Survey of microbial urea degrader diversity in two freshwater ecosystems: Lake Shenandoah and the Shenandoah River

One of the primary drivers of cyanobacterial harmful algal blooms (cHABs) in freshwater systems is nutrient loading, particularly of nitrogen and phosphorus. There has been an increased focus on assessing the role of nitrogen (N) in freshwater lakes and rivers that suffer cHABs. Urea, a widely-used, N-rich fertilizer, is a source of interest due to its abundance in freshwater ecosystems, primarily caused by anthropogenic nutrient loading. While recent work has shown that cHAB population succession may favor the toxic cyanobacterium Microcystis in urea-rich waters, the diversity of the associated bacterial community capable of degrading urea has yet to be determined. Therefore, we generated targeted sequence libraries of the gene encoding for the alpha subunit of the urease enzyme, ureC, from samples collected during summer (2015) from two model freshwater systems, Lake Shenandoah (LS) and the Shenandoah River (SR) (Virginia), to reveal potential urea-degrading members in threatened freshwater ecosystems. The total microbial community with urea-degrading capabilities was dominated by Proteobactiera in all samples, while Cyanobacteria was present in low abundance. This may be a result of the physical environment of LS and SR, or the low abundance of Cyanobacteria may be due to limitations in the custom database constructed for ureC amplicon analysis. LS and SR communities were similar overall, with the exception of a higher relative abundance of Acintobacteria ureC sequences in SR. Further analyses will aim to characterize more members with the ureC gene and expand upon the foundation built for community analyses based on ureC. These results provide better insight into the diversity of an important gene involved in bacterial urea degradation needed to resolve the microbial freshwater urea cycle

Lighted Schoolhouse at Daniel E. Morgan Elementary School: Pilot Program Evaluation

The Lighted Schoolhouse pilot project (LSH) at Daniel E. Morgan Elementary School (DEM) in the Hough neighborhood of Cleveland began operation in February 2005. It is a collaborative effort among a number of community organizations, led by the Urban League of Greater Cleveland (ULGC). The pilot LSH was initiated by then-Mayor Jane Campbell as a response to Cleveland’s designation as the poorest large city in the U.S., and was meant to address three community priorities: after-school programming, fuller use of schools, and pathways out of poverty. In June 2005, a team of evaluators from the Levin College of Urban Affairs at Cleveland State University was selected to evaluate the pilot project. The purpose of this evaluation is to: 1) assess the start-up and implementation process and the lessons learned; 2) track program activities and accomplishments; and 3) develop recommendations regarding the sustainability and replication of the pilot program. The Levin College Evaluation Team (LCET) also developed a

Chiasma

Newspaper reporting on events at the Boston University School of Medicine in the 1960s

Racism as a determinant of health: a protocol for conducting a systematic review and meta-analysis

Background Racism is increasingly recognized as a key determinant of health. A growing body of epidemiological evidence shows strong associations between self-reported racism and poor health outcomes across diverse minority groups in developed countries. While the relationship between racism and health has received increasing attention over the last two decades, a comprehensive meta-analysis focused on the health effects of racism has yet to be conducted. The aim of this review protocol is to provide a structure from which to conduct a systematic review and meta-analysis of studies that assess the relationship between racism and health. Methods This research will consist of a systematic review and meta-analysis. Studies will be considered for review if they are empirical studies reporting quantitative data on the association between racism and health for adults and/or children of all ages from any racial/ethnic/cultural groups. Outcome measures will include general health and well-being, physical health, mental health, healthcare use and health behaviors. Scientific databases (for example, Medline) will be searched using a comprehensive search strategy and reference lists will be manually searched for relevant studies. In addition, use of online search engines (for example, Google Scholar), key websites, and personal contact with experts will also be undertaken. Screening of search results and extraction of data from included studies will be independently conducted by at least two authors, including assessment of inter-rater reliability. Studies included in the review will be appraised for quality using tools tailored to each study design. Summary statistics of study characteristics and findings will be compiled and findings synthesized in a narrative summary as well as a meta-analysis. Discussion This review aims to examine associations between reported racism and health outcomes. This comprehensive and systematic review and meta-analysis of empirical research will provide a rigorous and reliable evidence base for future research, policy and practice, including information on the extent of available evidence for a range of racial/ethnic minority group

Real-time feedback improves imagined 3D primitive object classification from EEG

Brain-computer interfaces (BCI) enable movement-independent information transfer from humans to computers. Decoding imagined 3D objects from electroencephalography (EEG) may improve design ideation in engineering design or image reconstruction from EEG for application in brain-computer interfaces, neuro-prosthetics, and cognitive neuroscience research. Object-imagery decoding studies, to date, predominantly employ functional magnetic resonance imaging (fMRI) and do not provide real-time feedback. We present four linked studies in a study series to investigate: (1) whether five imagined 3D primitive objects (sphere, cone, pyramid, cylinder, and cube) could be decoded from EEG; and (2) the influence of real-time feedback on decoding accuracy. Studies 1 (N=10) and 2 (N=3) involved a single-session and a multi-session design, respectively, without real-time feedback. Studies 3 (N=2) and 4 (N=4) involved multiple sessions, without and with real-time feedback. The four studies involved 69 sessions in total of which 26 sessions were online with real-time feedback (15,480 trials for offline and at least 6,840 trials for online sessions in total). We demonstrate that decoding accuracy over multiple sessions improves significantly with biased feedback (p=0.004), compared to performance without feedback. This is the first study to show the effect of real-time feedback on the performance of primitive object-imagery BCI

Positives and negatives: reclaiming the female body and self-deprecation in stand-up comedy

Drawing on existing research into feminist humour, this article argues that many of the functions of self-deprecation within comic performance that have been identified and explored in relation to the American context of the late 90s and early 2000s are still evident on the current UK circuit. Self-deprecation in stand-up comedy by women continues to be understood as both positive (as part of the rise of popular feminisms) and negative (as reinforcing patriarchal norms). These contradictory understandings of self-deprecation in stand-up comedy are always inextricably linked to the identities of the audiences for such humour. I consider how emergent female stand-up performers may rationalise and understand the role self-deprecation plays within their own work in the current British context. I then discuss the work of stand-up comedian Luisa Omielan as an example of the rejection of self-deprecatory address. I make the argument that self-deprecation cannot function simply as positive or negative in the current UK context, but must always be considered (for both audiences and performers) as challenging and reinforcing restrictive patriarchal attitudes towards women simultaneously

Clinical Characteristics and Outcomes of Patients With Cutibacterium acnes Endocarditis

Importance: It is suggested that patients with Cutibacterium acnes endocarditis often present without fever or abnormal inflammatory markers. However, no study has yet confirmed this statement. Objective: To assess the clinical characteristics and outcomes of patients with C acnes endocarditis. Design, Setting, and Participants: A case series of 105 patients presenting to 7 hospitals in the Netherlands and France (4 university hospitals and 3 teaching hospitals) with definite endocarditis according to the modified Duke criteria between January 1, 2010, and December 31, 2020, was performed. Clinical characteristics and outcomes were retrieved from medical records. Cases were identified by blood or valve and prosthesis cultures positive for C acnes, retrieved from the medical microbiology databases. Infected pacemaker or internal cardioverter defibrillator lead cases were excluded. Statistical analysis was performed in November 2022. Main Outcomes and Measures: Main outcomes included symptoms at presentation, presence of prosthetic valve endocarditis, laboratory test results at presentation, time to positive results of blood cultures, 30-day and 1-year mortality rates, type of treatment (conservative or surgical), and endocarditis relapse rates. Results: A total of 105 patients (mean [SD] age, 61.1 [13.9] years; 96 men [91.4%]; 93 patients [88.6%] with prosthetic valve endocarditis) were identified and included. Seventy patients (66.7%) did not experience fever prior to hospital admission, nor was it present at hospitalization. The median C-reactive protein level was 3.6 mg/dL (IQR, 1.2-7.5 mg/dL), and the median leukocyte count was 10.0 × 103/µL (IQR, 8.2-12.2 × 103/µL). The median time to positive blood culture results was 7 days (IQR, 6-9 days). Surgery or reoperation was indicated for 88 patients and performed for 80 patients. Not performing the indicated surgical procedure was associated with high mortality rates. Seventeen patients were treated conservatively, in accordance with the European Society of Cardiology guideline; these patients showed relatively high rates of endocarditis recurrence (5 of 17 [29.4%]). Conclusions and Relevance: This case series suggests that C acnes endocarditis was seen predominantly among male patients with prosthetic heart valves. Diagnosing C acnes endocarditis is difficult due to its atypical presentation, with frequent absence of fever and inflammatory markers. The prolonged time to positivity of blood culture results further delays the diagnostic process. Not performing a surgical procedure when indicated seems to be associated with higher mortality rates. For prosthetic valve endocarditis with small vegetations, there should be a low threshold for surgery because this group seems prone to endocarditis recurrence.</p

Real-time feedback improves imagined 3D primitive object classification from EEG

Brain-computer interfaces (BCI) enable movement-independent information transfer from humans to computers. Decoding imagined 3D objects from electroencephalography (EEG) may improve design ideation in engineering design or image reconstruction from EEG for application in brain-computer interfaces, neuro-prosthetics, and cognitive neuroscience research. Object-imagery decoding studies, to date, predominantly employ functional magnetic resonance imaging (fMRI) and do not provide real-time feedback. We present four linked studies in a study series to investigate: (1) whether five imagined 3D primitive objects (sphere, cone, pyramid, cylinder, and cube) could be decoded from EEG; and (2) the influence of real-time feedback on decoding accuracy. Studies 1 (N = 10) and 2 (N = 3) involved a single-session and a multi-session design, respectively, without real-time feedback. Studies 3 (N = 2) and 4 (N = 4) involved multiple sessions, without and with real-time feedback. The four studies involved 69 sessions in total of which 26 sessions were online with real-time feedback (15,480 trials for offline and at least 6,840 trials for online sessions in total). We demonstrate that decoding accuracy over multiple sessions improves significantly with biased feedback (p = 0.004), compared to performance without feedback. This is the first study to show the effect of real-time feedback on the performance of primitive object-imagery BCI

Nonsurgical management of the boutonniere deformity

The present study examined the effectiveness of a 6-week experimental program of splinting and joint protection education in reducing the progression of the early boutonniere deformity. Nine patients with mild or moderately reducible boutonniere deformities were randomized into experimental and control groups and followed for 1 year. Improvements in active extension of the proximal interphalangial joint for patients in the experimental program suggest that early initiation of a nonsurgical intervention can reduce or reverse progression of the boutonniere deformity in some patients with rheumatoid arthritis. Although the number of patients was small, we conclude that early splinting and joint protection education may limit the anatomical and functional derangements of boutonniere deformity in the rheumatoid hand.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37785/1/1790030412_ftp.pd

Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL) : an open-label, parallel-group, pragmatic, randomised controlled trial

BACKGROUND: Bloodstream infection is associated with high mortality and serious morbidity in preterm babies. Evidence from clinical trials shows that antimicrobial-impregnated central venous catheters (CVCs) reduce catheter-related bloodstream infection in adults and children receiving intensive care, but there is a paucity of similar evidence for babies receiving neonatal intensive care. METHODS: This open-label, parallel-group, pragmatic, randomised controlled trial was done in 18 neonatal intensive care units in England. Newborn babies who needed a peripherally inserted CVC (PICC) were allocated randomly (1:1) to receive either a PICC impregnated with miconazole and rifampicin or a standard (non-antimicrobial-impregnated) PICC. Random allocation was done with a web-based program, which was centrally controlled to ensure allocation concealment. Randomisation sequences were computer-generated in random blocks of two and four, and stratified by site. Masking of clinicians to PICC allocation was impractical because rifampicin caused brown staining of the antimicrobial-impregnated PICC. However, participant inclusion in analyses and occurrence of outcome events were determined following an analysis plan that was specified before individuals saw the unblinded data. The primary outcome was the time from random allocation to first microbiologically confirmed bloodstream or cerebrospinal fluid (CSF) infection between 24 h after randomisation and 48 h after PICC removal or death. We analysed outcome data according to the intention-to-treat principle. We excluded babies for whom a PICC was not inserted from safety analyses, as these analyses were done with groups defined by the PICC used. This trial is registered with ISRCTN, number 81931394. FINDINGS: Between Aug 12, 2015, and Jan 11, 2017, we randomly assigned 861 babies (754 [88%] born before 32 weeks of gestation) to receive an antimicrobial-impregnated PICC (430 babies) or standard PICC (431 babies). The median time to PICC removal was 8·20 days (IQR 4·77-12·13) in the antimicrobial-impregnated PICC group versus 7·86 days (5·00-12·53) days in the standard PICC group (hazard ratio [HR] 1·03, 95% CI 0·89-1·18, p=0·73), with 46 (11%) of 430 babies versus 44 (10%) of 431 babies having a microbiologically confirmed bloodstream or CSF infection. The time from random allocation to first bloodstream or CSF infection was similar between the two groups (HR 1·11, 95% CI 0·73-1·67, p=0·63). Secondary outcomes relating to infection, rifampicin resistance in positive blood or CSF cultures, mortality, clinical outcomes at neonatal unit discharge, and time to PICC removal were similar between the two groups, although rifampicin resistance in positive cultures of PICC tips was higher in the antimicrobial-impregnated PICC group (relative risk 3·51, 95% CI 1·16-10·57, p=0·018). 60 adverse events were reported from 49 (13%) patients in the antimicrobial-impregnated PICC group and 50 events from 45 (10%) babies in the standard PICC group. INTERPRETATION: We found no evidence of benefit or harm associated with miconazole and rifampicin-impregnated PICCs compared with standard PICCs for newborn babies. Future research should focus on other types of antimicrobial impregnation of PICCs and alternative approaches for preventing infection. FUNDING: UK National Institute for Health Research Health Technology Assessment programme