Fine-scale spatiotemporal variations in bacterial community diversity in agricultural pond water.

Microbial communities in surface waters are affected by environmental conditions and can influence changes in water quality. To explore the hypothesis that the microbiome in agricultural waters associates with spatiotemporal variations in overall water quality and, in turn, has implications for resource monitoring and management, we characterized the relationships between the microbiota and physicochemical properties in a model irrigation pond as a factor of sampling time (i.e., 9:00, 12:00, 15:00) and location within the pond (i.e., bank vs. interior sites and cross-sectional depths at 0, 1, and 2 m). The microbial communities, which were defined by 16S rRNA gene sequencing analysis, significantly varied based on all sampling factors (PERMANOVA P < 0.05 for each). While the relative abundances of dominant phyla (e.g., Proteobacteria and Bacteroidetes) were relatively stable throughout the pond, subtle yet significant increases in α-diversity were observed as the day progressed (ANOVA P < 0.001). Key water quality properties that also increased between the morning and afternoon (i.e., pH, dissolved oxygen, and temperature) positively associated with relative abundances of Cyanobacteria, though were inversely proportional to Verrucomicrobia. These properties, among additional parameters such as bioavailable nutrients (e.g., NH3, NO3, PO4), chlorophyll, phycocyanin, conductivity, and colored dissolved organic matter, exhibited significant relationships with relative abundances of various bacterial genera as well. Further investigation of the microbiota in underlying sediments revealed significant differences between the bank and interior sites of the pond (P < 0.05 for α- and ß-diversity). Overall, our findings emphasize the importance of accounting for time of day and water sampling location and depth when surveying the microbiomes of irrigation ponds and other small freshwater sources.

Hypothyroidism in Bangladesh: Is Autoimmunity the Next Big Threat?

In many low and middle-income countries, iodine-deficient hypothyroidism leads to complex public health consequences. However, increasing evidence from population-based studies has linked thyroid autoimmunity with excess iodine intake. The iodine supplementation program in Bangladesh was a success story. This cross-sectional study aims to assess the pattern and predictors of autoimmunity among Bangladeshi hypothyroid patients. In this study, 154 consecutive, newly detected, biochemically-confirmed patients with primary hypothyroidism were recruited from the Endocrinology outpatient department of Bangabandhu Sheikh Mujib Medical University and tested for anti-thyroid peroxidase and anti-thyroglobulin antibody levels from October 2015 and November 2016. Patterns of thyroid autoimmunity were assessed via descriptive statistics. Predictors of autoimmunity were assessed with multivariable mixed-effect logistic regression. The mean age of participants was 36.1±11.0 years, and 70.1% were female. The frequency of thyroid autoimmunity in the study subjects was very high, 89.0% were positive for either anti-TPO or anti-Tg antibodies and 48.7% were positive for both. More participants were positive for anti-TPO antibodies (82.5%) than anti-Tg antibodies (55.2%). The risk of autoimmunity was associated with the thyroid's structural abnormalities but not with functional status. Weight gain and hypertension were associated with autoimmunity, whereas diabetes was protective against autoimmunity.

Cranial Musculoskeletal Description of Black-Throated Finch (Aves: Passeriformes: Estrildidae) with DiceCT.

Synopsis Dietary requirements and acquisition strategies change throughout ontogeny across various clades of tetrapods, including birds. For example, birds hatch with combinations of various behavioral, physiological, and morphological factors that place them on an altricial-precocial spectrum. Passeriformes (=songbirds) in particular, a family constituting approximately more than half of known bird species, displays the most drastic difference between hatchling and adults in each of these aspects of their feeding biology. How the shift in dietary resource acquisition is managed during ontogeny alongside its relationship to the morphology of the feeding apparatus has been largely understudied within birds. Such efforts have been hampered partly due to the small size of many birds and the diminutive jaw musculature they employ. In this study, we used standard and diffusible iodine-based contrast-enhanced computed tomography in conjunction with digital dissection to quantify and describe the cranial musculature of the Black-throated Finch (Poephila cincta) at fledgling and adult stages. Our results reveal that in both the fledgling and the adult, cranial musculature shows clear and complex partitioning in the Musculus adductor mandibulae externus that is consistent with other families within Passeriformes. We quantified jaw-muscle sizes and found that the adult showed a decrease in muscle mass in comparison to the fledgling individual. We propose that this could be the result of low sample size or a physiological effect of parental care in Passeriformes. Our study shows that high-resolution visualization techniques are informative at revealing morphological discrepancies for studies that involve small specimens such as Passeriformes especially with careful specimen selection criteria.

Modeling the kinetics of manure-borne fecal indicator removal in runoff.

Several manure-borne microorganism removal models have been developed to provide accurate estimations of the number of microorganisms removed from manure or manured soils undergoing rainfall. It has been commonly assumed that these models perform equally well when used to simulate microbe removal in runoff from manures of different consistency and levels of weathering. The objectives of this work were (a) to observe kinetics of the removal of Escherichia coli and enterococci with runoff for two different manure consistencies and three manure weathering durations, and (b) to compare performance of the log-linear, Vadas-Kleinman-Sharpley, and Bradford-Shijven models in simulation of the observed kinetics. Liquid and solid dairy manure were applied to grassed soil boxes that received simulated rainfall immediately after application and subsequently at 1 and 2 wk. Runoff samples were collected for 1 h at increasing time intervals during each event. Only the effective rainfall depth at the start of runoff was significantly affected by manure consistency (p = .033), whereas other parameters were not (p > .05). Substantial differences in microorganism removal kinetics during the initial, 1-, and 2-wk rainfall events were manifested by the significant (p < .05) effect of the degree of manure weathering in about 70% of cases. The log-linear model produced the largest fitting error especially during the initial rainfall event. The Vadas-Kleinman-Sharpley model and the Bradford-Schijven model were comparable in accuracy for all events. The latter model was slightly more accurate, and the former model had better expressed dependencies of parameter values on manure weathering. Ignoring manure weathering may lead to incorrect parameterization of manure removal models.

Intraseasonal variation of phycocyanin concentrations and environmental covariates in two agricultural irrigation ponds in Maryland, USA.

Recently, cyanobacteria blooms have become a concern for agricultural irrigation water quality. Numerous studies have shown that cyanotoxins from these harmful algal blooms (HABs) can be transported to and assimilated into crops when present in irrigation waters. Phycocyanin is a pigment known only to occur in cyanobacteria and is often used to indicate cyanobacteria presence in waters. The objective of this work was to identify the most influential environmental covariates affecting the phycocyanin concentrations in agricultural irrigation ponds that experience cyanobacteria blooms of the potentially toxigenic species Microcystis and Aphanizomenon using machine learning methodology. The study was performed at two agricultural irrigation ponds over a 5-month period in the summer of 2018. Phycocyanin concentrations, along with sensor-based and fluorometer-based water quality parameters including turbidity (NTU), pH, dissolved oxygen (DO), fluorescent dissolved organic matter (fDOM), conductivity, chlorophyll, color dissolved organic matter (CDOM), and extracted chlorophyll were measured. Regression tree analyses were used to determine the most influential water quality parameters on phycocyanin concentrations. Nearshore sampling locations had higher phycocyanin concentrations than interior sampling locations and "zones" of consistently higher concentrations of phycocyanin were found in both ponds. The regression tree analyses indicated extracted chlorophyll, CDOM, and NTU were the three most influential parameters on phycocyanin concentrations. This study indicates that sensor-based and fluorometer-based water quality parameters could be useful to identify spatial patterns of phycocyanin concentrations and therefore, cyanobacteria blooms, in agricultural irrigation ponds and potentially other water bodies.

Drone-based imaging to assess the microbial water quality in an irrigation pond: A pilot study.

Microbial water quality datasets are essential in irrigated agricultural practices to detect and inform measures to prevent the contamination of produce. Escherichia coli (E. coli) concentrations are commonly used to evaluate microbial water quality. Remote sensing imagery has been successfully used to retrieve several water quality parameters that can be determinants of E. coli habitats in waterbodies. This pilot study was conducted to test the possibility of using imagery from a small unmanned aerial vehicle (sUAV or drone) to improve the estimation of microbial water quality in small irrigation ponds. In situ measurements of pH, turbidity, specific conductance, and concentrations of dissolved oxygen, chlorophyll-a, phycocyanin, and fluorescent dissolved organic matter were taken at depths of 0-15 cm in 23 locations across a pond in Central Maryland, USA. The pond surface was concurrently imaged using a drone with three modified GoPro cameras, and a multispectral MicaSense RedEdge camera with five spectral bands. The GoPro imagery was decomposed into red, blue, and green components. Mean digital numbers for 1-m radius areas in the images were combined with the water quality data to provide input for a regression tree-based analysis. The accuracy of the regression-tree data description with "only imagery" inputs was the same or better than that of trees constructed with "only water-quality parameters" as inputs. From multiple cross-validation runs with "only imagery" inputs for the regression trees, the average (±SD) determination coefficient and root-mean-squared error of the decimal logarithm of E. coli concentrations were 0.793 ±â€¯0.035 and 0.131 ±â€¯0.011, respectively. The results of this study demonstrate the opportunities for using sUAV imagery for obtaining a more accurate delineation of the spatial variation of E. coli concentrations in irrigation ponds.

Guidelines for day-case surgery 2019: Guidelines from the Association of Anaesthetists and the British Association of Day Surgery.

Guidelines are presented for the organisational and clinical management of anaesthesia for day-case surgery in adults and children. The advice presented is based on previously published recommendations, clinical studies and expert opinion.

Intraseasonal variation of E. coli and environmental covariates in two irrigation ponds in Maryland, USA.

The microbial quality of irrigation water is typically assessed by measuring the concentrations of E. coli in irrigation water reservoirs that are variable in space and time. E. coli concentrations are affected by water quality parameters that co-vary with E. coli concentrations and may be easily measured with currently available sensors. The objective of this work was to identify the most influential environmental covariates affecting E. coli concentrations during a three-month biweekly monitoring period within two irrigation ponds in Maryland during the summer of 2017. E. coli levels as well as sensor-based water quality parameters including turbidity, pH, dissolved oxygen, dissolved fluorescent organic matter, conductivity, and chlorophyll were measured at 23 and 34 locations in ponds 1 and 2, respectively. Regression tree analyses were used to determine the most influential water quality parameters for the prediction of E. coli levels. Correlations between E. coli and water quality covariates were not strong and were inconsistently significant. Shoreline sample locations had higher E. coli concentrations than interior pond samples and significant differences were observed when comparing these two groups. Regression trees provided fairly accurate predictions of E. coli levels based on water quality parameters with R2 values ranging from 0.70 to 0.93. Factors identified via the regression trees varied by sampling date but common leading covariates included cyanobacteria, organic matter, and turbidity. Results indicated environmental covariates, sensed either remotely or in situ, could be useful to delineate areas with different E. coli survival conditions across irrigation ponds and potentially other water bodies such as lakes, rivers, or bays.

Functional Evaluation of Three Manure-Borne Indicator Bacteria Release Models with Multiyear Field Experiment Data.

Modeling the fate and transport of Escherichia coli is of substantial interest because of how this organism serves as an indicator of fecal contamination in microbial water quality assessment. The efficacy of models used to assess the export of E. coli from agricultural fields is dependent, in part, on submodels they utilize to simulate E. coli release from land-applied manure and animal waste. Although several release submodels have been proposed, they have only been evaluated and compared with data from laboratory or small plot E. coli release experiments. Our objective was to evaluate and compare performances of three manure-borne bacteria release submodels at field-scale: exponential release (EM), two-parametric Bradford and Schijven (B-S), and two-parametric Vadas-Kleinman-Sharpley (VKS); each was independently incorporated and tested as a submodel within the export model KINEROS2/STWIR, using E. coli. Dairy manure was uniformly applied via surface broadcasting once a year for six consecutive years on a 0.28 ha experimental field site. Two irrigation events followed each application: the first immediately followed the initial application and the second occurred one week later. Manure and soil samples were collected before and after irrigation, respectively, and manure, soil, and edge-of-field runoff samples were analyzed for E. coli. Model performance was evaluated with the Akaike criterion, coefficients of determination (R2), and root mean squared errors (RMSE) values. The percentage of exported manure-borne E. coli varied from 0.1% to 10% in most cases, generally reflecting the lag time between initiation of irrigation and initiation ofedge-of-field runoff. The export model performed better when using the VKS submodel which was preferred in 55% of cases. The B-S and EM submodels were preferred in 27% and 18% of cases, respectively. Two-parametric submodels were ultimately preferred over the single parameter submodel.

"Resident as teacher" in pediatric surgery: Innovation is overdue in Central Europe.

PURPOSE: We set out to evaluate how residents in pediatric surgery learn and how they teach. We hypnotized that European residents learn as much from their peers and teach as much as their fellows worldwide, but that they receive comparably less educational training. METHODS: An online questionnaire was distributed to the participants of the combined annual meeting for German, Swiss and Austrian residents in pediatric surgery. Participants were asked whom they learn from in different workplace environments (ward, operating room, emergency department), how, when and why they adopt the role of teacher and how they were prepared for this role. RESULTS: Response rate was 48%. 65 questionnaires were analyzed. Residents stated that they predominantly learn from each other on wards and in the emergency department, less frequently in the operating room. They ranked fellow residents as first or second most important source of instruction. 53% of participants have never had any educational training, for another 33% the instruction was being done by fellow residents without any set curriculum. 93% of the participating residents had no or did not know about any resident as teacher training program available to them. Nevertheless, motivation to teach was stated to be high and interest in educational training was assured. CONCLUSIONS: Our data delivers evidence that peer teaching during residency is the rule rather than the exception in Central Europe. Educational training however is scarce. Resident as teacher-training programs need to be introduced. Next to local initiatives, we strongly recommend national initiatives powered by regulatory authorities and surgical associations. TYPE OF STUDY: Research paper. LEVEL OF EVIDENCE: II.

Discharge on the day of surgery following unicompartmental knee arthroplasty within the United Kingdom NHS.

AIMS: Unicompartmental knee arthroplasty (UKA) has been successfully performed in the United States healthcare system on outpatients. Despite differences in healthcare structure and financial environment, we hypothesised that it would be feasible to replicate this success and perform UKA with safe day of surgery discharge within the NHS, in the United Kingdom. This has not been reported in any other United Kingdom centres. PATIENTS AND METHODS: We report our experience of implementing a pathway to allow safe day of surgery discharge following UKA. Data were prospectively collected on 72 patients who underwent UKA as a day case between December 2011 and September 2015. RESULTS: A total of 61 patients (85%) were discharged on the same day. The most common reason for failure was logistical; five patients had their operation too late in the day. Three patients failed to mobilise safely, two had inadequate control of pain and one had a leaking wound. The mean length of stay for those who were not discharged on the same day was 1.2 nights (1 to 3). During the same time, 58 patients underwent planned inpatient UKA, as they were deemed inappropriate for discharge on the day of surgery. However, three of these were safely discharged on the same day. Follow-up data, 24 hours post-operatively, were available for 70 patients; 51 (73%) reported no or mild pain, 14 (20%) had moderate pain and five (7%) had severe pain. There were no re-admissions. All patients had a high level of satisfaction. CONCLUSION: We found that patients can be safely and effectively discharged on the day of surgery after UKA, with high levels of satisfaction. This clearly offers improved management of resources and financial savings to healthcare trusts. Cite this article: Bone Joint J 2017;99-B:788-92.

[Learning from a critical incident reporting system in the pediatric intensive care unit]. / Lernen aus einem Fehlermeldesystem in der Kinderintensivstation.

BACKGROUND: To record and analyze critical incidents is of paramount importance for any organization dedicated to improving patient safety. Therefore, many hospitals have implemented a critical incident reporting system (CIRS). However, the impact, benefits and use of such CIRS systems on patient safety have often been reported to be unsatisfactory. AIM: What have we learned over the past decade about the effective and optimal use of a CIRS? MATERIAL AND METHODS: Following the Yorkshire contributory factors framework, the potential benefits of a CIRS are illustrated with selected examples from the neonatal and pediatric intensive care unit. Based on a literature search in PubMed from January 2000 to December 2014 this article also describes critical factors and concepts for the successful use of a CIRS. RESULTS: A positive mind-set towards errors, high psychological safety and the conviction that a CIRS can be beneficial are important factors to encourage individual healthcare personnel to report critical incidents and learn from errors. On the part of the organization, adequate resources of personnel, systematic analysis of the reported incidents as well as dissemination of the results and implementation of safety improvement strategies are critical factors for the effective use of a CIRS. All incidents with potential relevance for patient safety should be reported. The categorization of the reported incidents facilitates the analysis and identification of relevant conclusions. As an organization dedicated to improve patient safety we have to learn from errors as well as from successes. CONCLUSION: The successful use of a CIRS depends on the motivation of individual healthcare providers as well as on organizational features that encourage critical incident reporting.

Depth-Dependent Survival of Escherichia coli and Enterococci in Soil after Manure Application and Simulated Rainfall.

Once released, manure-borne bacteria can enter runoff via interaction with the thin mixing layer near the soil surface. The objectives of this work were to document temporal changes in profile distributions of manure-borne Escherichia coli and enterococci in the near-surface soil layers after simulated rainfalls and to examine differences in survival of the two fecal indicator bacteria. Rainfall simulations were performed in triplicate on soil-filled boxes with grass cover and solid manure application for 1 h with rainfall depths of 30, 60, and 90 mm. Soil samples were collected weekly from depth ranges of 0 to 1, 1 to 2, 2 to 5, and 5 to 10 cm for 1 month. Rainfall intensity was found to have a significant impact on the initial concentrations of fecal indicator bacteria in the soil. While total numbers of enterococci rapidly declined over time, E. coli populations experienced initial growth with concentration increases of 4, 10, and 25 times the initial levels at rainfall treatment depths of 30, 60, and 90 mm, respectively. E. coli populations grew to the approximately the same level in all treatments. The 0- to 1-cm layer contained more indicator bacteria than the layers beneath it, and survival of indicator bacteria was better in this layer, with decimation times between 12 and 18 days after the first week of growth. The proportion of bacteria in the 0- to 1-cm layer grew with time as the total number of bacteria in the 0- to 10-cm layer declined. The results of this work indicate the need to revisit the bacterial survival patterns that are assumed in water quality models.

The role of patient satisfaction surveys to improve patient care in day surgery

Introduction: Patient satisfaction surveys are validated tools in assessing the quality of healthcare services (3). This has been implemented in our day surgery department as part of a continuous quality improvement process. Methods: Data from postoperative phone calls were collected over two five month periods in 2011 and 2012. Reponses to the question, 'how can we improve your day surgery experience' were collected. Results: Overall patients expressed positive remarks about their care, but specified improvements regarding waiting area facilities and waiting times. Conclusions: Patient satisfaction surveys, alongside objective postoperative outcome measures, provide a more complete healthcare quality assessment (3) (AU)

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Performance of Weibull and Linear Semi-logarithmic Models in Simulating Inactivation in Waters.

Modeling inactivation of indicator microorganisms is a necessary component of microbial water quality forecast and management recommendations. The linear semi-logarithmic (LSL) model is commonly used to simulate the dependencies of bacterial concentrations in waters on time. There were indications that assumption of the semi-logarithmic linearity may not be accurate enough in waters. The objective of this work was to compare performance of the LSL and the two-parametric Weibull inactivation models with data on survival of indicator organism in various types of water from a representative database of 167 laboratory experiments. The Weibull model was preferred in >99% of all cases when the root mean squared errors and Nash-Sutcliffe statistics were compared. Comparison of corrected Akaike statistic values gave the preference to the Weibull model in only 35% of cases. This was caused by (i) a small number of experimental points on some inactivation curves, (ii) closeness of the shape parameter of the Weibull equation to one, and (iii) piecewise log-linear inactivation dynamic that could be well described by neither of the two models compared. Based on the Akaike test, the Weibull model was favored in agricultural, lake, and pristine waters, whereas the LSL model was preferred for groundwater, wastewater, rivers, and marine waters. The decimal reduction time parameter of both the LSL and Weibull models exhibited an Arrhenius-type dependence on temperature. Overall, the existing inactivation data indicate that the application of the Weibull model can improve the predictive capabilities of microbial water quality modeling.

Analysis of rich inelastic electron tunneling spectra: case study of terthiophene on Au(111).

Even moderately small molecules like 2,2':5',2"-terthiophene exhibit quite rich vibrational spectra. Detection and assignment of vibronic transitions of such a single adsorbed molecule in inelastic electron tunneling spectroscopy (IETS) using scanning tunneling microscopy are notoriously hampered by noise and the low efficiency of inelastic channels of typically well below 1%. We demonstrate by a thorough statistical analysis that detection of almost all predicted transitions can be determined experimentally within the energy range 0-120 meV with an estimated detection limit for the efficiency of inelastic channels of ∼0.15%. The maximum accuracy of our transition energies is 2 meV and thus smaller than the thermal broadening at 5 K. On short time scales up to some hours, that accuracy appears to be limited by tunneling current noise. The present analysis confirms earlier results which showed that IETS obeys propensity rules rather than selection rules as observed for optical transitions. Furthermore, the previous indications that anharmonic components in the interaction potentials are important for calculating properties of molecular vibrations were corroborated.

Iodine-129 and iodine-127 in European seawaters and in precipitation from Northern Germany.

In order to obtain a comprehensive survey on the consequences of the marine (129)I discharges from the European reprocessing plants La Hague and Sellafield, the distribution of (129)I and (127)I in surface waters of the North Sea, the English Channel, the Irish Sea, and the Northeast Atlantic was studied using accelerator mass spectrometry for (129)I and ICP-MS for (127)I. Samples of seawater were taken in the German Bight in May, September, and November 2005 and in the entire North Sea and the English Channel in August 2005. Further samples were obtained from the Irish Sea in June and August 2006 and from Arctic waters between Spitsbergen and Southern Norway in September 2005. (129)I is a conservative tracer in seawater. The concentrations of (127)I are relatively constant with exceptions of coastal areas with high biological activity and of areas influenced by influx from rivers and the Baltic Sea. The variability of the (129)I/(127)I isotopic ratios is exclusively determined by admixture of (129)I released from the reprocessing facilities Sellafield and La Hague to the seawater. The (129)I/(127)I ratios were between 4 × 10(-9)and 3 × 10(-6): at least 3 orders of magnitude higher than the natural equilibrium isotopic ratio 1.5 × 10(-12). (129)I/(127)I ratios of a few times 10(-10) were only found in seawater from the Indian Ocean and from the Pacific at Hawaii. Comparison of the results obtained for seawater with those of a measurement of airborne iodine species and with iodine isotopes in precipitation in Northern Germany demonstrates the transfer of (129)I and (127)I from the sea into the atmosphere and the dominating role of the marine discharges for the atmospheric fallout of (129)I in Western Europe. The results are discussed with the goal to estimate the relevance of the marine discharges for the contamination of the continental areas.

[The (German) Center for Cancer Registry Data (ZfKD) at the Robert Koch Institute (RKI) in Berlin]. / Das Zentrum für Krebsregisterdaten (ZfKD) im Robert Koch-Institut (RKI) in Berlin.

Cancer represents the second most common cause of death in Germany. The country's federal states operate regional population-based cancer registries that collect and analyze data on cancer patients. This provides an essential basis for describing the cancer burden in the German population. In order to obtain valid and reliable information on cancer incidence at the national level, the Robert Koch Institute (RKI) set up the Federal Cancer Surveillance Unit in 1983 as a central institution for evaluating this cancer registry data. In August 2009, when the Federal Cancer Registry Data Act (BKRG) came into force, the Center for Cancer Registry Data (ZfKD) at the RKI took over the work of the Cancer Surveillance Unit with a broader remit. In the future, it will also regularly publish findings on survival, prevalence, and tumor stage distribution. A newly established record linkage process will help identify multiple submissions from the federal states. Further innovations and new tasks of the ZfKD include expanding an interactive Internet platform and encouraging a more intensive use of cancer registry data for epidemiological research by providing datasets to external scientists. The range of information available to the interested public is also to be expanded.