Trends in Infective Endocarditis Hospitalizations, Characteristics, and Valve Operations in Patients With Opioid Use Disorders in the United States: 2005-2014.

Background To evaluate changes in patient characteristics and outcomes for infective endocarditis (IE) related to opioid use disorder (OUD), we used the National (Nationwide) Inpatient Sample (NIS) to characterize the trend in hospitalizations for patients with IE with and without OUD and those treated medically and surgically. Methods and Results Temporal trends in hospitalization characteristics for patients with IE with and without OUD and those treated medically and surgically were estimated via the NIS data in 2005-2014. Hospitalizations for OUD and IE increased from 119 to 202 and from 12 to 15 cases per 100 000 between 2005 and 2014, respectively. Hospitalizations with OUD among all IE hospitalizations increased from 6.3% in 2005 to 11.6% in 2014. Among all IE hospitalizations, patients being admitted for IE in the setting of OUD were younger compared with the cohort of IE without OUD (aged 37.6±0.21 years versus 60.9±0.16 years). Myocardial infarction, diabetes mellitus, chronic kidney disease, peripheral vascular disease, and heart failure were more common in patients without OUD. The OUD cohort more frequently had liver disease (46.0% versus 10.8%) and immunosuppressed status (4.3% versus 2.1%). Valve operations for IE accounted for 10.2% of all valve operations in 2005, and this increased to 12.7% in 2014. These proportions were similar between OUD (11.4%) and non-OUD (11.1%) cohorts. Operative mortality was lower in patients with OUD (4.3% versus 9.4%, P<0.001). Conclusions IE associated with OUD has a distinct phenotype and has become more prevalent. Surgical outcomes are favorable and operations were performed in similar proportions of patients who had IE with OUD compared with patients who had IE without OUD.

Seasonal patterns in body temperature of free-living rock hyrax (Procavia capensis).

Rock hyrax (Procavia capensis) are faced with large daily fluctuations in ambient temperature during summer and winter. In this study, peritoneal body temperature of free-living rock hyrax was investigated. During winter, when low ambient temperatures and food supply prevail, rock hyrax maintained a lower core body temperature relative to summer. In winter body temperatures during the day were more variable than at night. This daytime variability is likely a result of body temperatures being raised from basking in the sun. Body temperatures recorded during winter never fell to low levels recorded in previous laboratory studies. During summer ambient temperatures exceeded the thermoneutral zone of the rock hyrax throughout most of the day, while crevice temperatures remained within the thermoneutral zone of rock hyrax. However, in summer variation in core body temperature was small. Minimum and maximum body temperatures did not coincide with minimum and maximum ambient temperatures. Constant body temperatures were also recorded when ambient temperatures reached lethal limits. During summer it is likely that rock hyrax select cooler refugia to escape lethal temperatures and to prevent excessive water loss. Body temperature of rock hyrax recorded in this study reflects the adaptability of this animal to the wide range of ambient temperatures experienced in its natural environment.

Digestive efficiency of a generalist avian feeder, the Cape White-eye (Zosterops pallidus).

Digestive processes determine whether the particular diet of a bird is utilized efficiently and whether energetic demands are met. Assimilation efficiency is often used as an index of whether a diet is digested optimally. Studies on the digestive processing of generalist feeders are scarce. Cape White-eyes (Zosterops pallidus) have a diverse diet of fruit, nectar and insects. The nutrient contents of these three diets vary considerably and require quite different digestive processing. This study compared the digestive efficiencies of Cape White-eyes on these three diets by measuring transit times and assimilation efficiency. Cape White-eyes lost body mass significantly when fed fruit, while they maintained and gained body mass on nectar and mealworm diets, respectively. Assimilation efficiency varied significantly between the three diet types (nectar>mealworms>apples). When given a choice of diets, Cape White-eyes selected the diet, which was most efficiently digested and yielded the greatest energetic reward. Diet preference trials further showed that Cape White-eyes regulated daily energy intake. Assimilation efficiency depends on the accessibility of nutritional contents of a diet. Cape White-eyes did not maximize assimilation efficiency. Instead, they adjusted transit time to maximize the rate of energy gain per gram of food in order to maintain energy balance.