Assessment of Fungal Succession in Decomposing Swine Carcasses (Sus scrofa L.) Using DNA Metabarcoding.

The decomposition of animal bodies is a process defined by specific stages, described by the state of the body and participation of certain guilds of invertebrates and microorganisms. While the participation of invertebrates in decomposing is well-studied and actively used in crime scene investigations, information on bacteria and fungi from the scene is rarely collected or used in the identification of important factors such as estimated time of death. Modern molecular techniques such as DNA metabarcoding allow the identification and quantification of the composition of microbial communities. In this study, we used DNA metabarcoding to monitor fungal succession during the decomposition of juvenile pigs in grasslands of New Jersey, USA. Our findings show that decomposition stages differ in a diversity of fungal communities. In particular, we noted increased fungal species richness in the more advanced stages of decomposition (e.g., bloat and decay stages), with unique fungal taxa becoming active with the progression of decay. Overall, our findings improve knowledge of how fungi contribute to forensically relevant decomposition and could help with the assessment of crime scenes.

Internet information quality for ten common foot and ankle diagnoses.

BACKGROUND: Patients use the Internet regularly to access health-related information. This study's goal was to assess the quality and content of Internet-based information for common foot and ankle diagnoses. METHODS: We identified the ten most common foot and ankle diagnoses in our academic foot and ankle practice. Ten websites for each diagnosis were identified using two large Internet search engines. A custom grading form was used to determine website quality, based upon the Health On the Net Foundation (HON) principles, and information content. Four independent reviewers graded each website. RESULTS: One hundred thirty-six unique websites were reviewed. Average HON score was 62.4 (range, 52.3-68.8) and content score was 49.7 (range, 33.8-62.1) out of a maximum of 100. Interobserver variability was low. CONCLUSIONS: The overall quality of Internet information for common foot and ankle diagnoses is variable, raising concerns about what information is currently available to patients.

Implant removal after submuscular plating for pediatric femur fractures.

BACKGROUND: Submuscular plating for pediatric femur fracture has become more commonplace for treatment of length unstable fractures. These plates act as an internal fixator and rely on minimally invasive insertion techniques and long plate lengths to achieve the goal of stable fixation and local biologic fracture preservation. Plate removal in children after submuscular plating has not been reported in the literature. METHODS: We reviewed the records of 22 patients at our institution who were treated with a submuscular plate, which was eventually removed after fracture healing. A review of the radiographs and charts was performed to determine any unique problems or complications that may arise during the removal of these plates given their long lengths and minimally invasive insertion. RESULTS: In our series, 7 patients required a more extensive procedure to remove the plate than was required during plate insertion. These patients all required an open procedure at the leading edge of the plate to chisel overgrown bone away from the plate for removal. The timing of removal in our series was not related to difficulties during plate removal, rather it was the presence of bony overgrowth at the plates leading edge. This overgrowth was seen early on radiographically during the healing process in all patients who required increased operative exposure. CONCLUSIONS: The timing of plate removal after submuscular plating is not critical when trying to determine the potential complications at plate removal. The decisive factor related to difficulties with plate removal is leading plate edge overgrowth. Patients with this bone overgrowth at the leading edge of the plate need to be counseled regarding the need for an increased operative exposure during plate removal. LEVEL OF EVIDENCE: Case series, level 4.

Voices of Asian American youth: important characteristics of clinicians and clinical sites.

OBJECTIVE: The purpose of this work was to explore clinician and site characteristics that are important to Chinese and Vietnamese immigrant and first-generation youth. METHODS: A 3-stage mixed qualitative-quantitative design consisting of exploratory focus groups, a survey, and explanatory focus groups was used to ensure that all of the ideas were generated, prioritized, and explained by youth. Adolescents of Chinese and/or Vietnamese descent and aged 13 to 18 years were recruited in community centers and schools. In stage 1, 55 adolescents in 8 focus groups shared their views on factors that attract or deter them from seeking care. In stage 2, youth responded to a survey including 27 teen-generated items regarding clinicians and sites. In stage 3, 87 teens in 11 groups explained the top-rated items and offered suggestions on how to meet their needs. All of the stages were conducted in English, Mandarin Chinese, and Vietnamese. RESULTS: Most of the 245 survey respondents (77%) were born in Asia, and 70% had lived in the United States for <3 years. The 27 items were divided into 6 priority ranks by the marginal homogeneity test. Clinician cleanliness and experience shared first rank. Second rank was shared by Asian teens being treated like other teens, site cleanliness, clinician honesty, and clinician friendliness and attitude. The third rank was shared by respect, privacy, completeness, clinicians explaining their actions, and lower health care costs. Interspersed among ranks 5 and 6 were items specific to the needs of Asian youth: the clinician would offer more explanation because Asian families might not ask questions; the clinician would not assume that Asian teens are drug and sex free; the clinician would understand that Asian families may use traditional healing; the clinician would not assume that Asians do not know English; adolescents would not translate for parents; and the teen would be able to choose an Asian clinician. There was little variation in ratings by age, gender, ethnicity, or socioeconomic status. However, 11 of 27 items differed by acculturation. Examples include the greater importance ascribed by more acculturated youth to not being judged, to not having to translate, and to the clinician addressing behavioral issues. Acculturation also affected the youths' views regarding confidentiality and translation. CONCLUSIONS: Asian American adolescents value the same concerns as all adolescents: respect, honesty, competency, cleanliness, privacy, and nonjudgmental service. However, they also have unique perspectives, and youth at varying levels of acculturation differ in some of their views.