Validation of diagnosis codes for chorioamnionitis in medical encounter data, 2013-2018.

PURPOSE: Chorioamnionitis refers to intrauterine infection/inflammation that can be diagnosed clinically or from laboratory testing. This study aimed to validate chorioamnionitis International Classification of Diseases (ICD) codes using reference standards for clinical and histologic cases. METHODS: Department of Defense Birth and Infant Health Research program data identified a cohort of live deliveries at two United States military hospitals from 2013 to 2018. Deliveries were screened for chorioamnionitis using ICD codes from maternal delivery records; a sample of screen positive and negative deliveries was selected for chart review. Primary analyses validated deliveries using a reference standard for clinical chorioamnionitis; secondary analyses employed a reference standard that also included histologic cases, but were limited by temporal differences in availability of laboratory data. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values were calculated with 95% confidence intervals (CIs). RESULTS: Overall, 1857 deliveries (465 screen positive, 1392 screen negative) were eligible for analysis and 336 met the reference standard for clinical chorioamnionitis, yielding a PPV of 0.68 (95% CI 0.63, 0.72) and sensitivity of 0.76 (95% CI 0.72, 0.81). In secondary analyses, 390 deliveries met the reference standard for clinical or histologic chorioamnionitis, resulting in an overall PPV of 0.75 (95% CI 0.71, 0.79); in 2018, when more laboratory results were available, the PPV was 0.91 (95% CI 0.84, 0.97). NPV and specificity were ≥0.97 across reference standards. CONCLUSIONS: Chorioamnionitis ICD codes exhibited moderate correlation with clinical disease, suggesting challenges in using medical encounter data to isolate clinical cases from those only identified through laboratory testing.

Tissue-specific expression of 11ß-HSD and its effects on plasma corticosterone during the stress response.

The hypothalamic-pituitary-adrenal (HPA) axis is under complex regulatory control at multiple levels. Enzymatic regulation plays an important role in both circulating levels of glucocorticoids and target tissue exposure. Three key enzyme pathways are responsible for the immediate control of glucocorticoids. De novo synthesis of glucocorticoid from cholesterol involves a multistep enzymatic cascade. This cascade terminates with 11ß-hydroxylase, responsible for the final conversion of 11-deoxy precursors into active glucocorticoids. Additionally, 11ß-hydroxysteroid dehydrogenase type 1 (11ß-HSD1) controls regeneration of glucocorticoids from inactive metabolites, providing a secondary source of active glucocorticoids. Localized inactivation of glucocorticoids is under the control of Type 2 11ß-HSD (11ß-HSD2). The function of these enzymes is largely unexplored in wild species, particularly songbirds. Here, we investigated the contribution of both clearance and generation of glucocorticoids to regulation of the hormonal stress response via the use of pharmacological antagonists. Additionally, we mapped 11ß-HSD gene expression. We found 11ß-HSD1 primarily in liver, kidney and adrenal glands, although it was detectable across all tissue types. 11ß-HSD2 was predominately expressed in the adrenal glands and kidney with moderate gonadal and liver expression. Inhibition of glucocorticoid generation by metyrapone was found to decrease levels peripherally, while both peripheral and central administration of the 11ß-HSD2 inhibitor DETC resulted in elevated concentrations of corticosterone. These data suggest that during the stress response, peripheral antagonism of the 11ß-HSD system has a greater impact on circulating glucocorticoid levels than central control. Further studies should aim to elucidate the respective roles of the 11ß-HSD and 11ß-hydroxylase enzymes.

Synchronous timing of return to breeding sites in a long-distance migratory seabird with ocean-scale variation in migration schedules.

BACKGROUND: Migratory birds generally have tightly scheduled annual cycles, in which delays can have carry-over effects on the timing of later events, ultimately impacting reproductive output. Whether temporal carry-over effects are more pronounced among migrations over larger distances, with tighter schedules, is a largely unexplored question. METHODS: We tracked individual Arctic Skuas Stercorarius parasiticus, a long-distance migratory seabird, from eight breeding populations between Greenland and Siberia using light-level geolocators. We tested whether migration schedules among breeding populations differ as a function of their use of seven widely divergent wintering areas across the Atlantic Ocean, Mediterranean Sea and Indian Ocean. RESULTS: Breeding at higher latitudes led not only to later reproduction and migration, but also faster spring migration and shorter time between return to the breeding area and clutch initiation. Wintering area was consistent within individuals among years; and more distant areas were associated with more time spent on migration and less time in the wintering areas. Skuas adjusted the period spent in the wintering area, regardless of migration distance, which buffered the variation in timing of autumn migration. Choice of wintering area had only minor effects on timing of return at the breeding area and timing of breeding and these effects were not consistent between breeding populations. CONCLUSION: The lack of a consistent effect of wintering area on timing of return between breeding areas indicates that individuals synchronize their arrival with others in their population despite extensive individual differences in migration strategies.

Integrating orientation mechanisms, adrenocortical activity, and endurance flight in vagrancy behaviour.

Avian migratory processes are typically precisely oriented, yet vagrants are frequently recorded outside their normal range. Wind displaced vagrants often show corrective behaviour, and as an appropriate response is likely adaptive. We investigated the physiological response to vagrancy in passerines. Activation of the emergency life-history stage (ELHS), assessed by high baseline plasma corticosterone, is a potential mechanism to elicit compensatory behaviour in response to challenges resulting from navigational error, coupled with response to fuel load and flight. We compared circulating plasma corticosterone concentrations and body condition between three migratory groups in autumn: (1) wind displaced southwest (SW) vagrants and (2) long range southeast (SE) vagrants on the remote Faroe Islands, and (3) birds within the expected SW migratory route (controls) on the Falsterbo peninsula, Sweden. Vagrants were further grouped by those sampled immediately upon termination of over-water migratory flight and those already on the island. In all groups there was no indication of the activation of the ELHS in response to vagrancy. We found limited support for an increased rate of corticosterone elevation within our 3 min sample interval in a single species, but this was driven by an individual ELHS outlier. Fat scores were negatively correlated with circulating corticosterone; this relationship may suggest that ELHS activation depends upon an individual's energetic states. Interestingly, in individuals caught at the completion of an obligate long-distance flight, we found some evidence of corticosterone suppression. Although limited, data did support the induction of negative feedback mechanisms that suppress corticosterone during endurance exercise, even when fuel loads are low.

New frontiers in bird migration research.

Bird migrations are impressive behavioral phenomena, representing complex spatiotemporal strategies to balance costs of living while maximizing fitness. The field of bird migration research has made great strides over the past decades, yet fundamental gaps remain. Technologies have sparked a transformation in the study of bird migration research by revealing remarkable insights into the underlying behavioral, cognitive, physiological and evolutionary mechanisms of these diverse journeys. Here, we aim to encourage broad discussions and promote future studies by highlighting research fields that are characterized by major knowledge gaps or conflicting evidence, namely the fields of navigation, social learning, individual development, energetics and conservation. We approach each topic by summarizing the current state of knowledge and provide a future outlook of ideas and state-of-the-art methods to further advance the field. Integrating knowledge across these disciplines will allow us to understand the adaptive abilities of different species and to develop effective conservation strategies in a rapidly changing world.

Flying on their own wings: young and adult cuckoos respond similarly to long-distance displacement during migration.

Common cuckoos Cuculus canorus are obligate nest parasites yet young birds reach their distant, species-specific wintering grounds without being able to rely on guidance from experienced conspecifics - in fact they never meet their parents. Naïve marine animals use an inherited navigational map during migration but in inexperienced terrestrial animal migrants unequivocal evidence of navigation is lacking. We present satellite tracking data on common cuckoos experimentally displaced 1,800 km eastward from Rybachy to Kazan. After displacement, both young and adult travelled similarly towards the route of non-displaced control birds. The tracking data demonstrate the potential for young common cuckoos to return to the species-specific migration route after displacement, a response so far reported exclusively in experienced birds. Our results indicate that an inherited map allows first-time migrating cuckoos to locate suitable wintering grounds. This is in contrast to previous studies of solitary terrestrial bird migrants but similar to that reported from the marine environment.

Multiple fragmented habitat-patch use in an urban breeding passerine, the Short-toed Treecreeper.

Individual responses of wild birds to fragmented habitat have rarely been studied, despite large-scale habitat fragmentation and biodiversity loss resulting from widespread urbanisation. We investigated the spatial ecology of the Short-toed Treecreeper Certhia brachydactyla, a tiny, resident, woodland passerine that has recently colonised city parks at the northern extent of its range. High resolution spatiotemporal movements of this obligate tree-living species were determined using radio telemetry within the urbanized matrix of city parks in Copenhagen, Denmark. We identified regular edge crossing behaviour, novel in woodland birds. While low numbers of individuals precluded a comprehensive characterisation of home range for this population, we were able to describe a consistent behaviour which has consequences for our understanding of animal movement in urban ecosystems. We report that treecreepers move freely, and apparently do so regularly, between isolated habitat patches. This behaviour is a possible driver of the range expansion in this species and may contribute to rapid dispersal capabilities in certain avian species, including Short-toed Treecreepers, into northern Europe. Alternatively, these behaviours might be common and/or provide an adaptive advantage for birds utilising matrix habitats, for example within urban ecosystems.

Drawing and Hydrophobicity-patterning Long Polydimethylsiloxane Silicone Filaments.

Polydimethylsiloxane (PDMS) silicone is a versatile polymer that cannot readily be formed into long filaments. Traditional spinning methods fail because PDMS does not exhibit long-range fluidity at melting. We introduce an improved method to produce filaments of PDMS by a stepped temperature profile of the polymer as it cross-links from a fluid to an elastomer. By monitoring its warm-temperature viscosity, we estimate a window of time when its material properties are amendable to drawing into long filaments. The filaments pass through a high-temperature tube oven, curing them sufficiently to be harvested. These filaments are on the order of hundreds of micrometers in diameter and tens of centimeters in length, and even longer and thinner filaments are possible. These filaments retain many of the material properties of bulk PDMS, including switchable hydrophobicity. We demonstrate this capability with an automated corona-discharge patterning method. These patternable PDMS silicone filaments have applications in silicone weavings, gas-permeable sensor components, and model microscale foldamers.

Evaluation of preterm births and birth defects in liveborn infants of US military women who received smallpox vaccine.

BACKGROUND: Women serving in the US military have some unique occupational exposures, including exposure to vaccinations that are rarely required in civilian professions. When vaccinations are inadvertently given during pregnancy, such exposures raise special concerns. These analyses address health outcomes, particularly preterm births and birth defects, among infants who appear to have been exposed to maternal smallpox vaccination in pregnancy. METHODS: This retrospective cohort study included 31,420 infants born to active-duty military women during 2003-2004. We used Department of Defense databases to define maternal vaccination and infant health outcomes. Multivariable regression models were developed to describe associations between maternal smallpox vaccination and preterm births and birth defects in liveborn infants. RESULTS: There were 7,735 infants identified as born to women ever vaccinated against smallpox, and 672 infants born to women vaccinated in the first trimester of pregnancy. In multivariable modeling, maternal smallpox vaccination in pregnancy was not associated with preterm or extreme preterm delivery. Maternal smallpox vaccination in the first trimester of pregnancy was not significantly associated with overall birth defects (OR 1.40; 95% CI: 0.94, 2.07), or any of seven specific defects individually modeled. CONCLUSIONS: Results may be reassuring that smallpox vaccine, when inadvertently administered to pregnant women, is not associated with preterm delivery or birth defects in liveborn infants.

From Svalbard to Siberia: Passerines breeding in the High Arctic also endure the extreme cold of the Western Steppe.

Few species are adapted to high latitudes, and many over-winter in milder climates with migrations involving extensive barrier crossings. By escaping extreme conditions for the majority of the year, physiological and behavioural adaptations presumably need to be less pronounced. The snow bunting Plectrophenax nivalis is the most northerly breeding passerine. We tracked the Svalbard population using geolocators to reveal that these individuals not only breed in environmental extremes, but also spend the winters in the severe cold and highly stochastic weather conditions of the Siberian steppe. Migratory strategies appeared to be flexible between individuals and years. However, common wintering grounds in the Asian Western Steppe were identified, where birds could utilise vast crop- and grasslands while enduring low ambient temperatures. The timing of significant long distance movements was consistent among individuals, and the autumn routing of the >1000 km open water flight to Novaya Zemlya incurred favourable wind assistance and lower risk of precipitation, compared to the shorter route between Svalbard and Norway used in spring. Presumably, Svalbard snow buntings are physiologically well-adapted to extreme conditions and their migration, rather being a retreat from physiologically demanding conditions, allows utilisation of an abundance of resources in the Asian Steppe.

No apparent gain from continuing migration for more than 3000 kilometres: willow warblers breeding in Denmark winter across the entire northern Savannah as revealed by geolocators.

BACKGROUND: For most Afro-Palearctic migrants, particularly small songbirds, spatiotemporal migration schedules and migratory connectivity remain poorly understood. We mapped migration from breeding through winter of one of the smallest Afro-Palearctic migrants, the willow warbler Phylloscopus trochilus, using geolocators (n = 15). RESULTS: Birds migrated from North European breeding grounds to West Africa via the Iberian Peninsula following a narrow corridor along the West Coast of Africa. Birds then dispersed across the northern Savannah with termination of migration highly variable among individuals. The termination of migration appeared not to be related to timing, current and previous years' vegetation conditions or biometrics. During winter, most birds moved southwards to improved vegetation. CONCLUSION: The willow warblers showed a large, unexpected longitudinal spread in winter sites of more than 3000 km between individuals breeding within a 500 m range resulting in a low degree of connectivity. The large wintering area may well be related to generalist behaviour in the species. Our findings contribute to understanding the link between breeding and wintering ecology in long-distance migratory birds.

Gravity-Drawn Silicone Filaments: Production, Characterization, and Wormlike Chain Dynamics.

We introduce a method to produce continuous polydimethylsiloxane (PDMS) silicone filaments on the order of 0.5 m long and 100 µm in diameter. The approach overcomes traditional limitations in silicone drawing by partially precuring the polymer and drawing through a tube furnace. We characterize the filaments' mechanical properties, and their ability to switch hydrophobicity by UV-ozone and corona discharge patterning. The flexible filaments' dynamic properties were evaluated by way of athermal acoustic excitation at the air-water interface, revealing conformational reconfigurability consistent with a wormlike chain model. We envision applications in rapid prototyping and as a platform for model foldamer studies.

The effects of proopiomelanocortin deficiency on murine adrenal development and responsiveness to adrenocorticotropin.

The mature adrenal cortex is dependent upon proopiomelanocortin (POMC)-derived peptides for the maintenance of its size, structure, and endocrine function. Recent studies in mice genetically deficient in POMC have suggested that early exposure to POMC-derived peptides might also be necessary for the development of a functionally competent adrenal. We examined adrenal morphology and function in an independent line of mice lacking all POMC-derived peptides (Pomc-/-). Adrenal glands were found in all mice, although the glands of Pomc-/- mice had markedly reduced weight compared with control animals (0.5 +/- 0.1 vs. 2.1 +/- 0.1 mg, respectively; P < 0.05) and had disrupted cortical architecture. In Pomc-/- mice, plasma corticosterone was undetectable, and plasma aldosterone was significantly reduced compared with wild-type mice (498 +/- 88 vs. 1845 +/- 168 nmol/liter, respectively; P < 0.001). Heterozygous mice (Pomc+/-) had smaller adrenal glands with significantly lower levels of corticosterone both basally and in response to CRH and ACTH than wild-type mice, indicating that two functional copies of the Pomc gene are necessary to support the fully normal function of the hypothalamic-pituitary-adrenal axis. Three-month-old Pomc-/- mice were treated for 10 d with a highly specific ACTH analog. This treatment restored adrenal weight, cortical morphology, and plasma corticosterone to the levels seen in wild-type littermates. In conclusion, murine adrenal glands can develop without exposure to endogenous POMC-derived peptides during fetal and neonatal life. Although such glands are atrophic and hypofunctional, exposure to ACTH alone can restore their size, morphology, and corticosterone secretion.