Nutritional implications of feeding free-living birds in public urban areas.

Supplementary feeding can affect populations of birds. It reduces energy spent on foraging and reduces the risk of starvation, but it also increases the risk of disease transmission and predation. Supplementary feeding may reduce species richness if some species are better able to exploit supplementary food resources than others. Feeding may also artificially inflate the carrying capacity of the ecosystem, leading to bird nuisance in the form of droppings and noise. The aim of this study was to characterise and quantify the risk factors and consequences of feeding free-living birds in public areas in the western part of the city of Amsterdam. In seven study areas, the following data were collected: bird population size and species composition, feeding events, and the type and amount of supplementary food offered. Estimations were made of the nutritional energy provided and the number of birds that could be supported by the food offered. Members of the public who fed the birds were invited to complete a questionnaire on various aspects of feeding. Results showed that supplementary feeding attracts juvenile gulls and feral pigeons, which could in the long-term affect biodiversity. Bread was the main category of supplementary food being offered (estimated to be 67% of the total amount of food). The majority of respondents fed birds so as not to waste bread and meal leftovers. In six of the seven areas studied, an overabundance of nutritional energy was calculated. We conclude that the current type and extent of supplementary feeding in the city of Amsterdam is nutritionally unbalanced and affects species diversity at a local level. The overabundance is undesirable for reasons of both animal health, because it can lead to malnutrition, and public health, because surplus food attracts rats and may also have a negative effect on water quality.

Neurodevelopmental outcome in full-term newborns with refractory neonatal seizures.

AIM: This retrospective study describes the prognosis of full-term newborns with refractory neonatal seizures, comparing the need for treatment with two versus three or more antiepileptic drugs. METHODS: We reviewed our database (January 2002-December 2007) to include newborns with refractory neonatal seizures and abnormal electroencephalogram. Group A consisted of 17 newborns with two antiepileptic drugs. Group B consisted of 29 newborns with three or more antiepileptic drugs. Outcome was determined at 2 years of age using the Dutch Bayley Scales of Infant Development or a neurodevelopmental classification scheme. RESULTS: Group A and group B were comparable regarding to a variety of demographic and aetiologic factors. Thirteen newborns died before 2 years of age and one was lost to follow-up. Normal development at 2 years of age was found in 50% and 5% for group A and B, respectively. Severe neurodevelopmental delay at 2 years of age was found in 30% and 68% for group A and B, respectively. CONCLUSION: The number of antiepileptic drugs probably reflects increased seizure burden and is--in that way--related to poor outcome. This may be useful information for early prediction of adverse neurological outcome in the first days of life.

Cerebral MRI abnormalities in a premature infant with later confirmed congenital central hypoventilation syndrome.

We present a premature infant with an inability to ventilate spontaneously during sleep periods. In addition, the patient showed general hypotonia. The child had a delayed passage of stool and increased anal muscle tone, indicating Hirschsprung's disease. The combination of these symptoms suggested congenital central hypoventilation syndrome, which was confirmed postmortem by DNA analysis showing a mutation in the PHOX2B gene. MRI of the brain showed damage to the white matter, including the internal capsula. This type of damage to the white matter has not been described before in a premature infant, who did not experience birth asphyxia.

Diffusion tensor imaging of the cortical plate and subplate in very-low-birth-weight infants.

BACKGROUND: Many intervention studies in preterm infants aim to improve neurodevelopmental outcome, but short-term proxy outcome measurements are lacking. Cortical plate and subplate development could be such a marker. OBJECTIVE: Our aim was to provide normal DTI reference values for the cortical plate and subplate of preterm infants. MATERIALS AND METHODS: As part of an ongoing study we analysed diffusion tensor imaging (DTI) images of 19 preterm infants without evidence of injury on conventional MRI, with normal outcome (Bayley-II assessed at age 2), and scanned in the first 4 days of life. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values in the frontal and temporal subplate and cortical plate were measured in single and multiple voxel regions of interest (ROI) placed on predefined regions. RESULTS: Using single-voxel ROIs, statistically significant inverse correlation was found between gestational age (GA) and FA of the frontal (r = -0.5938, P = 0.0058) and temporal (r = -0.4912, P = 0.0327) cortical plate. ADC values had a significant positive correlation with GA in the frontal (r = 0.5427, P = 0.0164) and temporal (r = 0.5540, P = 0.0138) subplate. CONCLUSION: Diffusion tensor imaging allows in vivo exploration of the evolving cortical plate and subplate. We provide FA and ADC values of the subplate and cortical plate in very-low-birth-weight (VLBW) infants with normal developmental outcome that can be used as reference values.

Frequent occurrence of human-associated microsporidia in fecal droppings of urban pigeons in amsterdam, the Netherlands.

Human-associated microsporidia were frequently observed in fecal samples of 331 feral pigeons in Amsterdam, The Netherlands, obtained during high- and low-breeding periods. Thirty-six of 331 samples (11%) contained the human pathogens Enterocytozoon bieneusi (n = 18), Encephalitozoon hellem (n = 11), Encephalitozoon cuniculi (n = 6), and Encephalitozoon intestinalis (n = 1); 5 samples contained other microsporidia. Pigeon feces can be an important source of human microsporidian infection.

Prevalence of Leptospira spp. and Seoul hantavirus in brown rats (Rattus norvegicus) in four regions in the Netherlands, 2011-2015.

BACKGROUND:   Brown rats (Rattus norvegicus) may carry pathogens that can be a risk for public health. Brown rats in the Netherlands were tested for the zoonotic pathogens Leptospira spp. and Seoul hantavirus (SEOV), in order to obtain insight in their prevalence. METHODS AND RESULTS:   Cross-sectional studies were performed at four locations from 2011 to 2015. The rats were tested for Leptospira spp. using real-time PCR and/or culture resulting in a prevalence ranging between 33-57%. Testing for SEOV was done through an adapted human Seoul hantavirus ELISA and real-time RT-PCR. Although at several locations the ELISA indicated presence of SEOV antibodies, none could be confirmed by focus reduction neutralization testing. CONCLUSION:   The results indicate a widespread presence of Leptospira spp. in brown rats in the Netherlands, including areas with a low leptospirosis incidence in humans. No evidence for circulation of SEOV was found in this study.

Selecting the best index for following the temporal evolution of apparent diffusion coefficient and diffusion anisotropy after hypoxic-ischemic white matter injury in neonates.

BACKGROUND AND PURPOSE: Diffusion-weighted (DW) MR imaging is a useful technique for detecting ischemia. In adults and neonates, however, temporal changes on DW images after ischemia complicate interpretation. Our purpose was to investigate the temporal evolution of the apparent diffusion coefficient (ADC), diffusion-tensor (DT) imaging components, and anisotropy in neonatal brain after hypoxic-ischemic white matter injury and to determine which anisotropy index is preferable. METHODS: DT images were obtained with single-shot echo-planar imaging, by using pulsed field gradients in six directions. Sixteen volunteers and 10 term neonates with normal MR images were evaluated to obtain reference values. Among the anisotropy indexes of fractional anisotropy (FA), relative anisotropy (RA), volume ratio (VR), linear (CI) and planar (Cp) diffusion, and axial anisotropy (Am), simulations were performed to select the most appropriate indexes for clinical practice. The ADC, DT imaging components, and anisotropy were evaluated as a function of time after onset of symptoms in 11 neonates with hypoxic ischemia. RESULTS: In neonates, changes in lesions were characterized by a large decrease (40%) in all eigenvalues, with a stronger decrease in the direction perpendicular to the fibers, resulting in increased anisotropy indexes. The temporal evolution of the relative change in ADC did not show a significant trend (P >.05). The relative change in anisotropy decreased linearly with time (P <.05), with the strongest trend in anisotropy index Am. CONCLUSION: In clinical practice, anisotropy indexes FA, RA and Am appear to be useful. Am is the best index to monitor anisotropy changes. DT imaging provides information about diffusion parallel and perpendicular to white matter fibers, which helps the interpretation of physiologic changes after hypoxic-ischemic injury.

Winter Activity and Aboveground Hybridization Between the Two Biotypes of the West Nile Virus Vector Culex pipiens.

Culex (Cx.) pipiens mosquitoes are important vectors of West Nile virus (WNV). In Europe, the species Cx. pipiens consists of two biotypes, pipiens and molestus, which are morphologically identical, but differ in behavior. Typical behavior of the molestus biotype is the ability to remain active during winter, whereas the pipiens biotype enters diapause. The current paradigm is that the two biotypes occur sympatrically in southern Europe, but occur in isolated above- and belowground populations in northern Europe. In northern Europe, hybridization between biotypes is considered to be low because of the barrier that exists between typical habitats. Data on the occurrence of the biotypes and hybrids in northern Europe, however, are scarce, because identification to the level of biotype is often not performed. Our objective was to clarify the distribution of the Cx. pipiens biotypes and to determine hybridization rates in The Netherlands. Cx. pipiens mosquitoes were collected using three different approaches. First, traps were deployed randomly throughout The Netherlands during the summers of 2011 and 2012 (active surveillance). Second, using a web-based reporting platform and media campaign, Dutch citizens were asked to send dead mosquitoes to our laboratory during the winter and summer of 2014 (passive surveillance). Third, larvae and adults were collected during the summer of 2014 from aboveground locations in Amsterdam to identify molestus larval habitats. Real-time PCR was used for identification to the level of biotype. We found that biotype molestus and hybrids were feeding indoors during winter and summer in The Netherlands and that hybridization rates ranged between 6% and 15%. Larval habitats of biotype molestus were found to occur aboveground. The high percentage of hybridization has implications for assessing the risk of WNV transmission, because hybrids are thought to have ideal characteristics for bridging WNV between birds and humans.

A comparison study of multishot vs. single-shot DWI-EPI in the neonatal brain: reduced effects of ghosting compared to adults.

In the neonatal brain, it is important to use a fast imaging technique to acquire all diffusion weighted images (DWI) for apparent diffusion coefficient (ADC) calculation. Taking into account the occurrence of typical echo planar imaging (EPI) artifacts, we have investigated whether single-shot (SSh) or multishot (MSh) DWI-EPI should be preferred. In 14 neonates, 17 adult patients and 5 adult volunteers, DWIs are obtained both with SSh and MSh EPI. The occurrence of artifacts and their influence on the ADC are explored and further quantified using simulations and phantom studies. Two radiologists scored overall image quality and diagnosability of all images. Single-shot and MSh DWI-EPI scored equally well in neonates with respect to overall image quality and diagnosability. In newborns, more motion artifacts in MSh can be noticed while N/2-ghost artifacts in SSh occur less frequently than in adults. Both N/2-ghost and motion artifacts result in significant ADC abnormalities. There is a serious risk that these artifacts will be mistaken for genuine diffusion abnormalities. N/2-ghost artifacts are hardly noticed in the neonatal brain, which might be due to smaller cerebrospinal fluid (CSF) velocity than in adults. Apparent diffusion coefficient values in MSh are unreliable if motion occurs. We conclude that for ADC calculations in neonates SSh DWI-EPI is more reliable than MSh.

Predicting tick presence by environmental risk mapping.

Public health statistics recorded an increasing trend in the incidence of tick bites and erythema migrans (EM) in the Netherlands. We investigated whether the disease incidence could be predicted by a spatially explicit categorization model, based on environmental factors and a training set of tick absence-presence data. Presence and absence of Ixodes ricinus were determined by the blanket-dragging method at numerous sites spread over the Netherlands. The probability of tick presence on a 1 km by 1 km square grid was estimated from the field data using a satellite-based methodology. Expert elicitation was conducted to provide a Bayesian prior per landscape type. We applied a linear model to test for a linear relationship between incidence of EM consultations by general practitioners in the Netherlands and the estimated probability of tick presence. Ticks were present at 252 distinct sampling coordinates and absent at 425. Tick presence was estimated for 54% of the total land cover. Our model has predictive power for tick presence in the Netherlands, tick-bite incidence per municipality correlated significantly with the average probability of tick presence per grid. The estimated intercept of the linear model was positive and significant. This indicates that a significant fraction of the tick-bite consultations could be attributed to the I. ricinus population outside the resident municipality.

The bilirubin albumin ratio in the management of hyperbilirubinemia in preterm infants to improve neurodevelopmental outcome: a randomized controlled trial--BARTrial.

BACKGROUND AND OBJECTIVE: High bilirubin/albumin (B/A) ratios increase the risk of bilirubin neurotoxicity. The B/A ratio may be a valuable measure, in addition to the total serum bilirubin (TSB), in the management of hyperbilirubinemia. We aimed to assess whether the additional use of B/A ratios in the management of hyperbilirubinemia in preterm infants improved neurodevelopmental outcome. METHODS: In a prospective, randomized controlled trial, 615 preterm infants of 32 weeks' gestation or less were randomly assigned to treatment based on either B/A ratio and TSB thresholds (consensus-based), whichever threshold was crossed first, or on the TSB thresholds only. The primary outcome was neurodevelopment at 18 to 24 months' corrected age as assessed with the Bayley Scales of Infant Development III by investigators unaware of treatment allocation. Secondary outcomes included complications of preterm birth and death. RESULTS: Composite motor (100 ± 13 vs. 101 ± 12) and cognitive (101 ± 12 vs. 101 ± 11) scores did not differ between the B/A ratio and TSB groups. Demographic characteristics, maximal TSB levels, B/A ratios, and other secondary outcomes were similar. The rates of death and/or severe neurodevelopmental impairment for the B/A ratio versus TSB groups were 15.4% versus 15.5% (P = 1.0) and 2.8% versus 1.4% (P = 0.62) for birth weights ≤ 1000 g and 1.8% versus 5.8% (P = 0.03) and 4.1% versus 2.0% (P = 0.26) for birth weights of >1000 g. CONCLUSIONS: The additional use of B/A ratio in the management of hyperbilirubinemia in preterm infants did not improve their neurodevelopmental outcome. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN74465643.

Fractional anisotropy in white matter tracts of very-low-birth-weight infants.

BACKGROUND: Advances in neonatal intensive care have not yet reduced the high incidence of neurodevelopmental disability among very-low-birth-weight (VLBW) infants. As neurological deficits are related to white-matter injury, early detection is important. Diffusion tensor imaging (DTI) could be an excellent tool for assessment of white-matter injury. OBJECTIVE: To provide DTI fractional anisotropy (FA) reference values for white-matter tracts of VLBW infants for clinical use. MATERIALS AND METHODS: We retrospectively analysed DTI images of 28 VLBW infants (26-32 weeks gestational age) without evidence of white-matter abnormalities on conventional MRI sequences, and normal developmental outcome (assessed at age 1-3 years). For DTI an echoplanar sequence with diffusion gradient (b = 1,000 s/mm(2)) applied in 25 non-collinear directions was used. We measured FA and apparent diffusion coefficient (ADC) of different white-matter tracts in the first 4 days of life. RESULTS: A statistically significant correlation was found between gestational age and FA of the posterior limb of the internal capsule in VLBW infants (r = 0.495, P<0.01). CONCLUSION: Values of FA and ADC were measured in white-matter tracts of VLBW infants. FA of the pyramidal tracts measured in the first few days after birth is related to gestational age.

Infants with perinatal hypoxic ischemia: feasibility of fiber tracking at birth and 3 months.

The purpose of this study was to retrospectively investigate the feasibility of fiber tracking at birth and 3 months in infants with hypoxic ischemia to detect disturbances in white matter development. This retrospective study did not require institutional review board approval. All parents gave informed consent. Diffusion-tensor magnetic resonance (MR) images were obtained in full-term newborns: seven with standard MR imaging findings and 10 with perinatal hypoxic ischemia-related abnormalities. Visualization of white matter tracts was investigated by using a volume-tracing and quantification technique. Fiber tracking was useful for studying the neonatal brain. Abnormalities resulted in fiber patterns that were different from the fiber patterns of normal brain tissue. The corona radiata fibers were frequently affected.