The importance of "time to surgery" in the management of lumbar disc herniation in patients without progressive neurological deficits.

Background: Prolonged sciatica symptoms may result in disability and consequently, absence from work for a longer period. Up to 10% of patients may need surgery but it is difficult to predict and determine which of these patients would improve spontaneously in comparison to those who might benefit from discectomy surgery. We aimed to determine if delay in the "time to surgery" (TTS) has any adverse effects on the patient reported outcome measures (PROMs). Methods: Eighty-seven patients after exclusions were selected consecutively. PROMs were comprised of pre-operative, six weeks and six months post-operative back and leg pain visual analogue scores (VAS) and Oswestry disability index (ODI). The differences between these scores were correlated with TTS. Minimal clinically important difference (MCID) of 30% improvement for ODI scores and 33% for VAS scores from baseline were considered as significant improvement. Patients were grouped into TTS less than 6 months and TTS greater than 6 months from referral to TTS. The longest TTS was 18 months. Statistical analysis was done using JASP (Version 0.14.0) [computer software]. Results: The TTS was on average 22.5 weeks. MCID for the leg pain VAS was achieved in 90.2% patients with TTS <6 months and in 80.8% with TTS ≥6 months. The MCID for ODI was achieved in 60.7% with TTS <6 months and in 42.0% with TTS ≥6 months. The MCID for back pain VAS was achieved in 73.8% with TTS <6 months and in 50.0% of patients with TTS ≥6 months. Those who achieved the MCID in ODI score between the two groups were analysed using chi-square test with P=0.115. Those who achieved the MCID in VAS leg pain score between the two groups were analysed using chi-square test with P=0.227. No statistical difference was found in ODI and VAS for leg for patients with TTS before or after 6 months. Conclusions: Lumbar discectomies had a positive impact on patient's pain and function in our local district hospital. Delayed surgery of ≥6 months did not cause statistically significant worse outcomes. In the absence of worsening neurological deficit, it may be the wrong approach to define a value for the TTS.

Wind Speed and Landscape Context Mediate Campylobacter Risk among Poultry Reared in Open Environments.

Foodborne pathogens cause over 9 million illnesses in the United States each year, and Campylobacter from chickens is the largest contributor. Rearing poultry outdoors without the use of antibiotics is becoming an increasingly popular style of farming; however, little is understood about how environmental factors and farm management alter pathogen prevalence. Our survey of 27 farms in California, Oregon, Washington, and Idaho, USA, revealed a diversity of management practices used to rear poultry in the open environment. Here, we assess environmental and management factors that impact Campylobacter spp. prevalence in 962 individual chicken fecal samples from 62 flocks over a three-year period. We detected Campylobacter spp. in 250/962 (26.0%) of fecal samples screened, in 69.4% (43/62) of flocks, and on 85.2% (23/27) of farms. We found that Campylobacter spp. prevalence was predicted to increase in poultry on farms with higher average wind speeds in the seven days preceding sampling; on farms embedded in more agricultural landscapes; and in flocks typified by younger birds, more rotations, higher flock densities, and the production of broilers. Collectively, our results suggest that farms in areas with higher wind speeds and more surrounding agriculture face greater risk of Campylobacter spp. introduction into their flocks.

Prevalence Patterns for Enteric Parasites of Chickens Managed in Open Environments of the Western United States.

Growing demand for poultry meat and eggs labeled as organic, cage free, or pasture raised has increased the number of producers that manage chickens outdoors. In these open environments, there are likely diverse enteric parasites sustained by fecal-oral transmission or passage through intermediate invertebrate hosts (e.g., worms and insects) that chickens consume. Enteric parasites can reduce chicken health and productivity, but there are few published data describing the identities or prevalence of these parasites on farms that use open environments in the United States. We surveyed 27 poultry farms with open environments that were situated across a wide geographic range, including California, Oregon, Idaho, and Washington. These farms did not use anticoccidial drugs, coccidia vaccines, or parasiticides. Flock size, enclosure area, flock density, flock rotation frequency, and average flock age were highly correlated for all the farms in this study. We analyzed how enclosure size and flock rotations per year (which represented two axes of variation in management) correlated with prevalence of five observed parasite taxa at the farm level. Across all flocks, we detected by fecal flotation Eimeria spp. (95% flocks), Ascaridia galli (69%), Heterakis gallinarum (52%), Capillaria spp. (39%), Strongyloides avium (13%), tapeworm species (29%), Cryptosporidium spp. (3%), and Dispharynx nasuta (1%). Eighty-five percent of samples were coinfected with two or more parasite taxa. Sixty-seven percent of farms raised only layer chicken breeds, 4% raised only broiler breeds, and 30% raised both layer and broiler breeds. The average age of the broiler flocks was 11.0 wk (±1.1 SE), and flocks were moved 54.7 (±17.9) times annually to new locations in pastures (hereafter, "rotation"). Layer flocks averaged 84.9 (±7.67) wk of age and were moved less often on farms being rotated 20.0 (±6.05) times per year. Generalized linear mixed models indicated that for every 1 m2 increase in enclosure size, the odds of detecting Eimeria spp. increased by 0.03%. Furthermore, for every additional rotation per year, the odds of detecting A. galli decreased by 1.3%. For every additional rotation per year, the odds of detecting tapeworm species increased by 2.2%. We found no evidence that flock spatial management affected prevalence of the other parasites observed on the farms. Farming practices and parasite responses in these systems are highly varied, which makes it difficult to identify potential management interventions for reducing these infections.

Patrones de prevalencia de parásitos entéricos de pollos manejados en ambientes abiertos en el oeste de los Estados Unidos. La creciente demanda de carne de pollo y huevos etiquetados como orgánicos, sin jaula o criados en pastoreo ha aumentado el número de productores que manejan pollos al aire libre. En estos entornos abiertos, es probable que existan diversos parásitos entéricos que permanecen debido a la transmisión fecal-oral o por su paso a través de huéspedes invertebrados intermedios (por ejemplo, gusanos e insectos) que son consumidos por los pollos. Los parásitos entéricos pueden reducir la salud y la productividad de los pollos, pero existe poca información publicada que describa las identidades o la prevalencia de estos parásitos en granjas que utilizan entornos abiertos en los Estados Unidos. Se realizó una encuesta incluyendo 27 granjas avícolas con entornos abiertos que estaban situadas en un amplio rango geográfico, incluyendo California, Oregón, Idaho y Washington. Estas granjas no usaban medicamentos anticoccidiales, vacunas contra coccidias ni parasiticidas. El tamaño de la parvada, el área de pastoreo, la densidad de la parvada, la frecuencia de rotación de la parvada y la edad promedio de la parvada estuvieron altamente correlacionados para todas las granjas en este estudio. Se analizó cómo el tamaño del recinto y las rotaciones de parvadas por año (que representaban dos ejes de variación en el manejo) se correlacionaban con la prevalencia de cinco taxones de parásitos observados a nivel de granja. En todas las parvadas, se detectó por flotación fecal Eimeria spp. (95% de las parvadas), Ascaridia galli (69%), Heterakis gallinarum (52%), Capillaria spp. (39%), Strongyloides avium (13%), especies de nemátodos planos (29%), Cryptosporidium spp. (3%) y Dispharynx nasuta (1%). El ochenta y cinco por ciento de las muestras estaban coinfectadas con dos o más taxones de parásitos. El sesenta y siete por ciento de las granjas criaban solo razas de gallinas de postura, el 4% solo criaban razas de pollos de engorde y el 30% criaban razas de gallinas de postura y de pollos de engorde. La edad promedio de las parvadas de pollos de engorde fue de 11.0 semanas (±1.1 SE) y las parvadas se trasladaron 54.7 (±17.9) veces al año a nuevas ubicaciones en los pastos (en adelante, "rotación"). Las parvadas ponedoras promediaron 84.9 (± 7.67) semanas de edad y se trasladaron con menos frecuencia en granjas que se rotaron 20.0 (± 6.05) veces al año. Los modelos lineales mixtos generalizados indicaron que por cada aumento de un metro cuadrado en el tamaño del área de pastoreo, las probabilidades de detectar Eimeria spp. se incrementaron en un 0.03%. Además, por cada rotación adicional por año, las probabilidades de detectar A. galli disminuyeron en un 1.3%. Por cada rotación adicional por año, las probabilidades de detectar especies de tenia aumentaron en un 2.2%. No encontramos evidencia de que el manejo del espacio de la parvada afectara la prevalencia de los otros parásitos observados en las granjas. Las prácticas agrícolas y las respuestas de los parásitos en estos sistemas son muy variadas, lo que dificulta la identificación de posibles intervenciones de manejo para reducir estas infecciones.

A trait-based framework for predicting foodborne pathogen risk from wild birds.

Recent foodborne illness outbreaks have heightened pressures on growers to deter wildlife from farms, jeopardizing conservation efforts. However, it remains unclear which species, particularly birds, pose the greatest risk to food safety. Using >11,000 pathogen tests and 1565 bird surveys covering 139 bird species from across the western United States, we examined the importance of 11 traits in mediating wild bird risk to food safety. We tested whether traits associated with pathogen exposure (e.g., habitat associations, movement, and foraging strategy) and pace-of-life (clutch size and generation length) mediated foodborne pathogen prevalence and proclivities to enter farm fields and defecate on crops. Campylobacter spp. were the most prevalent enteric pathogen (8.0%), while Salmonella and Shiga-toxin producing Escherichia coli (STEC) were rare (0.46% and 0.22% prevalence, respectively). We found that several traits related to pathogen exposure predicted pathogen prevalence. Specifically, Campylobacter and STEC-associated virulence genes were more often detected in species associated with cattle feedlots and bird feeders, respectively. Campylobacter was also more prevalent in species that consumed plants and had longer generation lengths. We found that species associated with feedlots were more likely to enter fields and defecate on crops. Our results indicated that canopy-foraging insectivores were less likely to deposit foodborne pathogens on crops, suggesting growers may be able to promote pest-eating birds and birds of conservation concern (e.g., via nest boxes) without necessarily compromising food safety. As such, promoting insectivorous birds may represent a win-win-win for bird conservation, crop production, and food safety. Collectively, our results suggest that separating crop production from livestock farming may be the best way to lower food safety risks from birds. More broadly, our trait-based framework suggests a path forward for co-managing wildlife conservation and food safety risks in farmlands by providing a strategy for holistically evaluating the food safety risks of wild animals, including under-studied species.

Evaluating the benefits of a rapport-based approach to investigative interviews: A training study with law enforcement investigators.

Objective: The purpose of this study was to test the effectiveness of a rapport-based approach to interviewing that includes productive questioning skills, conversational rapport, and relational rapport-building tactics. Hypotheses: We predicted that training police investigators in a rapport-based approach would significantly increase the use of rapport-based tactics and that such tactics would directly influence the interviewee's perceptions of rapport and indirectly lead to increased cooperation and disclosure of information. Method: We trained federal, state, and local law enforcement investigators (N = 67) in the use of evidence-based interviewing techniques. Both before and after this training, investigators interviewed semi cooperative subjects (N = 125). Interviews were coded for the use of various interview tactics, as well as subjects' disclosure. Participants also completed a questionnaire regarding their perceptions of the interviewer and their decision to cooperate with the interviewer. Results: Evaluations of the training were positive, with high ratings of learning, preparedness to use tactics, and likelihood of use following the training. In posttraining interviews, investigators significantly increased their use of evidence-based tactics, including productive questioning, conversational rapport, and relational rapport-building tactics. Structural equation modeling demonstrated that investigators' use of the evidence-based interview tactics was directly associated with increased perceptions of rapport and trust and indirectly associated with increased cooperation and information disclosure. Conclusions: We demonstrated that rapport-based interview tactics could be successfully trained and that using such tactics can facilitate perceptions of rapport and trust, reduce individuals' resistance to cooperate, and increase information yield. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Landscape context affects the sustainability of organic farming systems.

Organic agriculture promotes sustainability compared to conventional agriculture. However, the multifunctional sustainability benefits of organic farms might be mediated by landscape context. Assessing how landscape context affects sustainability may aid in targeting organic production to landscapes that promote high biodiversity, crop yields, and profitability. We addressed this using a meta-analysis spanning 60 crop types on six continents that assessed whether landscape context affected biodiversity, yield, and profitability of organic vs. conventional agroecosystems. We considered landscape metrics reflecting landscape composition (percent cropland), compositional heterogeneity (number and diversity of cover types), and configurational heterogeneity (spatial arrangement of cover types) across our study systems. Organic sites had greater biodiversity (34%) and profits (50%) than conventional sites, despite lower yields (18%). Biodiversity gains increased as average crop field size in the landscape increased, suggesting organic farms provide a "refuge" in intensive landscapes. In contrast, as crop field size increased, yield gaps between organic and conventional farms increased and profitability benefits of organic farming decreased. Profitability of organic systems, which we were only able to measure for studies conducted in the United States, varied across landscapes in conjunction with production costs and price premiums, suggesting socioeconomic factors mediated profitability. Our results show biodiversity benefits of organic farming respond differently to landscape context compared to yield and profitability benefits, suggesting these sustainability metrics are decoupled. More broadly, our results show that the ecological, but not the economic, sustainability benefits of organic agriculture are most pronounced in more intensive agricultural landscapes.

Dung beetle-mediated soil modification: a data set for analyzing the effects of a recent introduction on soil quality.

Globally, dung beetles (Scarabaeidae: Scarabaeinae) are linked to many critical ecosystem processes involving the consumption and breakdown of mammal dung. Due to New Zealand's unique evolutionary history, resulting from its geographic isolation from Gondwana, endemic dung-dwelling fauna evolved in the absence of large mammals. Europeans introduced livestock to the islands in the late 18th and 19th centuries, resulting in a buildup of undecomposed feces and unrecycled nutrients due to the absence of dung beetles. To mitigate this situation, in 2011, the New Zealand Environmental Protection Agency approved the release of 11 species of exotic beetles with the expectation that these insects would fulfill a critically missing link in converting aboveground manure biomass into higher quality soils belowground. Widespread releases began in 2014. To enable others in the future to test the environmental impacts of the beetle introductions, we present a detailed characterization of soil physical, chemical, and biological properties, shortly after the initial and intentional introduction of dung beetles to 16 release sites across both the North and South Islands of New Zealand. As beetle populations become established, these baseline data will enable quantification of the degree to which different exotic dung beetle communities can modify soils, specifically if they facilitate soil nutrient cycling. There are no copyright or proprietary restrictions for research or teaching purposes. Usage of the data set must be cited by referencing this publication.

Coprophagous Insects and the Ecology of Infectious Diseases of Wildlife.

A diversity of macro- and microparasitic species exert strong influences on wildlife population density, community structure, and ecosystem functioning, all through their impacts on individual host fitness. Through consuming, manipulating, and relocating wildlife feces, over 7,000 species of coprophagous dung beetles interact with a staggering diversity of wildlife parasites with fecal-oral transmission in ways that both increase and decrease transmission. Here, we review the mechanisms by which dung beetles influence micro- and macroparasite transmission and outline a future research framework that integrates theory and empirical insights to advance our understanding of how these relationships may interact with ongoing environmental change drivers to further influence wildlife populations and community structure. Any organism that significantly influences parasite transmission will impact multiple levels of biological organization. Therefore, improving our understanding of the role of dung beetle interactions within disease ecology will be key to future efforts to understand the overall dynamics of infection in wildlife and how parasites contribute to the maintenance of ecosystem structure and function and evolutionary processes in wild animals.

Predator- and Scavenger-Mediated Ecosystem Services Determined by Distance to Field-Forest Interface in the Maine Lowbush Blueberry Agroecosystem.

Predators and scavengers play a vital role in regulating insect pests, weeds, and vertebrate scat in perennial agroecosystems. Understanding how farm management practices and surrounding habitat influence these beneficial ecosystem services contributes to our understanding of these complex ecological systems and guides future management decisions. In a mensurative 2-yr study, we determined how different pest management strategies and surrounding forest composition influenced levels of sentinel insect pupae, weed seeds, and deer scat (feces) removal. Removal of these bioresources was measured within 12 commercial lowbush blueberry fields during 2011 and 2012; farms differed in surrounding landscape composition and farm management strategies. Both the removal of sentinel pupae and scat, was significantly higher within field interiors than at field edges and within adjacent forests. Additionally, farm management strategy interacted with field position to result in significantly higher scat removal in conventional field interiors than organic field interiors. Surrounding forest composition had variable effects on removal of materials. Our results indicate higher levels of activity within field centers as opposed to field edges; this is contrary to what has been observed in other perennial cropping agroecosystems.

Suppression of Escherichia coli O157:H7 by Dung Beetles (Coleoptera: Scarabaeidae) using the lowbush blueberry agroecosystem as a model system.

Wildlife as a source of microbial contamination is a food safety concern. Deer feces (scat) have been determined as a point source for Escherichia coli O157:H7 contamination of fresh produce. The ecological role of the scooped scarab (Onthophagus hecate (Panzer)), a generalist dung beetle species common in Maine blueberry fields, was explored as a biological control agent and alternatively as a pathogen vector between deer scat and food. A large-scale field survey of wildlife scat indicated that pathogenic E. coli O157:H7 was present, albeit at a low prevalence (1.9% of samples, n = 318), in the Maine lowbush blueberry agroecosystem. A manipulative field experiment verified that, should contact occur between deer scat and blueberry plants and fruit during the summer, contamination with E. coli O157:H7 can occur and persist for more than 72 h. For both the positive control and an experimental scat inoculation treatment, the levels of the bacterial population decreased over time, but at different rates (treatment x time interaction: F (1.9,18.8) = 358.486, P < 0.0001). The positive control inoculation, which resulted in a higher initial E. coli level on fruit, decayed at a faster rate than inoculation of fruit via scat in the experimental treatment. We conducted 2 laboratory studies to elucidate aspects of dung beetle feeding ecology as it relates to suppression of E. coli O157:H7 from deer scat to lowbush blueberry fruit. In both experiments, dung beetles buried the same amount of scat whether or not the scat was inoculated with the pathogen (F(1,6) = 0.001; P = 0.999 and (F (2,17) = 4.10, P = 0.147). Beetles feeding on E. coli inoculated deer scat were not found to vector the pathogen to fruit. In two studies, beetles lowered the amount of pathogenic E. coli persisting in soils compared to soils without beetles (F (2,9) = 7.757; P = 0.05 and F (2,17) = 8.0621, P = 0.004). Our study suggests that the dung beetle species, Onthophagus hecate, has the potential to contribute to the suppression of E. coli O157:H7 in agricultural landscapes.

VGKC complex antibodies in epilepsy: diagnostic yield and therapeutic implications.

PURPOSE: In a significant number of patients developing epilepsy in adult life, the aetiology of their seizures remains unclear. Antibodies directed against the voltage gated potassium channel complex (VGKC Ab) have been identified in various cohorts of patients with epilepsy, although the role of these antibodies in epilepsy pathogenesis is not fully known. METHOD: We reviewed the notes of 144 patients with unexplained adult onset epilepsy who had been tested for VGKC Abs. We collected data on their clinical syndrome, investigation results and response to treatment. RESULTS: We identified 6 (4.2%) patients who had titres of >400 pM. One of the six patients was positive for LGI1 and another for CASPR2 subunit antibodies. All patients were given immunotherapy and experienced improvement in seizure control. No patient had the clinical syndrome of limbic encephalitis. CONCLUSION: Patients with otherwise unexplained epilepsy and positive VGKC Abs are a heterogeneous group. In our cohort there was an overall favourable response to immunotherapy but further prospective studies are needed to determine the significance of these antibodies and the optimum treatment regimen for patients.

Brain inflammation is induced by co-morbidities and risk factors for stroke.

Chronic systemic inflammatory conditions, such as atherosclerosis, diabetes and obesity are associated with increased risk of stroke, which suggests that systemic inflammation may contribute to the development of stroke in humans. The hypothesis that systemic inflammation may induce brain pathology can be tested in animals, and this was the key objective of the present study. First, we assessed inflammatory changes in the brain in rodent models of chronic, systemic inflammation. PET imaging revealed increased microglia activation in the brain of JCR-LA (corpulent) rats, which develop atherosclerosis and obesity, compared to the control lean strain. Immunostaining against Iba1 confirmed reactive microgliosis in these animals. An atherogenic diet in apolipoprotein E knock-out (ApoE(-/-)) mice induced microglial activation in the brain parenchyma within 8 weeks and increased expression of vascular adhesion molecules. Focal lipid deposition and neuroinflammation in periventricular and cortical areas and profound recruitment of activated myeloid phagocytes, T cells and granulocytes into the choroid plexus were also observed. In a small, preliminary study, patients at risk of stroke (multiple risk factors for stroke, with chronically elevated C-reactive protein, but negative MRI for brain pathology) exhibited increased inflammation in the brain, as indicated by PET imaging. These findings show that brain inflammation occurs in animals, and tentatively in humans, harbouring risk factors for stroke associated with elevated systemic inflammation. Thus a "primed" inflammatory environment in the brain may exist in individuals at risk of stroke and this can be adequately recapitulated in appropriate co-morbid animal models.