Geospatial mapping can be used to identify geographic areas and social factors associated with intentional injury as targets for prevention efforts distinct to a given community.

BACKGROUND: Geographic information systems (GIS) have proven effective in studying intentional injury in various communities; however, GIS is not implemented widely for use by Level I trauma centers in understanding patient populations. Our study of intentional injury combines the capabilities of GIS with a Level I trauma center registry to determine the spatial distribution of victims and correlated socioeconomic factors. METHODS: One thousand ninety-nine of 3,109 total incidents of intentional trauma in the trauma registry from 2005 to 2015 had sufficient street address information to be mapped in GIS. Comparison of these data, coupled with demographic data at the block group level, determined if any clustering or spatial patterns existed. Geographic information systems delivered these comparisons using several spatial statistics including kernel density, ordinary least squares test, and Moran's index. RESULTS: Kernel density analysis identified four major areas with significant clustering of incidents. The Moran's I value was 0.0318. Clustering exhibited a positive z-score and significant p value (p < 0.01). Examination of socioeconomic factors by spatial correlation with the distribution of intentional injury incidents identified three significant factors: unemployment, single-parent households, and lack of a high school degree. Tested factors did not exhibit substantial redundancy (variance inflation factor < 7.5). Nonsignificant tested factors included race, proximity to liquor stores and bars, median household income, per capita income, rate with public assistance, and population density. CONCLUSION: Spatial representation of trauma registry data using GIS effectively identifies high-risk areas for intentional injury. Analysis of local socioeconomic data identifies factors unique to those high-risk areas in the observed community. Implications of this study may include the routine use of GIS by Level I trauma centers in assessing intentional injury in a given community, the use of that data to guide the development of trauma prevention, and the assessment of other mechanisms of trauma using GIS. LEVEL OF EVIDENCE: Epidemiological, level IV.

Total and water-soluble phosphorus in broiler litter over three flocks with alum litter treatment and dietary inclusion of high available phosphorus corn and phytase supplementation.

Three pen trials were conducted to determine the main effect of alum addition to litter on form of poultry litter P using a 2 x 2 factorial structure of the subunit treatments: diets including high available phosphorus/low phytate corn (HAPC) and phytase (PHYT). Male broilers (1,760 per flock) were grown to 42 d having starter diets with 0.45% available P and grower diets with 0.35% available P. In the first trial, total litter P (tP) was greatest for the yellow dent corn (YDC) diet (12 g/kg) and least for the HAPC and PHYT combination (H&P) diet (6.9 g/kg) with the individual PHYT and HAPC diets falling in between at 9.1 g/kg and 9.4 g/kg tP. Also in the first trial, the litter water-soluble P (wP) was highest for PHYT (2.8 g/kg), least for the HAPC and H&P diets (1.5 g/kg) with the YDC diet falling between (2.2 g/kg). Alum was added to the litter after the first experiment. In the second and third experiments, alum inclusion significantly reduced the wP when compared with the treatments with no alum. In the third trial, the least wP was present in the alum-HAPC treatment. Phytase, YDC, and HAPC diets with no alum litter treatment generated the most wP. Since these diets appear to have little or no difference with respect to quantity of wP, this work suggests that form of litter P generated by alternative diets should be considered as criteria when attempting to reduce P in broiler litter applied to land.

The effects of high-air velocity on broiler performance.

Two trials using a total of 1,484 Ross male broilers were conducted to study the effect of air velocities of 180 and 120 m/min versus still air (<15 m/min) on BW gain (BWG) and feed:gain from 3 to 7 wk of age. Broilers were raised in a common environment to 3 wk of age. The experimental facility was a closed sided house containing eight wind tunnel floor pens and six floor pens. There were two wind tunnels (four pens/tunnel) used to test air velocities of 180 or 120 m/min. At 3 wk of age, 53 birds were placed in pens on litter in each of two wind tunnels (four pens/tunnel) or on litter in floor pens (six pens) in an environmentally controlled facility. All floor pens contained 3.75 square meters of floor space, one tube feeder, and one trough waterer. The temperature regimen was a diurnal cycle of 25-30-25 C with 23 C dewpoint. Air velocities of 180 and 120 m/min had no significant effect on BWG or feed:gain during the first week (3 to 4 wk) in the tunnels as compared with the still air. However, significant improvements were noted in BWG and feed:gains for increased air velocities from 4 to 5 and 5 to 6 wk of age. During the last week (6 to 7), an air velocity of 180 m/min significantly improved BWG and feed:gain, as compared with the 120 m/min or the still air.

MHC class I chain-like gene A (MICA) and its associations with inflammatory bowel disease and peripheral arthropathy.

MHC class I chain gene A (MICA) is a non-classical Class I gene which is expressed on the surface of epithelia without beta 2-microglobulin. The gene is found in the major histocompatibility complex (MHC) in tight linkage disequilibrium with human leucocyte antigen-B (HLA-B). Its precise function is unknown, but it interacts with gamma delta T cells of the intestinal immune system. This region of the MHC has been implicated in inflammatory bowel disease (IBD) pathogenesis by recent association mapping studies and this study was performed to examine the prevalence of MICA gene polymorphisms in IBD, in particular in type 2 peripheral arthropathy (PeA), which also has a strong HLA-B association. An assessment of the prevalence of MICA polymorphisms in IBD was made. Blood from 50 ulcerative colitis (UC) and 50 Crohn's disease controls was taken and MICA status determined using allele-specific PCR for 16 known alleles of MICA. A further 91 UC patients were recruited to confirm the results of this stage, and then the polymorphisms were studied in 52 type 1 and 45 type 2 PeA patients. The MICA status of these groups was compared with 118 blood and organ donor controls with appropriate correction for multiple comparisons. UC overall was associated with possession of MICA*007 in 32% compared to 11% of controls (P(c) = 0.017). This association was confirmed in a second cohort of 91 patients (23% versus 11%, P = 0.02). These were independent of HLA class I status. Type 2 IBD PeA was associated with MICA*008 in 98% compared to 73% of controls (P = 0.0001). MICA*007 is associated with susceptibility to UC in our population and MICA*008 with type 2 IBD PeA. Further work is now required to assess the distribution and expression of MICA throughout the gut in health and disease.

Clinical utility of intraatrial pacemaker stored electrograms to diagnose atrial fibrillation and flutter.

The purpose of this study was to determine if intraatrial electrograms (EGMs) are required to diagnose specific types of atrial tachyarrhythmias detected by pacemaker diagnostics. DDD pacemakers in 56 patients were programmed to store episodes of atrial tachyarrhythmias. Some episodes had a stored atrial EGM snapshot of the atrial tachyarrhythmia. The EGMs were analyzed to confirm whether the stored episodes were true atrial tachyarrhythmias or other pacemaker-sensed events. EGM confirmation of atrial tachyarrhythmias correlated with increasing duration and rate of episodes. In particular, using EGMs, 8 (18%) of 44 episodes < 10 seconds in duration confirmed atrial tachyarrhythmias compared to 16 (89%) of 18 episodes > 5 minutes in duration (P < 0.001). Only 10 (18%) of 56 detected atrial arrhythmia episodes at rates < 250 complexes per minute were confirmed by the atrial EGM as true arrhythmias compared to 33 (57%) of 58 detected episodes at rates > 250/min (P < 0.001) Twenty-nine (91%) of 32 EGM confirmed episodes of atrial fibrillation/flutter had an atrial rate > 250 complexes per minute and were a minimum of 10 seconds in duration. Fifteen (88%) of 17 episodes meeting the combined stored data criteria of > 250 complexes per minute and duration > 5 minutes were confirmed as atrial fibrillation or flutter by stored EGMs. Atrial EGMs identified that 71 (62%) of 114 stored high atrial rate (HAR) episodes were events other than true atrial tachyarrhythmias. Pacemaker diagnostic data with intraatrial EGMs can diagnose specific atrial tachyarrhythmias and identify other pacemaker-sensed events. Stored episodes > 250 complexes per minute and > 5 minutes in duration had a high correlation with atrial fibrillation and flutter.

The effect of nipple height on broiler performance.

Two trials, using a total of 3,200 male broilers, were conducted to compare the effects of a trough drinker versus three different heights on a nipple drinker system on body weight gain and feed:gain. The broilers were housed in temperature-controlled litter pens at 25 or 30 C. An 8-ft open trough was used. The nipple drinker heights were adjusted as 1) low (no neck stretch and drink from the side of the beak), 2) medium (stretch neck and drink from the end of the beak), and 3) high (first elevate breast, then stretch neck and drink from the end of the beak) positions. The nipple heights were adjusted twice weekly by visual inspection. The open drinker produced the heaviest birds. No significant treatment differences were observed for feed:gain at 25 C but increased numerically with increasing nipple height. This same pattern was evident at 30 C, but statistically significant differences did occur. Drinking from a nipple drinker is an unnatural drinking act for birds, and the greater the neck extension, especially during a panting situation, the more detrimental the effect on both body weight and feed:gain.

The effect of air velocity on broiler performance and feed and water consumption.

Two trials were conducted to determine the effect of air velocity on feed and water consumption at a constant temperature of 27 C and a daily cyclic temperature of 22-32-22 C. Air velocity over the broilers was <15 or 120 m/min. These temperature and air velocity treatments were arranged in a 2 x 2 factorial design in eight environmental chambers, with two replications of each treatment. The air velocity treatments were applied, and total feed and water consumption and daily patterns of consumption were determined for broilers from 21 to 49 d of age. Broilers exposed to the high air velocity consumed less water and more feed, gained more weight, and had an improved feed:gain ratio. The high air velocity had little effect on daily patterns of feed and water consumption. Both feed and water consumption were depressed during the peak of the daily cyclic temperature.

Vitamin D receptor gene polymorphism: association with Crohn's disease susceptibility.

BACKGROUND: The vitamin D receptor (VDR) gene represents a strong positional candidate susceptibility gene for inflammatory bowel disease (IBD). The VDR gene maps to a region on chromosome 12 that has been shown to be linked to IBD by genome screening techniques. It is the cellular receptor for 1,25(OH)(2) vitamin D(3) (calcitriol) which has a wide range of different regulatory effects on the immune system. IBD is characterised by activation of the mucosal immune system. AIM: To determine if polymorphisms in the VDR gene are associated with susceptibility to IBD SUBJECTS: European Caucasoids: 158 patients with ulcerative colitis, 245 with Crohn's disease, and 164 cadaveric renal allograft donor controls. METHOD: Single nucleotide polymorphisms (TaqI, ApaI, and FokI) in VDR were typed in patients with Crohn's disease, ulcerative colitis, and controls by polymerase chain reaction with sequence specific primers. RESULTS: There were significantly more homozygotes for the TaqI polymorphism at codon 352 of exon 8 (genotype "tt") among patients with Crohn's disease (frequency 0.22) than patients with ulcerative colitis (0.12) or controls (0.12) (odds ratio 1.99; 95% confidence interval 1.14-3.47; p=0.017). CONCLUSION: This study provides preliminary evidence for a genetic association between Crohn's disease susceptibility and a gene that lies within one of the candidate regions determined by linkage analysis.

Spontaneous regression of a pituitary cyst.

We present a pituitary cyst discovered on MRI in an amenorrheic patient that regressed over months. Although the precise etiology of the cyst is unproven, documentation of pituitary cyst regression has not to our knowledge been described previously.

The effect of environmental temperature and body weight on growth rate and feed:gain of male broilers.

High environmental temperatures are detrimental to the growth and feed:gain of broilers. The objective of this research was to determine the effects of incremental differences in environmental temperature on growth and feed:gain. The data are needed for decisions about the profitability of energy inputs when managing the housing environment. In Trial 1, broiler chicks were reared as a group to 21 d on litter with constant lighting and with water and feed available for ad libitum consumption. They were then moved to 10 environmental chambers. Each chamber was set at a different temperature ranging from 21.1 C to 31.1 C in 1.11 C increments. Weight gain and feed:gain were determined when the broilers were 28, 35, and 42 d old. In Trials 2 and 3, broilers were placed in the environmental chambers, and weight gain and feed:gain were determined for the 42 to 49 d period. The data were analyzed statistically, and regression equations were obtained for growth and feed:gain. Equations were based on body weight and temperature, and the body weight equation was plotted as grams gain per bird per day. Feed:gain was plotted for that body weight and temperature. Body weight gain per day increased to a maximum with increasing weight and then declined. The body weight at the maximum rate of gain was inversely related to temperature. Feed:gain increased as body weight increased. Feed:gain was directly related to temperature at weights above 800 g and the effect of temperature increased as body weight increased. The data will be useful for the evaluation of various management scenarios to determine the inputs that are profitable.

Air velocity and high temperature effects on broiler performance.

Three trials, using a total of 1,320 male broilers, were conducted to study the effect of air velocity at 125 m/min on body weight gain and feed: gain. The broilers were placed on litter in pens in a wind tunnel or on litter in floor pens with conventional cross ventilation when 4 wk old. Except for air velocity, the conditions in the floor pens and the tunnel were the same. In Trials 1 and 2, only nipple waterers were used. In Trial 3, one-half of the pens on the floor and one-half of the pens in the tunnel were equipped with trough waterers; the remaining pens were equipped with nipple waterers. When compared with conventional ventilation, tunnel rearing improved body weight gain and feed:gain in all three trials. In Trial 3, waterer type did not significantly affect body weight gain or feed:gain in the tunnel. However, body weight gain and feed:gain were reduced in floor-reared birds using nipple waterers as compared with birds using trough waterers. The increased panting of the conventionally ventilated birds, as compared with the tunnel-ventilated birds, may have contributed to their decreased body weight gain and improved feed:gain. The lower body weights may occur because of the difficulty the birds experience when drinking from nipples while panting.

Water consumption by broilers in high cyclic temperatures: bell versus nipple waterers.

Broilers were maintained on litter in environmental chambers to study water consumption from bell and nipple waterers. The chambers were set at high cyclic temperatures of either 24-35-24 C or 24-32-24 C daily cycles in three trials. Water consumption was recorded by computer each 30 min and calculated as a percentage of body weight. Daily water consumption from nipples was always less than from bell waterers. Water consumption by quarter-day revealed that consumption from nipples was often similar to that from bell waterers during the lowest temperatures but was less during the periods of highest temperatures. Further study revealed that water consumption from nipple waterers was related to the height of the nipples such that consumption was greater for lower nipples. The results suggest that panting broilers have difficulty drinking from high nipple waterers.

Hypertension-related morbidity and mortality in the southeastern United States.

Stroke mortality is higher in the Southeast compared with other regions of the United States. The prevalence of hypertension is also higher (black men = 35%, black women = 37.7%, white men = 26.5%, white women = 21.5%), and the proportion of patients whose hypertension is being controlled is poor, especially in white and black men. The prevalence of hypertension-related complications other than stroke is also higher in the Southeast. The five states with the highest death rates for congestive heart failure are all in the southern region. Of the 15 states with the highest rates of end-stage renal disease, 10 are in the Southeast. Obesity is very prevalent (24% to 28%) in the Southeast. Although Michigan tops the ranking for all states, 6 of the top 15 states are in the Southeast, as are 7 of the 10 states with the highest reported prevalence regarding no leisure-time physical activity. Similar to other areas of the United States, dietary sodium and saturated fat intake are high in the Southeast; dietary potassium intake appears to be relatively low. Other factors that may be associated with the high prevalence, poor control, and excess morbidity and mortality of hypertension-related complications in the Southeast include misperceptions of the seriousness of the problem, the severity of the hypertension, lack of adequate follow-up, reduced access to health care, the cost of treatment, and possibly, low birth weights. The Consortium of Southeastern Hypertension Control (COSEHC) is a nonprofit organization created in 1992 in response to a compelling need to improve the disproportionate hypertension-related morbidity and mortality throughout this region. The purpose of this position paper is to summarize the data that document the problem, the consequences, and possible causative factors.

The effect of brooding temperature on broiler performance.

In response to the energy crisis of the 1970s, this laboratory recommended that initial brooding temperatures for broilers be reduced to 29.4 C from 32.2 or 35 C. Because environmental temperature has been implicated in the ascites syndrome, this work was conducted to see whether the recommended brooding temperature of 29.4 C the 1st wk, 26.7 C the 2nd wk, and 23.9 C the 3rd wk would be satisfactory for broiler production when compared with higher brooding temperature regimens starting at 32.2 or 35 C. Brooding chicks at a temperature of 29.4 C the 1st wk, 26.7 C the 2nd wk, and 23.9 C the 3rd wk did not adversely affect broiler performance at 6 wk of age, when compared with higher brooding temperature regimens. Under the conditions of this experiment, brooding chicks at a temperature of 29.4 C the 1st wk, 26.7 C the 2nd wk, and 23.9 C the 3rd wk was satisfactory when compared with the higher temperature brooding regimens. Mortality due to ascites and total mortality significantly increased for broilers brooded in the negative control temperature regimen of 26.7 C the 1st wk, 23.9 C the 2nd wk, and 21.1 C when compared with some or all of the higher brooding temperature regimens. Heat loss calculations based on a commercial setting show an 18% savings in liquified petroleum (LP) gas usage for chicks brooded at 29.4 vs 35 C and a savings of 10% in LP gas usage for chicks brooded at 29.4 vs 32.2 C on a winter day.

Research note: Mycoplasma gallisepticum isolations resulting from dry versus wet swabs.

Commercial Leghorns vaccinated with F strain Mycoplasma gallisepticum were used to determine the effect of hydration of swab material with Frey's broth media on M. gallisepticum isolation. Twenty-four hens from each of four 10,000 bird houses were randomly selected and swabbed from the choanal cleft region. Twelve birds from each house were swabbed with ethylene-oxide-sterilized, 2.4-mm diameter rayon-tipped swabs, and 12 hens were swabbed with the same type swabs wetted with sterile Frey's broth media. Results of the present study demonstrate that wetting of the swab prior to swabbing does not affect the recovery of M. gallisepticum from commercial layers.