriptive analyses were used to characterize percent improvement. Multivariate logistic regression analyses were used to control for participants’ university status. Results: The current organizational culture highly supported tobacco cessation at both time points. Significant improvements (p < .05) from baseline to follow-up were observed for questions measuring organizational values for ‘prevention, screening, and early detection of cancer’ and ‘accessing cancer treatment and clinical trials’. Conclusions: Health promotion and education efforts using multiple approaches were effective to improve perceived organizational values and support for cancer prevention and early detection, and increase access to information about cancer clinical trials. Future studies are needed to examine broader impacts of implementing worksite health promotion initiatives. [ABSTRACT FROM AUTHOR]

Background The emergency department ( ED) is increasingly used by patients with life-limiting illness. These patients are frequently admitted to the hospital, where they suffer from poorly controlled symptoms and are often subjected to marginally effective therapies. Palliative care ( PC) has emerged as the specialty that cares for patients with advanced illness. PC has been shown to reduce symptoms, improve quality of life, and decrease resource utilization. Unfortunately, most patients who could benefit from PC are never identified. At present, there exists no validated screening tool to identify significant unmet PC needs among ED patients with life-limiting illness. Objectives The objective was to develop a simple, content-valid screening tool for use by ED providers to identify ED patients with significant PC needs. A positive screen would result in an inpatient PC consultation. Methods An initial screening tool was developed based on a critical review of the literature. Content validity was determined by a two-round modified Delphi technique using a panel of PC experts. The expert panel reviewed the items of the tool for accuracy and necessity using a Likert scale and provided narrative feedback. Expert's responses were aggregated and analyzed to revise the tool until consensus was achieved. Greater than 80% agreement, as well as meeting Lawshe's critical values, was required to achieve consensus. Results Fifteen experts completed two rounds of surveys to reach consensus on the content validity of the tool. Three screening items were accepted with minimal revisions. The remaining items were revised, condensed, or eliminated. The final tool contains 13 items divided into three steps: 1) presence of a life-limiting illness, 2) unmet PC needs, and 3) hospital admission. The majority of panelists (86%) endorsed adoption of the final screening tool. Conclusions Use of a modified Delphi technique resulted in the creation of a content-validated screening tool for identification of ED patients with significant unmet PC needs. Further validation testing of the instrument is warranted. [ABSTRACT FROM AUTHOR]

Fig. 1. was amended to reduce the size of the map and improve formatting of the manuscript. The authors claim this amendment does not affect the information being conveyed. [ABSTRACT FROM AUTHOR]

Gaseous emissions from poultry litter causes production problems for producers as well as the environment, by contributing to climate change and reducing air quality. Novel methods of reducing ammonia (NH3) and greenhouse gas (GHG) emissions in poultry facilities are needed. As such, our research evaluated GHG emissions over a 42 d period. Three separate flocks of 1000 broilers were used for this study. The first flock was used only to produce litter needed for the experiment. The second and third flocks were allocated to 20 pens in a randomized block design with four replicated of five treatments. The management practices studied included an unamended control; a conventional practice of incorporating aluminum sulfate (referred to as alum) at 98 kg/100 m2); a novel litter amendment made from alum mud, bauxite, and sulfuric acid (alum mud litter amendment, AMLA) applied at different rates (49 and 98 kg/100 m2) and methods (surface applied or incorporated). Nitrous oxide emissions were low for all treatments in flocks 2 and 3 (0.40 and 0.37 mg m2 hr−1, respectively). The formation of caked litter (due to excessive moisture) during day 35 and 42 caused high variability in CH4 and CO2 emissions. Alum mud litter amendment and alum did not significantly affect GHGs emissions from litter, regardless of the amendment rate or application method. In fact, litter amendments such as alum and AMLA typically lower GHG emissions from poultry facilities by reducing ventilation requirements to maintain air quality in cooler months due to lower NH3 levels, resulting in less propane use and concomitant reductions in CO2 emissions. [ABSTRACT FROM AUTHOR]

Treating manure with aluminum sulfate (alum) is a best management practice (BMP) which reduces ammonia (NH3) emissions and phosphorus (P) runoff from poultry litter. However, the price of alum has increased markedly in recent years, creating a need for less expensive products to control NH3 volatilization. The objective of this study was to evaluate the effects of a new litter amendment made from alum mud, bauxite, and sulfuric acid (alum mud litter amendment or AMLA) on NH3 emissions, litter chemistry, and poultry production in a pen trial. Three separate flocks of 1000 broilers were used for this study. The first flock of birds was used to produce the poultry litter needed for the experiment. The second and third flocks of birds were allocated to 20 pens in a randomized block design with four replicates of five treatments: (1) control, (2) 49 kg AMLA/100 m2 incorporated, (3) 98 kg AMLA/100 m2 incorporated, (4) 98 kg AMLA/100 m2 surface applied, and (5) 98 kg alum/100 m2 incorporated. Ammonia flux measurements and litter samples were collected from each pen at day 0, 7, 14, 21, 28, 35, and 42. The average litter pH for both flocks was higher in untreated litter (7.92) compared to incorporating alum (7.32) or AMLA (7.18). The two flocks' average NH4-N concentrations at day 42 were 38% and 30% higher for the high rates of incorporated alum and AMLA compared to the untreated litter. Compared with untreated litter, AMLA reduced overall NH3 emissions by 27% to 52% which was not significantly different from reductions in emissions by alum (35%). Alum mud litter amendment reduced cumulative NH3 losses from litter as much as, and in some cases more than, alum applied at the same rate. These data indicate that AMLA, which can be manufactured for lower price than alum, is an effective alternative litter amendment for reducing NH3 emissions from poultry litter. [ABSTRACT FROM AUTHOR]