Exploring Climate-Disease Connections in Geopolitical Versus Ecological Regions: The Case of West Nile Virus in the United States.

Many infectious disease forecasting models in the United States (US) are built with data partitioned into geopolitical regions centered on human activity as opposed to regions defined by natural ecosystems; although useful for data collection and intervention, this has the potential to mask biological relationships between the environment and disease. We explored this concept by analyzing the correlations between climate and West Nile virus (WNV) case data aggregated to geopolitical and ecological regions. We compared correlations between minimum, maximum, and mean annual temperature; precipitation; and annual WNV neuroinvasive disease (WNND) case data from 2005 to 2019 when partitioned into (a) climate regions defined by the National Oceanic and Atmospheric Administration (NOAA) and (b) Level I ecoregions defined by the Environmental Protection Agency (EPA). We found that correlations between climate and WNND in NOAA climate regions and EPA ecoregions were often contradictory in both direction and magnitude, with EPA ecoregions more often supporting previously established biological hypotheses and environmental dynamics underlying vector-borne disease transmission. Using ecological regions to examine the relationships between climate and disease cases can enhance the predictive power of forecasts at various scales, motivating a conceptual shift in large-scale analyses from geopolitical frameworks to more ecologically meaningful regions.

Scoping review of Culex mosquito life history trait heterogeneity in response to temperature.

BACKGROUND: Mosquitoes in the genus Culex are primary vectors in the US for West Nile virus (WNV) and other arboviruses. Climatic drivers such as temperature have differential effects on species-specific changes in mosquito range, distribution, and abundance, posing challenges for population modeling, disease forecasting, and subsequent public health decisions. Understanding these differences in underlying biological dynamics is crucial in the face of climate change. METHODS: We collected empirical data on thermal response for immature development rate, egg viability, oviposition, survival to adulthood, and adult lifespan for Culex pipiens, Cx. quinquefasciatus, Cx. tarsalis, and Cx. restuans from existing literature according to the PRISMA scoping review guidelines. RESULTS: We observed linear relationships with temperature for development rate and lifespan, and nonlinear relationships for survival and egg viability, with underlying variation between species. Optimal ranges and critical minima and maxima also appeared varied. To illustrate how model output can change with experimental input data from individual Culex species, we applied a modified equation for temperature-dependent mosquito type reproduction number for endemic spread of WNV among mosquitoes and observed different effects. CONCLUSIONS: Current models often input theoretical parameters estimated from a single vector species; we show the need to implement the real-world heterogeneity in thermal response between species and present a useful data resource for researchers working toward that goal.

Distinguishing viruses responsible for influenza-like illness.

The many respiratory viruses that cause influenza-like illness (ILI) are reported and tracked as one entity, defined by the CDC as a group of symptoms that include a fever of 100 degrees Fahrenheit, a cough, and/or a sore throat. In the United States alone, ILI impacts 9-49 million people every year. While tracking ILI as a single clinical syndrome is informative in many respects, the underlying viruses differ in parameters and outbreak properties. Most existing models treat either a single respiratory virus or ILI as a whole. However, there is a need for models capable of comparing several individual viruses that cause respiratory illness, including ILI. To address this need, here we present a flexible model and simulations of epidemics for influenza, RSV, rhinovirus, seasonal coronavirus, adenovirus, and SARS/MERS, parameterized by a systematic literature review and accompanied by a global sensitivity analysis. We find that for these biological causes of ILI, their parameter values, timing, prevalence, and proportional contributions differ substantially. These results demonstrate that distinguishing the viruses that cause ILI will be an important aspect of future work on diagnostics, mitigation, modeling, and preparation for future pandemics.

Analysis of Inpatient Hospital Falls with Serious Injury.

Fall-related serious injuries pose risks to patients and healthcare organizations. This retrospective, single-hospital study used a 38 variable instrument to understand characteristics of those who sustained a fall with serious injury. Analyses included descriptive statistics, frequency, and Chi-square tests of associations between key variables and outcomes of moderate versus major injury. Age range 25-91 years, predominantly 60-69 years (23.3%), and mostly male (50.9%). Highest percentage occurred between 0:00 and 06:59 (39.6%), and on Oncology service (28.3%). Fallers were in the room, (81.1%), sustained major injury (73.6%), fractured a major bone (43.4%), had altered mobility prior to the fall (67.9%), and had received at least one narcotic dose within 24 hours before the fall (43.2%). The associations between injury severity and age, gender, altered mobility, fall risk assessment pre-fall, and unit service line are not statistically significant, however have small-to-moderate clinical significance. This study adds to the literature in identifying characteristics of patients who sustain a fall-related serious injury.

Electron induced surface reactions of (η5-C5H5)Fe(CO)2Mn(CO)5, a potential heterobimetallic precursor for focused electron beam induced deposition (FEBID).

Electron-induced surface reactions of (η5-C5H5)Fe(CO)2Mn(CO)5 were explored in situ under ultra-high vacuum conditions using X-ray photoelectron spectroscopy and mass spectrometry. The initial step involves electron-stimulated decomposition of adsorbed (η5-C5H5)Fe(CO)2Mn(CO)5 molecules, accompanied by the desorption of an average of five CO ligands. A comparison with recent gas phase studies suggests that this precursor decomposition step occurs by a dissociative ionization (DI) process. Further electron irradiation decomposes the residual CO groups and (η5-C5H5, Cp) ligand, in the absence of any ligand desorption. The decomposition of CO ligands leads to Mn oxidation, while electron stimulated Cp decomposition causes all of the associated carbon atoms to be retained in the deposit. The lack of any Fe oxidation is ascribed to either the presence of a protective carbonaceous matrix around the Fe atoms created by the decomposition of the Cp ligand, or to desorption of both CO ligands bound to Fe in the initial decomposition step. The selective oxidation of Mn in the absence of any Fe oxidation suggests that the fate of metal atoms in mixed-metal precursors for focused electron beam induced deposition (FEBID) will be sensitive to the nature and number of ligands in the immediate coordination sphere. In related studies, the composition of deposits created from (η5-C5H5)Fe(CO)2Mn(CO)5 under steady state deposition conditions, representative of those used to create nanostructures in electron microscopes, were measured and found to be qualitatively consistent with predictions from the UHV surface science studies.

Comparing postdeposition reactions of electrons and radicals with Pt nanostructures created by focused electron beam induced deposition.

The ability of electrons and atomic hydrogen (AH) to remove residual chlorine from PtCl2 deposits created from cis-Pt(CO)2Cl2 by focused electron beam induced deposition (FEBID) is evaluated. Auger electron spectroscopy (AES) and energy-dispersive X-ray spectroscopy (EDS) measurements as well as thermodynamics calculations support the idea that electrons can remove chlorine from PtCl2 structures via an electron-stimulated desorption (ESD) process. It was found that the effectiveness of electrons to purify deposits greater than a few nanometers in height is compromised by the limited escape depth of the chloride ions generated in the purification step. In contrast, chlorine atoms can be efficiently and completely removed from PtCl2 deposits using AH, regardless of the thickness of the deposit. Although AH was found to be extremely effective at chemically purifying PtCl2 deposits, its viability as a FEBID purification strategy is compromised by the mobility of transient Pt-H species formed during the purification process. Scanning electron microscopy data show that this results in the formation of porous structures and can even cause the deposit to lose structural integrity. However, this phenomenon suggests that the use of AH may be a useful strategy to create high surface area Pt catalysts and may reverse the effects of sintering. In marked contrast to the effect observed with AH, densification of the structure was observed during the postdeposition purification of PtC x deposits created from MeCpPtMe3 using atomic oxygen (AO), although the limited penetration depth of AO restricts its effectiveness as a purification strategy to relatively small nanostructures.

Electron Induced Surface Reactions of cis-Pt(CO)2Cl2: A Route to Focused Electron Beam Induced Deposition of Pure Pt Nanostructures.

Using mechanistic data from surface science studies on electron-induced reactions of organometallic precursors, cis-Pt(CO)2Cl2 (1) was designed specifically for use in focused electron beam induced deposition (FEBID) of Pt nanostructures. Electron induced decomposition of adsorbed 1 under ultrahigh vacuum (UHV) conditions proceeds through initial CO loss as determined by in situ X-ray photoelectron spectroscopy and mass spectrometry. Although the Pt-Cl bonds remain intact during the initial decomposition step, larger electron doses induce removal of the residual chloride through an electron-stimulated desorption process. FEBID structures created from cis-Pt(CO)2Cl2 under steady state deposition conditions in an Auger spectrometer were determined to be PtCl2, free of carbon and oxygen. Coupled with the electron stimulated removal of chlorine demonstrated in the UHV experiments, the Auger deposition data establish a route to FEBID of pure Pt. Results from this study demonstrate that structure-activity relationships can be used to design new precursors specifically for FEBID.

Weathering of pyrogenic organic matter induces fungal oxidative enzyme response in single culture inoculation experiments.

The addition of pyrogenic organic matter (PyOM), the aromatic carbon-rich product of the incomplete combustion of plant biomass or fossil fuels, to soil can influence the rate of microbial metabolism of native soil carbon. The interaction of soil heterotrophs with PyOM may be governed by the surficial chemical and physical properties of PyOM that evolve with environmental exposure. We present results of a 36-day laboratory incubation investigating the interaction of a common white-rot fungus, Trametes versicolor, with three forms of 13C-enriched (2.08 atom% 13C) PyOM derived from Pinus ponderosa (450 °C): one freshly produced, and two artificially weathered (254 nm, UV light-water treatment and water-leaching alone). Analysis (FTIR, XPS) of the UV-weathered PyOM showed increased aliphatic C-H content and oxidation of aromatic carbon relative to both the original and water-leached PyOM. The addition of both weathered forms of PyOM stimulated (positively primed) fungal respiration of the growth media, while the unaltered PyOM mildly inhibited (negatively primed) respiration. Artificial weathering resulted in higher oxidative (laccase and peroxidase) enzyme activity than unaltered PyOM, possibly the result of a diminished capacity to bind reactive substrates and extracellular enzymes after weathering. However, and contrary to expectations, simple water-leached weathering resulted in a relatively higher enzyme activity and respiration than that of UV-weathering. The 13C content of respired CO2 indicated negligible fungal oxidation of PyOM for all treatments, demonstrating the overall low microbial reactivity of this high temperature PyOM. The increased enzymatic and positive priming response of T. versicolor to weathered PyOM highlights the importance of weathering-induced chemistry in controlling PyOM-microbe-soil carbon interactions.

Integrating informatics in undergraduate nursing curricula: using the QSEN framework as a guide.

Informatics education must prepare today's nurses to manage a deluge of information and use technology effectively. In addition, U.S. health care is being redesigned with technology that improves patient safety and quality of care. The Institute of Medicine's recommendations for health care safety and professional education prompted initiatives by the National League for Nursing, the American Association of Colleges of Nursing, and others to make informatics a fundamental part of nursing education. The Quality and Safety Education for Nurses (QSEN) project outlines specific competency goals for informatics knowledge, skills, and attitudes. However, progress toward integration of informatics in nursing curricula has been slow, and additional strategies need further exploration and discussion in the nursing literature. This article uses the QSEN framework to present strategies for teaching multiple facets of informatics in the classroom, simulation laboratory, and clinical settings in a baccalaureate nursing curriculum.