Deep vs shallow: GPS tags reveal a dichotomy in movement patterns of loggerhead turtles foraging in a coastal bay.

BACKGROUND: Individual variation in movement strategies of foraging loggerhead turtles have been documented on the scale of tens to hundreds of kilometers within single ocean basins. Use of different strategies among individuals may reflect variations in resources, predation pressure or competition. It is less common for individual turtles to use different foraging strategies on the scale of kilometers within a single coastal bay. We used GPS tags capable of back-filling fine-scale locations to document movement patterns of loggerhead turtles in a coastal bay in Northwest Florida, U.S.A. METHODS: Iridium-linked GPS tags were deployed on loggerhead turtles at a neritic foraging site in Northwest Florida. After filtering telemetry data, point locations were transformed to movement lines and then merged with the original point file to define travel paths and assess travel speed. Home ranges were determined using kernel density function. Diurnal behavioral shifts were examined by examining turtle movements compared to solar time. RESULTS: Of the 11 turtles tagged, three tracked turtles remained in deep (~ 6 m) water for almost the entire tracking period, while all other turtles undertook movements from deep water locations, located along edges and channels, to shallow (~ 1-2 m) shoals at regular intervals and primarily at night. Three individuals made short-term movements into the Gulf of Mexico when water temperatures dropped, and movement speeds in the Gulf were greater than those in the bay. Turtles exhibited a novel behavior we termed drifting. CONCLUSIONS: This study highlighted the value provided to fine-scale movement studies for species such as sea turtles that surface infrequently by the ability of these GPS tags to store and re-upload data. Future use of these tags at other loggerhead foraging sites, and concurrent with diving and foraging data, would provide a powerful tool to better understand fine-scale movement patterns of sea turtles.

Implementing Centering Parenting Model With an Urban Pediatric Population to Measure and Improve Clinical Outcomes and Parent Satisfaction.

INTRODUCTION: For CenteringParenting-a patient-centered, group family approach to child health-this study aimed to determine how the CenteringParenting model affects clinical outcomes compared with the traditional well-child care model and how the CenteringParenting model affect parent satisfaction as compared with the traditional well-child care model. This study was conducted at the Children's Health Center in West Reading, PA-a single-site pediatric practice that serves primarily an inner city with a population currently at 95,112. METHOD: Quantitative data collection was obtained from a retrospective chart review for both groups of patients to obtain outcome data. Phone interviews were completed, and participants were asked to respond to a series of questions using a 5-point Likert scale and several open-ended questions. All statistical analyses for this research were performed using SPSS (version 25.0; IBM Corp., Armonk, NY). Two groups were coded as the centering group and control group. Significance testing was performed using chi-square analysis for categorical data and t test for continuous data. RESULTS: CenteringParenting children are more likely to be UTD with their scheduled visits and vaccines than those receiving the traditional model of well-child care. Maternal depression screenings were more likely to be completed and documented and open discussions about maternal depression. Parents involved with group visits found it to be great care, liked being with other parents, learned a lot, and would recommend it to other parents. DISCUSSION: Limitations of the study include being a new site offering the CHI program for group well-child visits. As the program has continued to progress over the years, it has continued to grow and is now offered in both English and Spanish. Another limitation was not having trained breastfeeding professionals such as lactation counselors, consultants, or breastfeeding resource nurses. Future research is needed to study the implementation of breastfeeding in minority populations. In addition, a more in-depth study about triage calls and if parents feel more comfortable calling if they have a better connection to their provider and health care team. This issue was not addressed or questioned in this research and would be very beneficial to understand in the future how it relates to CPGs.

Immune profiling of adeno-associated virus response identifies B cell-specific targets that enable vector re-administration in mice.

Adeno-associated virus (AAV) vector-based gene therapies can be applied to a wide range of diseases. AAV expression can last for months to years, but vector re-administration may be necessary to achieve life-long treatment. Unfortunately, immune responses against these vectors are potentiated after the first administration, preventing the clinical use of repeated administration of AAVs. Reducing the immune response against AAVs while minimizing broad immunosuppression would improve gene delivery efficiency and long-term safety. In this study, we quantified the contributions of multiple immune system components of the anti-AAV response in mice. We identified B-cell-mediated immunity as a critical component preventing vector re-administration. Additionally, we found that IgG depletion alone was insufficient to enable re-administration, suggesting IgM antibodies play an important role in the immune response against AAV. Further, we found that AAV-mediated transduction is improved in µMT mice that lack functional IgM heavy chains and cannot form mature B-cells relative to wild-type mice. Combined, our results suggest that B-cells, including non-class switched B-cells, are a potential target for therapeutics enabling AAV re-administration. Our results also suggest that the µMT mice are a potentially useful experimental model for gene delivery studies since they allow repeated dosing for more efficient gene delivery from AAVs.

A pilot school-based health center intervention to improve asthma chronic care in high-poverty schools.

OBJECTIVE: To test the feasibility and effectiveness of a multifaceted intervention administered through school-based health centers (SBHCs) to improve asthma control for children in high-poverty schools with not well controlled asthma. METHODS: Students 4-14 years old with persistent asthma were enrolled from three SBHCs. The centers' advanced practice providers received training on evidence-based asthma guidelines. Students randomized to the intervention received directly observed therapy of their asthma controller medication, medication adjustments as needed by the centers' providers, and daily self-management support. Students randomized to usual care were referred back to their primary care provider (PCP) for routine asthma care. RESULTS: We enrolled 29 students. Students in the intervention group received their controller medication 92% of days they were in school. Ninety-four percent of follow-up assessments were completed. During the study, 11 of 12 intervention students had a step-up in medication; 2 of 15 usual care students were stepped up by their PCP. Asthma Control Test scores did not differ between groups, although there were significant improvements from baseline to the 7 month follow-up within each group (both p < .01). Both FEV1% predicted and FEV1/FVC ratio significantly worsened in the usual care group (both p = .001), but did not change in the intervention group (p = .76 and .28 respectively). CONCLUSIONS: Our pilot data suggest that a multifaceted intervention can be feasibly administered through SBHCs in communities with health disparities. Despite the small sample size, spirometry detected advantages in the intervention group. Further study is needed to optimize the intervention and evaluate outcomes. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT03032744.

Membrane-bound MMP-14 protease-activatable adeno-associated viral vectors for gene delivery to pancreatic tumors.

Adeno-associated virus' (AAV) relatively simple structure makes it accommodating for engineering into controllable delivery platforms. Cancer, such as pancreatic ductal adenocarcinoma (PDAC), are often characterized by upregulation of membrane-bound proteins, such as MMP-14, that propagate survival integrin signaling. In order to target tumors, we have engineered an MMP-14 protease-activatable AAV vector that responds to both membrane-bound and extracellularly active MMPs. This "provector" was generated by inserting a tetra-aspartic acid inactivating motif flanked by the MMP-14 cleavage sequence IPESLRAG into the capsid subunits. The MMP-14 provector shows lower background transduction than previously developed provectors, leading to a 9.5-fold increase in transduction ability. In a murine model of PDAC, the MMP-14 provector shows increased delivery to an allograft tumor. This proof-of-concept study illustrates the possibilities of membrane-bound protease-activatable gene therapies to target tumors.

Looking behind: Turning cards in the selection task.

Wason's selection task requires that one imagine which of four cards, each of which has a letter on one side and a number on the other, one would have to turn over to determine whether a statement about the cards is true or false. For example, one might see four cards showing T, H, 6, and 4 and be asked to say which card or cards one would have to turn over to determine whether a statement in the form of If a card has T on one side, it has 4 on the other is true. In the great majority of experiments with this task no cards are actually turned. This limits the conclusions that can be drawn from experimental results. In two experiments participants actually turned (had a computer turn) virtual cards so as to show what they contained on their originally hidden sides. Participants were given a monetary incentive to do well on the task, and they performed it, with trial-by-trial feedback, many times. Performance was much better than is typically obtained with the more common way of performing the task. Results also demonstrate the importance of the precise wording of the statement to be evaluated and how a misinterpretation could help account for a tendency for people to turn only a single card even when the turning of two is required. Results prompt several questions of a theoretical nature and are discussed as they relate to recent theoretical treatments of the selection task.

Frustration and Direct-Coupling Analyses to Predict Formation and Function of Adeno-Associated Virus.

Adeno-associated virus (AAV) is a promising gene therapy vector because of its efficient gene delivery and relatively mild immunogenicity. To improve delivery target specificity, researchers use combinatorial and rational library design strategies to generate novel AAV capsid variants. These approaches frequently propose high proportions of nonforming or noninfective capsid protein sequences that reduce the effective depth of synthesized vector DNA libraries, thereby raising the discovery cost of novel vectors. We evaluated two computational techniques for their ability to estimate the impact of residue mutations on AAV capsid protein-protein interactions and thus predict changes in vector fitness, reasoning that these approaches might inform the design of functionally enriched AAV libraries and accelerate therapeutic candidate identification. The Frustratometer computes an energy function derived from the energy landscape theory of protein folding. Direct-coupling analysis (DCA) is a statistical framework that captures residue coevolution within proteins. We applied the Frustratometer to select candidate protein residues predicted to favor assembled or disassembled capsid states, then predicted mutation effects at these sites using the Frustratometer and DCA. Capsid mutants were experimentally assessed for changes in virus formation, stability, and transduction ability. The Frustratometer-based metric showed a counterintuitive correlation with viral stability, whereas a DCA-derived metric was highly correlated with virus transduction ability in the small population of residues studied. Our results suggest that coevolutionary models may be able to elucidate complex capsid residue-residue interaction networks essential for viral function, but further study is needed to understand the relationship between protein energy simulations and viral capsid metastability.

Medication Use in Schools.

This article serves as a Position Statement of the Pediatric Pharmacy Association (PPA), which supports safe and effective medication use in schools. PPA recommends that schools develop comprehensive medication use policies to support safe and appropriate administration of both chronic and emergency medication in schools. These policies must address issues specific to pediatric patients, including off-label and over-the-counter medication use, various pediatric dosage forms, as well as appropriate medication storage, administration, and disposal practices. PPA also advocates for continued staff development and education regarding laws, regulations, and policies surrounding medication use in school to ensure safe and effective care of children and adolescents in the school setting.

Medication Use in Schools: Current Trends, Challenges, and Best Practices.

There are a significant number of students on maintenance medications for chronic diseases or with diagnoses that may result in medical emergencies requiring administration of medications in school. With passing of legislation in all 50 states allowing self-administration of emergency medications for allergic reactions and asthma, the landscape of medication use in schools is changing. These changes have raised questions about the need for legislation or policy development relating to self-carrying and self-administration of medications for other disease states, undesignated stock of emergency medications, and administration of medications by non-medical personnel. Medication administration in the school setting has become a complex issue, and this review will discuss current legislation related to medication use in schools and provide best practices for administering medications to children and adolescents while at school.

COASTAL HABITAT CHANGE AND MARINE MEGAFAUNA BEHAVIOR: FLORIDA MANATEES ENCOUNTERING REDUCED FOOD PROVISIONS IN A PROMINENT WINTER REFUGE.

A decline in submerged aquatic vegetation (SAV) within Florida's spring-fed, thermal refuges raises questions about how these systems support winter foraging of Florida manatees (Trichechus manatus latirostris). We analyzed telemetry data for 12 manatees over seven years to assess their use of Kings Bay, a winter refuge with diminished SAV. After accounting for the effect of water temperature, we hypothesized that the number of trips out of Kings Bay would increase and the time wintering manatees spent in Kings Bay would decrease. Trips out of and into Kings Bay also were compared to assess potential influences on exiting or entering. There were no detectable differences in the number of trips out of the bay or overall time manatees spent in Kings Bay across winters. The percentage of time water temperatures were below 20°C was the single best predictor of increased time spent in Kings Bay. Trips out of Kings Bay were more likely to occur after 12:00 h and during a high but ebbing tide, compared to trips into the bay. Nine manatees tracked for longer than 75 days in winter spent 7-57% of their time in the Gulf of Mexico, and three of these manatees spent 7-65% of the winter >80 km from the mouth of Kings Bay. Results suggest the low amount of SAV in Kings Bay does not obviate its use by manatees, though there are likely tradeoffs for manatees regularly foraging elsewhere. Accounting for movements of Florida manatees through a network of habitats may improve management strategies and facilitate desirable conservation outcomes.

Physical, chemical, and synthetic virology: Reprogramming viruses as controllable nanodevices.

The fields of physical, chemical, and synthetic virology work in partnership to reprogram viruses as controllable nanodevices. Physical virology provides the fundamental biophysical understanding of how virus capsids assemble, disassemble, display metastability, and assume various configurations. Chemical virology considers the virus capsid as a chemically addressable structure, providing chemical pathways to modify the capsid exterior, interior, and subunit interfaces. Synthetic virology takes an engineering approach, modifying the virus capsid through rational, combinatorial, and bioinformatics-driven design strategies. Advances in these three subfields of virology aim to develop virus-based materials and tools that can be applied to solve critical problems in biomedicine and biotechnology, including applications in gene therapy and drug delivery, diagnostics, and immunotherapy. Examples discussed include mammalian viruses, such as adeno-associated virus (AAV), plant viruses, such as cowpea mosaic virus (CPMV), and bacterial viruses, such as Qß bacteriophage. Importantly, research efforts in physical, chemical, and synthetic virology have further unraveled the design principles foundational to the form and function of viruses. This article is categorized under: Diagnostic Tools > Diagnostic Nanodevices Biology-Inspired Nanomaterials > Protein and Virus-Based Structures.

Consortial brown tide - picocyanobacteria blooms in Guantánamo Bay, Cuba.

A brown tide bloom of Aureoumbra lagunensis developed in Guantánamo Bay, Cuba during a period of drought in 2013 that followed heavy winds and rainfall from Hurricane Sandy in late October 2012. Based on satellite images and water turbidity measurements, the bloom appeared to initiate in January 2013. The causative species (A. lagunensis) was confirmed by microscopic observation, and pigment and genetic analyses of bloom samples collected on May 28 of that year. During that time, A. lagunensis reached concentrations of 900,000 cells ml-1 (28 ppm by biovolume) in the middle portion of the Bay. Samples could not be collected from the northern (Cuban) half of the Bay because of political considerations. Subsequent sampling of the southern half of the Bay in November 2013, April 2014, and October 2014 showed persistent lower concentrations of A. lagunensis, with dominance shifting to the cyanobacterium Synechococcus (up to 33 ppm in April), an algal group that comprised a minor bloom component on May 28. Thus, unlike the brown tide bloom in Laguna Madre, which lasted 8 years, the bloom in Guantánamo Bay was short-lived, much like recent blooms in the Indian River, Florida. Although hypersaline conditions have been linked to brown tide development in the lagoons of Texas and Florida, observed euhaline conditions in Guantánamo Bay (salinity 35-36) indicate that strong hypersalinity is not a requirement for A. lagunensis bloom formation. Microzooplankton biomass dominated by ciliates was high during the observed peak of the brown tide, and ciliate abundance was high compared to other systems not impacted by brown tide. Preferential grazing by zooplankton on non-brown tide species, as shown in A. lagunensis blooms in Texas and Florida, may have been a factor in the development of the Cuban brown tide bloom. However, subsequent selection of microzooplankton capable of utilizing A. lagunensis as a primary food source may have contributed to the short-lived duration of the brown tide bloom in Guantánamo Bay.

Aspiration as a Function of Age, Sex, Liquid Type, Bolus Volume, and Bolus Delivery Across the Healthy Adult Life Span.

OBJECTIVES: The purpose of this investigation was to examine, via flexible endoscopic evaluation of swallowing (FEES), factors that affect penetration and aspiration during swallowing across the adult lifespan. METHODS: Healthy adults (N = 203) across the third to ninth decades of life participated. Penetration Aspiration Scale (PAS) scores were assessed during FEES as a function of age, sex, liquid type (water and skim, 2%, and whole milk), volume (5, 10, 15, and 20 ml), and delivery (cup and straw). RESULTS: The PAS scores differed significantly by liquid type ( P < .0001) and age group ( P < .0001). In general, PAS scores were higher for milk versus water swallows and for older age groups. Significant interactions of liquid type by age ( P = .0042) and sex by volume ( P = .020) were also evidenced. In addition, the odds of penetration and aspiration increased significantly with milks compared to water and age ( P < .05). Increased bolus volume also increased the odds of aspiration ( P < .05). CONCLUSIONS: Aspiration may be an underappreciated phenomenon in healthy adults. The inclusion of both water and milk test boluses of various volumes during FEES may be important for the appropriate assessment of adult penetration and aspiration.

Is it safe to discharge geriatric trauma patients with anemia?

INTRODUCTION: The consequences of discharging anemic geriatric trauma patients are not well studied. We hypothesize that anemia at discharge is associated with adverse outcomes. METHODS: A 1-year retrospective review of patients ≥65 years was performed. Hemoglobin levels at admission (HbA), discharge (HbD) and the lowest inpatient level (HbL) were recorded. Severity of anemia was categorized as mild (Hb ≥ 10.0 g/dl), moderate (Hb < 10.0 and ≥ 8.5 g/dl) and severe (Hb < 8.5 g/dl). The study endpoint was death or unplanned readmission 60 days following discharge. Univariate and multivariable analysis were used to determine if anemia predicted the outcome. A p value of 0.05 was considered significant. RESULTS: 550 patients were included. Moderate and severe anemia for HbA each predicted the study endpoint. Both HbD and HbL were highly correlated with HbA but did not predict the study endpoint. CONCLUSION: The degree of discharge anemia was not predictive of 60-day mortality or unplanned admissions in geriatric trauma patients.

Pseudo-outbreak of Brevundimonas diminuta Attributed to Contamination of Culture Medium Supplement.

We report an epidemiological investigation of a cluster of Brevundimonas diminuta isolates cultured from sterile sites. Inoculation of supplement medium yielded growth of B. diminuta. Molecular typing indicated likely contamination of the lot. No B. diminuta was further isolated after replacement of the supplement with a new lot number. Infect Control Hosp Epidemiol 2017;38:598-601.

The Effectiveness of Eye Movement Desensitization and Reprocessing Therapy to Treat Symptoms Following Trauma in Timor Leste.

The effectiveness of eye movement desensitization and reprocessing (EMDR) therapy for treating trauma symptoms was examined in a postwar/conflict, developing nation, Timor Leste. Participants were 21 Timorese adults with symptoms of posttraumatic stress disorder (PTSD), assessed as those who scored ≥2 on the Harvard Trauma Questionnaire (HTQ). Participants were treated with EMDR therapy. Depression and anxiety symptoms were assessed using the Hopkins Symptom Checklist. Symptom changes post-EMDR treatment were compared to a stabilization control intervention period in which participants served as their own waitlist control. Sessions were 60-90 mins. The average number of sessions was 4.15 (SD = 2.06). Despite difficulties providing treatment cross-culturally (i.e., language barriers), EMDR therapy was followed by significant and large reductions in trauma symptoms (Cohen's d = 2.48), depression (d = 2.09), and anxiety (d = 1.77). At posttreatment, 20 (95.2%) participants scored below the HTQ PTSD cutoff of 2. Reliable reductions in trauma symptoms were reported by 18 participants (85.7%) posttreatment and 16 (76.2%) at 3-month follow-up. Symptoms did not improve during the control period. Findings support the use of EMDR therapy for treatment of adults with PTSD in a cross-cultural, postwar/conflict setting, and suggest that structured trauma treatments can be applied in Timor Leste.

Conditional Deletion of Bmal1 in Ovarian Theca Cells Disrupts Ovulation in Female Mice.

Rhythmic events in female reproductive physiology, including ovulation, are tightly controlled by the circadian timing system. The molecular clock, a feedback loop oscillator of clock gene transcription factors, dictates rhythms of gene expression in the hypothalamo-pituitary-ovarian axis. Circadian disruption due to environmental factors (eg, shift work) or genetic manipulation of the clock has negative impacts on fertility. Although the central pacemaker in the suprachiasmatic nucleus classically regulates the timing of ovulation, we have shown that this rhythm also depends on phasic sensitivity to LH. We hypothesized that this rhythm relies on clock function in a specific cellular compartment of the ovarian follicle. To test this hypothesis we generated mice with deletion of the Bmal1 locus in ovarian granulosa cells (GCs) (Granulosa Cell Bmal1 KO; GCKO) or theca cells (TCs) (Theca Cell Bmal1 KO; TCKO). Reproductive cycles, preovulatory LH secretion, ovarian morphology and behavior were not grossly altered in GCKO or TCKO mice. We detected phasic sensitivity to LH in wild-type littermate control (LC) and GCKO mice but not TCKO mice. This decline in sensitivity to LH is coincident with impaired fertility and altered patterns of LH receptor (Lhcgr) mRNA abundance in the ovary of TCKO mice. These data suggest that the TC is a pacemaker that contributes to the timing and amplitude of ovulation by modulating phasic sensitivity to LH. The TC clock may play a critical role in circadian disruption-mediated reproductive pathology and could be a target for chronobiotic management of infertility due to environmental circadian disruption and/or hormone-dependent reprogramming in women.

Effect of Quencher, Denaturants, Temperature and pH on the Fluorescent Properties of BSA Protected Gold Nanoclusters.

In this paper, we have synthesized BSA protected gold nanoclusters (BSA Au nanocluster) and studied the effect of quencher, protein denaturant, pH and temperature on the fluorescence properties of the tryptophan molecule of the BSA Au nanocluster and native BSA. We have also studied their effect on the peak emission of BSA Au nanoclusters (650 nm). The phtophysical characterization of a newly developed fluorophore in different environments is absolutely necessary to futher develop their biomedical and analytical applications. It was observed from our experiments that the tryptophan in BSA Au nanoclusters is better shielded from the polar environment. Tryptophan in native BSA showed a red shift in its peak emission wavelength position. Tryptophan is a highly polarity sensitive dye and a minimal change in its microenvironment can be easily observed in its photophysical properties.

Ultrasonographic evaluation of geniohyoid muscle and hyoid bone during swallowing in young adults.

OBJECTIVES/HYPOTHESIS: The geniohyoid muscle plays an important role in hyoid bone movement. Adequate hyoid bone movement during swallowing is important for effective bolus flow and pharyngeal clearing. The aim of this study was to estimate the relationship between the geniohyoid muscle size and function and hyoid bone movement during swallowing in healthy young adults, as measured via ultrasound, in different body positions. STUDY DESIGN: Cross-sectional study. METHODS: Forty young (20-40 years old) adults (20 male and 20 female) participated. The cross-sectional area of the geniohyoid muscle at rest (seated position), the geniohyoid muscle contraction velocity, and the hyoid bone displacement during swallowing 10 mL of mineral water were measured by ultrasound in seated, supine, and right lateral decubitus positions. RESULTS: The size of the geniohyoid muscle correlated with body height. Males had larger geniohyoid cross-sectional area than females and greater maximal and anterior hyoid displacement during swallowing than females, and maximal and anterior hyoid bone displacement during swallowing correlated with the size of geniohyoid muscle only when the body was in the supine position; these two movements were positively correlated to each other. CONCLUSIONS: Genders vary in hyoid bone movement during swallowing, and the correlation between geniohyoid muscle size and hyoid bone displacement varies among different body positions during swallowing. This investigation also illuminates the use of ultrasound in providing quantitative measures of geniohyoid muscle and hyoid bone displacement during swallowing. LEVEL OF EVIDENCE: 2c.