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Association of Mycoplasma ovipneumoniae with pneumonia in domestic small ruminants has been described in Europe, Asia, and New Zealand but has received less attention in the United States. In 2011, the US Department of Agriculture's National Animal Health Monitoring System detected M. ovipneumoniae shedding in 88% of 453 domestic sheep operations tested in 22 states that accounted for 85.5% of US ewe inventory in 2001. We evaluated factors associated with M. ovipneumoniae infection presence and prevalence, and we compared health, lamb production, and ewe losses in infected and uninfected operations. M. ovipneumoniae detection was more common in larger operations than in smaller operations. Both likelihood of detection (at the operation level) and within-operation prevalence were higher in operations with more open management practices than in operations with more closed management practices. M. ovipneumoniae-positive operations showed significantly lower lambing rates and lower rates of lamb survival to weaning after accounting for differences in operation size and management practice. While its effect on any single rate was not particularly large, in aggregate we estimated that M. ovipneumoniae presence was associated with an approximately 4.3% reduction in annual lamb production.

Severe sepsis and septic shock are common causes of intensive care unit (ICU) admission, length of stay, mortality and cost. Sepsis is very difficult to diagnose in real-time and early treatment can show positive benefits. Current sepsis scores are hierarchically calculated, creating significant case-control and/or misclassification biases in developing real-time diagnostic classifiers based on real-time clinical data. This study examines the impact on kernel density classifier performance of a continuous sepsis score derived from a hierarchical score and based on current well-accepted metrics. Clinical data and model-based insulin sensitivity from 36 patients in the Christchurch Hospital ICU (6071 h) is used to segregate severe sepsis and septic shock from mild sepsis and SIRS using a modified continuous sepsis score using a kernel density estimator (KDE) method. Best case resubstitution, worst case bootstrap, and expected case .632 bootstrap estimates are calculated. Diagnostic quality is assessed using likelihood ratios (LHRs), ROC curves, diagnostic odds-ratios (DOR), sensitivity and specificity. Results were compared to those using the hierarchical sepsis score and the same KDE. The continuous sepsis score yielded smoother, more realistic time-varying trajectories for sepsis evolution. The classifier provided very good results, potentially able to change clinical decisions, but did not reach the best diagnostic accuracy for all performance metrics. Using several metrics avoided assessment bias, and likelihood ratios provided the best overall assessment relative to clinical decision making processes. Finally, quantifying infection presence is a source of case-control and misclassification bias in classifier development, showing clear need for improved sepsis scores.

Background Epidemiological and clinical data of human coronaviruses (HCoVs) infections are restricted to span 1–3 years at most. We conducted a comprehensive 9-year study on HCoVs by analyzing 1137 respiratory samples from four subsets of patients (asymptomatic, general community, with comorbidities, and hospitalized) in Sao Paulo, Brazil. Methods A pan-coronavirus RT-PCR screening assay was performed, followed by species-specific real-time RT-PCR monoplex assays. Results Human coronaviruses were detected in 88 of 1137 (7.7%) of the samples. The most frequently detected HCoV species were NL63 (50.0%) and OC43 (27.3%). Patients with comorbidities presented the highest risk of acquiring coronavirus infection (odds ratio = 4.17; 95% confidence interval = 1.9–9.3), and children with heart diseases revealed a significant HCoV infection presence. Dyspnea was more associated with HCoV-229E infections (66.6%), and cyanosis was reported only in HCoV-OC43 infections. There were interseasonal differences in the detection frequencies, with HCoV-229E being predominant in the year 2004 (61.5%) and HCoV-NL63 (70.8%) in 2008. Conclusions Our data provide a novel insight into the epidemiology and clinical knowledge of HCoVs among different subsets of patients, revealing that these viruses may cause more than mild respiratory tract disease.