Early Gut Microbiota Perturbations Following Intrapartum Antibiotic Prophylaxis to Prevent Group B Streptococcal Disease

peer-reviewedThe faecal microbiota composition of infants born to mothers receiving intrapartum antibiotic prophylaxis with ampicillin against group B Streptococcus was compared with that of control infants, at day 7 and 30 of life. Recruited newborns were both exclusive breastfed and mixed fed, in order to also study the effect of dietary factors on the microbiota composition. Massive parallel sequencing of the V3-V4 region of the 16S rRNA gene and qPCR analysis were performed. Antibiotic prophylaxis caused the most marked changes on the microbiota in breastfed infants, mainly resulting in a higher relative abundance of Enterobacteriaceae, compared with control infants (52% vs. 14%, p = 0.044) and mixed-fed infants (52% vs. 16%, p = 0.13 NS) at day 7 and in a lower bacterial diversity compared to mixed-fed infants and controls. Bifidobacteria were also particularly vulnerable and abundances were reduced in breastfed (p = 0.001) and mixed-fed antibiotic treated groups compared to non-treated groups. Reductions in bifidobacteria in antibiotic treated infants were also confirmed by qPCR. By day 30, the bifidobacterial population recovered and abundances significantly increased in both breastfed (p = 0.025) and mixed-fed (p = 0.013) antibiotic treated groups, whereas Enterobacteriaceae abundances remained highest in the breastfed antibiotic treated group (44%), compared with control infants (16%) and mixed-fed antibiotic treated group (28%). This study has therefore demonstrated the short term consequences of maternal intrapartum antibiotic prophylaxis on the infant faecal microbial population, particularly in that of breastfed infants.This work was part funded by the Irish Department of Agriculture Food and Marine INFANTMET Project (RefNo 10FDairy), Science Foundation of Ireland–funded Centre for Science, Engineering and Technology, the Alimentary Pharmabiotic Centre and by EU FP7 MyNewGut project (No.:613979; www.mynewgut.eu). The research activity of GM and KM were supported by the Global Grant Spinner project 2013 and a Teagasc Walsh Fellowship, respectively

The seasonal change of PAHs in Svalbard surface snow

The Arctic region is threatened by contamination deriving from both long-range pollution and local human activities. Polycyclic Aromatic Hydrocarbons (PAHs) are environmental tracers of emission, transport and deposition processes. A first campaign has been conducted at Ny-Ålesund, Svalbard, from October 2018 to May 2019, monitoring weekly concentrations of PAHs in Arctic surface snow. The trend of the 16 high priority PAH compounds showed that long-range inputs occurred mainly in the winter, with concentrations ranging from 0.8 ng L−1 to 37 ng L−1. In contrast to this, the most abundant analyte retene, showed an opposite seasonal trend with highest values in autumn and late spring (up to 97 ng L−1), while in winter this compound remained below 3 ng L−1. This is most likely due to local contributions from outcropping coal deposits and stockpiles. Our results show a general agreement with the atmospheric signal, although significant skews can be attributed to post-depositional processes, wind erosion, melting episodes and redistribution

Multiplicity Statistics of Stars in the Sagittarius Dwarf Spheroidal Galaxy: Comparison to the Milky Way

We use time-resolved spectra from the Apache Point Observatory Galactic Evolution Experiment (APOGEE) to examine the distribution of radial velocity (RV) variations in 249 stars identified as members of the Sagittarius (Sgr) dwarf spheroidal (dSph) galaxy by Hayes et al (2020). We select Milky Way (MW) stars that have stellar parameters ($log(g)$, $T_{eff}$, and $[Fe/H]$) similar to those of the Sagittarius members by means of a k-d tree of dimension 3. We find that the shape of the distribution of RV shifts in Sgr dSph stars is similar to that measured in their MW analogs, but the total fraction of RV variable stars in the Sgr dSph is larger by a factor of $\sim 2$. After ruling out other explanations for this difference, we conclude that the fraction of close binaries in the Sgr dSph is intrinsically higher than in the MW. We discuss the implications of this result for the physical processes leading to the formation of close binaries in dwarf spheroidal and spiral galaxies

Automated observation of physical snowpack properties in Ny-Ålesund

The snow season in the Svalbard archipelago generally lasts 6–10 months a year and significantly impacts the regional climate, glaciers mass balance, permafrost thermal regime and ecology. Due to the lack of long-term continuous snowpack physical data, it is still challenging for the numerical snow physics models to simulate multi-layer snowpack evolution, especially for remote Arctic areas. To fill this gap, in November 2020, an automated nivometric station (ANS) was installed ∼1 km Southwest from the settlement of Ny-Ålesund (Spitzbergen, Svalbard), in a flat area over the lowland tundra. It automatically provides continuous snow data, including NIR images of the fractional snow-cover area (fSCA), snow depth (SD), internal snow temperature and liquid water content (LWC) profiles at different depths with a 10 min time resolution. Here we present the first-year record of automatic snow preliminary measurements collected between November 2020 and July 2021 together with weekly manual observations for comparison. The snow season at the ANS site lasted for 225 days with an annual net accumulation of 117 cm (392 mm of water equivalent). The LWC in the snowpack was generally low (<4%) during wintertime, nevertheless, we observed three snow-melting events between November and February 2021 and one in June 2021, connected with positive temperature and rain on snow events (ROS). In view of the foreseen future developments, the ANS is the first automated, comprehensive snowpack monitoring system in Ny-Ålesund measuring key essential climate variables needed to understand the seasonal evolution of the snow cover on land

Atlantoaxial subluxation in the pediatric patient: Case series and literature review

Objective: Atlantoaxial subluxation (AAS) occurs when there is misalignment of the atlantoaxial joint. Several etiologies confer increased risk of AAS in children, including neck trauma, inflammation, infection, or inherent ligamentous laxity of the cervical spine. Methods: A single-center, retrospective case review was performed. Thirty-four patients with an ICD-10 diagnosis of S13.1 were identified. Demographics and clinical data were reviewed for etiology, imaging techniques, treatment, and clinical outcome. Results: Out of thirty-four patients, twenty-two suffered cervical spine trauma, seven presented with Grisel’s Syndrome, four presented with ligamentous laxity, and one had an unrecognizable etiology. Most diagnoses of cervical spine subluxation and/or instability were detected on computerized tomography (CT), while radiography and magnetic resonance imaging (MRI) were largely performed for follow-up monitoring. Six patients underwent cervical spine fusion, five had halo traction, twelve wore a hard and/or soft collar without having surgery or halo traction, and eight were referred to physical therapy without other interventions. Conclusion: Pediatric patients with atlantoaxial subluxation may benefit from limited 3D CT scans of the upper cervical spine for accurate diagnosis. Conservative treatment with hard cervical collar and immobilization after reduction may be attempted, but halo traction and halo vest immobilization may be necessary. If non-operative treatment fails, cervical spine internal reduction and fixation may be necessary to maintain normal C1-C2 alignment

Reply to Oleske et al. Blood Lead Concentrations in Newark Children. Comment on “Franklin et al. Broken Promises to the People of Newark: A Historical Review of the Newark Uprising, the Newark Agreements, and Rutgers New Jersey Medical School’s Commitments to Newark. Int. J. Environ. Res. Public Health 2021, 18, 2117”

We read, with tremendous gratitude, Dr. Oleske and Dr. Bogden’s comment in the International Journal of Environmental Research and Public Health titled, “Blood Lead Concentrations in Newark Children” [...

Mechanisms of Peer Review and their Potential Impact on Neurosurgeons: A Pilot Survey

INTRODUCTION: Physician peer review is a universal practice among United States hospitals. While there are many commonalities in peer review procedures, many of them established by law, there is also much institutional variation which should be well understood by practicing neurosurgeons. METHODS: We conducted a 13-question pilot survey of a sample of five hospital systems with whom members of the CSNS-Medicolegal committee are affiliated. Survey questions were constructed to qualitatively assess three features of Hospital Peer Review: (1) committee composition and process, (2) committee outcomes, and (3) legal protections and ramifications RESULTS: The most common paradigm for physician peer review committee (PPRC) was an interdisciplinary group with representatives from most major medical and surgical subspecialties. Referrals for peer review inquiry could be made by any hospital employee and were largely anonymous. Most institutions included a pre-committee screening process conducted by the PPRC leadership. The most common outcomes of an inquiry were resolution with no further action or ongoing focused professional practice evaluation (FFPE). Only in rare circumstances were hospital privileges reported to be revoked or terminated. Members of the PPRC were consistently protected from retaliatory litigation related to peer review participation. The majority of hospitals had a multi-layered decision process and availability of appeal to minimize the potential for punitive investigations. DISCUSSION: According to a recent study, only 62% of hospitals consider their peer review process to be highly or significantly standardized. This pilot survey provides commentary of potential areas of commonality and variation among hospital peer review practices

In reply: congress of neurological surgeons systematic review and evidence-based guidelines on the treatment of pediatric hydrocephalus: update of the 2014 guidelines

We appreciate the thoughtful critique1 of our recent publication “Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines on the Treatment of Pediatric Hydrocephalus: Update of the 2014 Guidelines.”2 We must emphasize that our process used a rigorous methodology to update answers to questions asked in the original 2014 guidelines. 3 One question in our original publication regarded the use of antibiotic-impregnated shunts (AISs) in children with hydrocephalus. For this question, we evaluated whether AIS reduced the risk of infection compared to standard shunts. In our update, we found level I evidence that supported our finding, based on the British antibiotic and silver-impregnated catheters for ventriculoperitoneal shunts (BASICS) of AISs.4 In our posed PICO (population, intervention, control, and outcomes) question, we did not evaluate long-term function or mechanical failure related to AIS. The hypothesis that mechanical failure may be caused by masked AIS infections has yet to be proven with published medical evidence. In addition, while the Fragility Index (FI) of the BASICS study may be low, the study was still statistically significant and adequately powered to answer this question