Evaluation of the Appropriateness of Previously Developed Escherichia coli Biotype I Surrogates as Predictors of Non-O157:H7 Shiga Toxin-Producing E. coli in Beef Processing

Non-O157 Shiga-toxin producing Escherichia coli (STECs) serovars O145:NM, O45:H2, O26:H11, O103:H11, O111 (organism was originally ordered from American Type Culture Collection (ATCC) under accession # BAA-2217, and has since then been reclassified as O147, see Appendix), O121:H19, and E. coli biotype I surrogates were individually cultured in tryptic soy broth (TSB) at 37°C for 18 hours. Rifampicin-resistant (rif-resistant) surrogates were compared to the parent strains listed above. Stationary phase and acid-adapted organisms were each transferred into phosphate buffer saline (PBS) acidified with L-lactic acid at pH 2.5, 3.0, and 3.5, and enumerated for survivors following a 2-hour exposure time. In order to construct a thermal destruction curve, organisms were transferred into a capillary tube, flame sealed, submerged in a water bath at 55, 60 and 65 ± 0.5°C, and enumerated for survivors. For freezing (-20 ± 0.5°C) and refrigerated (4 ± 0.5°C) storage, bacterial strains were enumerated on days 0, 7, 14, 21, 28, 60, and 90 to determine the response to freezing and refrigerated storage. Growth curves of E. coli biotype I surrogates (parent and rif-resistant) were similar to those of STECs throughout the evaluation. For acid resistance, acid-adapted organisms at pH 3.0 showed initial log reductions (CFU/ml) ranging from 1.7-2.5, where organism O26:H11 had the greatest log reduction (2.5). After 2 hours exposure time, reductions ranged from 5.1-7.4 log CFU/ml. D-values were calculated for each organism at 55, 60 and 65 ± 0.5°C. Acid-adapted organisms at 65°C had D-values ranging from 0.13-0.64 min, with a rif-resistant E. coli biotype I surrogate (BAA-1429 rif) having the highest D-value at this temperature. For the response to refrigeration and freezing temperatures, there were no notable trends or patterns observed, and no one single E. coli biotype I surrogate represented all of the non-O157 STECs. Organisms were analyzed individually and in sets (surrogates, rif-resistant surrogates and STECs) to represent a mean. Analyzing the organisms in sets eliminated certain individual strain-to-strain variation, and showed fewer differences (P < 0.05). Surrogates analyzed as a mean of the five strains indicate they may be best utilized in combination to represent all six of the non-O157 STECs

Time budget and habitat use patterns of marbled godwits (Limosa fedoa beringiae) breeding on the Alaska Peninsula

Diurnal time budgets and habitat use patterns of breeding Ugashik marbled godwits (Limosa fedoa beringiae) were studied on the north-central portion of the Alaska Peninsula during spring and summer 1995-1996. Marbled godwits were observed from blinds and behaviors were described for the four phases of the breeding season: pair-formation, egg-laying, incubation and post-hatching. During pair-formation, males spent the majority of time performing flight displays (40.2%), most notably the ceremonial flight (30.7%). Males spent 34.3% of the egg-laying period guarding their mates probably to reduce the threat of cuckoldry. Females incubated during the daytime and males incubated at night. Off-duty males were engaged in maintenance activities (49.4%) or were alert/erect (22.7%). Four marbled godwit nests and the first newly hatched, downy marbled godwit chicks ever recorded in Alaska were found within the study site. One parent guarded the chicks which allowed the other to forage in nearby wetlands. Males performed male-exit flight as they prepared to depart for coastal staging lagoons approximately three weeks after their chicks hatched. Interspecific and intraspecific hostility peaked during the post-hatching period although aggressiveness towards neighboring shorebirds decreased. Godwits may benefit from the aggressive nature of some neighboring shorebirds and more timid species may receive a similar benefit from nesting close to godwit semi-colonies. The scattering of nests in loose semi-colonies may reduce predation by offering both nest concealment and group defense. Cover types and microhabitat characteristics were compared between sites used by marbled godwits ("present") and paired sites where no godwits were observed throughout the breeding season ("absent"), and among sites used for broodrearing, foraging, ground display and nesting. Logistic regression models predicted the probability of godwit occurrence or the probability of a godwit broodrearing, foraging, displaying or nesting based upon significant site features. Results indicate that different cover types were used for broodrearing, foraging, ground display and nesting, and cover types differed between present and absent sites. Microhabitat characteristics were different between present and absent sites, and they varied among the different use sites. The odds of finding a godwit at a site or the odds of finding a godwit broodrearing, foraging, displaying or nesting changed with changes in the significant microhabitat characteristics. As the percent shrub cover increased the odds of finding a brood or a nest increased 2.65-fold and 1.95-fold, respectively. The vegetation at broodrearing sites was taller (1.6 dm) than the vegetation at the other use sites, while the vegetation at nest sites was considerably shorter (1.3 dm) and denser. The probability of finding a godwit foraging increased with increasing forb cover and water depth, and decreasing shrub and moss cover and site roughness. Godwits used the periphery of wetlands for ground display. These grassy areas were typically transition zones between the wetland itself and the drier shrub communities

Biofilm formation on enteral feeding tubes by Cronobacter sakazakii, Salmonella serovars and other Enterobacteriaceae

WHO (2007) recommended that to reduce microbial risks, powdered infant formula should be reconstituted with water at temperatures >70 °C, and that such feeds should be used within 2 h of preparation. However, this recommendation does not consider the use of enteral feeding tubes which can be in place for more than 48 h and can be loci for bacterial attachment. This study determined the extent to which 29 strains of Cronobacter sakazakii, Salmonella serovars, other Enterobacteriaceae and Acinetobacter spp. can adhere and grow on enteral feeding tubes composed of polyvinyl chloride and polyurethane. The study also included silver-impregnated tubing which was expected to have antibacterial activity. Bacterial biofilm formation by members of the Enterobacteriaceae was ca. 105-106 cfu/cm after 24 h. Negligible biofilm was detected for Acinetobacter gensp. 13; ca. 10 cfu/cm, whereas Cr. sakazakii strain ATCC 12868 had the highest biofilm cell density of 107 cfu/cm. Biofilm formation did not correlate with capsule production, and was not inhibited on silver-impregnated tubing. Bacteria grew in the tube lumen to cell densities of 107 cfu/ml within 8 h, and 109 cfu/ml within 24 h. It is plausible that in vivo the biofilm will both inoculate subsequent routine feeds and as the biofilm ages, clumps of cells will be shed which may survive passage through the neonate's stomach. Therefore biofilm formation on enteral feeding tubes constitutes a risk factor for susceptible neonates

Use of Palmaz stents in a newborn with congenital aneurysms and coarctation of the abdominal aorta

Anomalies of the abdominal aorta are rare in the pediatric population limiting the reported knowledge base from which management decisions can be made. A 3-week-old male with congenital abdominal aortic coarctation and multiple aneurysms presented with malignant hypertension. We report the safe deployment of overlapping Palmaz stents using a 4-French catheter delivery system with significant relief of the coarctation gradient and restoration of adequate renal perfusion. © 2006 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/55844/1/20749_ftp.pd

Minithoracotomy for mitral valve repair improves inpatient and postdischarge economic savings

ObjectiveSmall series of thoracotomy for mitral valve repair have demonstrated clinical benefit. This multi-institutional administrative database analysis compares outcomes of thoracotomy and sternotomy approaches for mitral repair.MethodsThe Premier database was queried from 2007 to 2011 for mitral repair hospitalizations. Premier contains billing, cost, and coding data from more than 600 US hospitals, totaling 25 million discharges. Thoracotomy and sternotomy approaches were identified through expert rules; robotics were excluded. Propensity matching on baseline characteristics was performed. Regression analysis of surgical approach on outcomes and costs was modeled.ResultsExpert rule analysis positively identified thoracotomy in 847 and sternotomy in 566. Propensity matching created 2 groups of 367. Mortalities were similar (thoracotomy 1.1% vs sternotomy 1.9%). Sepsis and other infections were significantly lower with thoracotomy (1.1% vs 4.4%). After adjustment for hospital differences, thoracotomy carried a 17.2% lower hospitalization cost (−$8289) with a 2-day stay reduction. Readmission rates were significantly lower with thoracotomy (26.2% vs 35.7% at 30 days and 31.6% vs 44.1% at 90 days). Thoracotomy was more common in southern and northeastern hospitals (63% vs 37% and 64% vs 36%, respectively), teaching hospitals (64% vs 36%) and larger hospitals (>600 beds, 78% vs 22%).ConclusionsRelative to sternotomy, thoracotomy for mitral repairs provides similar mortality, less morbidity, fewer infections, shorter stay, and significant cost savings during primary admission. The markedly lower readmission rates for thoracotomy will translate into additional institutional cost savings when a penalty on hospitals begins under the Affordable Care Act's Hospital Readmissions Reduction Program

Minimally Invasive Mitral Valve Surgery III: Training and Robotic-Assisted Approaches.

Minimally invasive mitral valve operations are increasingly common in the United States, but robotic-assisted approaches have not been widely adopted for a variety of reasons. This expert opinion reviews the state of the art and defines best practices, training, and techniques for developing a successful robotics program

The Mars 2020 Perseverance Rover Mast Camera Zoom (Mastcam-Z) Multispectral, Stereoscopic Imaging Investigation

Mastcam-Z is a multispectral, stereoscopic imaging investigation on the Mars 2020 mission's Perseverance rover. Mastcam-Z consists of a pair of focusable, 4:1 zoomable cameras that provide broadband red/green/blue and narrowband 400-1000 nm color imaging with fields of view from 25.6 degrees x19.2 degrees (26 mm focal length at 283 mu rad/pixel) to 6.2 degrees x4.6 degrees (110 mm focal length at 67.4 mu rad/pixel). The cameras can resolve (>= 5 pixels) similar to 0.7 mm features at 2 m and similar to 3.3 cm features at 100 m distance. Mastcam-Z shares significant heritage with the Mastcam instruments on the Mars Science Laboratory Curiosity rover. Each Mastcam-Z camera consists of zoom, focus, and filter wheel mechanisms and a 1648x1214 pixel charge-coupled device detector and electronics. The two Mastcam-Z cameras are mounted with a 24.4 cm stereo baseline and 2.3 degrees total toe-in on a camera plate similar to 2 m above the surface on the rover's Remote Sensing Mast, which provides azimuth and elevation actuation. A separate digital electronics assembly inside the rover provides power, data processing and storage, and the interface to the rover computer. Primary and secondary Mastcam-Z calibration targets mounted on the rover top deck enable tactical reflectance calibration. Mastcam-Z multispectral, stereo, and panoramic images will be used to provide detailed morphology, topography, and geologic context along the rover's traverse; constrain mineralogic, photometric, and physical properties of surface materials; monitor and characterize atmospheric and astronomical phenomena; and document the rover's sample extraction and caching locations. Mastcam-Z images will also provide key engineering information to support sample selection and other rover driving and tool/instrument operations decisions

Minimally Invasive Mitral Valve Surgery II: Surgical Technique and Postoperative Management.

Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery

Minimally Invasive Mitral Valve Surgery I: Patient Selection, Evaluation, and Planning.

Widespread adoption of minimally invasive mitral valve repair and replacement may be fostered by practice consensus and standardization. This expert opinion, first of a 3-part series, outlines current best practices in patient evaluation and selection for minimally invasive mitral valve procedures, and discusses preoperative planning for cannulation and myocardial protection