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1.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3893-3896, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018851

RESUMO

Electrical stimulation of residual nerves can be used to provide amputees with intuitive sensory feedback. An important aspect of this artificial sensory feedback is the ability to convey the magnitude of tactile stimuli. Using classical psychophysical methods, we quantified the just-noticeable differences for electrocutaneous stimulation pulse frequency in both intact participants and one transradial amputee. For the transradial amputee, we also quantified the just-noticeable difference of intraneural microstimulation pulse frequency via chronically implanted Utah Slanted Electrode Arrays. We demonstrate that intensity discrimination is similar across conditions: intraneural microstimulation of the residual nerves, electrocutaneous stimulation of the reinnervated skin on the residual limb, and electrocutaneous stimulation of intact hands. We also show that intensity discrimination performance is significantly better at lower pulse frequencies than at higher pulse frequencies - a finding that's unique to electrocutaneous and intraneural stimulation and suggests that supplemental sensory cues may be present at lower pulse frequencies. These results can help guide the implementation of artificial sensory feedback for sensorized bionic arms.Clinical Relevance- Intraneural and electrocutaneous artificial sensory feedback are comparable in their ability to convey the magnitude of tactile stimuli via pulse frequency.


Assuntos
Amputados , Retroalimentação Sensorial , Mãos , Humanos , Tato , Utah
2.
MMWR Morb Mortal Wkly Rep ; 69(37): 1319-1323, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32941418

RESUMO

Reports suggest that children aged ≥10 years can efficiently transmit SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1,2). However, limited data are available on SARS-CoV-2 transmission from young children, particularly in child care settings (3). To better understand transmission from young children, contact tracing data collected from three COVID-19 outbreaks in child care facilities in Salt Lake County, Utah, during April 1-July 10, 2020, were retrospectively reviewed to explore attack rates and transmission patterns. A total of 184 persons, including 110 (60%) children had a known epidemiologic link to one of these three facilities. Among these persons, 31 confirmed COVID-19 cases occurred; 13 (42%) in children. Among pediatric patients with facility-associated confirmed COVID-19, all had mild or no symptoms. Twelve children acquired COVID-19 in child care facilities. Transmission was documented from these children to at least 12 (26%) of 46 nonfacility contacts (confirmed or probable cases). One parent was hospitalized. Transmission was observed from two of three children with confirmed, asymptomatic COVID-19. Detailed contact tracing data show that children can play a role in transmission from child care settings to household contacts. Having SARS-CoV-2 testing available, timely results, and testing of contacts of persons with COVID-19 in child care settings regardless of symptoms can help prevent transmission. CDC guidance for child care programs recommends the use of face masks, particularly among staff members, especially when children are too young to wear masks, along with hand hygiene, frequent cleaning and disinfecting of high-touch surfaces, and staying home when ill to reduce SARS-CoV-2 transmission (4).


Assuntos
Creches , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Surtos de Doenças , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Adolescente , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Criança , Pré-Escolar , Cidades/epidemiologia , Técnicas de Laboratório Clínico , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pandemias , Utah/epidemiologia , Adulto Jovem
3.
MMWR Morb Mortal Wkly Rep ; 69(38): 1369-1373, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32970656

RESUMO

Coronavirus disease 2019 (COVID-19) has had a substantial impact on racial and ethnic minority populations and essential workers in the United States, but the role of geographic social and economic inequities (i.e., deprivation) in these disparities has not been examined (1,2). As of July 9, 2020, Utah had reported 27,356 confirmed COVID-19 cases. To better understand how area-level deprivation might reinforce ethnic, racial, and workplace-based COVID-19 inequities (3), the Utah Department of Health (UDOH) analyzed confirmed cases of infection with SARS-CoV-2 (the virus that causes COVID-19), COVID-19 hospitalizations, and SARS-CoV-2 testing rates in relation to deprivation as measured by Utah's Health Improvement Index (HII) (4). Age-weighted odds ratios (weighted ORs) were calculated by weighting rates for four age groups (≤24, 25-44, 45-64, and ≥65 years) to a 2000 U.S. Census age-standardized population. Odds of infection increased with level of deprivation and were two times greater in high-deprivation areas (weighted OR = 2.08; 95% confidence interval [CI] = 1.99-2.17) and three times greater (weighted OR = 3.11; 95% CI = 2.98-3.24) in very high-deprivation areas, compared with those in very low-deprivation areas. Odds of hospitalization and testing also increased with deprivation, but to a lesser extent. Local jurisdictions should use measures of deprivation and other social determinants of health to enhance transmission reduction strategies (e.g., increasing availability and accessibility of SARS-CoV-2 testing and distributing prevention guidance) to areas with greatest need. These strategies might include increasing availability and accessibility of SARS-CoV-2 testing, contact tracing, isolation options, preventive care, disease management, and prevention guidance to facilities (e.g., clinics, community centers, and businesses) in areas with high levels of deprivation.


Assuntos
Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Áreas de Pobreza , Adulto , Idoso , Infecções por Coronavirus/diagnóstico , Humanos , Incidência , Pessoa de Meia-Idade , Fatores de Risco , Utah/epidemiologia , Adulto Jovem
4.
MMWR Morb Mortal Wkly Rep ; 69(33): 1133-1138, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32817604

RESUMO

Improved understanding of the overall distribution of workplace coronavirus disease 2019 (COVID-19) outbreaks by industry sector could help direct targeted public health action; however, this has not been described. The Utah Department of Health (UDOH) analyzed COVID-19 surveillance data to describe workplace outbreaks by industry sectors. In this report, workplaces refer to non-health care, noncongregate-living, and noneducational settings. As of June 5, 2020, UDOH reported 277 COVID-19 outbreaks, 210 (76%) of which occurred in workplaces. Approximately 12% (1,389 of 11,448) of confirmed COVID-19 cases in Utah were associated with workplace outbreaks. The 210 workplace outbreaks occurred in 15 of 20 industry sectors;* nearly one half of all workplace outbreaks occurred in three sectors: Manufacturing (43; 20%), Construction (32; 15%) and Wholesale Trade (29; 14%); 58% (806 of 1,389) of workplace outbreak-associated cases occurred in these three sectors. Although 24% of Utah's workforce in all 15 affected sectors identified as Hispanic or Latino (Hispanic) or a race other than non-Hispanic white (nonwhite†) (1), 73% (970 of 1,335) of workplace outbreak-associated COVID-19 cases were in persons who identified as Hispanic or nonwhite. Systemic social inequities have resulted in the overrepresentation of Hispanic and nonwhite workers in frontline occupations where exposure to SARS-CoV-2, the virus that causes COVID-19, might be higher (2); extra vigilance in these sectors is needed to ensure prevention and mitigation strategies are applied equitably and effectively to workers of racial and ethnic groups disproportionately affected by COVID-19. Health departments can adapt workplace guidance to each industry sector affected by COVID-19 to account for different production processes and working conditions.


Assuntos
Grupos de Populações Continentais/estatística & dados numéricos , Infecções por Coronavirus/etnologia , Surtos de Doenças , Grupos Étnicos/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Indústrias/estatística & dados numéricos , Doenças Profissionais/etnologia , Pneumonia Viral/etnologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Utah/epidemiologia , Local de Trabalho , Adulto Jovem
5.
Environ Pollut ; 266(Pt 1): 115072, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32836014

RESUMO

Effects of mining and metals production have been reported in freshwater lake sediments from around the world but are rarely quantified in saline lake sediments, despite the importance of these lake ecosystems. Here we used dated sediment cores from Great Salt Lake, Utah, USA, a large saline lake adjacent to one of the world's largest copper mines, to measure historical changes in the deposition of 22 metals. Metal concentrations were low prior to the onset of mining in the catchment in 1860 CE. Concentrations of copper, lead, zinc, cadmium, mercury, and other metals began increasing in the late 1800s, with peaks in the 1950s, concomitant with enhanced mining and smelting activities. Sedimentary metal concentrations in the 1950s were 20-40-fold above background levels for copper, lead, silver, and molybdenum. Concentrations of most metals in surficial sediments have decreased 2-5-fold, reflecting: 1) storage and mineralization of sedimenting materials in a deep brine layer, thereby reducing metal transport to the sediments; 2) improved pollution control technologies, and; 3) reduction in mining activity beginning in the 1970s and 1980s. Despite reductions, concentrations of many metals in surficial sediments remain above acceptable contamination thresholds for aquatic ecosystems with migratory birds, and consumption advisories for mercury have been placed on three waterfowl species. The research also highlights that metal deposition in saline lakes is complicated by effects of hypersaline brines and deep-water anoxia in regulating sediment redox and release of metals to surface waters. Given the importance of saline lakes to migratory birds, metals contamination from mining and metals production should be a focus of saline lake remediation.


Assuntos
Lagos , Poluentes Químicos da Água/análise , Ecossistema , Monitoramento Ambiental , Sedimentos Geológicos , Utah
6.
Environ Pollut ; 265(Pt B): 115122, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32806468

RESUMO

Current practices employed by most wastewater treatment plants (WWTP) are unable to completely remove endocrine disrupting compounds (EDCs) from reclaimed waters, and consistently discharge these substances to receiving systems. Effluent-dominated and dependent surface waters, especially during low instream flows, can increase exposure and risks to aquatic organisms due to adverse biological effects associated with EDCs. Given the ecological implications that may arise from exposure to such compounds, the present a multi-approach study examined spatio-temporal estrogenic potential of wastewater effluent to fish in East Canyon Creek (ECC), Utah, USA, a unique urban river with instream flows seasonally influenced by snowmelt. Juvenile rainbow trout (Oncorhynchus mykiss) were caged at different upstream and downstream sites from an effluent discharge during the summer and fall seasons. In the summer, where approximately 50% of the streamflow was dominated by effluent, fish from the upstream and a downstream site, located 13 miles away from the effluent discharge, presented significantly elevated concentrations of plasma vitellogenin (VTG). Similarly, significantly high 17ß-estradiol to 11-ketotestosterone ratios were measured in the summer across all sites and time points, compared to the fall. In the laboratory, juvenile fish and primary hepatocytes were exposed to concentrated effluent and surface water samples. Quantification of VTG, although in significantly lower levels, resembled response patterns observed in fish from the field study. Furthermore, analytical quantification of common EDCs in wastewater revealed the presence of estriol and estrone, though these did not appear to be related to the observed biological responses, as these were more significant in sites were no EDCs were detected. These combined observations suggest potential estrogenicity for fish in ECC under continuous exposures and highlight the advantages of following weight-of-evidence (WoE) approaches for environmental monitoring, as targeted analytically-based assessments may or may not support the identification of causative contaminants for adverse biological effects.


Assuntos
Disruptores Endócrinos , Estrona , Animais , Fenômenos Físicos , Utah , Vitelogeninas
7.
JAMA Netw Open ; 3(8): e2017703, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32797176

RESUMO

Importance: International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes are used to characterize coronavirus disease 2019 (COVID-19)-related symptoms. Their accuracy is unknown, which could affect downstream analyses. Objective: To compare the performance of fever-, cough-, and dyspnea-specific ICD-10 codes with medical record review among patients tested for COVID-19. Design, Setting, and Participants: This cohort study included patients who underwent quantitative reverse transcriptase-polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 at University of Utah Health from March 10 to April 6, 2020. Data analysis was performed in April 2020. Main Outcomes and Measures: The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ICD-10 codes for fever (R50*), cough (R05*), and dyspnea (R06.0*) were compared with manual medical record review. Performance was calculated overall and stratified by COVID-19 test result, sex, age group (<50, 50-64, and >64 years), and inpatient status. Bootstrapping was used to generate 95% CIs, and Pearson χ2 tests were used to compare different subgroups. Results: Among 2201 patients tested for COVD-19, the mean (SD) age was 42 (17) years; 1201 (55%) were female, 1569 (71%) were White, and 282 (13%) were Hispanic or Latino. The prevalence of fever was 66% (1444 patients), that of cough was 88% (1930 patients), and that of dyspnea was 64% (1399 patients). For fever, the sensitivity of ICD-10 codes was 0.26 (95% CI, 0.24-0.29), specificity was 0.98 (95% CI, 0.96-0.99), PPV was 0.96 (95% CI, 0.93-0.97), and NPV was 0.41 (95% CI, 0.39-0.43). For cough, the sensitivity of ICD-10 codes was 0.44 (95% CI, 0.42-0.46), specificity was 0.88 (95% CI, 0.84-0.92), PPV was 0.96 (95% CI, 0.95-0.97), and NPV was 0.18 (95% CI, 0.16-0.20). For dyspnea, the sensitivity of ICD-10 codes was 0.24 (95% CI, 0.22-0.26), specificity was 0.97 (95% CI, 0.96-0.98), PPV was 0.93 (95% CI, 0.90-0.96), and NPV was 0.42 (95% CI, 0.40-0.44). ICD-10 code performance was better for inpatients than for outpatients for fever (χ2 = 41.30; P < .001) and dyspnea (χ2 = 14.25; P = .003) but not for cough (χ2 = 5.13; P = .16). Conclusions and Relevance: These findings suggest that ICD-10 codes lack sensitivity and have poor NPV for symptoms associated with COVID-19. This inaccuracy has implications for any downstream data model, scientific discovery, or surveillance that relies on these codes.


Assuntos
Codificação Clínica/normas , Infecções por Coronavirus/diagnóstico , Tosse/diagnóstico , Dispneia/diagnóstico , Registros Eletrônicos de Saúde , Febre/diagnóstico , Classificação Internacional de Doenças , Pneumonia Viral/diagnóstico , Adulto , Idoso , Betacoronavirus , Codificação Clínica/métodos , Estudos de Coortes , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Tosse/etiologia , Dispneia/etiologia , Feminino , Febre/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Utah/epidemiologia
8.
Sci Total Environ ; 737: 140222, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32783844

RESUMO

In the present study we examined spatial and seasonal trends in the levels of a wide suite of semi-volatile organic compounds (SVOCs) in brown trout (Salmo trutta) and mottled sculpin (Cottus bairdii) in East Canyon Creek, Utah, USA, an effluent-dominated stream during summer months. Fish samples were collected from four sampling sites, including one reference site upstream, and three sites at incremental distances downstream of the effluent discharge over multiple seasons. The samples were analyzed for 218 lipophilic contaminants, including pesticides and their metabolites, polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), and polybrominated diphenyl ethers (PBDEs) and other flame retardants. Some PAHs, pesticides and their metabolites, PCBs, PBDEs and other flame retardants were measured in mottled sculpin (11 analytes) and brown trout (17 analytes). Hexachlorobenzene (HCB), p,p'-DDE, BDE-47 and triphenyl phosphate (TPHP) were the most frequently detected contaminants in mottled sculpin and brown trout, while BDE-47 and p,p'-DDE were measured at the highest concentrations, reaching up to 73 and 19 ng/g wet weight, respectively. Our results indicated that snowmelt did not alter accumulation of the examined lipophilic contaminants, and no consistent seasonal differences were observed in their accumulation. A spatial pattern was observed for PBDE congeners, where lowest levels were measured in fish tissues from a reference site, and highest concentrations were measured in fish collected downstream of the effluent discharge, indicating that municipal effluent discharge contributes to the elevated PBDE levels in fish residing in this effluent-dominated stream. We further calculated screening level consumption risks following United States Environmental Protection Agency (EPA) methods, and identified the importance of considering discharge gradients in effluent-dominated systems during bioaccumulation assessments.


Assuntos
Retardadores de Chama/análise , Bifenilos Policlorados/análise , Compostos Orgânicos Voláteis , Poluentes Químicos da Água/análise , Animais , Monitoramento Ambiental , Éteres Difenil Halogenados/análise , Estações do Ano , Utah
9.
MMWR Morb Mortal Wkly Rep ; 69(29): 956-959, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32701943

RESUMO

On November 7, 2018, the Utah Department of Health (UDOH) reported the first confirmed human rabies death in the state since 1944 (1). The case occurred in a person who had been treated over a period of 19 days at four health care facilities and an emergency medical transport service across three counties and two states. Human rabies is preventable through preexposure or postexposure vaccination but is invariably fatal upon symptom onset. Timely identification of persons who might have been exposed to rabies virus is therefore crucial to administer postexposure prophylaxis (PEP). Because of the large number of health care workers who had been involved in the patient's care, a standardized online risk assessment survey was developed by UDOH based on Advisory Committee on Immunization Practices recommendations (2). This online tool was evaluated for accuracy, acceptability, and administrative obligation by reviewing the results from the tool and conducting focus group discussions and a follow-up survey. Among 90 health care workers initially identified by the online risk assessment as being potentially exposed to infectious material, 74 were classified as exposed. All 74 health care workers received PEP following consultation with occupational health staff members, indicating a positive predictive value of the assessment tool of 82%. In a follow-up survey, 42 (76%) of the 55 respondents reported that they were satisfied with the assessment process. In focus group discussions, participants suggested that the survey could be improved by providing additional information about rabies exposures because many of them were unfamiliar with human-to-human rabies transmission. This evaluation highlighted the importance of adopting clear communication strategies, demonstrated the benefits of using an online risk assessment during a mass rabies exposure, and provided specific feedback for CDC to improve resources available for states and health care facilities after mass rabies exposures.


Assuntos
Pessoal de Saúde , Internet , Exposição Ocupacional/estatística & dados numéricos , Raiva/prevenção & controle , Medição de Risco/métodos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/efeitos adversos , Satisfação do Paciente/estatística & dados numéricos , Profilaxia Pós-Exposição/estatística & dados numéricos , Raiva/epidemiologia , Raiva/transmissão , Utah/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-32635606

RESUMO

Homelessness is a public health issue that many organizations are addressing through a Housing First Model. One such organization is The Road Home (TRH), which provides services to homeless individuals and families in Salt Lake County. TRH is perhaps best known for their emergency shelters, but the organization also administers the Rapid Rehousing Program (RRHP), designed to help families experiencing homelessness transition back into stable housing. Those experiencing homelessness tend to have high rates of chronic mental/physical disabilities as well as issues related to substance abuse. Having a home is the first step toward achieving some kind of stability in their lives. The RRHP allows families to find housing in the private rental market and will cover the initial costs and several months of rent for clients. While the program has been praised by policymakers and social service providers for helping homeless families find rental housing, there is no empirical research about participant perspectives regarding their residential (in)security. The research question of this article is: what is the role of the RRHP in supporting the security of families experiencing homelessness? Researchers collected qualitative data through focus groups and interviews with 31 participants, 23 families experiencing homelessness, two landlords, six case managers, and service providers. Lastly, we identify recommendations for program improvements based on information gathered from research participants. It is our hope that the information presented in this article can and will be used in a way that improves public health by increasing the residential security of families experiencing homelessness.


Assuntos
Pessoas em Situação de Rua , Habitação , Qualidade de Vida , Adulto , Criança , Feminino , Grupos Focais , Humanos , Masculino , Estados Unidos , Utah
11.
Pediatrics ; 146(2)2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32632024

RESUMO

OBJECTIVES: To describe the proportion of children screened by the Modified Checklist for Autism in Toddlers (M-CHAT), identify characteristics associated with screen completion, and examine associations between autism spectrum disorder (ASD) screening and later ASD diagnosis. METHODS: We examined data from children attending 18- and 24-month visits between 2013 and 2016 from 20 clinics within a health care system for evidence of screening with the M-CHAT and subsequent coding of ASD diagnosis at age >4.75 years. We interviewed providers for information about usual methods of M-CHAT scoring and ASD referral. RESULTS: Of 36 233 toddlers, 73% were screened and 1.4% were later diagnosed with ASD. Hispanic children were less likely to be screened (adjusted prevalence ratio [APR]: 0.95, 95% confidence interval [CI]: 0.92-0.98), and family physicians were less likely to screen (APR: 0.12, 95% CI: 0.09-0.15). Compared with unscreened children, screen-positive children were more likely to be diagnosed with ASD (APR: 10.3, 95% CI: 7.6-14.1) and were diagnosed younger (38.5 vs 48.5 months, P < .001). The M-CHAT's sensitivity for ASD diagnosis was 33.1%, and the positive predictive value was 17.8%. Providers routinely omitted the M-CHAT follow-up interview and had uneven referral patterns. CONCLUSIONS: A majority of children were screened for ASD, but disparities exist among those screened. Benefits for screen-positive children are improved detection and younger age of diagnosis. Performance of the M-CHAT can be improved in real-world health care settings by administering screens with fidelity and facilitating timely ASD evaluations for screen-positive children. Providers should continue to monitor for signs of ASD in screen-negative children.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Testes Neuropsicológicos , Atenção Primária à Saúde/métodos , Transtorno do Espectro Autista/epidemiologia , Lista de Checagem , Pré-Escolar , Diagnóstico Tardio , Diagnóstico Precoce , Feminino , Seguimentos , Disparidades em Assistência à Saúde , Hispano-Americanos , Humanos , Lactente , Masculino , Programas de Rastreamento/métodos , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Utah/epidemiologia
12.
Int J Syst Evol Microbiol ; 70(7): 4261-4268, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32568028

RESUMO

Three novel carbon monoxide-oxidizing Halobacteria were isolated from Bonneville Salt Flats (Utah, USA) salt crusts and nearby saline soils. Phylogenetic analysis of 16S rRNA gene sequences revealed that strains PCN9T, WSA2T and WSH3T belong to the genera Halobacterium, Halobaculum and Halovenus, respectively. Strains PCN9T, WSA2T and WSH3T grew optimally at 40 °C (PCN9T) or 50 °C (WSA2T, WSH3T). NaCl optima were 3 M (PCN9T, WSA2T) or 4 M NaCl (WSH3T). Carbon monoxide was oxidized by all isolates, each of which contained a molybdenum-dependent CO dehydrogenase. G+C contents for the three respective isolates were 66.75, 67.62, and 63.97 mol% as derived from genome analyses. The closest phylogenetic relatives for PCN9T, WSA2T and WSH3T were Halobacterium noricense A1T, Halobaculum roseum D90T and Halovenus aranensis EB27T with 98.71, 98.19 and 95.95 % 16S rRNA gene sequence similarities, respectively. Genome comparisons of PCN9T with Halobacterium noricense A1T yielded an average nucleotide identity (ANI) of 82.0% and a digital DNA-DNA hybridization (dDDH) value of 25.7 %; comparisons of WSA2T with Halobaculum roseum D90T yielded ANI and dDDH values of 86.34 and 31.1 %, respectively. The ANI value for a comparison of WSH3T with Halovenus aranensis EB27T was 75.2 %. Physiological, biochemical, genetic and genomic characteristics of PCN9T, WSA2T and WSH3T differentiated them from their closest phylogenetic neighbours and indicated that they represent novel species for which the names Halobaculum bonnevillei, Halobaculum saliterrae and Halovenus carboxidivorans are proposed, respectively. The type strains are PCN9T (=JCM 32472=LMG 31022=ATCC TSD-126), WSA2T (=JCM 32473=ATCC TSD-127) and WSH3T (=JCM 32474=ATCC TSD-128).


Assuntos
Halobacteriaceae/classificação , Halobacterium/classificação , Filogenia , Salinidade , Microbiologia do Solo , Monóxido de Carbono/metabolismo , DNA Arqueal/genética , Halobacteriaceae/isolamento & purificação , Halobacterium/isolamento & purificação , RNA Ribossômico 16S/genética , Análise de Sequência de DNA , Solo/química , Utah
13.
Sci Total Environ ; 736: 139603, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32502782

RESUMO

Whether seasonal instream flow dynamics influence bioaccumulation of pharmaceuticals by fish is not well understood, specifically for urban lotic systems in semi-arid regions when flows are influenced by snowmelt. We examined uptake of select pharmaceuticals in rainbow trout (Oncorhynchus mykiss) caged in situ upstream and at incremental distances downstream (0.1, 1.4, 13 miles) from a municipal effluent discharge to East Canyon Creek in Park City, Utah, USA during summer and fall of 2018. Fish were sampled over 7-d to examine if uptake occurred, and to define uptake kinetics. Water and fish tissues were analyzed via isotope dilution liquid chromatography tandem mass spectrometry. Several pharmaceuticals were consistently detected in water, fish tissue and plasma, including carbamazepine, diphenhydramine, diltiazem, and fluoxetine. Pharmaceutical levels in water ranged up to 151 ng/L for carbamazepine, whereas the effluent tracer sucralose was consistently observed at low µg/L levels. During both summer and fall experiments at each of three downstream locations from effluent discharge, rainbow trout rapidly accumulated these pharmaceuticals; tissue levels reached steady state conditions within 24-96 h. Spatial and temporal differences for pharmaceutical levels in rainbow trout directly corresponded with surface water exposure concentrations, and uptake kinetics for individual pharmaceuticals did not vary among sites or seasons. Such observations are consistent with recent laboratory bioconcentration studies, which collectively indicate inhalational exposure from water governs rapid accumulation of ionizable base pharmaceuticals by fish in inland surface waters.


Assuntos
Oncorhynchus mykiss , Preparações Farmacêuticas , Poluentes Químicos da Água/análise , Animais , Bioacumulação , Cidades , Cinética , Utah
14.
PLoS One ; 15(5): e0233495, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437416

RESUMO

BACKGROUND: The Charlson and Elixhauser comorbidity indices are mortality predictors often used in clinical, administrative, and research applications. The Intermountain Mortality Risk Scores (IMRS) are validated mortality predictors that use all factors from the complete blood count and basic metabolic profile. How IMRS, Charlson, and Elixhauser relate to each other is unknown. METHODS: All inpatient admissions except obstetric patients at Intermountain Healthcare's 21 adult care hospitals from 2010-2014 (N = 197,680) were examined in a observational cohort study. The most recent admission was a patient's index encounter. Follow-up to 2018 used hospital death records, Utah death certificates, and the Social Security death master file. Three Charlson versions, 8 Elixhauser versions, and 3 IMRS formulations were evaluated in Cox regression and the one of each that was most predictive was used in dual risk score mortality analyses (in-hospital, 30-day, 1-year, and 5-year mortality). RESULTS: Indices with the strongest mortality associations and selected for dual score study were the age-adjusted Charlson, the van Walraven version of the acute Elixhauser, and the 1-year IMRS. For in-hospital mortality, Charlson (c = 0.719; HR = 4.75, 95% CI = 4.45, 5.07), Elixhauser (c = 0.783; HR = 5.79, CI = 5.41, 6.19), and IMRS (c = 0.821; HR = 17.95, CI = 15.90, 20.26) were significant predictors (p<0.001) in univariate analyses. Dual score analysis of Charlson (HR = 1.79, CI = 1.66, 1.92) with IMRS (HR = 13.10, CI = 11.53, 14.87) and of Elixhauser (HR = 3.00, CI = 2.80, 3.21) with IMRS (HR = 11.42, CI = 10.09, 12.92) found significance for both scores in each model. Results were similar for 30-day, 1-year, and 5-year mortality. CONCLUSIONS: IMRS provided the strongest ability to predict mortality, adding to and attenuating the predictive ability of the Charlson and Elixhauser indices whose mortality associations remained statistically significant. IMRS uses common, standardized, objective laboratory data and should be further evaluated for integration into mortality risk evaluations.


Assuntos
Serviços de Laboratório Clínico , Mortalidade Hospitalar , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Utah
15.
Pediatr Blood Cancer ; 67(8): e28408, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32437093

RESUMO

BACKGROUND: In this study, we aimed to evaluate incidence rates and family risk of the most common childhood cancers, tumors in the central nervous system (CNS), and leukemia among individuals from Norway and individuals with Scandinavian ancestry living in Utah. METHODS: We used the Utah Population Database and the Norwegian National Population Register linked to Cancer registries to identify cancers in children born between 1966 and 2015 and their first-degree relatives. We calculated incidence rates and hazards ratios. RESULTS: The overall incidence of CNS tumors increased with consecutive birth cohorts similarly in Utah and Norway (both P < 0.001). Incidence rates of leukemia were more stable and similar in both Utah and in Norway with 4.6/100 000 person-years among children (<15 years) born in the last cohort. A family history of CNS tumors was significantly associated with risk of childhood CNS tumors in Utah HR = 3.05 (95% CI 1.80-5.16) and Norway HR = 2.87 (95% CI 2.20-3.74). In Norway, children with a first-degree relative diagnosed with leukemia had high risk of leukemia (HR = 2.39, 95% CI 1.61-3.55). CONCLUSION: Despite geographical distance and assumed large lifestyle differences, two genetically linked pediatric populations show similar incidences of CNS tumors and leukemia in the period 1966-2015. CNS tumors and leukemia aggregated in families in both countries.


Assuntos
Neoplasias do Sistema Nervoso Central , Família , Predisposição Genética para Doença , Leucemia , Sistema de Registros , Adolescente , Adulto , Idoso , Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias do Sistema Nervoso Central/etnologia , Neoplasias do Sistema Nervoso Central/genética , Criança , Pré-Escolar , Feminino , Humanos , Leucemia/epidemiologia , Leucemia/etnologia , Leucemia/genética , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Utah/epidemiologia
16.
PLoS One ; 15(5): e0232492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32413032

RESUMO

Coyotes (Canis latrans) and kit foxes (Vulpes macrotis) are desert canids that share ecological similarities, but have disparate histories with anthropogenic pressure that may influence their responses towards novel stimuli. We used remote cameras to investigate response to novel stimuli for these two species. We predicted that coyotes (heavily pressured species) would be more wary towards novel stimuli on unprotected land (canid harvest activities are permitted) than in protected areas (canid harvest activities are not permitted), whereas kit foxes (less pressured species) would exhibit no difference. We examined differences in the investigative behaviors at 660 scent stations in both protected and unprotected areas. Coyotes showed no differences between protected and unprotected land and were generally more wary than kit foxes, supporting our prediction. Kit foxes were more investigative on protected land, contrary to our expectations. Our study provides evidence that anthropogenic pressure can alter the behaviors of wildlife species.


Assuntos
Comportamento Animal/fisiologia , Coiotes/fisiologia , Raposas/fisiologia , Animais , Animais Selvagens/fisiologia , Clima Desértico , Espécies em Perigo de Extinção , Comportamento Exploratório/fisiologia , Odorantes , Feromônios/fisiologia , Fotografação , Tecnologia de Sensoriamento Remoto , Especificidade da Espécie , Utah
17.
JCO Oncol Pract ; 16(7): e557-e562, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32463765

RESUMO

PURPOSE: A telehealth oncology practice was created to care for patients in rural communities to improve access to health care, decrease financial burdens, and save time. PATIENTS AND METHODS: Patients with cancer at Sevier Valley Hospital in Richfield, Utah, were treated with a real-time video-based telehealth program under the care of an oncologist at a tertiary medical center. Data on financial savings, travel hours, mileage avoided, carbon emissions reduced, and revenue retained by Sevier Valley Hospital were collected from 2015 to 2018. RESULTS: From 2015 to 2018, 119 patients with cancer in Richfield, Utah, were treated with telehealth for oncology visits, accounting for 1,025 patient encounters. On average, patients saved 4 hours and 40 minutes and 332 miles roundtrip per encounter. In total, patients' savings were estimated to be $333,074. Carbon emissions were reduced by approximately 150,000 kg. Of new patient referrals, 59% were for solid tumors (70 of 119 referrals; 42 metastatic and 28 nonmetastatic cancers), and 41% were hematology consultations (49 of 119 referrals; 28 classical and 21 malignant hematologic conditions). We estimate that Sevier Valley Hospital retained $3,605,500 in revenue over this 4-year period. CONCLUSION: Using a telehealth program in rural Utah, patients with cancer benefited from substantial time and monetary savings. The local medical center was able to retain revenue it would have otherwise lost to outsourcing cancer care. Recent regulatory changes to address the COVID-19 pandemic should increase the number of patients with cancer treated via telehealth nationwide.


Assuntos
Infecções por Coronavirus/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Pandemias/economia , Pneumonia Viral/economia , Saúde da População , Telemedicina/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Qualidade da Assistência à Saúde/economia , População Rural , Telemedicina/tendências , Utah/epidemiologia
18.
Ann Am Thorac Soc ; 17(8): 1008-1015, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32425051

RESUMO

Coronavirus disease (COVID-19) is a potentially fatal illness with no proven therapy beyond excellent supportive care. Treatments are urgently sought. Adaptations to traditional trial logistics and design to allow rapid implementation, evaluation of trials within a global trials context, flexible interim monitoring, and access outside traditional research hospitals (even in settings where formal placebos are unavailable) may be helpful. Thoughtful adaptations to traditional trial designs, especially within the global context of related studies, may also foster collaborative relationships among government, community, and the research enterprise. Here, we describe the protocol for a pragmatic, active comparator trial in as many as 300 patients comparing two current "off-label" treatments for COVID-19-hydroxychloroquine and azithromycin-in academic and nonacademic hospitals in Utah. We developed the trial in response to local pressures for widespread, indiscriminate off-label use of these medications. We used a hybrid Bayesian-frequentist design for interim monitoring to allow rapid, contextual assessment of the available evidence. We also developed an inference grid for interpreting the range of possible results from this trial within the context of parallel trials and prepared for a network meta-analysis of the resulting data. This trial was prospectively registered (ClinicalTrials.gov Identifier: NCT04329832) before enrollment of the first patient.Clinical trial registered with www.clinicaltrials.gov (NCT04329832).


Assuntos
Azitromicina , Infecções por Coronavirus , Hidroxicloroquina , Pandemias , Pneumonia Viral , Adulto , Anti-Infecciosos/administração & dosagem , Anti-Infecciosos/efeitos adversos , Azitromicina/administração & dosagem , Azitromicina/efeitos adversos , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Monitoramento de Medicamentos/métodos , Feminino , Humanos , Hidroxicloroquina/administração & dosagem , Hidroxicloroquina/efeitos adversos , Masculino , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Utah
19.
J Environ Manage ; 267: 110612, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32349952

RESUMO

Globally, the management of invasive plants is motivated by a desire to improve ecosystem services (e.g., recreation, flood mitigation, soil fertility for agriculture, aesthetics) and critical habitat for imperiled species. To reduce invader populations and impacts, it is important to document the social and ecological basis (i.e., the social-ecological system) for the management that has been employed and areas where a greater level of coordination among stakeholder groups (managers, scientists, legislators, resource users) could improve efforts. We present a conceptual model that builds on current thinking for how best to connect these four stakeholder groups-to foster stronger citizen lobbying for impacted resources, science-based governance, legislator-driven noxious weed laws and funding for management and science, knowledge co-production by scientists and managers, and co-management by managers and resource users. In light of our model, we present two case studies based in Nebraska and Utah, U.S.A. involving a common North American wetland invader, Phragmites australis (non-native common reed). In Nebraska, potential lawsuits stemming from water conveyance was strong motivation for funding management. In Utah, duck hunters and other resource users initially instigated management. Progress toward the successful management of Phragmites has been the result of manager-scientist partnerships addressing a knowing-doing gap among practitioners, the complexities of management mosaics, as well as overcoming economic and logistical constraints. Our model demonstrates how legislative initiatives can fund new research and bolster on-going management, while organically building strong partnerships among scientists, managers, and resource users that are key for successfully managing invasive species.


Assuntos
Ecossistema , Poaceae , Conservação dos Recursos Naturais , Espécies Introduzidas , Nebraska , Utah
20.
Artigo em Inglês | MEDLINE | ID: covidwho-112348

RESUMO

Differences in jurisdictional public health actions have played a significant role in the relative success of local communities in combating and containing the COVID-19 pandemic. We forecast the possible COVID-19 outbreak in one US state (Utah) by applying empirical data from South Korea and Italy, two countries that implemented disparate public health actions. Forecasts were created by aligning the start of the pandemic in Utah with that in South Korea and Italy, getting a short-run forecast based on actual daily rates of spread, and long-run forecast by employing a log-logistic model with four parameters. Applying the South Korea model, the epidemic peak in Utah is 169 cases/day, with epidemic resolution by the end of May. Applying the Italy model, new cases are forecast to exceed 200/day by mid-April, with the potential for 250 new cases a day at the epidemic peak, with the epidemic continuing through the end of August. We identify a 3-month variation in the likely length of the pandemic, a 1.5-fold difference in the number of daily infections at outbreak peak, and a 3-fold difference in the expected cumulative cases when applying the experience of two developed countries in handling this virus to the Utah context.


Assuntos
Infecções por Coronavirus/epidemiologia , Previsões/métodos , Modelos Estatísticos , Pandemias , Pneumonia Viral/epidemiologia , Humanos , Itália/epidemiologia , Reprodutibilidade dos Testes , República da Coreia/epidemiologia , Utah/epidemiologia
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