Thermal tolerance for the tropical clawed frog, Xenopus tropicalis with comments on comparative methods for amphibian studies.

Thermal tolerance data are important for identifying the potential range of non-native species following introduction and establishment. Such data are particularly important for understanding invasion risks of tropical species introduced to temperate climates and identifying whether they can survive outside tropical regions. A breeding population of the tropical clawed frog (Xenopus tropicalis) was recently discovered in west-central Florida, U.S.A. This fully aquatic species is native to the rainforest belt of west Africa and has not been documented outside its native range. Because of the lack of invasion history, data are sparse on the thermal limits for this species. We used chronic lethal and critical thermal methodologies to investigate thermal tolerance on adult stages and critical thermal methods on tadpoles. Because of our use of both chronic and critical methodologies, we also examined the literature to reveal common methods used to investigate thermal minimum and maximum temperature in amphibians, which were found to be dominated by the critical maximum. Chronic lethal temperatures for adult X. tropicalis were 9.73 °C and 36.68 °C. Critical temperatures were affected by acclimation temperature and life stage; adults were more tolerant of extreme temperatures. Based on these critical thermal data and the fact that breeding tends to occur when temperatures are suitable for survival, tadpole stages are unlikely to be affected by extreme temperatures. Instead, range expansion in Florida will likely be limited by the adult stages. Our findings indicate that the tropical clawed frog could occupy much of southern Peninsular Florida and other tropical and subtropical regions worldwide.

Pterygodermatites (Mesopectines) whartoni (Nematoda: Rictulariidae) encysted larvae in invasive Cuban treefrogs (Osteopilus septentrionalis) from Florida, United States.

Species of Pterygodermatites are spirurid nematodes that have expanded their geographic distribution worldwide. They infect a variety of mammalian definitive hosts with few reports of potential paratenic infections in amphibian and reptile hosts. In this study, we report Pterygodermatites sp. larvae identified in free-ranging, invasive Cuban treefrogs (Osteopilus septentrionalis), from central Florida, United States. Encysted larvae were recovered from the skeletal muscle and/or the coelomic cavity of three frogs; molecular characterization of the small subunit (18S) ribosomal RNA and cytochrome oxidase I genes of the parasites matched reported sequences of Pterygodermatites (Mesopectines) whartoni (Tubangui, 1931). This is a parasite native to Southeastern Asia and to the best of the authors' knowledge, it is the first report of the species in the New World. The recovery of invasive Pterygodermatites from invasive Cuban treefrogs in North America highlights the growing concern regarding the potential impact non-native parasites and invasive species may have on native wildlife populations.

Clinical Knowledge Model for the Prevention of Healthcare-Associated Venous Thromboembolism.

Knowledge models inform organizational behavior through the logical association of documentation processes, definitions, data elements, and value sets. The development of a well-designed knowledge model allows for the reuse of electronic health record data to promote efficiency in practice, data interoperability, and the extensibility of data to new capabilities or functionality such as clinical decision support, quality improvement, and research. The purpose of this article is to describe the development and validation of a knowledge model for healthcare-associated venous thromboembolism prevention. The team used FloMap, an Internet-based survey resource, to compare metadata from six healthcare organizations to an initial draft model. The team used consensus decision-making over time to compare survey results. The resulting model included seven panels, 41 questions, and 231 values. A second validation step included completion of an Internet-based survey with 26 staff nurse respondents representing 15 healthcare organizations, two electronic health record vendors, and one academic institution. The final knowledge model contained nine Logical Observation Identifiers Names and Codes panels, 32 concepts, and 195 values representing an additional six panels (groupings), 15 concepts (questions), and the specification of 195 values (answers). The final model is useful for consistent documentation to demonstrate the contribution of nursing practice to the prevention of venous thromboembolism.

A Randomized Controlled Trial of the Effects of a Web-Based Intervention on Perceived Stress and Diet Quality Among First-Year University Students.

Background: e-Health interventions can potentially improve health care. My Viva Plan® (MVP) is a web-based program that focuses on mindfulness, nutrition, and physical fitness. The aim of this study was to evaluate the effects of this platform on stress indicators and diet quality among first-year university students. Methods: Ninety-seven university students were enrolled in a randomized, controlled clinical trial. Participants were randomized into control (n = 49) and MVP (n = 48) groups. Perceived stress was measured using the self-report Stress Indicator Questionnaire. Diet quality was assessed by the nutrient-rich foods index, and body composition was assessed by a hand-to-foot, multifrequency, bioelectrical impedance analysis. Results: There were no differences in physical, sleep, behavioral, emotional, and personal habit indicators between groups. Diet quality and body composition were similar between groups, except among women in the MVP group with decreased body fat (-1.2 ± 2.6 kg, p < 0.05). Participant engagement was low: 50% of the MVP group did not access the platform. Conclusions: The MVP web-based intervention was not associated with improvements in stress indicators, diet quality, and body composition, likely due to the characteristics of our cohort of healthy young individuals. Future studies should focus on enhancing motivational approaches to explore the potential of e-health interventions that improve health behavior.Clinical Trial Registration number: NCT03579264A.

Data Science Implementation Trends in Nursing Practice: A Review of the 2021 Literature.

OBJECTIVES: The goal of this work was to provide a review of the implementation of data science-driven applications focused on structural or outcome-related nurse-sensitive indicators in the literature in 2021. By conducting this review, we aim to inform readers of trends in the nursing indicators being addressed, the patient populations and settings of focus, and lessons and challenges identified during the implementation of these tools. METHODS: We conducted a rigorous descriptive review of the literature to identify relevant research published in 2021. We extracted data on model development, implementation-related strategies and measures, lessons learned, and challenges and stakeholder involvement. We also assessed whether reports of data science application implementations currently follow the guidelines of the Developmental and Exploratory Clinical Investigations of DEcision support systems driven by AI (DECIDE-AI) framework. RESULTS: Of 4,943 articles found in PubMed (NLM) and CINAHL (EBSCOhost), 11 were included in the final review and data extraction. Systems leveraging data science were developed for adult patient populations and were primarily deployed in hospital settings. The clinical domains targeted included mortality/deterioration, utilization/resource allocation, and hospital-acquired infections/COVID-19. The composition of development teams and types of stakeholders involved varied. Research teams more frequently reported on implementation methods than implementation results. Most studies provided lessons learned that could help inform future implementations of data science systems in health care. CONCLUSION: In 2021, very few studies report on the implementation of data science-driven applications focused on structural- or outcome-related nurse-sensitive indicators. This gap in the sharing of implementation strategies needs to be addressed in order for these systems to be successfully adopted in health care settings.

Experimental evaluation of how biological invasions and climate change interact to alter the vertical assembly of an amphibian community.

While biotic-abiotic interactions are increasingly documented in nature, a process-based understanding of how such interactions influence community assembly is lacking in the ecological literature. Perhaps the most emblematic and pervasive example of such interactions is the synergistic threat to biodiversity posed by climate change and invasive species. Invasive species often out-compete or prey on native species. Despite this long-standing and widespread issue, little is known about how abiotic conditions, such as climate change, will influence the frequency and severity of negative biotic interactions that threaten the persistence of native fauna. Treefrogs are a globally diverse group of amphibians that climb to complete life-cycle processes, such as foraging and reproduction, as well as to evade predators and competitors, resulting in frog communities that are vertically partitioned. Furthermore, treefrogs adjust their vertical position to maintain optimal body temperature and hydration in response to environmental change. Here, utilizing this model group, we designed a novel experiment to determine how extrinsic abiotic and biotic factors (changes to water availability and an introduced predator, respectively) interact with intrinsic biological traits, such as individual physiology and behaviour, to influence treefrogs' vertical niche. Our study found that treefrogs adjusted their vertical niche through displacement behaviours in accordance with abiotic resources. However, biotic interactions resulted in native treefrogs distancing themselves from abiotic resources to avoid the non-native species. Importantly, under altered abiotic conditions, both native species avoided the non-native species 33 %- 70 % more than they avoided their native counterpart. Additionally, exposure to the non-native species resulted in native species altering their tree climbing behaviours by 56 % - 78 % and becoming more vertically dynamic to avoid the non-native antagonist. Our experiment determined that vertical niche selection and community interactions were most accurately represented by a biotic-abiotic interaction model, rather than a model that considers these factors to operate in an isolated (singular) or even additive manner. Our study provides evidence that native species may be resilient to interacting disturbances via physiological adaptations to local climate and plasticity in space-use behaviours that mediate the impact of the introduced predator.

Baltimore City Health Department's Use of Public-Private Partnerships to Create a Continuum of COVID-19 Services for Special Populations.

The Baltimore City Health Department (BCHD) has developed a COVID-19 continuum of services to protect special populations at high risk of COVID-19 made possible through inter-agency and public-private partnerships. We present descriptions of each element along with descriptive data. Lessons are discussed to inform future public health frameworks.

Effects of semi-constant temperature on embryonic and hatchling phenotypes of six-tubercled Amazon River turtles, Podocnemis sextuberculata.

PURPOSE: We evaluated how constant incubation temperatures affect life-history traits pre-hatching and post-hatching of the six-tubercled Amazon River turtle, Podocnemis sextuberculata. METHODS: We incubated eggs from natural nests at ten semi-constant temperatures between 22.26 ± 1.01 °C and 37.37 ± 0.38°C (2013) and at six temperatures between 25.75 ± 0.22 °C and 36.17 ± 0.15°C (2016). In 2013, we raised hatchling for 90 days to evaluate effects of temperature on early hatchling growth. We evaluated maternal effects in 2016. RESULTS: P. sextuberculata displays temperature-dependent sex determination and produces males at colder and females at warmer temperatures (TSD Ia). The estimated pivotal temperature was 33.73 ± 0.15 °C and the transitional range of temperatures (TRT) 1.16 ± 0.59 °C. Semi-constant temperatures below 26 °C and above 38 °C were lethal. Intermediate temperatures (32.25 °C and 31.5 °C, respectively) were optimal for hatching success and produced larger hatchlings that grew slower early in life compared to colder or warmer conditions, which produced smaller hatchlings. Warmer incubation temperatures within the optimal range (28°C-37 °C) accelerated embryonic development. In contrast, comparisons of 30, 60 and 90 days-old suggests that warmer incubation temperatures reduced growth and mass gain rates post-hatching, such that incubation temperature effects on body size at emergence disappeared by 3 months of age. CONCLUSIONS: Six-tubercled Amazon River turtles showed the highest pivotal temperature reported for any turtle. The relatively narrow TRT may limit the evolutionary potential of this vulnerable turtle in the face of global warming. Future incubation experiments at a finer scale (33°C-36 °C) are warranted to refine the sex-ratio reaction norm. Field studies that monitor natural nests are imperative to evaluate conservation measures and the effect of female-biased illegal hunting and climate change. By providing data about the thermal biology of an understudied lineage of non-model species, our study helps fill gaps in our understanding of the evolution of vertebrate sex determination and its potential adaptive value.

COVID-19 Vaccination Of People Experiencing Homelessness And Incarceration In Minnesota.

We used data from a statewide public health-health system collaboration to describe trends in COVID-19 vaccination rates by racial and ethnic groups among people experiencing homelessness or incarceration in Minnesota. Vaccination completion rates among the general population and people incarcerated in state prisons were substantially higher than those among people experiencing homelessness or jail incarceration.

Rat Lungworm (Angiostrongylus cantonensis) in the Invasive Cuban Treefrog (Osteopilus septentrionalis) in Central Florida, USA.

Cuban treefrogs, Osteopilus septentrionalis, were grossly examined for parasites and parasite species confirmed by PCR. Angiostrongylus cantonensis larvae were recovered from the hind leg muscle of O. septentrionalis. This is the first report of the zoonotic rat lungworm in the Cuban treefrog and new geographic location (Volusia County) in Florida, US.

Primary Care Concerns for the Aging Population With HIV.

Because individuals with HIV are living longer, comorbidities are moving to the forefront of HIV patient care. People with HIV have a higher risk for HIV-related and non-HIV-related cancers than the general population, making cancer screening vital for this population. Immunizations are another important element of primary care for older adults with HIV, including a COVID-19 vaccine, about which data continue to evolve. This article summarizes a presentation by Steven C. Johnson, MD, at the International Antiviral Society-USA (IAS-USA) virtual HIV course Aging and HIV: Issues, Screening, and Management in Individuals with HIV as They Age in June 2021.

Pain Information Model and Its Potential for Predictive Analytics: Applicability of a Big Data Science Framework.

PURPOSE: To describe the application of a big data science framework to develop a pain information model and to discuss the potential for its use in predictive modeling. DESIGN AND METHOD: This is an application of a cross-industry standard process for a data mining adapted framework (the Applied Healthcare Data Science Framework) to build an information model on pain management and its potential for predictive modeling. Data were derived from electronic health records and were composed of approximately 51,000 records of unique adult patients admitted to clinical and surgical units between July 2015 and June 2019. FINDINGS: The application of the Applied Healthcare Data Science Framework steps allowed the development of an information model on pain management, considering pain assessment, interventions, goals, and outcomes. The developed model has the potential to be used for predicting which patients are most likely to be discharged with self-reported pain. CONCLUSIONS: Through the application of the framework, it is possible to support health professionals' decision making on the use of data to improve the effectiveness of pain management. CLINICAL RELEVANCE: In the long term, the framework is intended to guide data science methodologies to personalize treatments, reduce costs, and improve health outcomes.

Successful use of generic direct acting antiviral medications to treat hepatitis C-a New Zealand-wide study.

AIMS: Direct acting antiviral (DAA) hepatitis C (HCV) medications are funded in New Zealand since 2016 for some and since 2019 for all genotypes. The purpose of this study was to review New Zealand-wide data of the use of generic HCV DAA medications imported through Tasmanian FixHepC Buyer's Club and the associated side effect profiles. METHODS: This is a retrospective data audit on the use of generic DAAs to treat HCV; outcomes from consecutive hepatitis C patients (naïve and pre-treated) treated with generic DAAs (sofosbuvir/ledipasvir, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir, ribavirin) collected from all known sites that used Buyer's club medications in eight New Zealand district health board regions were summarised. Demographic, disease characteristics, FibroScan and blood markers' (platelets, ALT, GGT, AFP) data were collected. RESULTS: Study sample was 81.8% New Zealand European, 64.8% male of median 56.0 (IQR: 48.0-60.0) years old. Three participants (4.5%) were HIV positive. 74.7% of the participants had signs of fibrosis (F1-F4); 40.5% had cirrhosis/scaring (F4). 61.7% of the patients were naïve to treatment. 42.0%, 40.1% and 12.0% received sofosbuvir/ledipasvir, sofosbuvir/daclatasvir, sofosbuvir/velpatasvir, respectively; 32.1% also received ribavirin. 80.2% of patients received treatment for 12 weeks. 95.1% (154/162) of the sample achieved sustained virological response at 12 weeks post-treatment, 2.5% relapsed, 1.2% were lost to follow-up. The main minor side effects included fatigue, headache, difficulty sleeping, experienced by 21.7%, 7.0%, 7.0%, respectively. An average total cost for medication and monitoring was 2,027 to 2,659 NZD (12 weeks), and 3,054 to 4,260 NZD (24 weeks) per patient. CONCLUSIONS: Generic DAAs to treat hepatitis C are safe, efficient and a cheaper than branded medications option.

A refined methodology for validation of information models derived from flowsheet data and applied to a genitourinary case.

Use of electronic health record data is expanding to support quality improvement and research; however, this requires standardization of the data and validation within and across organizations. Information models (IMs) are created to standardize data elements into a logical organization that includes data elements, definitions, data types, values, and relationships. To be generalizable, these models need to be validated across organizations. The purpose of this case report is to describe a refined methodology for validation of flowsheet IMs and apply the revised process to a genitourinary IM created in one organization. The refined IM process, adding evidence and input from experts, produced a clinically relevant and evidence-based model of genitourinary care. The refined IM process provides a foundation for optimizing electronic health records with comparable nurse sensitive data that can add to common data models for continuity of care and ongoing use for quality improvement and research.

Cannabis Chemovar Nomenclature Misrepresents Chemical and Genetic Diversity; Survey of Variations in Chemical Profiles and Genetic Markers in Nevada Medical Cannabis Samples.

Introduction: Medical cannabis patients receive clinical benefits from the secondary metabolites of the plant, which contain a variety of cannabinoids and terpenoids in combinations that can be used to classify the chemovars. State-regulated medical cannabis programs rely on breeder-reported "strain" names both within diversion control systems and to describe the medical cannabis products that are sold to patients in medical cannabis dispensaries. In state-regulated medical cannabis programs, there is no conventional nomenclature system that correlates the breeder-reported names with their profiles of active ingredients, and these "strain" names are invalid as they refer to chemical differences properly referred to as to chemovars. Materials and Methods: To determine the actual levels of chemical diversity represented in 2662 samples of Cannabis flower collected between January 2016 and June of 2017 in Nevada, chemical profile data were measured from these samples by a state-qualified third-party testing laboratory. Principal component analysis (PCA) was used to define clusters in data sets representing both cannabinoids and terpenoids, cannabinoids only, or terpenoids only. Results: The PCA of the terpenoid only data set revealed three well-defined clusters. All three terpenoids only data clusters had high tetrahydrocannabinolic acid synthase, but the terpene profiles listed in reverse-order of abundance best defined these chemovars. The three chemovars in Nevada were labeled with 396 breeder-reported sample names, which overestimate the diversity and do not inform patients regarding chemical properties. Representative DNA samples were taken from each chemovar to determine whether the genetic diversity was greater than the chemical diversity. The limited genotyping experiment was based on DNA sequence polymorphisms. The genetic analysis revealed twelve distinct genetic clades, which still does not account for the entirety of the 396 reported sample names. The finite genotypes did not correlate with the chemotypes determined for the samples. This suggests that either the DNA-markers used were too narrowly restricted for factual separation or that environmental factors contributed more significantly to the chemical profiles of cannabis than genetics. Conclusion: The three chemovars and twelve genotypes reflect low medical diversity on the market in Nevada during its "medical use only" phase. Furthermore, the 396 breeder-reported sample names within this set imply a false sense of diversity of products in Nevada dispensaries.

A single nucleotide polymorphism assay sheds light on the extent and distribution of genetic diversity, population structure and functional basis of key traits in cultivated north American cannabis.

BACKGROUND: The taxonomic classification of Cannabis genus has been delineated through three main types: sativa (tall and less branched plant with long and narrow leaves), indica (short and highly branched plant with broader leaves) and ruderalis (heirloom type with short stature, less branching and small thick leaves). While still under discussion, particularly whether the genus is polytypic or monotypic, this broad classification reflects putative geographical origins of each group and putative chemotype and pharmacologic effect. METHODS: Here we describe a thorough investigation of cannabis accessions using a set of 23 highly informative and polymorphic SNP (Single Nucleotide Polymorphism) markers associated with important traits such as cannabinoid and terpenoid expression as well as fibre and resin production. The assay offers insight into cannabis population structure, phylogenetic relationship, population genetics and correlation to secondary metabolite concentrations. We demonstrate the utility of the assay for rapid, repeatable and cost-efficient genotyping of commercial and industrial cannabis accessions for use in product traceability, breeding programs, regulatory compliance and consumer education. RESULTS: We identified 5 clusters in the sample set, including industrial hemp (K5) and resin hemp, which likely underwent a bottleneck to stabilize cannabidiolic acid (CBDA) accumulation (K2, Type II & III). Tetrahydrocannabinolic acid (THCA) resin (Type I) makes up the other three clusters with terpinolene (K4 - colloquial "sativa" or "Narrow Leaflet Drug" (NLD), myrcene/pinene (K1) and myrcene/limonene/linalool (K3 - colloquial "indica", "Broad Leaflet Drug" (BLD), which also putatively harbour an active version of the cannabichrometic acid Synthase gene (CBCAS). CONCLUSION: The final chemical compositions of cannabis products have key traits related to their genetic identities. Our analyses in the context of the NCBI Cannabis sativa Annotation Release 100 allows for hypothesis testing with regards to secondary metabolite production. Genetic markers related to secondary metabolite production will be important in many sectors of the cannabis marketplace. For example, markers related to THC production will be important for adaptable and compliant large-scale seed production under the new US Domestic Hemp Production Program.

Shmapped: development of an app to record and promote the well-being benefits of noticing urban nature.

The majority of research to date on the links between well-being and green spaces comes from cross-sectional studies. Shmapped is an app that allows for the collection of well-being and location data live in the field and acts as a novel dual data collection tool and well-being intervention, which prompts users to notice the good things about their surroundings. We describe the process of developing Shmapped from storyboarding, budgeting, and timescales; selecting a developer; drawing up data protection plans; and collaborating with developers and end-user testers to ultimately publishing Shmapped. The development process and end-user testing resulted in a highly functional app. Limitations and future uses of such novel dual data collection and intervention apps are discussed and recommendations are made for prospective developers and researchers.

Experimental fragmentation of pipe bombs with varying case thickness.

Among all the improvised explosive devices (IEDs) known, pipe bombs are one of the most popular devices used by terrorists. They are simple to use, easy to construct and materials are readily available. For this IED, fragmentation is the primary injury mechanism, which makes them a desirable weapon for terrorists aiming to inflict maximum human casualties. Although the investigation of fragmentation pattern is not novel, there is limited data available on pipe bombs performance in the open literature. Therefore, this research is looking at validating results in current literature, which showed limited repetition and weak experimental design so far; by trial with six pipe bombs with two different thickness (3 of each). The pipe bombs consisted of mild steel casing and aluminised ammonium nitrate as the explosive filler. Fragments were collected, with an average recovery of 72%, and measured regarding mass and velocity. The experiment results show a correlation between the pipe thickness and both the size and velocity of fragments.

A CBC algorithm combined with immature platelet fraction is able to identify JAK2 V617F mutation-positive polycythaemia vera patients.

INTRODUCTION: The recent lowering of the World Health Organisation (WHO) haemoglobin (Hb) and haematocrit (HCT) thresholds for diagnosis of polycythaemia vera (PV) has markedly increased the proportion of complete blood counts (CBC) that could be referred for haematologist review for comment, including advice on JAK2 V617F mutation analysis. The utility of an algorithm based on CBC indices and immature platelet fraction (IPF) to select cases for haematologist review was investigated. METHODS: IPF analysis was performed on 22 patients with known JAK2 V617F mutation and 41 patients who were negative for this mutation previously tested because of suspicion of PV. A reference range study for IPF was performed on 102 normal patients. The algorithm was applied to data from 163 358 CBC analyses to identify those most likely to have PV for review by a haematologist. RESULTS: The CBC algorithm and IPF requirement were satisfied by 47 patients (0.03%), eight of whom were known to have myeloproliferative disorders; the remaining 39 were referred for haematologist review. CONCLUSION: Utilising the algorithm enables identification of patients with a high likelihood of PV for haematological review. Large numbers are able to be screened efficiently and cost-effectively. Some patients with masked PV are able to be detected before clinical presentation.

Identifying barriers to treatment of HCV in the primary care setting.

OBJECTIVE: To identify practice, attitudes, and potential barriers to treatment of Hepatitis C to primary care practitioners. DESIGN: A postal survey of general practitioners in New Zealand. SETTING: Nationwide postal survey to all general practitioners in New Zealand. PARTICIPANTS: All general practitioners in New Zealand identified by their association with Primary Health Organizations. MAIN OUTCOMES: Identification barriers to treatment of Hepatitis C amenable to intervention by general practitioners in New Zealand. RESULTS: 3817 general practitioners surveyed. 925 (24.2%) surveys returned. 187 (21%) currently prescribe Hepatitis C medications. 620 (70%) indicated that no general practitioner in their practice had interest in managing Hepatitis C therapy. Hepatitis C training was associated with increased prescribing activity-29% in those with training versus 10% in those without training. Confidence levels in initiating or continuing Hepatitis C therapy significantly rose from 23.8 and 47.8 to 50.2 and 67.7, respectively, with training. Inadequate reimbursement (44%), too few Hepatitis C patients (40%), and caseload with other patients (40%) were the most frequently identified barriers to treatment. Difficulty in obtaining transient elastography (35%) prior to treatment, lack of training (32%), and the perception that Hepatitis C therapy should be done by a specialist (30%) were also frequently reported barriers. General practitioners consistently underestimated the prevalence of Hepatitis C in their practice by a factor of 4.3 to 13.6 (based on an estimated prevalence of 1.9%). CONCLUSION: Although the most frequently cited barrier to general practitioner treatment of HCV was reimbursement, this is entwined with other purported barriers such as complexity of the patients, time commitment, caseload, and need for expertise. A lack of awareness of the prevalence of Hepatitis C in the general population is an important barrier. A comprehensive strategy to address multiple barriers, improve treatment regimens, and increase awareness of HCV is needed for ultimate success in the eradication of HCV in New Zealand and worldwide.