Higher Initial Levels Research Articles

Optimal strategies for capital constrained low-carbon supply chains under yield uncertainty

We investigate the optimal strategies for a capital constrained low-carbon supply chain with uncertain yield, with the features of green finance and carbon cap-and-trade scheme. The results indicate that the green finance subsidy and the low-carbon subsidy have positive impacts on the carbon emission reduction, but the yield uncertainty has negative impacts. For manufacturers with low initial emission level, the green finance subsidy is more efficient than the low-carbon subsidy. However, for manufacturers with high initial emission level, the low-carbon subsidy is more effective than the green finance subsidy. Further analysis indicates that green finance can increase the positive effects of the carbon cap-and-trade scheme on manufacturers with medium or low emission levels, but the yield uncertainty can decrease the positive effects. For high emission manufacturers, with green finance, the cap-and-trade can have more negative effects on the investment in carbon emission reduction, and with the yield uncertainty, the cap-and-trade can have less negative effects on the manufacturers’ carbon emission reduction.

Outcome of cesarean scar pregnancy treated with local methotrexate injection.

ABSTRACTLocal injection of methotrexate (MTX) has been widely used for caesarean scar pregnancy (CSP), but the optimal candidate remains undetermined. The aim of this study is to determine the risk factors associated with treatment failure among patients who received a single dose of local MTX.This is a retrospective cohort study. Clinical information was compared between treatment success vs. failure groups. Risk factors related to treatment failure were also investigated with multivariate analysis.Of 47 patients diagnosed with CSP, 30 received local MTX injection. The initial serum ß- human chorionic gonadotropin (hCG) level in the failure group was significantly higher than in the success group (p = 0.048), and the cut-off value was 47,000 mIU/ml. The rate of type 2 position of the gestational sac in the failure group was significantly higher than in the treatment success group (p = 0.031). A high initial serum ß-hCG level (≥ 47,000 mIU/ml) was identified as the independent risk factor for treatment failure (adjusted odds ratio = 21.9; 95% confidence interval = 1.3–383.1).Type 2 gestational sac position and a higher level of ß-hCG at diagnosis appear to be associated with poor outcomes after local injection of a single dose of MTX.

Carbon monoxide intoxication in geriatric patients: How important are lactate values at admission?

The aim of this study was to investigate the demographic and clinical characteristics and treatment modalities of elderly patients with carbon monoxide (CO) intoxication. The secondary aim was to evaluate the importance of plasma lactate values in the diagnosis of acute CO intoxication in geriatric patients. Data on geriatric patients who were admitted to the emergency department of Atatürk University Medical Faculty between January 2013 and April 2016 were analyzed retrospectively. Of the 197 cases included in the study, 97 were in the intoxication group and 100 were in the control group; 82.5% of the intoxication cases had mild neurological symptoms and 17.5% had severe neurological symptoms. Carboxyhemoglobin levels were significantly higher in patients with severe neurological symptoms (p = 0.031). All patients with severe neurological symptoms received hyperbaric-oxygen therapy (p < 0.001). In the intoxication group, lactate levels were significantly higher than in the control group (p = 0.001). The specificity for lactate 4 mmol/L and above was found as 98.0% with a positive predictive value and negative predictive value of 84.5% and 53.3%, respectively. High initial lactate levels may be a guide for cases with nonspecific symptoms in geriatric patients with suspected CO intoxication.

CSR as a Socially Constructed Phenomenon: Simulating the Interplay between Public Expectations and Firms' Choices

Compliance in the domain of CSR differs from financial compliance in that mere abidance to legal rules is insufficient. By its very nature, CSR compliance is a socially constructed phenomenon. Public expectations regarding CSR evolve over time but are also driven by how the majority of firms behave. CSR non-compliance is constituted by not meeting these expectations. Firms meeting or exceeding public expectations receive a bonus in terms of public support, firms not meeting public expectations get punished, and firms respond to this by choosing their CSR engagement. Using an agent-based-model, we simulate this interaction. For firms, we presume simple decision rationales based on benefits and costs. We vary model parameters, like CSR-related costs, but also the public’s ability to perceive CSR-related out-/under-performance and the magnitude of the punishment and rewards associated with this. Of interest are CSR levels in the firm population, how firms adapt their CSR engagement, depending on the parameters chosen but also, which parameter constellations correspond to observations of CSR levels in reality. Looking at differences between a setting in which the public predominantly punishes under-performance as opposed to a setting in which the public predominantly rewards out-performance we see different implications. For constellations with a high malus for under-performance, firms which substantially lag in terms of CSR quickly catch up to avoid reputational costs. In the long run, in particular after the laggards caught up, the CSR development responds to the bonus associated with outperforming the average in terms of CSR. For constellations with a substantial bonus for CSR out-performance, firms with very low costs of CSR engagement specialize in CSR, set high initial levels of CSR engagement and constantly out-perform the rest of the population and pull the CSR average upwards. Comparing constellations with empirical data, we see that the catching-up effect can be found in the development of the CSR engagement of firms as measured by data from the Thomson-Reuters-Eikon Database, while there is no corresponding CSR escalation of high performers.

Biological mechanisms and individual variation in fibrinolysis after major trauma

ObjectiveTo understand more about the individual variation in the time course of fibrinolysis following major injury and to assess the potential for stratification of trauma patients for tranexamic acid (TXA)...

Researchers’ achievement goals: Prevalence, structure, and associations with job burnout/engagement and professional learning

Researchers’ motivations are important for high-quality research and the productivity of the scientific system, but remain largely uninvestigated. Using three studies, we tested the usefulness of Achievement Goal Theory (AGT) for describing research motivations, investigated which goals researchers pursue, and examined their associations with job burnout/engagement and professional learning. Interviewing 20 researchers (Study 1), we found that most of their goals in the research context were classifiable as achievement goals. Apart from mastery and performance goals that are well-established in the AGT literature, they also mentioned relational and work-avoidance goals. Mastery goals comprised task and learning standards, performance goals comprised appearance and normative strivings. In Study 2, we used a standardized questionnaire to assess these goals in 824 researchers, along with burnout/engagement, professional learning time, and professional learning gains. Results confirmed the separability of all conceptualized goals, measurement invariance across academic status, and differential patterns of associations with burnout/engagement and professional learning. In Study 3, we analyzed these constructs in 471 researchers at two time points, six months apart. Results attested measurement invariance over time. Cross-lagged analyses documented similar associations as in Study 2. Learning approach and relational goals had positive effects on professional learning; appearance avoidance and work-avoidance goals were negative predictors. In contrast, burnout was negatively predicted by normative avoidance goals. However, high initial burnout levels were associated with reduced task approach and learning approach, and stronger work-avoidance goals six months later. Taken together, the results highlight the usefulness of AGT for understanding researchers’ motivations, and their relatedness with professional learning and well-being at work.

Dynamics of Necking and Fracture in Ductile Porous Materials

AbstractThe onset of necking in dynamically expanding ductile rings is delayed due to the stabilizing effect of inertia, and with increasing expansion velocity, both the number of necks incepted and the number of fragments increase. In general, neck retardation is expected to delay fragmentation as necking is often the precursor to fracture. However, in porous ductile materials, it is possible that fracture can occur without significant necking. Thus, the objective of this work is to unravel the complex interaction of initial porosity and inertia on the onset of necking and fracture. To this end, we have carried out a series of finite element calculations of unit cells with sinusoidal geometric perturbations and varying levels of initial porosity under a wide range of dynamic loading conditions. In the calculations, the material is modeled using a constitutive framework that includes many of the hardening and softening mechanisms that are characteristics of ductile metallic materials, such as strain hardening, strain rate hardening, thermal softening, and damage-induced softening. The contribution of the inertia effect on the loading process is evaluated through a dimensionless parameter that combines the effects of loading rate, material properties, and unit cell size. Our results show that low initial porosity levels favor necking before fracture, and high initial porosity levels favor fracture before necking, especially at high loading rates where inertia effects delay the onset of necking. The finite element results are also compared with the predictions of linear stability analysis of necking instabilities in porous ductile materials.

Analyzing transient respirometric data by analytical algorithm for Monod kinetic parameters.

This study aims to develop an analytical algorithm with oxygen update (Ou) data obtained from transient respirometric measurement. Based on Monod kinetics, this study formulates a novel two-phase analytical model for an oxygen uptake rate plot (OUR vs. Ou) obtained by respirometric techniques. The first phase is a hyperbolic equation relating to exogenous and endogenous respiration, while the second phase is a linear equation for endogenous respiration only. An algorithm was therefore developed to analyze four Monod parameters by locating the best phase-separating point at which the absolute average relative error (ARE) of OUR is minimized. An analysis using test data on acetate verified that the algorithm is capable of transient kinetic parameter estimation with an ARE below 5-10%. A sensitivity analysis on domestic wastewater coupled with a Monte Carlo simulation concluded that the kinetic test must be conducted at a relatively high initial substrate level (So/Xo ≧ 1 and So/Ks ≧ 10) for reliable parameter estimation. Moreover, it is crucial to conduct the kinetic test with sufficient and acclimated seed culture for the degradation of substrate. The results of this study can be used to develop an automatic transient kinetic analyzer with modern programmable respirometers.

Study on Runoff and Infiltration for Expansive Soil Slopes in Simulated Rainfall

In order to understand the hydrological process of expansive soil slopes, simulated rainfall experiments were conducted to study the effects of slope gradient and initial soil moisture content on runoff and infiltration for expansive soil slopes located in south China. The field program consisted of four neighboring slopes (70%, 47%, 32%, and 21%) instrumented by a runoff collection system and moisture content sensors (EC-5). Results from the monitored tests indicate that there was delay in the response of surface runoff. The runoff initiation time decreased with initial soil water content and increasing slope gradient. After the generation of runoff, the cumulative runoff per unit area and the runoff rate increased linearly and logarithmically with time, respectively. The greater the initial soil moisture content was, the smaller the influence of slope gradient on runoff. A rainfall may contribute from 39% to about 100% of its total rainfall as infiltration, indicating that infiltration remained an important component of the rainwater falling on the slope, despite the high initial soil water content. The larger the initial sealing degree of slope surface was the smaller the cumulative infiltration per unit area of the slope. However, the soil moisture reaction was more obvious. The influence of inclination is no longer discernible at high initial moisture levels. The greater the initial soil moisture content and the smaller the slope gradient, the weaker was the change of soil water content caused by simulated rainfall. The influence of initial soil moisture content and slope gradient on the processes of flow and changes of soil water content identified in this study may be helpful in the surface water control for expansive soil slopes.

When Do Plans Matter?

Problem, research strategy, and findings: Plans often sit on the shelf and fail to promote action. This raises the question of how and when plans matter. This is especially important in sustainability planning where local governments are more likely to take actions with short-term benefits that are easy to adopt. How can planners promote more sustainability actions, especially those with longer term benefits? In this study we examine factors influencing local sustainability actions by tracking 651 U.S. local governments’ adoption of 34 sustainability actions from 2010 to 2015. We differentiate places that recently adopted a sustainability plan from those that have had a plan for a longer period and those that have never adopted a sustainability plan. We use difference-in-difference (DID) modeling to assess what effect plans have on the level of sustainability actions. We find a plan may have its greatest effect in motivating actions when it is newly created. Places that adopted a plan between 2010 and 2015 exhibited a significant increase in sustainability actions during those same years. By contrast, places that already had a plan in 2010 showed higher initial levels of sustainability actions but did not show a higher level of growth in the number of actions adopted compared with places without plans. In general, we find local governments with higher levels of sustainability actions articulate social equity goals, devote staff and budget resources to the effort, engage the public, and promote interdepartmental coordination. Local governments under Republican control enact fewer sustainability actions.Takeaway for practice: Sustainability plans are most effective in spurring local sustainability actions when they are newly created. However, this initiation impact in motivating actions wanes over time. Promoting continued adoption of sustainability actions requires a comprehensive approach with attention to political support, public participation, social equity, interdepartmental coordination, and local capacity.

Relationship between Clinical Features of Diabetic Retinopathy and Systemic Factors in Patients with Newly Diagnosed Type II Diabetes Mellitus.

BackgroundWe investigated the relationship between clinical features of diabetic retinopathy (DR) and systemic factors in patients with newly diagnosed type II diabetes mellitus (T2DM).MethodsRetrospective review of newly diagnosed T2DM-patients who underwent complete ophthalmic examinations at the time of T2DM diagnosis were conducted. We reviewed DM related systemic factor data and investigated systemic factors related to the presence of DR at T2DM diagnosis. In DR patients, the relationship between DR severity and systemic factors was analyzed.ResultsOf 380 patients, forty (10.53%) patients had DR at the initial ophthalmologic examination. Glycated hemoglobin (HbA1C), fasting plasma glucose (FPG), urine albumin to creatinine ratio (UACR), and urine microalbumin level were significantly higher in DR patients than in patients without DR. In the multivariate logistic regression analysis, high HbA1C was a significant risk factor for the presence of DR at new T2DM diagnosis (odds ratio, 2.372; P < 0.001). HbA1C, FPG, UACR, and urine microalbumin level showed significantly positive correlations with DR severity .ConclusionIn patients with newly diagnosed T2DM, 10.53% have DR at initial ophthalmologic examination and high HbA1C, FPG, UACR and urine microalbumin levels. These factors are significantly positively correlated with DR severity. Therefore, more careful fundus examination is needed for newly diagnosed T2DM patients with high HbA1C, FPG, UACR, and urine microalbumin levels.

Nutrient regime of agrochernozems in oilseeds cultivation in the Kansk forest-steppe

The study was conducted on chernozem-type soils prevailing in the Kansk forest-steppe. The aim of the investigation is to study the temperature and nutrient regime of agrochernozems in spring rapeseed and camelina sativa cultivation. By the period of oilseeds sowing, the temperature did not reach a stable transition through + 5°C of the soil layer at the depths of 0-20 cm. From May to June, the soil temperature sharply increases up to +13-16°C, and in July it warmed up to 29-30°C. In August, agrochernozems cooled up to + +5-12°C. It has been found that a 0–20 cm layer of the camelina sativa agrocenosis is on average in 2°C warmer than rapeseed. The quantitative parameters resulting from the processes of ammonification and nitrification in the oilseeds agrocenoses are inversely related. The differences in the quantitative estimation of mineral nitrogen in the rapeseed and camelina sativa agrocenosis are not statistically proven. The initial identical high availability level of labile phosphorus in the oil crops agrocenoses is associated with the predecessor. The decline of this indicator in the rapeseed and camelina agrocenosis to a low level of security in the July period is due to its expenditure on the formation of plant productivity. The availability of exchangeable potassium for agrochernozems in agrocenoses is average, but in absolute terms it is higher in soils of camelina sativa agrocenosis.

Suicide attempt of an overt hypothyroid patient with levothyroxine: A case report

Rationale: Levothyroxine is the most commonly used agent in thyroid hormone replacement therapy. Although there are many hypothyroid patients who use levothyroxine as a treatment, high level of thyroid stimulating hormone is found in a limited number of levothyroxine overdose cases worldwide. Patient concern: A 34-year-old male patient taking 4.5 mg levothyroxine for suicide. Diagnosis: Overdose of levothyroxine. Interventions: The patient was admitted to the intensive care unit for follow-up treatment. Cardiac rithym and vital parameters of patient were closely monitored. Outcomes: The patient discharged without any life-threatening complications. Lessons: Patient with initial high thyroid stimulating hormone levels may not be in hyperthyroidism crisis by levothyroxine poisoning.

Glucose oxidase-like activity of cerium oxide nanoparticles: use for personal glucose meter-based label-free target DNA detection.

Recently, personal glucose meter (PGM) has been utilized for the detection of non-glucose targets for point-of-care (POC) testing. Aimed at this goal, we herein developed a new PGM-based label-free read-out method for polymerase chain reaction (PCR) based on our novel finding that cerium oxide nanoparticles (CeO2 NPs) exhibit glucose oxidase-like activity comparable to the natural glucose oxidase enzyme.Methods: In principle, DNA amplicons produced by PCR in the presence of target DNA electrostatically bind to CeO2 NPs, leading to their aggregation and reducing the efficiency for CeO2 NP-catalyzed glucose oxidation reaction. Thus, glucose is hardly oxidized to gluconic acid, resulting in the maintenance of initial high glucose level. On the contrary, in the absence of target DNA or presence of non-target DNA, DNA amplicons are not produced and glucose is effectively oxidized by the glucose oxidase-like activity of CeO2 NPs, leading to the significant reduction of glucose level. Finally, the resulting glucose level is simply measured by using PGM.Results: With this strategy, DNA amplicons were quantitatively examined within 5 min, realizing ultrafast analysis of PCR results without any cumbersome and labor-intensive procedures. In addition, the target genomic DNA derived from Escherichia coli (E. coli) was sensitively determined down to 10 copies with high selectivity.Conclusion: Importantly, the use of PGM as a detection component enables its direct application in POC settings. Based on the meritorious features of PGM such as rapidity, simplicity, and cost-effectiveness, we expect that the devised system could serve as a core platform for the on-site read-out of PCR amplification.

Study of the dynamics of inhibition of native microflora of vegetable and mushroom products under the action of processing by relativistic electrons

The process of processing and selling fresh vegetable and mushroom products is accompanied by a high risk of rapid bacteriological damage and, as a consequence, short shelf life. The search for methods of processing lightly damaged varieties of plant materials is an urgent problem of the food industry. Studies have been carried out to study the effect of relativistic electrons on a 10 MeV facility (Tekleor company) on the dynamics of inhibition of native microflora during storage of delicate types of plant materials. Fresh mushroom champignons and fresh spinach greens were chosen as objects of study. Product samples were Packed weighing 200 g in plastic bags brand RA / PE. Storage and transportation of samples was carried out at a temperature of 8–10 ° С. After processing the experimental data, a plateau zone was revealed during processing with a beam energy of 1 kGy with a further decrease in the number of microorganisms with an increase in dose to 2 kGy. Studies of changes in the dynamics of inhibition of the initial number of microorganisms in mushroom and green products showed that in the microflora of mushroom and green products, there are stable types of microorganisms that are characterized by the presence of a plateau zone. Processing spinach with a beam energy of 1 and 2 kGy allows extending the shelf life compared to control samples from 5 to 12 and 15 days. The treatment of champignon mushrooms with a beam energy of 2 kGy, despite the high initial level of seed contamination with native microflora, allowed us to maintain the upper limit of the norm (1 · 105 CFU / g) of microbiological seed for up to 5 days.

Inter-State Disparities in the Reduction of Multidimensional Deprivations in India

The higher economic growth in the post-reform period has increased the standard of living of the people. At the same time, it widened the inter-state inequality. It was argued that the increasing inequality might lead to social disarticulation and hinder growth. Thus, a discussion on growing inter-state inequality became a policy debate in recent years to achieve inclusive growth. In this backdrop, this article analyses trends in the inter-state inequality with regards to multidimensional deprivations (MD) in the domains of education, health and poverty during the post-reform period in India. It also assesses whether levels of deprivation among the Indian states are converging/diverging over a period of time. Weighted coefficient of variation and Theil entropy measures were used to assess the inter-state inequality and β-convergence estimates were used to test whether there is convergence/divergence among the Indian states with regards to reduction in MD over time. The analysis found that the inter-state disparity in MD has increased during the post-reform period in India; the levels of deprivation among the better off states declined over time, while most of the backward states could not do so due to their high initial level deprivations.

The association of peer behavioral regulation with motor-cognitive readiness skills in preschool

An increasing number of young children nationally participate in preschool education, yet very little is known about the influence of peers' behavioral regulation, such as maintaining focus on a task in the face of distractions and inhibiting a dominant response (attentionimpulse control), and remembering instructions (engagement) on children's motor-cognitive readiness skills (i.e., peer effects). This study determined whether peer effects are present in this earliest sector of schooling. Research has shown that a child's own behavioral regulation is associated with his or her academic outcomes. However, not much is known about how children are affected by classmates with poor behavioural regulation. This study begins to fill the gaps in our understanding of preschool peer effects in the form of peers' behavioral regulation relative to children's motor-cognitive readiness skills. It addresses two research questions: (1) Is the average level and amount of variation of peers' behavioral regulation skills (i.e., engagement and attentionimpulse control) in a classroom associated with growth in children's motor-cognitive readiness outcomes in preschool (motor, content knowledge, and language)? (2) Do these associations differ for children with high and low initial levels of behavioral regulation? The analytic sample is drawn from a cluster (school) randomized controlled trial testing a family-centered, school-based intervention (N=1050 children in 99 classrooms drawn from 10 high-poverty schools). Results indicated that classroom-level peer engagement skills made a unique contribution to children's growth of motor skills during the preschool academic year.Furthermore, children with higher engagement skills at the beginning of the preschool year had higher motor-cognitive readiness skills (motor, content knowledge, and language) at the end of the year when they were in classrooms with peers with high engagement skills. This study extends previous work with older children and indicates that after adjusting for an assortment of demographic, preschool program-related factors, and motor-cognitive readiness at entry into preschool, peers' engagement skills may make a unique contribution to children’s motor-cognitive readiness skills during the preschool academic year.

Commuter e-bike use is associated with increased total physical activity over time

Abstract Background Active commuting such as cycling has been recommended as a practical way to increase population physical activity levels and improve health. Beside positive health effects observed in experimental studies, less is known about how e-bikes can improve public health outcomes in real-life settings. Objectives To describe the patterns over time in physical activity, sedentary behavior, cardiorespiratory fitness and psychophysiological well-being in a population of new commuter e-bike users. Methods This was a population-based prospective longitudinal study in France. 33 new users of e-bike were recruited and measured at 4-time points (T0, T1, T2, T3), from before the effective beginning of the e-bike use (T0) until a mean of 4.6 months of use (T3) (min: 3.2, max: 7). Repeated measures multilevel modeling was used on 4 waves of measurements to assess variations over time of e-bike use, total moderate and vigorous physical activity (MVPA) and total sedentary time (SED-time). Pre-post comparisons between T0 and T3 were performed to detect change in cardiorespiratory fitness, markers of adiposity, self-esteem, quality of life (SF12-v2), and physical activity motivations (EMAPS). Results Adherence to e-bike commuting was high and stable, with a mean of 82% (3%) of weekly use. Multilevel modeling indicated that MVPA followed a significant increasing curvilinear trajectory over time, plateauing after 90 days (+ 21 MET-h/week compared to mean T0 at 33 MET-h/week). No significant change was found in SED-time, averaging a mean of 8.6 hours/day. Greater adherence to using an e-bike was associated with greater increases in MVPA. Several markers of physical and mental health improved. Conclusions New commuter e-bike users undergo a significant increase in MVPA while being already at a high level before e-bike use onset. This increase in MVPA could be meaningful to attenuate detrimental effects of a persistent high sedentary behavior. Key messages MVPA significantly increases among new commuter e-bike users, along with improvements in physical and mental health. High SED-time is persistent, making increase in MVPA in a population with a moderately high initial level still crucial.

Early-life Health and Lifetime Outcomes: Evidence from the Large-scale Schistosomiasis Eradication in China

Schistosomiasis is one of the most prevalent parasitic diseases in the world. This study uses a large-scale deworming program targeted to schistosomiasis in China to identify the long-term impacts of early-life health on adult outcomes. We find that disease interventions led to increases in educational attainment and female fertility. The effects on targets with a low initial educational level focus on basic education, while targets with a high initial level experience educational development at a higher level. We also document that childhood schistosomiasis infection decreased adult income and consumption, explained by the negative disease impact on adult cognitive abilities, education, and employment status. The gender heterogeneity in education and earnings is consistent with the theoretical model.

1524. Presentation of Acute Focal Bacterial Nephritis in Children

BackgroundAscending infections are thought as the main route of infection in acute pyelonephritis (APN). However, among patients diagnosed with APN, a subset has atypical presentation unexplainable by ascending routes of infections. This study aimed to review 8 cases initially diagnosed as APN, however presenting with no or minimal pyuria and presenting as acute focal bacterial nephritis (AFBN).MethodsThis was a retrospective cohort study of children <18 years old without underlying diseases, treated for their first episode of APN during 2006 and 2016. Those that fit the following inclusion criteria were diagnosed as AFBN: (1) characteristic CT findings compatible AFBS, (2) atypical presentation of APN including lack of urinary symptoms, and (3) no antibiotic administration prior to urine culture. Electronic medical records were analyzed, and radiologic images re-evaluated.ResultsDuring the 11-year period, of the total of 359 patients were diagnosed with the first episode of APN. Of these, 8 were re-diagnosed as AFBN. The mean age was 9.8 years old (1.9–17.4). Abdominal pain with nausea and vomiting were chief complaints (62.5%), and none had urinary symptoms including dysuria, incontinence, or increased frequency. Initial urinalysis in all the patients showed WBC <10–19 hpf, and were negative for nitrite. High initial WBC and CRP levels were observed (median 17.892 × 103/mm3 and 13.1 mg/dL, respectively). Cultures were positive for E. coli in 3 cases. CT findings showed nephromegaly with multifocal wedge-shaped heterogeneous enhancement defects corresponding to blood supply patterns of renal segmental arteries, no hydronephrosis, and no inflammation in the pelviureteric calyceal system. A mean duration of fever was 6.6 days, and time to defervescence after initiation of antibiotics was an average of 3 days.ConclusionLack of urinary symptoms, insignificant pyuria, and CT findings of AFBN support the possibility of an alternative route of infection, other than the ascending route.Disclosures All authors: No reported disclosures.