Coding-Complete Genome Sequences of G6P[14] Rotavirus Strain Detected in a Human Stool Specimen within the United States.

In this study, we report the detection of a G6P[14] rotavirus strain from a human stool sample within the United States. The full genotype constellation of the G6P[14] strain was identified as G6-P[14]-I2-R2-C2-M2-A11-N2-T6-E2-H3.

Rotavirus Strain Trends in United States, 2009-2016: Results from the National Rotavirus Strain Surveillance System (NRSSS).

Before the introduction of vaccines, group A rotaviruses (RVA) were the leading cause of acute gastroenteritis in children worldwide. The National Rotavirus Strain Surveillance System (NRSSS) was established in 1996 by the Centers for Disease Control and Prevention (CDC) to perform passive RVA surveillance in the USA. We report the distribution of RVA genotypes collected through NRSSS during the 2009-2016 RVA seasons and retrospectively examine the genotypes detected through the NRSSS since 1996. During the 2009-2016 RVA seasons, 2134 RVA-positive fecal specimens were sent to the CDC for analysis of the VP7 and VP4 genes by RT-PCR genotyping assays and sequencing. During 2009-2011, RVA genotype G3P[8] dominated, while G12P[8] was the dominant genotype during 2012-2016. Vaccine strains were detected in 1.7% of specimens and uncommon/unusual strains, including equine-like G3P[8] strains, were found in 1.9%. Phylogenetic analyses showed limited VP7 and VP4 sequence variation within the common genotypes with 1-3 alleles/lineages identified per genotype. A review of 20 years of NRSSS surveillance showed two changes in genotype dominance, from G1P[8] to G3P[8] and then G3P[8] to G12P[8]. A better understanding of the long-term effects of vaccine use on epidemiological and evolutionary dynamics of circulating RVA strains requires continued surveillance.

Association Between Storage Interval and Contamination of Reprocessed Flexible Endoscopes in a Pediatric Gastrointestinal Procedural Unit.

OBJECTIVE The maximum safe storage interval after endoscope reprocessing remains unknown. We assessed the association between storage interval and endoscope contamination to evaluate the need for scope reprocessing prior to use. METHODS We conducted a study in 2 phases. In phase 1, we cultured 9 gastrointestinal (GI) endoscopes that had been stored for at least 7 days since reprocessing. Each scope was cultured in 3 places: external surfaces of hand piece, insertion tube, and internal channels. In phase 2, after reprocessing these scopes, we hung and cultured them prospectively in a similar fashion at 1-, 2-, 4-, 6-, and 8-week intervals without patient use. We defined clinically relevant contamination as >100 colony-forming units per milliliter (CFU/mL). RESULTS In phase 1, median hang time was 69 days (range, 8-555 days). Considering the 27 total cultures, 3 of 27 GI endoscopes (11.1%) had positive cultures, all with nonpathogenic skin flora at ≤100 CFU/mL. Median hang time was not statistically different between scopes with positive and negative cultures (P=.82). In phase 2, 7 of 131 prospective cultures (5.3%) from 6 of 9 GI endoscopes at varying storage intervals were positive, all at ≤100 CFU/mL. At 56 days after reprocessing (the longest storage interval studied), 1 of 24 cultures (4.2%) was positive (100 CFU/mL of Bacillus species from external biopsy/suction ports). CONCLUSIONS No endoscopes demonstrated clinically relevant contamination at hang times ranging from 7 to 555 days, and most scopes remained uncontaminated up to 56 days after reprocessing. Our data suggest that properly cleaned and disinfected GI endoscopes could be stored safely for longer intervals than currently recommended. Infect. Control Hosp. Epidemiol. 2017;38:131-135.

Children's and parents' perspectives about activity performance and participation after spinal cord injury: initial development of a patient-reported outcome measure.

OBJECTIVE: To report on a cognitive testing study on newly constructed items designed to evaluate client-reported outcomes of activity performance and participation after spinal cord injury (SCI). METHOD: Thirty-three children with SCI and 13 caregivers participated in cognitive testing interviews. Open-ended questions were used to gain a better understanding of activity performance and participation. The interviews were transcribed verbatim. A thematic analysis was carried out independently by 2 researchers, and key sentences and phrases from both analyses were merged. RESULTS: Four themes were defined: (1) apprehension related to activity performance and participation, (2) reference point, (3) missing out, and (4) autonomy. CONCLUSION: Insight into children's and caregivers' perspectives provided important information that helped refine the wording of test items and response scales. The theme of autonomy provided a stronger catalyst to solidify items for both child- and parent-reported outcomes. This study further validated the complexity of the construct of participation.

Developments in tissue culture detection of respiratory viruses.

Viral culture is the historical gold standard for detection of most viruses that cause respiratory tract infections. Viral culture remains valuable because it is reasonably sensitive for most respiratory viruses, and it is cheaper and less technically demanding than nucleic acid amplified tests. The disadvantages of conventional viral culture using multiple tubes of cell lines are that it is labor intensive, moderately expensive, and slow. Advances in viral culture include the introduction of new cell lines, which can be more sensitive or convenient than previously used cell lines, and the use of shell-vial culture for respiratory viruses. Shell-vial culture is as sensitive as conventional culture for most respiratory viruses and it has a much shorter turn-around time. The shorter turn-around time increases the clinical utility of these cultures.

Linking theory and practice for restoration of step-pool streams.

Step-pools sequences are increasingly used to restore stream channels. This increase corresponds to significant advances in theory for step-pools in recent years. The need for step-pools in stream restoration arises as urban development encroaches into steep terrain in response to population pressures, as stream channels in lower-gradient areas require stabilization due to hydrological alterations associated with land-use changes, and as step-pools are recognized for their potential to enhance stream habitats. Despite an increasingly voluminous literature and great demand for restoration using step-pool sequences, however, the link between theory and practice is limited. In this article, we present four unique cases of stream restoration using step-pools, including the evolution of the approaches, the project designs, and adjustments in the system following restoration. Baxter Creek in El Cerrito, California demonstrates an early application of artificial step-pools in which natural adjustments occurred toward geomorphic stability and ecological improvement. Restoration of East Alamo Creek in a large residential development near San Ramon, California illustrates an example of step-pools increasingly used in locations where such a channel form would not naturally occur. Construction of a step-pool channel in Karnowsky Creek within the Siuslaw National Forest, Oregon overcame constraints posed by access and the type and availability of materials; the placement of logs allowed natural scouring below steps. Dry Canyon Creek on the property of the Mountains Restoration Trust in Calabasas, California afforded a somewhat experimental approach to designing step-pools, allowing observation and learning in the future. These cases demonstrate how theories and relationships developed for step-pool sequences over the past two decades have been applied in real-world settings. The lessons from these examples enable us to develop considerations useful for deriving an appropriate course of design, approval, and construction of artificial step-pool systems. They also raise additional fundamental questions concerning appropriate strategies for restoration of step-pool streams. Outstanding challenges are highlighted as opportunities for continuing theoretical work.

Lifelong menstrual histories are typically erratic and trending: a taxonomy.

OBJECTIVE: Menstrual cycles are composites of complex events; the data describing them are correspondingly rich. We seek to quantitatively represent menstrual histories from menarche to menopause and to evaluate the clinical belief that regular and stable cycle lengths are the most normative histories. DESIGN: Using prospective data from the Tremin Trust, we classified the menstrual histories of 628 women as very stable (type I), stable but with greater variability in cycle lengths (type II), oscillating and erratic with a downward trend in cycle length (type III), oscillating and erratic with no downward trend in cycle length (type IV), or highly erratic and variable (type V). Classification criteria were created by examining basic summary statistics of menstrual cycle lengths. Specifically, we identified key features describing variability of median cycle length, the mean of the interquartile range, the consistency of the interquartile range, the slope of median cycle lengths, and the number of stable 5-year intervals between ages 15 and 45+. RESULTS: We present the first characterization of full menstrual histories. Our taxonomy captures the essential features of menstrual bleeding patterns for a heterogeneous population. Persistently stable histories (types I and II) were seen in only 28% of the women; erratic histories (types III through V) characterized 72%. When examining all participants, significant differences were seen in age at menarche (P < 0.05), age at menopause (P < 0.01), and number of births (P < 0.01) between these stable and erratic groups. CONCLUSIONS: Although clinicians have traditionally thought of "normal" menstrual histories as being regular and stable, the distribution of women in our five categories suggest that variable histories are most common. Clinically, these results may suggest the need for a paradigm shift in what gynecologists view as normal and abnormal menstrual cycle histories.

Human metapneumovirus in children tested at a tertiary-care hospital.

BACKGROUND: Respiratory infections are the leading cause of outpatient visits in the United States, but the etiology of many of these infections is unknown. Human metapneumovirus (hMPV) is a recently discovered virus that causes respiratory infections. METHODS: Respiratory specimens obtained from patients

Dynamic and static measures of growth among pre- and postmenarcheal females in rural Bangladesh.

Height and weight for age and height and weight velocity are examined in a sample of Bangladeshi adolescents aged 10-20 years with an average age at menarche of 15.8 years. Interpopulation differences between pre- and postmenarcheal girls are assessed and age patterns are compared to standards of U.S. and British adolescents. Bangladeshi adolescents are shorter and lighter for their age and lighter for their height than are U.S. adolescents. The growth spurt in height and weight is delayed and spread out over time, and growth rates are lower throughout the spurt when compared to British and U.S. girls. As in developed countries, most girls attain menarche after peak height velocity, while weight gain per year is highest around the time of menarche. There is no significant relationship between age at menarche and height or weight at menarche.