Geospatial Mapping to Target Injury Prevention for Older Adult Ground-Level Falls: A Feasibility Study.

BACKGROUND: Trauma centers target injury prevention efforts based on trauma registry and local epidemiological data. Identifying geographic patterns of injury through geospatial mapping has emerged as a technology to help identify at-risk individuals. Yet, the feasibility of using spatial analysis to target injury prevention efforts remains unknown. OBJECTIVE: This study aims to demonstrate the use of geospatial mapping of older adult ground-level falls to target injury prevention efforts. METHODS: This retrospective cohort analysis of ground-level falls among older adults was conducted from 2017 to 2020 at a Level I trauma center and safety net hospital. Trauma admissions, U.S. census median income, Hispanic percentage, and population density by zip codes were combined to create choropleth and heat maps to identify injury hot spots to target fall prevention classes. RESULTS: A total of 5,629 patients were reviewed, of which 3,002 (53%) were fall cases. Low-level falls (<10 ft) accounted for 2,224 cases; 1,449 were among older adults centered around the study hospital. Ground-level falls accounted for 1,663 patients, of whom 1,182 were older adults clustering around senior housing, assisted living facilities, nursing homes, and rehabilitation centers. As a result, our fall prevention classes are now targeted at these newly identified locations. CONCLUSION: Geospatial analysis provided powerful visualization of fall injury locations to target our fall prevention efforts. Geospatial analysis is a feasible tool for trauma centers to guide injury prevention strategies that effectively target the populations most in need.

Rare presentation of the cutaneous metastasis of colon cancer imitating herpes zoster.

The cutaneous metastasis of colon cancer is rare, and most commonly manifests as nodules or masses. In the case of our patient, a rarely described vesiculomaculopapular rash resembling herpes zoster was observed and treated as such; however, biopsy later revealed metastatic colonic adenocarcinoma. Metastasis of colon cancer to the skin typically confers a poor prognosis, however, early identification may allow for quicker intervention and more aggressive treatments, that may extend survival. Given the immunocompromised state of cancer patients undergoing antineoplastic therapy, a herpes zoster eruption would not be unexpected, but an astute primary care provider should keep metastatic disease in their differential.

The genome of deep-sea vent chemolithoautotroph Thiomicrospira crunogena XCL-2.

Presented here is the complete genome sequence of Thiomicrospira crunogena XCL-2, representative of ubiquitous chemolithoautotrophic sulfur-oxidizing bacteria isolated from deep-sea hydrothermal vents. This gammaproteobacterium has a single chromosome (2,427,734 base pairs), and its genome illustrates many of the adaptations that have enabled it to thrive at vents globally. It has 14 methyl-accepting chemotaxis protein genes, including four that may assist in positioning it in the redoxcline. A relative abundance of coding sequences (CDSs) encoding regulatory proteins likely control the expression of genes encoding carboxysomes, multiple dissolved inorganic nitrogen and phosphate transporters, as well as a phosphonate operon, which provide this species with a variety of options for acquiring these substrates from the environment. Thiom. crunogena XCL-2 is unusual among obligate sulfur-oxidizing bacteria in relying on the Sox system for the oxidation of reduced sulfur compounds. The genome has characteristics consistent with an obligately chemolithoautotrophic lifestyle, including few transporters predicted to have organic allocrits, and Calvin-Benson-Bassham cycle CDSs scattered throughout the genome.