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2.
MMWR Morb Mortal Wkly Rep ; 69(9): 236-240, 2020 Mar 06.
Artículo en Inglés | MEDLINE | ID: mdl-32134907

RESUMEN

On July 10, 2019, Wisconsin Department of Health Services (WDHS) was notified of five previously healthy adolescents with severe lung injuries who reported use of e-cigarette, or vaping, products before symptom onset. As of December 31, 2019, 105 confirmed or probable cases of e-cigarette, or vaping, product use-associated lung injury (EVALI)* had been reported to WDHS . Three social clusters (A, B, and C), comprising eight EVALI patients (cluster A = two patients, cluster B = three, and cluster C = three) were identified. WDHS investigated these clusters with standard and follow-up interviews; laboratory analysis of e-cigarette, or vaping, products; and analysis of bronchoalveolar lavage (BAL) fluid. All eight patients reported daily use of tetrahydrocannabinol (THC)-containing e-cigarette, or vaping, product cartridges (THC cartridges) in the month preceding symptom onset. All THC cartridges were purchased from local illicit dealers, and all patients reported using THC cartridges labeled as "Dank Vapes," among other illicit brand names. At least two members of each cluster reported frequent sharing of THC cartridges before symptom onset. All eight patients also reported daily use of nicotine-containing e-cigarette, or vaping, products. Vitamin E acetate (VEA) was detected in all five THC cartridges tested from two patients, and in BAL fluid from two other patients. These findings suggest that THC cartridges containing VEA and sold on the illicit market were likely responsible for these small clusters of EVALI. Based on information presented in this and previous reports (1,2) CDC recommends not using THC-containing e-cigarette, or vaping, products, especially those obtained from informal sources such as friends, family, or in-person or online dealers (1). VEA is strongly linked to the EVALI outbreak and should not be added to e-cigarette, or vaping, products (1).


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina/estadística & datos numéricos , Lesión Pulmonar/epidemiología , Vapeo/efectos adversos , Adolescente , Análisis por Conglomerados , Dronabinol/toxicidad , Femenino , Humanos , Masculino , Vapeo/psicología , Vitamina E/toxicidad , Wisconsin/epidemiología , Adulto Joven
3.
MMWR Morb Mortal Wkly Rep ; 69(8): 207-211, 2020 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-32106217

RESUMEN

In January 2018, the Wisconsin Department of Health Services, Division of Public Health (DPH), received a report of a culture-confirmed case of Legionnaires' disease. The patient, who was immunocompromised, had died at a local hospital 10 days after being admitted. DPH and an infection preventionist from the hospital investigated to determine the source of the infection and prevent additional cases. Because the case was suspected to be nosocomial, health care facility water samples were tested for Legionella. When these samples were negative, water sources in the patient's home were tested. These tested positive for Legionella pneumophila, and the bacteria remained after an attempt to remediate. The patient and home isolates were identified as L. pneumophila serogroup 3, sequence type 93, by whole-genome multilocus sequence typing. A second resident of the home did not become ill. This case highlights the potential for immunocompromised persons and others at risk for Legionnaires' disease to be exposed to Legionella through home water systems containing the bacteria and demonstrates the difficulty of home remediation. This case also illustrates the role of lower respiratory tract specimens in the identification of less common Legionella infections (e.g., L. pneumophila serogroup 3) and confirmation of the infection source.


Asunto(s)
Exposición a Riesgos Ambientales/efectos adversos , Vivienda , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/diagnóstico , Anciano , Resultado Fatal , Humanos , Legionella pneumophila/clasificación , Serotipificación , Wisconsin
4.
PLoS One ; 15(2): e0228372, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32027686

RESUMEN

Social media is increasingly utilized as a resource in healthcare. We sought to identify perceptions of using social media as an educational tool among healthcare practitioners. An electronic survey was distributed to healthcare administrators, nurses, nurse practitioners, pharmacists, physicians, and physician assistants f hospital systems and affiliated health science schools in Georgia, Maryland, South Carolina, and Wisconsin. Survey questions evaluated respondents' use and views of social media for educational purposes and workplace accessibility using a Likert scale (1 = strongly disagree, 5 = strongly agree). Nurses (75%), pharmacists (11%), and administrators (7%) were the most frequent respondents. Facebook® (27%), Pinterest® (17%), and Instagram® (17%) were the most frequently accessed social media platforms. Nearly 85% agreed or strongly agreed that social media can be an effective tool for educational purposes. Among those who had social media platforms, 43.0% use them for educational purposes. Pinterest® (30%), Facebook® (22%), LinkedIn® (16%), and Twitter® (14%) were most frequently used for education. About 50% of respondents had limited or no access to social media at work. Administrators, those with unlimited and limited work access, and respondents aged 20-29 and 30-39 years were more likely to agree that social media is an educational tool (OR: 3.41 (95% CI 1.31 to 8.84), 4.18 (95% CI 2.30 to 7.60), 1.66 (95% CI 1.22 to 2.25), 4.40 (95% CI 2.80 to 6.92), 2.14 (95% CI 1.53 to 3.01) respectively). Residents, physicians, and those with unlimited access were less likely to agree with allowing social media access at work for educational purposes only. Healthcare practitioners frequently utilize social media, and many believe it can be an effective educational tool in healthcare.


Asunto(s)
Educación Continua/métodos , Personal de Salud , Percepción , Medios de Comunicación Sociales , Adulto , Femenino , Georgia/epidemiología , Personal de Salud/educación , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Humanos , Difusión de la Información/métodos , Internado y Residencia/estadística & datos numéricos , Masculino , Maryland/epidemiología , Enfermeras Practicantes/educación , Enfermeras Practicantes/psicología , Enfermeras Practicantes/estadística & datos numéricos , Farmacéuticos/psicología , Farmacéuticos/estadística & datos numéricos , Asistentes Médicos/educación , Asistentes Médicos/psicología , Asistentes Médicos/estadística & datos numéricos , Médicos/psicología , Médicos/estadística & datos numéricos , Medios de Comunicación Sociales/normas , South Carolina/epidemiología , Encuestas y Cuestionarios , Wisconsin/epidemiología , Adulto Joven
5.
Int J Biometeorol ; 64(5): 713-727, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32072321

RESUMEN

Common approaches currently used to monitor forest phenology include direct field observation and indirect approaches such as satellite remote sensing and carbon flux measurements. However, differences in both temporal and spatial scales of these methods make direct comparison challenging. In order to evaluate the reliability of indirect measures of autumn phenology in estimating direct observations, we compared the timing of three transition dates and the rate of autumn progression derived from (i) satellite data (MOD13Q1 006 enhanced vegetation index (EVI) and normalized difference vegetation index (NDVI) products, 2000-2017), (ii) carbon flux measurements (net ecosystem exchange (NEE) and gross primary production (GPP), 1997-2016), and (iii) field observation (2010, 2012 for the north site and 2010, 2012, and 2013 for the south site) from a mixed forest in northern Wisconsin, USA. Overall, the transition dates and progression rates derived from NDVI were closest to that of field observations. Furthermore, the start of autumn derived from satellite data was earlier than directly observed leaf coloration (LC), which resulted from species-specific canopy senescence patterns and the sensitivity of the vegetation indices. Even after full leaf fall was reached, EVI continued to detect coloring which was likely due to the presence of understory plant species. Finally, NEE and GPP changes tended to start before LC as a result of tree physiological and environmental changes and continued after full leaf fall possibly due to understory and coniferous activity. These results highlight the need for long-term field observations of both trees and understory species, information on species-specific canopy senescence patterns, and species composition in understanding the efficiency of indirect approaches in estimating autumn forest phenology.


Asunto(s)
Ecosistema , Bosques , Carbono , Ciclo del Carbono , Hojas de la Planta , Reproducibilidad de los Resultados , Estaciones del Año , Árboles , Wisconsin
6.
Plant Dis ; 104(3): 951-957, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31891549

RESUMEN

This research was conducted to identify species causing powdery mildew on cucurbits and to determine genetic variations among isolates of the pathogen. We collected 109 isolates from six cucurbit species hosts (Cucumis melo, Cucumis sativus, Cucurbita maxima, Cucurbita moschata, Cucurbita pepo, and Lagenaria siceraria) in California, Illinois, Indiana, Michigan, New York, Texas, Washington, and Wisconsin in the United States and in Italy. By sequencing the internal transcribed spacer region of the nuclear rDNA of these 109 isolates, Podosphaera xanthii was found as the only species causing powdery mildew on cucurbits in the United States. Genotyping-by-sequencing was applied to these 109 isolates to investigate their genetic diversity, which showed a trend of isolates clustering from New York and Italy. In addition, the virulence of 36 isolates was compared and a significant difference (P < 0.0001) was found among them. Furthermore, results of the virulence tests of 28 isolates from Illinois showed significant effects of collection years, hosts, and locations on the virulence of the isolates.


Asunto(s)
Variación Genética , Enfermedades de las Plantas , California , Genotipo , Illinois , Italia , Michigan , New York , Texas , Washingtón , Wisconsin
8.
Phytopathology ; 110(5): 1049-1055, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31939718

RESUMEN

Common scab, caused by Streptomyces scabies and related species, is a potato tuber blemish disease that causes reductions in marketable yield worldwide. Evidence of suppression of common scab by indigenous soil microbial populations has been found in several studies. However, we lack a comprehensive understanding of how common scab severity relates functionally to potato varieties, farming systems, soil physical and chemical properties, and soil microbial communities. These factors may affect disease directly or indirectly by affecting one of the other variables. We performed a survey of 30 sampling locations across 12 fields in Wisconsin and used structural equation modeling to disentangle the direct effects of potato market classes, farm management (conventional versus organic), and soil physiochemical properties on common scab severity from their indirect effects mediated through soil bacterial and fungal communities. We found that, although potato market classes affected disease severity directly, the effects of farm management and soil physiochemistry were best explained as indirect, mediated by their impacts on soil bacterial communities. This suggests that evaluating the consequences of specific management practices for soil microbial communities may be useful for understanding disease pressure across fields.


Asunto(s)
Microbiota , Solanum tuberosum , Enfermedades de las Plantas , Suelo , Microbiología del Suelo , Wisconsin
9.
Waste Manag ; 104: 262-269, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31991267

RESUMEN

Anaerobic digestion (AD) reduces GHG emission and facilitates renewable energy generation. The slow rate of adoption of this technology is often attributed to economic and technical considerations. Collaboration of two or more dairy farms into a centralized AD system can improve the process economics through economies of scale. However, uncertainties related to the process parameters and the scope/scale of the collaborative implementation impede its adoption. This study presents techno-economic optimization model as a design aid to determine ideal location, capacity, and participation level (cluster size) that maximize economic return on a cooperative digester. This study employs a probabilistic approach to overcome uncertainty regarding project parameters such as manure biomethane potential (BMP), project capital, and electricity sale price. Two case studies based on dairy production regions in Wisconsin were developed to test the model and demonstrate its capabilities. Herd sizes and spatial distribution in a given region were found to be critical factors in determining the viability of digestion projects in general, and collaborative digestion systems in particular. The number of simulation runs needed to capture the probability of profitable AD facility establishment was less than 1000 for both case studies assessed. Electricity sale price and biomethane potential of feedstock utilized were found to be the most restrictive to the feasibility of AD adoption. Changing the optimization objective function, to adopting maximization, favored the formation of collaborative AD facilities for both case studies evaluated.


Asunto(s)
Biocombustibles , Estiércol , Anaerobiosis , Animales , Metano , Técnicas de Planificación , Incertidumbre , Wisconsin
10.
J Vet Med Educ ; 47(1): 2-7, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30920944

RESUMEN

Cultural humility, with its concomitant understanding of the importance of the influences of diversity and inclusion, improves health outcomes in the human medical field. Recent changes to the American Veterinary Medical Association Council on Education requirements in veterinary medicine include teaching the impact of implicit bias on the delivery of veterinary medical services. Because overt enhancement of self-awareness is not fodder for traditional veterinary medical education delivery systems, in this article we review existing literature on the impact of recognition of implicit bias on health care and offer insights on ways to help veterinary students learn this skill, drawing on evidence from an inter-professional intervention called WisCARES (Wisconsin Companion Animal Resources, Education, and Social Services).


Asunto(s)
Sesgo , Competencia Cultural , Diversidad Cultural , Educación Médica , Educación en Veterinaria , Guías de Práctica Clínica como Asunto , Actitud del Personal de Salud , Concienciación , Competencia Cultural/educación , Curriculum , Educación en Veterinaria/normas , Humanos , Wisconsin
12.
13.
Pest Manag Sci ; 76(1): 150-160, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31087487

RESUMEN

BACKGROUND: We previously identified a glyphosate-resistant A. trifida phenotype from Wisconsin USA that showed a non-rapid response to glyphosate. The mechanism of glyphosate resistance in this phenotype has yet to be elucidated. We conducted experiments to investigate non-target-site resistance and target-site resistance mechanisms. The roles of glyphosate absorption, translocation, and metabolism in resistance of this phenotype have not been reported previously, nor have EPSPS protein abundance or mutations to the full-length sequence of EPSPS. RESULTS: Whole-plant dose-response results confirmed a 6.5-level of glyphosate resistance for the resistant (R) phenotype compared to a susceptible (S) phenotype. Absorption and translocation of 14 C-glyphosate were similar between R and S phenotypes over 72 h. Glyphosate and AMPA concentrations in leaf tissue did not differ between R and S phenotypes over 96 h. In vivo shikimate leaf disc assays confirmed that glyphosate EC50 values were 4.6- to 5.4-fold greater for the R than S phenotype. Shikimate accumulation was similar between phenotypes at high glyphosate concentrations (>1000 µM), suggesting that glyphosate entered chloroplasts and inhibited EPSPS. This finding was supported by results showing that EPSPS copy number and EPSPS protein abundance did not differ between R and S phenotypes, nor did EPSPS sequence at Gly101, Thr102, and Pro106 positions. Comparison of full-length EPSPS sequences found five nonsynonymous polymorphisms that differed between R and S phenotypes. However, their locations were distant from the glyphosate target site and, therefore, not likely to affect enzyme-glyphosate interaction. CONCLUSION: The results suggest that a novel mechanism confers glyphosate resistance in this A. trifida phenotype. © 2019 Society of Chemical Industry.


Asunto(s)
Ambrosia , 3-Fosfoshikimato 1-Carboxiviniltransferasa , Glicina/análogos & derivados , Resistencia a los Herbicidas , Herbicidas , Wisconsin
15.
Public Health Rep ; 134(2_suppl): 58S-63S, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31682555

RESUMEN

The Plain community is the fastest-growing religious minority in Wisconsin. This community has a high incidence of genetic disorders, many of which are identifiable through newborn screening. We describe efforts by the Wisconsin Newborn Screening Program (WNSP) to improve health care in the Plain community by targeting early identification of, and intervention for, patients with inherited metabolic disorders. WNSP formed partnerships with families and health care providers to increase awareness of screening procedures and the intended benefits of screening, modify testing algorithms to enhance detection, and establish medical homes for patients with confirmed disorders. The estimated number of Plain newborns screened increased by 25.5% during the study period, from 547 in 2011 to 736 in 2017; 122 persons underwent carrier testing, and 143 newborns received second-tier testing. From 2014 to 2017, affected patients received 71 metabolic evaluations in their community medical home without travel to major health centers. This article demonstrates how a comprehensive public health program can help increase screening rates, enhance detection, and establish follow-up care in a hard-to-reach religious community. A key lesson learned was the importance of communication among all stakeholders to develop an effective public health program.


Asunto(s)
Comunicación , Cuidados a Largo Plazo , Enfermedades Metabólicas/diagnóstico , Enfermedades Metabólicas/epidemiología , Tamizaje Neonatal , Religión , Femenino , Humanos , Incidencia , Recién Nacido , Masculino , Enfermedades Metabólicas/genética , Aceptación de la Atención de Salud/psicología , Wisconsin/epidemiología
16.
Public Health Rep ; 134(2_suppl): 6S-10S, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31682556

RESUMEN

The Wisconsin Clinical Laboratory Network (WCLN) at the University of Wisconsin-Madison is a partnership of 138 clinical and public health laboratories (as of February 2019) coordinated by the Wisconsin State Laboratory of Hygiene. This article describes the WCLN, its current activities, and lessons learned through this partnership. A laboratory technical advisory group, which consists of representatives from clinical laboratories, provides clinical laboratory perspective to the WCLN and fosters communication among laboratories. Activities and resources available through the WCLN include annual regional meetings, annual technical workshops, webinars, an email listserv, laboratory informational messages, in-person visits by a WCLN coordinator to clinical laboratories, and laboratory-based surveillance data and summaries distributed by the Wisconsin State Laboratory of Hygiene. One challenge to maintaining the WCLN is securing continual funding for network activities. Key lessons learned from this partnership of more than 20 years include the importance of in-person meetings, the clinical perspective of the laboratory technical advisory group, and providing activities and resources to clinical laboratories to foster sharing of data and clinical specimens for public health surveillance and outbreak response.


Asunto(s)
Laboratorios/organización & administración , Vigilancia en Salud Pública , Salud Pública , Asociación entre el Sector Público-Privado , Conducta Cooperativa , Humanos , Laboratorios/economía , Estudios de Casos Organizacionales , Salud Pública/economía , Salud Pública/normas , Wisconsin
17.
Sleep Health ; 5(6): 639-646, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31727591

RESUMEN

OBJECTIVE: To estimate associations of retirement with self-reported frequency and duration of naps. DESIGN: Prospective cohort study. SETTING: Population-based. PARTICIPANTS: 1359 current and former Wisconsin state employees, aged 54-69. MEASUREMENTS: Four annual surveys mailed between 2010 and 2014 elicited employment status and nap characteristics. Changes in employment status and nap characteristics were identified from survey pairs measured 1 year apart (up to 3 survey pairs per subject). General linear mixed models with repeated measures were used to estimate changes in minutes napped per week (MNPW), weekly nap frequency, and individual nap duration as predicted by retirement transitions vs stable employment status. All models were adjusted for demographic characteristics, self-rated health, medical diagnoses, sleep problems, circadian preference, and change in nocturnal sleep duration. RESULTS: There were 3101 survey pairs in the analytic sample. Full retirement (transition from working ≥35 h/wk to not working for pay) over a 1-year period predicted a statistically significantly larger mean change in MNPW than stable employment status: mean (95% confidence interval) = +48 (+16, +80) MNPW. Associations between staged retirement transitions (from full-time to part-time work, or from part-time work to full retirement) and 1-year changes in MNPW were not statistically significant. The MNPW changes associated with full retirement were attributable to nap frequency increase of +0.4 (+0.1, +0.8) d/wk; nap duration did not change significantly. CONCLUSIONS: Compared with stable employment status, full retirement is associated with an average 1-year increase of +48 MNPW. This change is attributable to a frequency gain of 0.4 d/wk napped. Changes in nap duration were negligible.


Asunto(s)
Jubilación/estadística & datos numéricos , Sueño , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Autoinforme , Wisconsin
19.
J Environ Qual ; 48(4): 889-898, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31589665

RESUMEN

Reducing agricultural runoff is important year round, particularly on landscapes that receive wintertime applications of manure. No-tillage systems are typically associated with reduced runoff loads during the growing season, but surface roughness from fall tillage may aid infiltration on frozen soils by providing surface depressional storage. The timing of winter manure applications may also affect runoff, depending on snow and soil frost conditions. Therefore, the objective of this study was to evaluate runoff and nutrient loads during the freezing season from combinations of tillage and manure application timings. Six management treatments were tested in south-central Wisconsin during the winters of 2015-2016 and 2016-2017 with a complete factorial design: two tillage treatments (fall chisel plow vs. no-tillage) and three manure application timings (early December, late January, and unmanured). Nutrient loads from winter manure application were lower on chisel-plowed versus untilled soils during both monitoring years. Loads were also lower from manure applied to soils with less frost development. Wintertime manure applications pose a risk of surface nutrient losses, but fall tillage and timing applications to thawed soils can help reduce loads.


Asunto(s)
Estiércol , Nutrientes , Agricultura , Congelación , Fósforo , Estaciones del Año , Suelo , Wisconsin
20.
J Environ Qual ; 48(4): 950-958, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31589695

RESUMEN

Agricultural water quality projects in two distinct topographic regions in Wisconsin collected 5 to 10 yr of continuous stream discharge, suspended sediment (SS), total P (TP), and total dissolved P (TDP) in four watersheds (2100-5000 ha) from 2006 to 2016. Previous agricultural nonpoint SS and TP reduction efforts in two of these watersheds documented cold versus warm season differences in water quality response. The goal of this study was to identify seasonal partitioning of SS, TP, and TDP in storm event loads to inform stream water quality protection efforts. We used National Weather Service Coop Observer frost depth reports to identify dates when watershed soils were frozen. By comparing daily mean event discharge for dates relative to frost, we identified a 32-d post-frost high-discharge "thaw" period. Combined, the frozen and thaw periods contributed about half of the annual SS and TP runoff event loads, ranging from 47 to 63% for SS and from 45 to 51% for TP. The proportion of runoff event TDP during this time was even higher, 62 to 79%, with the majority during thaw. Watershed average volumetric runoff coefficients (event flow/precipitation and snowmelt) were two to four times higher during the freeze and the thaw compared with the rest of the year. To reduce total stream loads in regions with similar climates to Wisconsin, this study indicates that using management practices that curb sediment and P delivery to streams in the winter and early spring may be as important as those designed for nonfrozen conditions.


Asunto(s)
Agricultura , Fósforo , Monitoreo del Ambiente , Estaciones del Año , Movimientos del Agua , Calidad del Agua , Wisconsin
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