Preliminary study of the sedimentation of Lake St. Clair from minor river and stream tributaries

Sediment samples collected from the minor tributary streams and rivers of Lake St. Clair were analyzed to determine if there were any distinct mineral assemblages within the <64 micrometer size fraction. These assemblages could then identify lake sediment provenances. Mineral assemblages were identified for all the streams and rivers by x-ray dffraction analysis, and were found to be uniform in composition. It is suggested that the sources for the suspended and bottom sediments of the streams and rivers have similar compositions, such as that of a uniform till plain. The distribution patterns of the fluvially transported sediments in the lake can not be determined solely on the basis of the composition of the <64 micrometer size fraction.No embarg

Is there a nonadherent subtype of hypertensive patient? A latent class analysis approach

To determine subtypes of adherence, 636 hypertensive patients (48% White, 34% male) reported adherence to medications, diet, exercise, smoking, and home blood pressure monitoring. A latent class analysis approach was used to identify subgroups that adhere to these five self-management behaviors. Fit statistics suggested two latent classes. The first class (labeled “more adherent”) included patients with greater probability of adhering to recommendations compared with the second class (labeled “less adherent”) with regard to nonsmoking (97.7% versus 76.3%), medications (75.5% versus 49.5%), diet (70.7% versus 46.9%), exercise (63.4% versus 27.2%), and blood pressure monitoring (32% versus 3.4%). Logistic regression analyses used to characterize the two classes showed that “more adherent” participants were more likely to report full-time employment, adequate income, and better emotional and physical well-being. Results suggest the presence of a less adherent subtype of hypertensive patients. Behavioral interventions designed to improve adherence might best target these at-risk patients for greater treatment efficiency

Eddington-Limited Accretion in z~2 WISE-selected Hot, Dust-Obscured Galaxies

Hot, Dust-Obscured Galaxies, or "Hot DOGs", are a rare, dusty, hyperluminous galaxy population discovered by the WISE mission. Predominantly at redshifts 2-3, they include the most luminous known galaxies in the universe. Their high luminosities likely come from accretion onto highly obscured super massive black holes (SMBHs). We have conducted a pilot survey to measure the SMBH masses of five z~2 Hot DOGs via broad H_alpha emission lines, using Keck/MOSFIRE and Gemini/FLAMINGOS-2. We detect broad H_alpha emission in all five Hot DOGs. We find substantial corresponding SMBH masses for these Hot DOGs (~ 10^{9} M_sun), and their derived Eddington ratios are close to unity. These z~2 Hot DOGs are the most luminous AGNs at given BH masses, suggesting they are accreting at the maximum rates for their BHs. A similar property is found for known z~6 quasars. Our results are consistent with scenarios in which Hot DOGs represent a transitional, high-accretion phase between obscured and unobscured quasars. Hot DOGs may mark a special evolutionary stage before the red quasar and optical quasar phases, and they may be present at other cosmic epochs.Comment: 15 pages, 9 figures. Accepted by Ap

Single or Double Degenerate Progenitors? Searching for Shock Emission in the SDSS-II Type Ia Supernovae

From the set of nearly 500 spectroscopically confirmed type~Ia supernovae and around 10,000 unconfirmed candidates from SDSS-II, we select a subset of 108 confirmed SNe Ia with well-observed early-time light curves to search for signatures from shock interaction of the supernova with a companion star. No evidence for shock emission is seen; however, the cadence and photometric noise could hide a weak shock signal. We simulate shocked light curves using SN Ia templates and a simple, Gaussian shock model to emulate the noise properties of the SDSS-II sample and estimate the detectability of the shock interaction signal as a function of shock amplitude, shock width, and shock fraction. We find no direct evidence for shock interaction in the rest-frame $B$-band, but place an upper limit on the shock amplitude at 9% of supernova peak flux ($M_B > -16.6$ mag). If the single degenerate channel dominates type~Ia progenitors, this result constrains the companion stars to be less than about 6 $M_{\odot}$ on the main sequence, and strongly disfavors red giant companions.Comment: 28 pages, 3 figure

Characteristics of antifungal utilization for hospitalized children in the United States

OBJECTIVE: To characterize antifungal prescribing patterns, including the indication for antifungal use, in hospitalized children across the United States. DESIGN: We analyzed antifungal prescribing data from 32 hospitals that participated in the SHARPS Antibiotic Resistance, Prescribing, and Efficacy among Children (SHARPEC) study, a cross-sectional point-prevalence survey conducted between June 2016 and December 2017. METHODS: Inpatients aged \u3c18 years with an active systemic antifungal order were included in the analysis. We classified antifungal prescribing by indication (ie, prophylaxis, empiric, targeted), and we compared the proportion of patients in each category based on patient and antifungal characteristics. RESULTS: Among 34,927 surveyed patients, 2,095 (6%) received at least 1 systemic antifungal and there were 2,207 antifungal prescriptions. Most patients had an underlying oncology or bone marrow transplant diagnosis (57%) or were premature (13%). The most prescribed antifungal was fluconazole (48%) and the most common indication for antifungal use was prophylaxis (64%). Of 2,095 patients receiving antifungals, 79 (4%) were prescribed \u3e1 antifungal, most often as targeted therapy (48%). The antifungal prescribing rate ranged from 13.6 to 131.2 antifungals per 1,000 patients across hospitals ( CONCLUSIONS: Most antifungal use in hospitalized children was for prophylaxis, and the rate of antifungal prescribing varied significantly across hospitals. Potential targets for antifungal stewardship efforts include high-risk, high-utilization populations, such as oncology and bone marrow transplant patients, and specific patterns of utilization, including prophylactic and combination antifungal therapy

Injury Rates in Age-Only Versus Age-and-Weight Playing Standard Conditions in American Youth Football

BACKGROUND: American youth football leagues are typically structured using either age-only (AO) or age-and-weight (AW) playing standard conditions. These playing standard conditions group players by age in the former condition and by a combination of age and weight in the latter condition. However, no study has systematically compared injury risk between these 2 playing standards. PURPOSE: To compare injury rates between youth tackle football players in the AO and AW playing standard conditions. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Athletic trainers evaluated and recorded injuries at each practice and game during the 2012 and 2013 football seasons. Players (age, 5-14 years) were drawn from 13 recreational leagues across 6 states. The sample included 4092 athlete-seasons (AW, 2065; AO, 2027) from 210 teams (AW, 106; O, 104). Injury rate ratios (RRs) with 95% CIs were used to compare the playing standard conditions. Multivariate Poisson regression was used to estimate RRs adjusted for residual effects of age and clustering by team and league. There were 4 endpoints of interest: (1) any injury, (2) non-time loss (NTL) injuries only, (3) time loss (TL) injuries only, and (4) concussions only. RESULTS: Over 2 seasons, the cohort accumulated 1475 injuries and 142,536 athlete-exposures (AEs). The most common injuries were contusions (34.4%), ligament sprains (16.3%), concussions (9.6%), and muscle strains (7.8%). The overall injury rate for both playing standard conditions combined was 10.3 per 1000 AEs (95% CI, 9.8-10.9). The TL injury, NTL injury, and concussion rates in both playing standard conditions combined were 3.1, 7.2, and 1.0 per 1000 AEs, respectively. In multivariate Poisson regression models controlling for age, team, and league, no differences were found between playing standard conditions in the overall injury rate (RRoverall, 1.1; 95% CI, 0.4-2.6). Rates for the other 3 endpoints were also similar (RRNTL, 1.1 [95% CI, 0.4-3.0]; RRTL, 0.9 [95% CI, 0.4-1.9]; RRconcussion, 0.6 [95% CI, 0.3-1.4]). CONCLUSION: For the injury endpoints examined in this study, the injury rates were similar in the AO and AW playing standards. Future research should examine other policies, rules, and behavioral factors that may affect injury risk within youth football

Comparative genomics of isolates of a pseudomonas aeruginosa epidemic strain associated with chronic lung infections of cystic fibrosis patients

Pseudomonas aeruginosa is the main cause of fatal chronic lung infections among individuals suffering from cystic fibrosis (CF). During the past 15 years, particularly aggressive strains transmitted among CF patients have been identified, initially in Europe and more recently in Canada. The aim of this study was to generate high-quality genome sequences for 7 isolates of the Liverpool epidemic strain (LES) from the United Kingdom and Canada representing different virulence characteristics in order to: (1) associate comparative genomics results with virulence factor variability and (2) identify genomic and/or phenotypic divergence between the two geographical locations. We performed phenotypic characterization of pyoverdine, pyocyanin, motility, biofilm formation, and proteolytic activity. We also assessed the degree of virulence using the Dictyostelium discoideum amoeba model. Comparative genomics analysis revealed at least one large deletion (40-50 kb) in 6 out of the 7 isolates compared to the reference genome of LESB58. These deletions correspond to prophages, which are known to increase the competitiveness of LESB58 in chronic lung infection. We also identified 308 non-synonymous polymorphisms, of which 28 were associated with virulence determinants and 52 with regulatory proteins. At the phenotypic level, isolates showed extensive variability in production of pyocyanin, pyoverdine, proteases and biofilm as well as in swimming motility, while being predominantly avirulent in the amoeba model. Isolates from the two continents were phylogenetically and phenotypically undistinguishable. Most regulatory mutations were isolate-specific and 29% of them were predicted to have high functional impact. Therefore, polymorphism in regulatory genes is likely to be an important basis for phenotypic diversity among LES isolates, which in turn might contribute to this strain's adaptability to varying conditions in the CF lung