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1.
Proc Natl Acad Sci U S A ; 121(13): e2311127121, 2024 Mar 26.
Article in English | MEDLINE | ID: mdl-38507447

ABSTRACT

Microbiota comprise the bulk of life's diversity, yet we know little about how populations of microbes accumulate adaptive diversity across natural landscapes. Adaptation to stressful soil conditions in plants provides seminal examples of adaptation in response to natural selection via allelic substitution. For microbes symbiotic with plants however, horizontal gene transfer allows for adaptation via gene gain and loss, which could generate fundamentally different evolutionary dynamics. We use comparative genomics and genetics to elucidate the evolutionary mechanisms of adaptation to physiologically stressful serpentine soils in rhizobial bacteria in western North American grasslands. In vitro experiments demonstrate that the presence of a locus of major effect, the nre operon, is necessary and sufficient to confer adaptation to nickel, a heavy metal enriched to toxic levels in serpentine soil, and a major axis of environmental soil chemistry variation. We find discordance between inferred evolutionary histories of the core genome and nreAXY genes, which often reside in putative genomic islands. This suggests that the evolutionary history of this adaptive variant is marked by frequent losses, and/or gains via horizontal acquisition across divergent rhizobium clades. However, different nre alleles confer distinct levels of nickel resistance, suggesting allelic substitution could also play a role in rhizobium adaptation to serpentine soil. These results illustrate that the interplay between evolution via gene gain and loss and evolution via allelic substitution may underlie adaptation in wild soil microbiota. Both processes are important to consider for understanding adaptive diversity in microbes and improving stress-adapted microbial inocula for human use.


Subject(s)
Metals, Heavy , Rhizobium , Humans , Rhizobium/genetics , Nickel , Metals, Heavy/toxicity , Genomics , Soil
2.
Emerg Infect Dis ; 30(2): 354-357, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38270133

ABSTRACT

To assess the susceptibility of elk (Cervus canadensis) and mule deer (Odocoileus hemionus) to SARS-CoV-2, we performed experimental infections in both species. Elk did not shed infectious virus but mounted low-level serologic responses. Mule deer shed and transmitted virus and mounted pronounced serologic responses and thus could play a role in SARS-CoV-2 epidemiology.


Subject(s)
COVID-19 , Deer , Animals , COVID-19/veterinary , SARS-CoV-2 , Equidae
3.
J Neuroeng Rehabil ; 21(1): 84, 2024 May 28.
Article in English | MEDLINE | ID: mdl-38802847

ABSTRACT

BACKGROUND: Sleep disturbance and fatigue are common in individuals undergoing inpatient rehabilitation following stroke. Understanding the relationships between sleep, fatigue, motor performance, and key biomarkers of inflammation and neuroplasticity could provide valuable insight into stroke recovery, possibly leading to personalized rehabilitation strategies. This study aimed to investigate the influence of sleep quality on motor function following stroke utilizing wearable technology to obtain objective sleep measurements. Additionally, we aimed to determine if there were relationships between sleep, fatigue, and motor function. Lastly, the study aimed to determine if salivary biomarkers of stress, inflammation, and neuroplasticity were associated with motor function or fatigue post-stroke. METHODS: Eighteen individuals who experienced a stroke and were undergoing inpatient rehabilitation participated in a cross-sectional observational study. Following consent, participants completed questionnaires to assess sleep patterns, fatigue, and quality of life. Objective sleep was measured throughout one night using the wearable Philips Actiwatch. Upper limb motor performance was assessed on the following day and saliva was collected for biomarker analysis. Correlation analyses were performed to assess the relationships between variables. RESULTS: Participants reported poor sleep quality, frequent awakenings, and difficulties falling asleep following stroke. We identified a significant negative relationship between fatigue severity and both sleep quality (r=-0.539, p = 0.021) and participants experience of awakening from sleep (r=-0.656, p = 0.003). A significant positive relationship was found between grip strength on the non-hemiplegic limb and salivary gene expression of Brain-derived Neurotrophic Factor (r = 0.606, p = 0.028), as well as a significant negative relationship between grip strength on the hemiplegic side and salivary gene expression of C-reactive Protein (r=-0.556, p = 0.048). CONCLUSION: The findings of this study emphasize the importance of considering sleep quality, fatigue, and biomarkers in stroke rehabilitation to optimize recovery and that interventions may need to be tailored to the individual. Future longitudinal studies are required to explore these relationships over time. Integrating wearable technology for sleep and biomarker analysis can enhance monitoring and prediction of outcomes following stroke, ultimately improving rehabilitation strategies and patient outcomes.


Subject(s)
Actigraphy , Biomarkers , Fatigue , Saliva , Stroke Rehabilitation , Wearable Electronic Devices , Humans , Stroke Rehabilitation/instrumentation , Stroke Rehabilitation/methods , Male , Female , Fatigue/etiology , Fatigue/diagnosis , Middle Aged , Biomarkers/analysis , Cross-Sectional Studies , Actigraphy/instrumentation , Aged , Saliva/metabolism , Saliva/chemistry , Sleep/physiology , Adult , Stroke/complications , Stroke/physiopathology , Movement/physiology
4.
Proc Biol Sci ; 290(1990): 20222153, 2023 01 11.
Article in English | MEDLINE | ID: mdl-36598018

ABSTRACT

In mutualism, hosts select symbionts via partner choice and preferentially direct more resources to symbionts that provide greater benefits via sanctions. At the initiation of symbiosis, prior to resource exchange, it is not known how the presence of multiple symbiont options (i.e. the symbiont social environment) impacts partner choice outcomes. Furthermore, little research addresses whether hosts primarily discriminate among symbionts via sanctions, partner choice or a combination. We inoculated the legume, Acmispon wrangelianus, with 28 pairs of fluorescently labelled Mesorhizobium strains that vary continuously in quality as nitrogen-fixing symbionts. We find that hosts exert robust partner choice, which enhances their fitness. This partner choice is conditional such that a strain's success in initiating nodules is impacted by other strains in the social environment. This social genetic effect is as important as a strain's own genotype in determining nodulation and has both transitive (consistent) and intransitive (idiosyncratic) effects on the probability that a symbiont will form a nodule. Furthermore, both absolute and conditional partner choice act in concert with sanctions, among and within nodules. Thus, multiple forms of host discrimination act as a series of sieves that optimize host benefits and select for costly symbiont cooperation in mixed symbiont populations.


Subject(s)
Fabaceae , Symbiosis/genetics , Nitrogen Fixation , Genotype , Nitrogen
5.
Proc Natl Acad Sci U S A ; 117(42): 26382-26388, 2020 10 20.
Article in English | MEDLINE | ID: mdl-32994343

ABSTRACT

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached nearly every country in the world with extraordinary person-to-person transmission. The most likely original source of the virus was spillover from an animal reservoir and subsequent adaptation to humans sometime during the winter of 2019 in Wuhan Province, China. Because of its genetic similarity to SARS-CoV-1, it is probable that this novel virus has a similar host range and receptor specificity. Due to concern for human-pet transmission, we investigated the susceptibility of domestic cats and dogs to infection and potential for infected cats to transmit to naive cats. We report that cats are highly susceptible to infection, with a prolonged period of oral and nasal viral shedding that is not accompanied by clinical signs, and are capable of direct contact transmission to other cats. These studies confirm that cats are susceptible to productive SARS-CoV-2 infection, but are unlikely to develop clinical disease. Further, we document that cats developed a robust neutralizing antibody response that prevented reinfection following a second viral challenge. Conversely, we found that dogs do not shed virus following infection but do seroconvert and mount an antiviral neutralizing antibody response. There is currently no evidence that cats or dogs play a significant role in human infection; however, reverse zoonosis is possible if infected owners expose their domestic pets to the virus during acute infection. Resistance to reinfection holds promise that a vaccine strategy may protect cats and, by extension, humans.


Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/virology , Pneumonia, Viral/virology , Animals , Animals, Domestic , Antibodies, Neutralizing/blood , Antibodies, Neutralizing/immunology , Antigens, Viral/immunology , Betacoronavirus/immunology , COVID-19 , Cats , Coronavirus Infections/pathology , Coronavirus Infections/transmission , Disease Models, Animal , Dogs , Female , Male , Pandemics , Pneumonia, Viral/pathology , Pneumonia, Viral/transmission , SARS-CoV-2 , Virus Shedding
6.
Emerg Infect Dis ; 28(9): 1852-1855, 2022 09.
Article in English | MEDLINE | ID: mdl-35830965

ABSTRACT

We assessed 2 wild canid species, red foxes (Vulpes vulpes) and coyotes (Canis latrans), for susceptibility to SARS-CoV-2. After experimental inoculation, red foxes became infected and shed infectious virus. Conversely, experimentally challenged coyotes did not become infected; therefore, coyotes are unlikely to be competent hosts for SARS-CoV-2.


Subject(s)
COVID-19 , Coyotes , Animals , Foxes , SARS-CoV-2
7.
J Evol Biol ; 35(6): 844-854, 2022 06.
Article in English | MEDLINE | ID: mdl-35506571

ABSTRACT

In mutualisms, variation at genes determining partner fitness provides the raw material upon which coevolutionary selection acts, setting the dynamics and pace of coevolution. However, we know little about variation in the effects of genes that underlie symbiotic fitness in natural mutualist populations. In some species of legumes that form root nodule symbioses with nitrogen-fixing rhizobial bacteria, hosts secrete nodule-specific cysteine-rich (NCR) peptides that cause rhizobia to differentiate in the nodule environment. However, rhizobia can cleave NCR peptides through the expression of genes like the plasmid-borne Host range restriction peptidase (hrrP), whose product degrades specific NCR peptides. Although hrrP activity can confer host exploitation by depressing host fitness and enhancing symbiont fitness, the effects of hrrP on symbiosis phenotypes depend strongly on the genotypes of the interacting partners. However, the effects of hrrP have yet to be characterised in a natural population context, so its contribution to variation in wild mutualist populations is unknown. To understand the distribution of effects of hrrP in wild rhizobia, we measured mutualism phenotypes conferred by hrrP in 12 wild Ensifer medicae strains. To evaluate context dependency of hrrP effects, we compared hrrP effects across two Medicago polymorpha host genotypes and across two experimental years for five E. medicae strains. We show for the first time in a natural population context that hrrP has a wide distribution of effect sizes for many mutualism traits, ranging from strongly positive to strongly negative. Furthermore, we show that hrrP effect size varies across host genotypes and experiment years, suggesting that researchers should be cautious about extrapolating the role of genes in natural populations from controlled laboratory studies of single genetic variants.


Subject(s)
Fabaceae , Rhizobium , Fabaceae/genetics , Fabaceae/microbiology , Negotiating , Peptides , Rhizobium/genetics , Symbiosis/genetics , Vegetables
8.
Emerg Infect Dis ; 27(8): 2073-2080, 2021 08.
Article in English | MEDLINE | ID: mdl-34286685

ABSTRACT

Wild animals have been implicated as the origin of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but it is largely unknown how the virus affects most wildlife species and if wildlife could ultimately serve as a reservoir for maintaining the virus outside the human population. We show that several common peridomestic species, including deer mice, bushy-tailed woodrats, and striped skunks, are susceptible to infection and can shed the virus in respiratory secretions. In contrast, we demonstrate that cottontail rabbits, fox squirrels, Wyoming ground squirrels, black-tailed prairie dogs, house mice, and racoons are not susceptible to SARS-CoV-2 infection. Our results expand the knowledge base of susceptible species and provide evidence that human-wildlife interactions could result in continued transmission of SARS-CoV-2.


Subject(s)
COVID-19 , SARS-CoV-2 , Animals , Animals, Wild , Disease Susceptibility , Humans , Mammals , Mice
9.
Mol Ecol ; 27(23): 4758-4774, 2018 12.
Article in English | MEDLINE | ID: mdl-30325569

ABSTRACT

To establish and spread in a new location, an invasive species must be able to carry out its life cycle in novel environmental conditions. A key trait underlying fitness is the shift from vegetative to reproductive growth through floral development. In this study, we used a common garden experiment and genotyping-by-sequencing to test whether the latitudinal flowering cline of the North American invasive plant Medicago polymorpha was translocated from its European native range through multiple introductions, or whether the cline rapidly established due to evolution following a genetic bottleneck. Analysis of flowering time in 736 common garden plants showed a latitudinal flowering time cline in both the native and invaded ranges where genotypes from lower latitudes flowered earlier. Genotyping-by-sequencing of 9,658 SNPs in 446 individuals revealed two major subpopulations of M. polymorpha in the native range, only one of which is present in the invaded range. Additionally, native range populations have higher genetic diversity than invaded range populations, suggesting that a genetic bottleneck occurred during invasion. All invaded range individuals are closely related to plants collected from native range populations in Portugal and southern Spain, and population assignment tests assigned invaded range individuals to this same narrow source region. Taken together, our results suggest that latitudinal clinal variation in flowering time has rapidly evolved across the invaded range despite a genetic bottleneck following introduction.


Subject(s)
Flowers/physiology , Genetics, Population , Introduced Species , Medicago/genetics , Genotype , Medicago/physiology , North America , Polymorphism, Single Nucleotide
10.
Ecol Lett ; 18(11): 1270-1284, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26388306

ABSTRACT

Cheating is a focal concept in the study of mutualism, with the majority of researchers considering cheating to be both prevalent and highly damaging. However, current definitions of cheating do not reliably capture the evolutionary threat that has been a central motivation for the study of cheating. We describe the development of the cheating concept and distill a relative-fitness-based definition of cheating that encapsulates the evolutionary threat posed by cheating, i.e. that cheaters will spread and erode the benefits of mutualism. We then describe experiments required to conclude that cheating is occurring and to quantify fitness conflict more generally. Next, we discuss how our definition and methods can generate comparability and integration of theory and experiments, which are currently divided by their respective prioritisations of fitness consequences and traits. To evaluate the current empirical evidence for cheating, we review the literature on several of the best-studied mutualisms. We find that although there are numerous observations of low-quality partners, there is currently very little support from fitness data that any of these meet our criteria to be considered cheaters. Finally, we highlight future directions for research on conflict in mutualisms, including novel research avenues opened by a relative-fitness-based definition of cheating.

11.
J Reprod Med ; 60(5-6): 219-22, 2015.
Article in English | MEDLINE | ID: mdl-26126307

ABSTRACT

OBJECTIVE: To determine if maternal blood contamination falsely elevates the lamellar body count fetal lung maturity test. STUDY DESIGN: Fifty mothers undergoing amniocentesis for fetal lung maturity consented to participation in the study. For each participant a blood-contaminated sample using the patient's own blood was run in tandem with the noncontaminated sample used for clinical practice. RESULTS: Of the 50 study patient samples the lamellar body count decreased by ≥ 3,000/µL in 33 (66%) and remained unchanged in 16 (32%). In only 1 case did the value increase--the actual result of 37,000/µL increased to 44,000/µL, both of which exceeded the mature level in our institution. CONCLUSION: Maternal blood contamination of amniotic fluid does not falsely increase the lamellar body count in 98% of cases. The result was falsely lowered in 2 out of 3 cases. Therefore, a mature lamellar body count test result in a blood-contaminated sample is reliable


Subject(s)
Amniocentesis , Amniotic Fluid/cytology , Blood , Fetal Organ Maturity , Lung/embryology , Female , Humans , Infant, Newborn , Pregnancy , Prospective Studies , Respiratory Distress Syndrome, Newborn/prevention & control
12.
BMC Genomics ; 15: 1160, 2014 Dec 22.
Article in English | MEDLINE | ID: mdl-25534372

ABSTRACT

BACKGROUND: As our world becomes warmer, agriculture is increasingly impacted by rising soil salinity and understanding plant adaptation to salt stress can help enable effective crop breeding. Salt tolerance is a complex plant phenotype and we know little about the pathways utilized by naturally tolerant plants. Legumes are important species in agricultural and natural ecosystems, since they engage in symbiotic nitrogen-fixation, but are especially vulnerable to salinity stress. RESULTS: Our studies of the model legume Medicago truncatula in field and greenhouse settings demonstrate that Tunisian populations are locally adapted to saline soils at the metapopulation level and that saline origin genotypes are less impacted by salt than non-saline origin genotypes; these populations thus likely contain adaptively diverged alleles. Whole genome resequencing of 39 wild accessions reveals ongoing migration and candidate genomic regions that assort non-randomly with soil salinity. Consistent with natural selection acting at these sites, saline alleles are typically rare in the range-wide species' gene pool and are also typically derived relative to the sister species M. littoralis. Candidate regions for adaptation contain genes that regulate physiological acclimation to salt stress, such as abscisic acid and jasmonic acid signaling, including a novel salt-tolerance candidate orthologous to the uncharacterized gene AtCIPK21. Unexpectedly, these regions also contain biotic stress genes and flowering time pathway genes. We show that flowering time is differentiated between saline and non-saline populations and may allow salt stress escape. CONCLUSIONS: This work nominates multiple potential pathways of adaptation to naturally stressful environments in a model legume. These candidates point to the importance of both tolerance and avoidance in natural legume populations. We have uncovered several promising targets that could be used to breed for enhanced salt tolerance in crop legumes to enhance food security in an era of increasing soil salinization.


Subject(s)
Adaptation, Physiological/genetics , Ecological and Environmental Phenomena , Genomics , Medicago truncatula/genetics , Medicago truncatula/physiology , Salinity , Evolution, Molecular , Gene Frequency , Genetic Loci/genetics , Molecular Sequence Annotation , Recombination, Genetic , Selection, Genetic , Soil/chemistry , Species Specificity
13.
Ecol Lett ; 17(9): 1121-9, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25039752

ABSTRACT

The primary dilemma in evolutionarily stable mutualisms is that natural selection for cheating could overwhelm selection for cooperation. Cheating need not entail parasitism; selection favours cheating as a quantitative trait whenever less-cooperative partners are more fit than more-cooperative partners. Mutualisms might be stabilised by mechanisms that direct benefits to more-cooperative individuals, which counter selection for cheating; however, empirical evidence that natural selection favours cheating in mutualisms is sparse. We measured selection on cheating in single-partner pairings of wild legume and rhizobium lineages, which prevented legume choice. Across contrasting environments, selection consistently favoured cheating by rhizobia, but did not favour legumes that provided less benefit to rhizobium partners. This is the first simultaneous measurement of selection on cheating across both host and symbiont lineages from a natural population. We empirically confirm selection for cheating as a source of antagonistic coevolutionary pressure in mutualism and a biological dilemma for models of cooperation.


Subject(s)
Environment , Fabaceae/microbiology , Models, Biological , Rhizobium/physiology , Selection, Genetic , Symbiosis , Analysis of Variance , Reproducibility of Results
14.
BMC Ecol ; 14: 8, 2014 Mar 19.
Article in English | MEDLINE | ID: mdl-24641813

ABSTRACT

BACKGROUND: Specialized interactions help structure communities, but persistence of specialized organisms is puzzling because a generalist can occupy more environments and partake in more beneficial interactions. The "Jack-of-all-trades is a master of none" hypothesis asserts that specialists persist because the fitness of a generalist utilizing a particular habitat is lower than that of a specialist adapted to that habitat. Yet, there are many reasons to expect that mutualists will generalize on partners.Plant-soil feedbacks help to structure plant and microbial communities, but how frequently are soil-based symbiotic mutualistic interactions sufficiently specialized to influence species distributions and community composition? To address this question, we quantified realized partner richness and phylogenetic breadth of four wild-grown native legumes (Lupinus bicolor, L. arboreus, Acmispon strigosus and A. heermannii) and performed inoculation trials to test the ability of two hosts (L. bicolor and A. strigosus) to nodulate (fundamental partner richness), benefit from (response specificity), and provide benefit to (effect specificity) 31 Bradyrhizobium genotypes. RESULTS: In the wild, each Lupinus species hosted a broader genetic range of Bradyrhizobium than did either Acmispon species, suggesting that Acmispon species are more specialized. In the greenhouse, however, L. bicolor and A. strigosus did not differ in fundamental association specificity: all inoculated genotypes nodulated both hosts. Nevertheless, A. strigosus exhibited more specificity, i.e., greater variation in its response to, and effect on, Bradyrhizobium genotypes. Lupinus bicolor benefited from a broader range of genotypes but averaged less benefit from each. Both hosts obtained more fitness benefit from symbionts isolated from conspecific hosts; those symbionts in turn gained greater fitness benefit from hosts of the same species from which they were isolated. CONCLUSIONS: This study affirmed two important tenets of evolutionary theory. First, as predicted by the Jack-of-all-trades is a master of none hypothesis, specialist A. strigosus obtained greater benefit from its beneficial symbionts than did generalist L. bicolor. Second, as predicted by coevolutionary theory, each test species performed better with partner genotypes isolated from conspecifics. Finally, positive fitness feedback between the tested hosts and symbionts suggests that positive plant-soil feedback could contribute to their patchy distributions in this system.


Subject(s)
Bradyrhizobium/physiology , Fabaceae/microbiology , Symbiosis/physiology , Bradyrhizobium/genetics , California , DNA, Bacterial/genetics , Fabaceae/physiology , Genetic Fitness , Genotype , Phylogeny , Plant Root Nodulation
15.
Nat Microbiol ; 9(8): 1929-1939, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39095495

ABSTRACT

Legumes are ecologically and economically important plants that contribute to nutrient cycling and agricultural sustainability, features tied to their intimate symbiosis with nitrogen-fixing rhizobia. Rhizobia vary dramatically in quality, ranging from highly growth-promoting to non-beneficial; therefore, legumes must optimize their symbiosis with rhizobia through host mechanisms that select for beneficial rhizobia and limit losses to non-beneficial strains. In this Perspective, we examine the considerable scientific progress made in decoding host control over rhizobia, empirically examining both molecular and cellular mechanisms and their effects on rhizobia symbiosis and its benefits. We consider pre-infection controls, which require the production and detection of precise molecular signals by the legume to attract and select for compatible rhizobia strains. We also discuss post-infection mechanisms that leverage the nodule-level and cell-level compartmentalization of symbionts to enable host control over rhizobia development and proliferation in planta. These layers of host control each contribute to legume fitness by directing host resources towards a narrowing subset of more-beneficial rhizobia.


Subject(s)
Fabaceae , Nitrogen Fixation , Rhizobium , Symbiosis , Fabaceae/microbiology , Rhizobium/physiology , Rhizobium/metabolism , Host Microbial Interactions , Root Nodules, Plant/microbiology , Plant Root Nodulation
16.
New Phytol ; 197(4): 1311-1320, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23312014

ABSTRACT

Although adaptive plant population divergence across contrasting soil conditions is often driven by abiotic soil factors, natural enemies may also contribute. Cryptic matching to the native soil color is a form of defensive camouflage that seeds can use to avoid detection by seed predators. The legume Acmispon wrangelianus occurs across a variety of gray-green serpentine soils and brown nonserpentine soils. Quantitative digital image analysis of seed and soil colors was used to test whether genetically based seed color is a closer match to the color of the native soil than to the color of other nearby soils. Lineages bear seeds that more closely match the color of their native serpentine or nonserpentine soil type than the opposing soil type. Further, even within a soil type, lineages bear seeds with a closer color match to the soil at their native site than to other sites. The striking concordance between seed and native soil color suggests that natural selection for locally camouflaged seed color morphs, probably driven by seed predators, may maintain adaptive divergence in pigmentation, despite the opportunity for migration between soil environments.


Subject(s)
Adaptation, Physiological , Color , Environment , Fabaceae/anatomy & histology , Seeds/anatomy & histology , Soil/chemistry , Geography , Selection, Genetic
17.
Int J Qual Health Care ; 25(5): 573-81, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23962990

ABSTRACT

OBJECTIVE: To describe parent perceptions of their child's hospital discharge and assess the relationship between these perceptions and hospital readmission. DESIGN: A prospective study of parents surveyed with questions adapted from the care transitions measure, an adult survey that assesses components of discharge care. Participant answers, scored on a 5-point Likert scale, were compared between children who did and did not experience a readmission using a Fisher's exact test and logistic regression that accounted for patient characteristics associated with increased readmission risk, including complex chronic condition and assistance with medical technology. SETTING: A tertiary-care children's hospital. PARTICIPANTS: A total of 348 parents surveyed following their child's hospital discharge between March and October 2010. INTERVENTION: None. MAIN OUTCOME MEASURE: Unplanned readmission within 30 days of discharge. RESULTS: There were 28 children (8.1%) who experienced a readmission. Children had a lower readmission rate (4.4 vs. 11.3%, P = 0.004) and lower adjusted readmission likelihood [odds ratio 0.2 (95% confidence interval 0.1, 0.6)] when their parents strongly agreed (n = 206) with the statement, 'I felt that my child was healthy enough to leave the hospital' from the index admission. Parent perceptions relating to care management responsibilities, medications, written discharge plan, warning signs and symptoms to watch for and primary care follow-up were not associated with readmission risk in multivariate analysis. CONCLUSIONS: Parent perception of their child's health at discharge was associated with the risk of a subsequent, unplanned readmission. Addressing concerns with this perception prior to hospital discharge may help mitigate readmission risk in children.


Subject(s)
Parents/psychology , Patient Discharge , Patient Readmission , Adolescent , Child , Child, Preschool , Data Collection , Female , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Male , Patient Discharge/standards , Patient Discharge/statistics & numerical data , Patient Readmission/statistics & numerical data , Patient Satisfaction , Prospective Studies , Young Adult
18.
South Med J ; 106(2): 131-5, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23380748

ABSTRACT

OBJECTIVES: To determine the effect of a third stage of labor ≥15 minutes on bleeding after delivery and other risk factors for a postpartum hemorrhage (PPH). METHODS: This was a case-control study of women undergoing vaginal delivery with placental delivery ≥15 minutes matched by gestational age to the next delivery with placental delivery <15 minutes. Multiple risk factors were evaluated for association with delayed placenta and with PPH. RESULTS: There were 226 pregnancies ≥15 minutes (cases) versus 226 whose placental time was <15 minutes (controls). The best-fit model identified placental delivery ≥15 minutes, history of retained placenta, nulliparity, and increased length of first stage of labor as significant factors for PPH. CONCLUSIONS: The best risk model for PPH includes placental delivery ≥15 minutes, history of retained placenta, nulliparity, and longer first stage of labor.


Subject(s)
Delivery, Obstetric , Labor Stage, Third , Obstetric Labor Complications , Postpartum Hemorrhage/etiology , Adult , Case-Control Studies , Female , Hemoglobins/analysis , Humans , Labor Stage, First , Multivariate Analysis , Parity , Placenta, Retained , Pregnancy , Retrospective Studies , Risk Factors , Time Factors , Young Adult
19.
J Perinat Neonatal Nurs ; 27(3): 205-14; quiz 215-6, 2013.
Article in English | MEDLINE | ID: mdl-23899798

ABSTRACT

Neuromuscular diseases can have a tremendous impact on pregnant women and affect offspring. Healthcare providers need to have a firm understanding of the genetics involved as well as the potential complications that can arise when treating pregnant women who have been diagnosed with a neuromuscular disease or have an increased risk for delivering an infant affected by one of these disorders. This article provides a comprehensive synopsis of genetics, including the strategies for obtaining a detailed patient and family genetic history through construction of a pedigree, as well as imparting some key knowledge for providing appropriate counseling and treatment to affected individuals and families. It addresses the genetic testing, diagnosis, impact, and medical considerations for both patients and offspring affected by myotonic dystrophy, Duchenne and Becker muscular dystrophies, limb-girdle muscular dystrophy, Charcot-Marie-Tooth disease, and spinal muscular atrophy.


Subject(s)
Genetic Predisposition to Disease/epidemiology , Genetic Testing , Neuromuscular Diseases/genetics , Pregnancy Complications/diagnosis , Pregnancy, High-Risk , Female , Follow-Up Studies , Humans , Incidence , Infant, Newborn , Infant, Newborn, Diseases/diagnosis , Infant, Newborn, Diseases/therapy , Male , Neuromuscular Diseases/epidemiology , Neuromuscular Diseases/physiopathology , Pregnancy , Pregnancy Complications/therapy , Risk Assessment
20.
Virology ; 582: 100-105, 2023 05.
Article in English | MEDLINE | ID: mdl-37043909

ABSTRACT

Influenza A viruses are a diverse group of pathogens that have been responsible for millions of human and avian deaths throughout history. Here, we illustrate the transmission potential of H7N9 influenza A virus between Coturnix quail (Coturnix sp.), domestic ducks (Anas platyrhynchos domesticus), chickens (Gallus gallus domesticus), and house sparrows (Passer domesticus) co-housed in an artificial barnyard setting. In each of four replicates, individuals from a single species were infected with the virus. Quail shed virus orally and were a source of infection for both chickens and ducks. Infected chickens transmitted the virus to quail but not to ducks or house sparrows. Infected ducks transmitted to chickens, resulting in seroconversion without viral shedding. House sparrows did not shed virus sufficiently to transmit to other species. These results demonstrate that onward transmission varies by index species, and that gallinaceous birds are more likely to maintain H7N9 than ducks or passerines.


Subject(s)
Influenza A Virus, H7N9 Subtype , Influenza in Birds , Animals , Humans , Chickens , Coturnix , Ducks , Virus Shedding
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