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Early mobility, functional independence, and ambulation are associated benefits after lower limb amputation (LLA), whereas an increased risk of clinical complications is associated with no prosthesis.To describe time to prosthesis receipt after amputation and to assess the impact of patient demographic and health factors on the rate of prosthesis receipt within 12 months post LLA.A retrospective cohort analysis using commercial administrative claims data. Kaplan-Meier and Cox proportional-hazards models were applied to assess time to prosthesis receipt.Watson/Truven administrative database 2014-2016.Adults aged 18-64 years with LLA who maintained their current insurance enrollment for 12 months after amputation.Independent variables included diabetes/vascular disease status, amputation level, age, gender, and region.Prosthesis receipt was defined based on the presence of codes billed for prosthesis services. Time was measured in days from date of amputation surgery.Among the sample, 510 individuals maintained insurance enrollment for 12 months after amputation, of which 443 individuals received a prosthesis within that period (79% below knee and 21% above knee). The adjusted average rate of time to prosthesis receipt was 138 (95% confidence interval [CI]: 113-185) days. Individuals with diabetes/vascular disease were 22% (hazard ratio: 1.22, 95% CI: 1.02-1.49) more likely to receive a prosthesis earlier than individuals without diabetes/vascular disease and women received a prosthesis later than men at 141 (95% CI: 126-162) days versus 106 (95% CI: 96-119) days, respectively.This study expands the understanding of factors that influence the likelihood of receiving a prosthesis along with the timing of prosthesis receipt after LLA among commercially insured adults. At least half of this sample received a prosthesis within 5 months or less. Disparities in timing and access to a prosthesis based on amputation level and gender were noted; future efforts are needed to address these issues.

We explore the parameter space for the contribution to Callisto's H corona observed by the Hubble Space Telescope (Roth et al. 2017a) from sublimated H2O and radiolytically produced H2 using the Direct Simulation Monte Carlo (DSMC) method. The spatial morphology of this corona produced via photo- and magnetospheric electron impact-induced dissociation is described by tracking the motion of and simulating collisions between the hot H atoms and thermal molecules including a near-surface O2 component. Our results indicate that sublimated H2O produced from the surface ice, whether assumed to be intimately mixed with or distinctly segregated from the dark non-ice or ice-poor regolith, cannot explain the observed structure of the H corona. On the other hand, a global H2 component can reproduced the observation, and is also capable of producing the enhanced electron densities observed at high altitudes by Galileo's plasma-wave instrument (Gurnett et al., 1997, 2000), providing the first evidence of H2 in Callisto's atmosphere. The range of H2 surface densities explored, under a variety of conditions, that are consistent with these observations is ~(0.4-1)x10^8 cm^-3. The simulated H2 escape rates and estimated lifetimes suggest that Callisto has a neutral H2 torus. We also place a rough upper limit on the peak H2O number density (

The brown treesnake (BTS) (Boiga irregularis) invasion on Guåhan (in English, Guam) led to the extirpation of nearly all native forest birds. In recent years, methods have been developed to reduce BTS abundance on a landscape scale. To help assess the prospects for the successful reintroduction of native birds to Guåhan following BTS suppression, we modeled bird population persistence based on their life history characteristics and relative sensitivity to BTS predation. We constructed individual-based models and simulated BTS predation in hypothetical founding populations for each of seven candidate bird species. We represented BTS predation risk in two steps: risk of being encountered and risk of mortality if encountered. We link encounter risk from the bird's perspective to snake contact rates at camera traps with live animal lures, the most direct practical means of estimating BTS predation risk. Our simulations support the well-documented fact that Guåhan's birds cannot persist with an uncontrolled population of BTS but do indicate that bird persistence in Guåhan's forests is possible with suppression short of total eradication. We estimate threshold BTS contact rates would need to be below 0.0002-0.0006 snake contacts per bird per night for these birds to persist on the landscape, which translates to an annual encounter probability of 0.07-0.20. We simulated the effects of snake-proof nest boxes for Sihek (Todiramphus cinnamominus) and Såli (Aplonis opaca), but the benefits were small relative to the overall variation in contact rate thresholds among species. This variation among focal bird species in sustainable predation levels can be used to prioritize species for reintroduction in a BTS-suppressed landscape, but variation among these species is narrow relative to the required reduction from current BTS levels, which may be four orders of magnitude higher (0.18). Our modeling indicates that the required predation thresholds may need to be lower than have yet been demonstrated with current BTS management. Our predation threshold metric provides an important management tool to help estimate target BTS suppression levels that can be used to determine when bird reintroduction campaigns might begin and serves as a model for other systems to match predator control with reintroduction efforts.

Nitroheterocycles represent an important class of compound used to treat trypanosomiasis. They often function as prodrugs and can undergo type I nitroreductase (NTR1)-mediated activation before promoting their anti-parasitic activities although the nature of these downstream effects has yet to be determined. Here, we show that in an NTR1-dependent process, benznidazole promotes DNA damage in the nuclear genome of Trypanosoma brucei, providing the first direct link between activation of this prodrug and a downstream trypanocidal mechanism. Phenotypic and protein expression studies revealed that components of the trypanosome's homologous recombination (HR) repair pathway (TbMRE11, γH2A, TbRAD51) cooperate to resolve the benznidazole-induced damage, indicating that the prodrug-induced lesions are most likely double stand DNA breaks, while the sequence/recruitment kinetics of these factors parallels that in other eukaryotes HR systems. When extended to other NTR1-activated 2-nitroimidazoles, some were shown to promote DNA damage. Intriguingly, the lesions induced by these required TbMRE11 and TbCSB activities to fix leading us to postulate that TbCSB may operate in systems other than the transcription-coupled nucleotide excision repair pathway. Understanding how existing trypanosomal drugs work will aid future drug design and help unlock novel reactions/pathways that could be exploited as targets for therapeutic intervention.

Introduction Adverse events after a lower limb amputation (LLA) can negatively affect the rehabilitation process and may lead to emergency department (ED) visits. Earlier receipt of a prosthesis, as compared to delayed or not receiving a prosthesis, may decrease or moderate the risk of increased ED utilization. In addition, adverse events (ie, fall‐related injury [FRI]) may be associated with increased health care utilization as measured by ED use. The implication of the timing of prosthesis provision after amputation and reduced ED use is not well established. Obtaining data about ED utilization early post‐LLA could assist the rehabilitation team in ensuring timely and appropriate access to improve outcomes. Objective To determine the role that timing of prosthesis receipt has in ED utilization and the association of fall/FRI with health care utilization. Design Retrospective observational cohort using commercial claims data. A logistic regression model was used to assess factors that influence ED utilization post‐LLA. Setting Watson/Truven administrative database 2014 to 2016. Participants The study sample consisted of 510 adults age 18 to 64 years with continuous enrollment for 3 years. Interventions Independent variables included age, sex, diabetes status, amputation level, fall diagnosis, and prosthesis receipt. Fall was defined as presence of a diagnosis code in any outpatient procedure after the amputation date. Main Outcome Measure ED use after amputation was defined as the presence of procedure codes that billed for ED services (99281 to 99285). Results Individuals who receive a prosthesis early, within 0 to 3 months, post‐LLA were 48% (odds ratio [OR] 0.52, 95% confidence interval [CI] 0.28 to 0.97) less likely to use the ED compared to those who did not receive a prosthesis. Individuals who experienced a fall/FRI had 2.8 (OR 2.86, 95% CI 1.23 to 6.66) times the odds of ED utilization. Conclusion Receipt of a prosthesis reduces the risk of ED use. The current study underscores the value of prostheses during the rehabilitation process after LLA.

Estimates of species abundance are critical to understand population processes and to assess and select management actions. However, capturing and marking individuals for abundance estimation, while providing robust information, can be economically and logistically prohibitive, particularly for species with cryptic behavior. Camera traps can be used to collect data at temporal and spatial scales necessary for estimating abundance, but the use of camera traps comes with limitations when target species are not uniquely identifiable (i.e., "unmarked"). Abundance estimation is particularly useful in the management of invasive species, with herpetofauna being recognized as some of the most pervasive and detrimental invasive vertebrate species. However, the use of camera traps for these taxa presents additional challenges with relevancy across multiple taxa. It is often necessary to use lures to attract animals in order to obtain sufficient observations, yet lure attraction can influence species' landscape use and potentially induce bias in abundance estimators. We investigated these challenges and assessed the feasibility of obtaining reliable abundance estimates using camera-trapping data on a population of invasive brown treesnakes (Boiga irregularis) in Guam. Data were collected using camera traps in an enclosed area where snakes were subject to high-intensity capture-recapture effort, resulting in presumed abundance of 116 snakes (density = 23/ha). We then applied spatial count, random encounter and staying time, space to event, and instantaneous sampling estimators to photo-capture data to estimate abundance and compared estimates to our presumed abundance. We found that all estimators for unmarked populations performed poorly, with inaccurate or imprecise abundance estimates that limit their usefulness for management in this system. We further investigated the sensitivity of these estimators to the use of lures (i.e., violating the assumption that animal behavior is unchanged by sampling) and camera density in a simulation study. Increasing the effective distances of a lure (i.e., lure attraction) and camera density both resulted in biased abundance estimates. Each estimator rarely recovered truth or suffered from convergence issues. Our results indicate that, when limited to unmarked estimators and the use of lures, camera traps alone are unlikely to produce abundance estimates with utility for brown treesnake management.