Pathogen Surveillance for Acute Infectious Conjunctivitis.

Importance: Acute infectious conjunctivitis is a common ocular condition with major public health consequences. Objective: To assess regional variations and microbial etiologies of acute infectious conjunctivitis to guide treatment. Design, Setting, and Participants: In this cross-sectional study, patients with presumed acute infectious conjunctivitis were enrolled in the study at 5 sites (Honolulu, Hawaii; Los Angeles, San Francisco, and San Diego, California; and Petah-Tikva, Israel) from March 2021 to March 2023. Patients with allergic or toxic conjunctivitis were excluded. Main Outcomes and Measures: Pathogens were identified by unbiased RNA deep sequencing. Results: In all, 52 patients (mean [range] age, 48 [7-80] years; 31 females [60%]) were enrolled at 5 sites (6 patients from Honolulu, 9 from San Diego, 11 from Los Angeles, 13 from San Francisco, and 13 from Petah-Tikva). RNA deep sequencing detected human adenovirus species D in one-quarter of patients (13 of 52). A wide range of pathogens, including human coronavirus 229E, SARS-CoV-2, and herpes simplex virus type 1, was also identified, as well as several bacteria and fungi. Moreover, 62% (32 of 52) of patients presented with purulent discharge, while only 8% (4 of 52) of patients had confirmed bacterial pathogens. Conclusion and Relevance: In this cross-sectional study, pathogens associated with acute infectious conjunctivitis varied between all 5 sites in the US and Israel. Purulent discharge was a common presenting sign in this study, with a low specificity for bacteria-associated conjunctivitis, suggesting that further diagnostic workup may be necessary to inform antibiotic stewardship. Additional research on cost-effectiveness of using RNA deep sequencing is needed to ascertain whether it is better to monitor patients clinically until resolution of disease.

Climate change in the Catalan Pyrenees intersects with socioeconomic factors to shape crop diversity and management.

Most studies on climate change's impacts on agriculture focus on modeling techniques based on large-scale meteorological data, while few have investigated how farmer's perception of climate change's impacts can affect crop diversity and crop management practices, especially in industrialized contexts. To fill this gap, we conducted 24 semi-structured interviews in a study site located in the Catalan Pyrenees. Our results show for the first time in an industrialized context that farmers perceive multiple interrelated climate change impacts on local agroecosystems. For instance, snowfall and freeze events have decreased, which respondents associated with the increase of pests and diseases affecting both wild flora and cultivated plants. Similarly, changes in precipitation patterns lead to a perceived decrease in useful rain for agriculture. Farmers are also reporting changes in their management practices, such as increased irrigation or use of pesticides, which respond to these climatic factors but also to changes in the crops that are cultivated. Crop diversity is in decline in the area both at the species and landrace levels, especially in rainfed fields. This is mainly driven by socioeconomic factors such as agricultural abandonment or access to commercial seeds, although climate change factors such as increased pests or decreased rainfall can have an impact. Despite the crop diversity losses found, many landraces have been maintained, mainly due to their cultural value, and also new crop species have been introduced, which are now viable due to the increase in temperature. Although we focused on a specific case study, we found several trends that are also present in other contexts. Therefore, the results of this research are relevant at a global scale since they show that climate change is affecting mountain agroecosystems in industrialized contexts and may affect more drastically both agrobiodiversity and crop management practices in agroecosystems worldwide. Supplementary Information: The online version contains supplementary material available at 10.1007/s13593-022-00806-3.

Incidencia y factores desencadenantes de las caídas intrahospitalarias / Incidence and precipitating factors in in-hospital falls

Este estudio describe la incidencia de las caídas en el Hospital Universitario Dr. Josep Trueta de Girona durante el período de un año, y se identifican los factores intrínsecos y extrínsecos al paciente en relación con las caídas acontencidas. Entre los factores intrínsecos se destacan, de parte de los pacientes, la confusión, alteración de la comunicación, desorientación temporo-espacial, inestabilidad en la marcha, agitación, tratamiento con psicofármacos e hipotensores. Casi el 40 por ciento de los pacientes tenían medidas de protección en el momento de la caída. Se protegió de forma significativa a los pacientes más dependientes. En relación con los factores extrínsecos se identificaron suelos resbaladizos, calzado inseguro y ausencia de barandillas en la cama. Se concluye que es necesario un mayor reconocimiento de los factores desencadenantes y una mejor utilización de las medidas de protección en los hospitales

Incidencia y factores desencadenantes de las caídas intrahospitalarias / Incidence and precipitating factors in in-hospital falls

Este estudio describe la incidencia de las caídas en el Hospital Universitario Dr. Josep Trueta de Girona durante el período de un año, y se identifican los factores intrínsecos y extrínsecos al paciente en relación con las caídas acontencidas. Entre los factores intrínsecos se destacan, de parte de los pacientes, la confusión, alteración de la comunicación, desorientación temporo-espacial, inestabilidad en la marcha, agitación, tratamiento con psicofármacos e hipotensores. Casi el 40 por ciento de los pacientes tenían medidas de protección en el momento de la caída. Se protegió de forma significativa a los pacientes más dependientes. En relación con los factores extrínsecos se identificaron suelos resbaladizos, calzado inseguro y ausencia de barandillas en la cama. Se concluye que es necesario un mayor reconocimiento de los factores desencadenantes y una mejor utilización de las medidas de protección en los hospitales