Chronic helminth infection burden differentially affects haematopoietic cell development while ageing selectively impairs adaptive responses to infection

Throughout the lifespan of an individual, the immune system undergoes complex changes while facing novel and chronic infections. Helminths, which infect over one billion people and impose heavy livestock productivity losses, typically cause chronic infections by avoiding and suppressing host immunity. Yet, how age affects immune responses to lifelong parasitic infection is poorly understood. To disentangle the processes involved, we employed supervised statistical learning techniques to identify which factors among haematopoietic stem and progenitor cells (HSPC), and both innate and adaptive responses regulate parasite burdens and how they are affected by host age. Older mice harboured greater numbers of the parasites’ offspring than younger mice. Protective immune responses that did not vary with age were dominated by HSPC, while ageing specifically eroded adaptive immunity, with reduced numbers of naïve T cells, poor T cell responsiveness to parasites, and impaired antibody production. We identified immune factors consistent with previously-reported immune responses to helminths, and also revealed novel interactions between helminths and HSPC maturation. Our approach thus allowed disentangling the concurrent effects of ageing and infection across the full maturation cycle of the immune response and highlights the potential of such approaches to improve understanding of the immune system within the whole organism

Rural Hospital Nursing Skill Mix and Work Environment Associated with Frequency of Adverse Events.

Introduction: Though rural hospitals serve about one fifth of the United States (U.S.), few studies have investigated relationships among nursing resources and rural hospital adverse events. Objectives: The purpose was to determine relationships among nursing skill mix (proportion of Registered Nurses (RNs) to all nursing staff), the work environment and adverse events (medication errors, patient falls with injury, pressure ulcers, and urinary tract infections) in rural hospitals. Methods: Using a cross-sectional design, nurse survey data from a large study examining nurse organizational factors, patient safety, and quality from four U.S. states were linked to the 2006 American Hospital Association data. The work environment was measured using the Practice Environment Scale of the Nursing Work Index (PES-NWI). Nurses reported adverse event frequency. Data analyses were descriptive and inferential. Results: On average, 72% of nursing staff were RNs (range = 45% to 100%). Adverse event frequency ranged from 0% to 67%, across 76 hospitals. In regression models, a 10-point increase in the proportion of RNs among all nursing staff and a one standard deviation increase in the PES-NWI score were significantly associated with decreased odds of frequent adverse events. Conclusion: Rural hospitals that increase the nursing skill mix and improve the work environment may achieve reduced adverse event frequency

Evidence for improved urban flood resilience by sustainable drainage retrofit

The rapid growth of cities under modern development pressure has resulted in surface water flooding becoming an increasing hazard and future climate change uncertainties may exacerbate this threat still further: retrofitting sustainable drainage systems to attenuate stormwater runoff has been advocated as part of an integrated solution required to address this problem. Many of these adaptations not only enhance a community’s resilience to flooding, but may also offer additional benefits in terms of improved environmental amenity and quality of life. The evidence base for sustainable drainage is critically evaluated in respect of the implications for urban planning, as applied to existing housing stocks and business properties in urban areas worldwide. It is concluded that this approach can make a substantial contribution towards urban resilience as part of an integrated approach to managing extreme storms. This will be of interest to urban planners and designers considering the implementation of integrated flood risk management

Vortex fluidics-mediated DNA rescue from formalin-fixed museum specimens.

DNA from formalin-preserved tissue could unlock a vast repository of genetic information stored in museums worldwide. However, formaldehyde crosslinks proteins and DNA, and prevents ready amplification and DNA sequencing. Formaldehyde acylation also fragments the DNA. Treatment with proteinase K proteolyzes crosslinked proteins to rescue the DNA, though the process is quite slow. To reduce processing time and improve rescue efficiency, we applied the mechanical energy of a vortex fluidic device (VFD) to drive the catalytic activity of proteinase K and recover DNA from American lobster tissue (Homarus americanus) fixed in 3.7% formalin for >1-year. A scan of VFD rotational speeds identified the optimal rotational speed for recovery of PCR-amplifiable DNA and while 500+ base pairs were sequenced, shorter read lengths were more consistently obtained. This VFD-based method also effectively recovered DNA from formalin-preserved samples. The results provide a roadmap for exploring DNA from millions of historical and even extinct species

Assessing the Viability of the EQ-5D as Part of a Battery of Outcomes in Elderly Total Knee Arthroplasty Patients: A Comparison of Generic, Condition-Specific, and Preference-Based Patient-Reported Outcome Measures

Background In the current economic climate it has become increasingly important to evaluate the effectiveness of expensive procedures such as total knee arthroplasties (TKAs). Patient-reported outcome measures, such as generic and condition-specific profile measures, are popular ways of determining outcomes. However, these cannot be used reliably for the purpose of economic evaluations. The EQ-5D, designed for cost-utility analysis, could offer potential advantages to outcome measurement; however, little is known about the viability and performance of this measure in more elderly (_ 75 years) patient cohorts. Aims The aim of this study was to assess the viability of the EQ-5D for use in the evaluation of TKA and to provide justification for its continued inclusion in the clinical audit of patients undergoing arthroplasty in a large general hospital. Methods Seven-hundred and seventy-nine consecutive patients undergoing TKA participated in this study. Self-report audit questionnaire booklets were administered at baseline (during a pre-admission clinic appointment) and six months post-operatively (postally). Booklets comprised of the Oxford Knee Scale (OKS;), 12-dimension Short Form (SF-12;), and the EQ-5D (). Results Two-hundred and forty-six subjects completed both the baseline and follow-up audit surveys. Correlations were strongest between the EQ-5D and OKS instruments (baseline: Tb=-0.58; p0.01; follow-up: Tb=-0.41; p0.01),.. The EQ-5D displayed large effect sizes (d=0.94) and was able to detect clinically important HRQoL improvements (ROC P-value=0.65; CI0.08; p0.001), discriminate those patients who were experiencing poorer pre-operative health (p0.001), and detect those who deteriorated post-operatively (p0.001). Adequate reliability (Cronbach's =0.79) of the EQ-5D instrument was seen post-operatively as well. Conclusions Results from this study reveal that the EQ-5D instrument shows good responsiveness to health changes in elderly TKA patients post-operatively. Its correlations with the OKS, detection of poorer pre-operative health, and detection of deterioration post-operatively also suggest good validity for the EQ-5D in this cohort. Finally, the relatively large reliability statistic post-operatively supports the use of the EQ-5D in audits. Together, these findings support the continued use of the EQ-5D instrument in future arthroplasty audits and provide evidence that it is viable for the use in cost-utility analysis.sch_phyunpub2424unpu

Community Lost? Changes and Stratification in Perceived Neighborhood Social Cohesion among Families with Children

CC BY-NC 4.0Neighborhood social cohesion is strongly associated with health and well-being, especially among families with children. However, there is a widespread perception in the media, policy circles, and prominent research traditions that neighborhood social cohesion has decreased in recent decades for the United States as a whole and among certain subpopulations. Unfortunately, the empirical evidence for such trends is thin. In this study, we use data on families with children from two studies, the Survey of Income and Program Participation and the Fragile Families and Child Wellbeing Study, to explore trends in neighborhood social cohesion and how individual- and neighborhood-level characteristics pattern disparities in the experience of neighborhood social cohesion. Counter to popular perceptions, our results show increases in neighborhood social cohesion over recent decades, at least for families with children. However, our results reveal persistent disparities in the experience of neighborhood social cohesion by individual and neighborhood characteristics.OA publication support through Carolina Consortium agreement with Sag

A watershed approach to recovering salmon in changing climate conditions

The Snohomish Basin Forum adopted the Snohomish Basin Protection Plan in 2015 which clearly stated that the survival of our iconic salmon will be challenged by climate change. From that integrative watershed planning effort the Snohomish Basin Technical Committee investigated how locally predicted impacts of climate change affect salmon recovery in the Snohomish Basin and what key actions can be taken to ameliorate those impacts. As the basin continues to implement the Snohomish Basin Salmon Recovery Plan, it will be critical to restore and protect areas that preserve the basin’s hydrologic patterns and key habitat functions that support salmon in their various life stages. Restoration and protection actions implemented will need to remain successful as the changing climate shapes our natural system. It will be critical to incorporate what is known about climate change impacts into our salmon recovery plans and strategies

Ventral extra-striate cortical areas are required for human visual texture segmentation

A patient (HJA) with bilateral occipital lobe damage to ventral cortical areas V2, V3 and V4 was tested on a texture segmentation task involving texture bar detection in an array of oriented lines. Performance detecting a target shape was assessed as the orientations of the background lines had increasing orientation noise. Control participants found the task easier when the background lines had the same orientation or only slightly shifted in orientation. HJA was poor with all backgrounds but particularly so when the background lines had the same or almost the same orientations. The results suggest that V1 alone is not sufficient to perform easy texture segmentation, even when the background of the display is a homogeneous texture. Ventral extra-striate cortical areas are needed in order to detect texture boundaries. We suggest that extra-striate visual areas enhance the borders between the target and background, while also playing a role in reducing the signal from homogeneous texture backgrounds