Maternal methadone use in pregnancy : factors associated with the development of neonatal abstinence syndrome and implications for healthcare resources

The objectives of this study were to investigate factors associated with the development of neonatal abstinence syndrome (NAS) and to assess the implications for healthcare resources of infants born to drug-misusing women. Design. Retrospective cohort study from 1 January 2004 to 31 December 2006. Setting. Inner-city maternity hospital providing dedicated multidisciplinary care to drug-misusing women. Four hundred and fifty singleton pregnancies of drugmisusing women prescribed substitute methadone in pregnancy. Development of NAS and duration of infant hospital stay. 45.5% of infants developed NAS requiring pharmacological treatment. The odds ratio of the infant developing NAS was independently related to prescribed maternal methadone dose rather than associated polydrug misuse. Breastfeeding was associated with reduced odds of requiring treatment for NAS (OR 0.55, 95% CI 0.34-0.88). Preterm birth did not influence the odds of the infant receiving treatment for NAS. 48.4% infants were admitted to the neonatal unit (NNU) 40% of these primarily for treatment of NAS. The median total hospital stay for all infants was 10 days (interquartile range 7-17 days). Infants born to methadone-prescribed drug-misusing mothers represented 2.9% of hospital births, but used 18.2% of NNU cot days. Higher maternal methadone dose is associated with a higher incidence of NAS. Pregnant drug-misusing women should be encouraged and supported to breastfeed. Their infants are extremely vulnerable and draw heavily on healthcare resources

Analysis of the subunit assembly of the type IC restriction-modification enzyme EcoR124I

Type I restriction-modification (R-M) enzymes are composed of three different subunits, of which HsdS determines DNA specificity, HsdM is responsible for DNA methylation and HsdR is required for restriction. The HsdM and HsdS subunits can also form an independent DNA methyltransferase with a subunit stoichiometry of M2S1. We found that the purified Eco R124I R-M enzyme was a mixture of two species as detected by the presence of two differently migrating specific DNA-protein complexes in a gel retardation assay. An analysis of protein subunits isolated from the complexes indicated that the larger species had a stoichiometry of R2M2S1and the smaller species had a stoichiometry of R1M2S1. In vitro analysis of subunit assembly revealed that while binding of the first HsdR subunit to the M2S1complex was very tight, the second HsdR subunit was bound weakly and it dissociated from the R1M2S1complex with an apparent K d of approximately 2.4 x 10(-7) M. Functional assays have shown that only the R2M2S1complex is capable of DNA cleavage, however, the R1M2S1complex retains ATPase activity. The relevance of this situation is discussed in terms of the regulation of restriction activity in vivo upon conjugative transfer of a plasmid-born R-M system into an unmodified host cell

A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis

Background: We aimed to describe the longitudinal changes in bone mineral content and influencing factors, in children with cystic fibrosis (CF). Methods: One hundred children (50 females) had dual X-ray absorptiometry (DXA) performed. Of these, 48 and 24 children had two to three scans, respectively over 10 years of follow-up. DXA data were expressed as lumbar spine bone mineral content standard deviation score (LSBMCSDS) adjusted for age, gender, ethnicity and bone area. Markers of disease, anthropometry and bone biochemistry were collected retrospectively. Results: Baseline LSBMCSDS was >0.5 SDS in 13% children, between −0.5; 0.5 SDS, in 50% and ≤−0.5 in the remainder. Seventy-eight percent of the children who had baseline LSBMCSDS >−0.5, and 35% of the children with poor baseline (LSBMCSDS<−0.5), showed decreasing values in subsequent assessments. However, mean LS BMC SDS did not show a significant decline in subsequent assessments (−0.51; −0.64; −0.56; p=0.178). Lower forced expiratory volume in 1 s percent (FEV1%) low body mass index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC. Conclusions: Bone mineral content as assessed by DXA is sub-optimal and decreases with time in most children with CF and this study has highlighted parameters that can be addressed to improve bone health

Cyclostationary Processes on Shape Spaces for Gait-Based Recognition

Abstract. We present a geometric and statistical approach to gaitbased human recognition. The novelty here is to consider observations of gait, considered as planar silhouettes, to be cyclostationary processes on a shape space of simple closed curves. Consequently, gait analysis reduces to quantifying differences between underlying stochastic processes using their observations. Individual shapes can be compared using geodesic lengths, but the comparison of gait cycles requires tools for extraction, interpolation, registration, and averaging of individual gait cycles before comparisons. The main steps in our approach are: (i) off-line extraction of human silhouettes from IR video data, (ii) use of piecewise-geodesic paths, connecting the observed shapes, to smoothly interpolate between them, (iii) computation of an average gait cycle within class (i.e. associated with a person) using Karcher means, (iv) registration of average cycles using linear and nonlinear time scaling, (iv) comparisons of average cycles using geodesic lengths between the corresponding shapes. We illustrate this approach on gait sequence obtained from infrared video clips. Experimental results are presented for a data set of 26 subjects.

Alleviation of restriction by DNA condensation and non-specific DNA binding ligands

During conditions of cell stress, the type I restriction and modification enzymes of bacteria show reduced, but not zero, levels of restriction of unmethylated foreign DNA. In such conditions, chemically identical unmethylated recognition sequences also occur on the chromosome of the host but restriction alleviation prevents the enzymes from destroying the host DNA. How is this distinction between chemically identical DNA molecules achieved? For some, but not all, type I restriction enzymes, alleviation is partially due to proteolytic degradation of a subunit of the enzyme. We identify that the additional alleviation factor is attributable to the structural difference between foreign DNA entering the cell as a random coil and host DNA, which exists in a condensed nucleoid structure coated with many non-specific ligands. The type I restriction enzyme is able to destroy the ‘naked’ DNA using a complex reaction linked to DNA translocation, but this essential translocation process is inhibited by DNA condensation and the presence of non-specific ligands bound along the DNA

On the stationarity of linearly forced turbulence in finite domains

A simple scheme of forcing turbulence away from decay was introduced by Lundgren some time ago, the `linear forcing', which amounts to a force term linear in the velocity field with a constant coefficient. The evolution of linearly forced turbulence towards a stationary final state, as indicated by direct numerical simulations (DNS), is examined from a theoretical point of view based on symmetry arguments. In order to follow closely the DNS the flow is assumed to live in a cubic domain with periodic boundary conditions. The simplicity of the linear forcing scheme allows one to re-write the problem as one of decaying turbulence with a decreasing viscosity. Scaling symmetry considerations suggest that the system evolves to a stationary state, evolution that may be understood as the gradual breaking of a larger approximate symmetry to a smaller exact symmetry. The same arguments show that the finiteness of the domain is intimately related to the evolution of the system to a stationary state at late times, as well as the consistency of this state with a high degree of isotropy imposed by the symmetries of the domain itself. The fluctuations observed in the DNS for all quantities in the stationary state can be associated with deviations from isotropy. Indeed, self-preserving isotropic turbulence models are used to study evolution from a direct dynamical point of view, emphasizing the naturalness of the Taylor microscale as a self-similarity scale in this system. In this context the stationary state emerges as a stable fixed point. Self-preservation seems to be the reason behind a noted similarity of the third order structure function between the linearly forced and freely decaying turbulence, where again the finiteness of the domain plays an significant role.Comment: 15 pages, 7 figures, changes in the discussion at the end of section VI, formula (60) correcte

Fully Automatic Expression-Invariant Face Correspondence

We consider the problem of computing accurate point-to-point correspondences among a set of human face scans with varying expressions. Our fully automatic approach does not require any manually placed markers on the scan. Instead, the approach learns the locations of a set of landmarks present in a database and uses this knowledge to automatically predict the locations of these landmarks on a newly available scan. The predicted landmarks are then used to compute point-to-point correspondences between a template model and the newly available scan. To accurately fit the expression of the template to the expression of the scan, we use as template a blendshape model. Our algorithm was tested on a database of human faces of different ethnic groups with strongly varying expressions. Experimental results show that the obtained point-to-point correspondence is both highly accurate and consistent for most of the tested 3D face models

Influence of real-world characteristics on outcomes for patients with methicillin-resistant Staphylococcal skin and soft tissue infections:a multi-country medical chart review in Europe

BACKGROUND: Patient-related (demographic/disease) and treatment-related (drug/clinician/hospital) characteristics were evaluated as potential predictors of healthcare resource use and opportunities for early switch (ES) from intravenous (IV)-to-oral methicillin-resistant Staphylococcus aureus (MRSA)-active antibiotic therapy and early hospital discharge (ED). METHODS: This retrospective observational medical chart study analyzed patients (across 12 European countries) with microbiologically confirmed MRSA complicated skin and soft tissue infections (cSSTI), ≥3 days of IV anti-MRSA antibiotics during hospitalization (July 1, 2010-June 30, 2011), and discharged alive by July 31, 2011. Logistic/linear regression models evaluated characteristics potentially associated with actual resource use (length of IV therapy, length of hospital stay [LOS], IV-to-oral antibiotic switch), and ES and ED (using literature-based and expert-verified criteria) outcomes. RESULTS: 1542 patients (mean ± SD age 60.8 ± 16.5 years; 61.5% males) were assessed with 81.0% hospitalized for MRSA cSSTI as the primary reason. Several patient demographic, infection, complication, treatment, and hospital characteristics were predictive of length of IV therapy, LOS, IV-to-oral antibiotic switch, or ES and ED opportunities. Outcomes and ES and ED opportunities varied across countries. Length of IV therapy and LOS (r = 0.66, p < 0.0001) and eligibilities for ES and ED (r = 0.44, p < 0.0001) showed relatively strong correlations. IV-to-oral antibiotic switch patients had significantly shorter length of IV therapy (−5.19 days, p < 0.001) and non-significantly shorter LOS (−1.86 days, p > 0.05). Certain patient and treatment characteristics were associated with increased odds of ES (healthcare-associated/ hospital-acquired infection) and ED (patient living arrangements, healthcare-associated/ hospital-acquired infection, initiating MRSA-active treatment 1–2 days post cSSTI index date, existing ED protocol), while other factors decreased the odds of ES (no documented MRSA culture, ≥4 days from admission to cSSTI index date, IV-to-oral switch, IV line infection) and ED (dementia, no documented MRSA culture, initiating MRSA-active treatment ≥3 days post cSSTI index date, existing ES protocol). CONCLUSIONS: Practice patterns and opportunity for further ES and ED were affected by several infection, treatment, hospital, and geographical characteristics, which should be considered in identifying ES and ED opportunities and designing interventions for MRSA cSSTI to reduce IV days and LOS while maintaining the quality of care. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2334-14-476) contains supplementary material, which is available to authorized users

Evaluation of afoxolaner chewables to control flea populations in naturally infested dogs in private residences in Tampa FL, USA

Citation: Dryden, M. W., Smith, V., Chwala, M., Jones, E., Crevoiserat, L., McGrady, J. C., . . . Carithers, D. (2015). Evaluation of afoxolaner chewables to control flea populations in naturally infested dogs in private residences in Tampa FL, USA. Parasites & Vectors, 8, 7. doi:10.1186/s13071-015-0897-zBackground: A study was conducted to evaluate the effectiveness of afoxolaner chewables to control flea populations in naturally infested dogs in private residences in Tampa FL, USA. Evaluations of on-animal and premises flea burdens, flea sex structure and fed-unfed premises flea populations were conducted to more accurately assess flea population dynamics in households. Methods: Thirty seven naturally flea infested dogs in 23 homes in Tampa, FL were enrolled in the study and treated with afoxolaner chewables. Chewables (NexGard (R) Chewables; Merial) were administered according to label directions by study investigators on study day 0 and once again between study days 28 and 30. Flea infestations on pets were assessed using visual area thumb counts and premises flea infestations were assessed using intermittent-light flea traps on days 0, 7, 14, 21, and once between study days 28-30, 40-45, and 54-60. Results: Within 7 days of administration of afoxolaner chewable tablets, flea counts on dogs were reduced by 99.3 %. By one month post-treatment, total flea counts on dogs were reduced by 99.9 %, with 97.3 % (36/37) of the dogs being flea free. Following the second dosing on study day 28-30, total on-dog flea burden was reduced by 100 % on days 40-45 and 54-60. On day 0, the traps collected a geometric mean of 18.2 fleas. Subsequent reductions in emerging flea populations were 97.7 and 100 % by days 28-30 and 54-60, respectively. There were 515 total fleas (Ctenocephalides felis felis) collected in the intermittent light flea traps on day 0, and 40.4 % of those fleas displayed visual evidence of having fed. Seven days after initial treatment, only 13.1 % of the fleas contained blood and by day 14 only 4.9 % of the fleas collected in traps displayed evidence of having fed. On day 0, prior to treatment, 60 % of the unfed fleas collected in intermittent-light flea traps were females, but by days 28-30, unfed males accounted for 78 % of the population. Conclusions: This in-home investigation conducted during the summer of 2014 in subtropical Tampa, FL demonstrated that afoxolaner chewables rapidly and effectively eliminated flea populations in infested dogs and homes

Crater lake cichlids individually specialize along the benthic-limnetic axis

A common pattern of adaptive diversification in freshwater fishes is the repeated evolution of elongated open water (limnetic) species and high-bodied shore (benthic) species from generalist ancestors. Studies on phenotype-diet correlations have suggested that population-wide individual specialization occurs at an early evolutionary and ecological stage of divergence and niche partitioning. This variable restricted niche use across individuals can provide the raw material for earliest stages of sympatric divergence. We investigated variation in morphology and diet as well as their correlations along the benthic-limnetic axis in an extremely young Midas cichlid species, Amphilophus tolteca, endemic to the Nicaraguan crater lake Asososca Managua. We found that A. tolteca varied continuously in ecologically relevant traits such as body shape and lower pharyngeal jaw morphology. The correlation of these phenotypes with niche suggested that individuals are specialized along the benthic-limnetic axis. No genetic differentiation within the crater lake was detected based on genotypes from 13 microsatellite loci. Overall, we found that individual specialization in this young crater lake species encompasses the limnetic- as well as the benthic macro-habitat. Yet there is no evidence for any diversification within the species, making this a candidate system for studying what might be the early stages preceding sympatric divergence