Population In Pennsylvania Research Articles

Ellis–Van Creveld syndrome and its anesthetic implications

Ellis–Van-Creveld syndrome (EVC), otherwise known as chondroectodermal or mesoectodermal dysplasia, is an autosomal recessive disorder found in the Amish population of Pennsylvania in the USA, with the incidence of 1:244,000 for the general population. The classical syndrome encompasses a tetrad of clinical manifestations, including di sproportionate dwarfism, postaxial polydactyly, ectodermal dysplasia (mainly affecting the teeth, nails, and hair), and congenital heart disease (CHD). Additional involvement may occur in organs of endodermal origin, such as the pulmonary, renal, gastrointestinal (hepatic and pancreatic), hematologic, and central nervous systems. The perioperative care of a 2-year girl who underwent surgical correction of supernumerary digits is presented here.

Assessment of intra and interregional genetic variation in the Eastern Red-backed Salamander, Plethodon cinereus, via analysis of novel microsatellite markers.

The red-backed salamander (Plethodon cinereus) has long-served as a model system in ecology, evolution, and behavior, and studies surveying molecular variation in this species have become increasingly common over the past decade. However, difficulties are commonly encountered when extending microsatellite markers to populations that are unstudied from a genetic perspective due to high levels of genetic differentiation across this species’ range. To ameliorate this issue, we used 454 pyrosequencing to identify hundreds of microsatellite loci. We then screened 40 of our top candidate loci in populations in Virginia, Pennsylvania, and Ohio—including an isolated island population ~ 4.5 km off the shore of Lake Erie (South Bass Island). We identified 25 loci that are polymorphic in a well-studied region of Virginia and 11 of these loci were polymorphic in populations located in the genetically unstudied regions of Ohio and Pennsylvania. Use of these loci to examine patterns of variation within populations revealed that South Bass Island has low diversity in comparison to other sites. However, neither South Bass Island nor isolated populations around Cleveland are inbred. Assessment of variation between populations revealed three well defined genetic clusters corresponding to Virginia, mainland Ohio/Pennsylvania, and South Bass Island. Comparisons of our results to those of others working in various parts of the range are consistent with the idea that differentiation is lower in regions that were once glaciated. However, these comparisons also suggest that well differentiated isolated populations in the formerly glaciated portion of the range are not uncommon. This work provides novel genetic resources that will facilitate population genetic studies in a part of the red-backed salamander’s range that has not previously been studied in this manner. Moreover, this work refines our understanding of how neutral variation is distributed in this ecologically important organism.

Genetic Characterization of Sarcoptes scabiei from Black Bears (Ursus americanus) and Other Hosts in the Eastern United States.

Since the early 1990s there has been an increase in the number of cases and geographic expansion of severe mange in the black bear (Ursus americanus) population in Pennsylvania. Although there are 3 species of mites associated with mange in bears, Sarcoptes scabiei has been identified as the etiologic agent in these Pennsylvania cases. Historically, S. scabiei-associated mange in bears has been uncommon and sporadic, although it is widespread and relatively common in canid populations. To better understand this recent emergence of sarcoptic mange in bears in Pennsylvania and nearby states, we genetically characterized S. scabiei samples from black bears in the eastern United States. These sequences were compared with newly acquired S. scabiei sequences from wild canids (red fox [Vulpes vulpes] and coyote [Canis latrans]) and a porcupine (Erethizon dorsatum) from Pennsylvania and Kentucky and also existing sequences in GenBank. The internal transcribed spacer (ITS)-2 region and cytochrome c oxidase subunit 1 (cox1) gene were amplified and sequenced. Twenty-four ITS-2 sequences were obtained from mites from bears (n = 16), red fox (n = 5), coyote (n = 2), and a porcupine. The sequences from bear samples were identical to each other or differed only at polymorphic bases, whereas S. scabiei from canids were more variable, but 2 were identical to S. scabiei sequences from bears. Eighteen cox1 sequences obtained from mites from bears represented 6 novel haplotypes. Phylogenetic analysis of cox1 sequences revealed 4 clades: 2 clades of mites of human origin from Panama or Australia, a clade of mites from rabbits from China, and a large unresolved clade that included the remaining S. scabiei sequences from various hosts and regions, including sequences from the bears from the current study. Although the cox1 gene was more variable than the ITS-2, phylogenetic analyses failed to detect any clustering of S. scabiei from eastern U.S. hosts. Rather, sequences from black bears grouped into a large clade that included S. scabiei from numerous hosts from Europe, Asia, Africa, and Australia. Collectively, these data suggest that the increasing number of S. scabiei cases in northeastern black bears is not due to the emergence and expansion of a single parasite strain.

A decade of colonization: the spread of the Asian tiger mosquito in Pennsylvania and implications for disease risk.

In recent decades, the Asian tiger mosquito expanded its geographic range throughout the northeastern United States, including Pennsylvania. The establishment of Aedes albopictus in novel areas raises significant public health concerns, since this species is a highly competent vector of several arboviruses, including chikungunya, West Nile, and dengue. In this study, we used geographic information systems (GIS) to examine a decade of colonization by Ae. albopictus throughout Pennsylvania between 2001 and 2010. We examined the spatial and temporal distribution of Ae. albopictus using spatial statistical analysis and examined the risk of dengue virus transmission using a model that captures the probability of transmission. Our findings show that since 2001, the Ae. albopictus population in Pennsylvania has increased, becoming established and expanding in range throughout much of the state. Since 2010, imported cases of dengue fever have been recorded in Pennsylvania. Imported cases of dengue, in combination with summer temperatures conducive for virus transmission, raise the risk of local disease transmission.

Interspecific and intraspecific hybrid Epichloë species symbiotic with the North American native grass Poa alsodes

ABSTRACTThe endophyte presence and diversity in natural populations of Poa alsodes were evaluated along a latitudinal transect from the southern distribution range in North Carolina to New York. Two distinct Epichloë hybrid taxa were identified from 23 populations. Each taxon could easily be distinguished by polymerase chain reaction (PCR) genotyping with primers designed to mating type genes and alkaloid biosynthesis genes that encode key pathway steps for ergot alkaloids, indole-diterpenes, lolines, and peramine. The most commonly found Epichloë taxon, Poa alsodes Taxonomic Group-1 (PalTG-1), was detected in 22 populations at high infection frequencies (72–100%), with the exception of one population at high elevation (26% infection). The second taxon, PalTG-2, was observed only in five populations in Pennsylvania constituting 12% of infected samples. Phylogenetic analyses placed PalTG-1 as an interspecific hybrid of E. amarillans and E. typhina subsp. poae ancestors, and it is considered a new hybrid species, which the authors name Epichloë alsodes. PalTG-2 is an intraspecific hybrid of two E. typhina subsp. poae ancestors, similar to E. schardlii from the host Cinna arundinacea, which the authors propose as a new variety, Epichloë schardlii var. pennsylvanica. Epichloë alsodes isolates were all mating type MTA MTB and tested positive for dmaW, easC, perA, and some LOL genes, but only the alkaloid N-acetylnorloline was detected in E. alsodes–infected plant material. Epichloë schardlii var. pennsylvanica isolates were all mating type MTB MTB and tested positive for perA, but peramine was not produced. Both E. alsodes and E. schardlii var. pennsylvanica appeared to have complete perA genes, but point mutations were identified in E. alsodes that would render the encoded perA gene nonfunctional.

Applying social and ecological approaches to evaluate factors influencing river otter (Lontra canadensis) visitation to fish-rearing facilities in Pennsylvania

In Pennsylvania the production of game and other fish species is a $1.6 billion industry, and loss from depredation can take a serious toll on fish stocks and associated revenues. Following a reintroduction project and natural expansion of native populations, river otters (Lontra canadensis) are now widely distributed throughout Pennsylvania. To determine occurrence and extent of depredation by river otters, we conducted telephone or mail surveys with 156 (80%) of Pennsylvania’s 196 fish-rearing facilities. River otters were reported in the vicinity of 50 (32%) facilities, of which 23 (46%) reported river otter visitation. Of the facilities that reported river otter visitation, most (87%) reported losing 100,000 fish annually, and private facilities were more likely to experience visitation by river otters. Our results demonstrate that the existence of river otter populations in Pennsylvania does not appear to be a significant economic threat to fish-rearing facilities and physical and landscape characteristics of the facilities are important in determining the likelihood of river otter visitation.

New Reports of Nonnative Plants in Pennsylvania

ABSTRACT Range extensions to Butler County (Albizia julibrissin Durazz., Maclura pomifera (Raf.) C.K. Schneid., and Magnolia kobus DC.), Mercer County (Bellis perennis L.), Venango County (Lespedeza cuneata (Dum. Cours.) G. Don), and both Allegheny and Lawrence Counties (Arundinaria gigantea (Walter) Muhl.) are reported. All species are nonnative to Pennsylvania, and L. cuneata and A. julibrissin are considered invasive species in the commonwealth. The occurrence of M. kobus from a wet lowland forest in Butler County represents the first naturalized report of the species from the western half of the commonwealth. The reports of A. gigantea from Allegheny and Lawrence Counties are notable because they represent the second known occurrences of naturalized populations in Pennsylvania.

Abstract A13: Developing easy-to-read cancer education curriculum materials for the Appalachian population: The power of community collaboration

Abstract Appalachian and rural populations historically have been subject to health disparities due to factors of lack of access to care and services, poverty, and low education. The Appalachia Community Cancer Network (ACCN) is one of 23 Community Networks Program Centers funded by the National Cancer Institute (NCI) and addresses the cancer disparity issues of the Appalachian population in Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. ACCN is a collaboration of academic and community partners involved in increasing cancer awareness and education, conducting community-based participatory research, and creating mentoring and training opportunities for junior researchers. All ACCN projects and initiatives are informed by regional and program-wide community advisory boards to ensure that the work being done is culturally relevant and sensitive to the needs of rural and medically underserved audiences. Examples of how advisory boards and community partners are utilized include providing review and feedback on cancer educational materials, assistance with recruitment of faith-based partners and participants in research projects, and clinical trials awareness programs. Responding to a request by its community coalitions to develop a tool with easier to read basic cancer information for use with people who are traditionally hard to engage, ACCN developed Undertanding Cancer. This collaborative work is a five-chapter resource that includes not only text, but a glossary of terms, pre- and post-survey assessments, lists of resources, Power Point slides, and a CD-ROM with all of the materials. The modules have been carefully and exclusively adapted from NCI resources and tailored for use in the rural Appalachian culture. All of the materials were pilot tested with the ACCN Community Advisory Committee and regional Advisory Boards in Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia. This train-the-trainer curriculum was evaluated by rolling it out across five states with the goal of training at least 150 trainers. A pre/post-test model was used to measure a change in knowledge. Additionally changes in attitudes and behaviors were assessed for all participants using participant information forms, evaluations, healthy changes checklist, and trainer activity reports. The usefulness of this community-based project is in being designed to help partners use the modules creatively and effectively in different community settings. This session will focus on the development of the resource, as well as the dissemination and evaluation, and lessons learned. An unexpected outcome of the training curriculum is the community's response to needing additional resources that are similar in design and structure of the orignal resource but focused on specific cancer sites and in other formats besides Power Point slides. The result is the development of a companion piece, Understanding Colon Cancer, which is available as a table-top flip chart or Power Point slides. Dissemination and evaluation of Understanding Colon Cancer is ongoing at this time. This poster session would be beneficial for anyone planning to develop easy-to-read cancer education materials. Acknowledgements: Appalachia Community Cancer Network (ACCN), Mary Babb Randolph Cancer Center, West Virginia University, ACCN Community Advisory Committee and regional Community Advisory Boards. Inspiration for this publication is credited to Cancer 101: A Cancer Education Training Program for American Indians and Alaska Natives. Citation Format: David R. Reese, Mary Ellen Conn. Developing easy-to-read cancer education curriculum materials for the Appalachian population: The power of community collaboration. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr A13.

The Urban/Rural Dichotomy in the Distribution of Breast Cancer across Pennsylvania

Breast cancer rates clearly differ across the United States. This is due to a variety of factors, but at least one determinant is the population density. Breast cancer detection rates and treatment paradigms may differ in rural areas when compared with more urban ones. As the population becomes more mobile and diffuse, this may or may not be a worsening problem. The current analysis was undertaken to examine the breast cancer incidence and outcomes in a single state in an attempt to plan for resource allocation in the future. A retrospective analysis was performed using data available from the Pennsylvania Department of Health regarding breast cancer rates by county, the distribution of cases with regard to degree of rurality, death rates by county as a function of rurality, and the age distribution of all presenting cases. Data from 1999 were compared with those of 2009. The United States Census Bureau definition of rurality was used, which specifies that a county be classified as rural if the population density is less than 284 persons/square mile. Between 1999 and 2009, the population of Pennsylvania increased by approximately 3.4 per cent (421,325 people). The urban population increased by 3.9 per cent, whereas the rural population increased by only 2.2 per cent. During that same period, the number of cancer cases/100,000 population remained about the same: 391.41 in 1999; 390.7 in 2009. However, the distribution of cases shifted during that time toward more rural areas of the state: in 1999, there were 372.3 breast cancer cases/100,000 population compared with 2009 when the rate was 384.4/100,000 population. The number of cancer deaths/100,000 population actually dropped overall during the decade: 98.5 in 1999 versus 82.3 in 2009. Though this was true in both urban and rural counties, the decrease was much less pronounced in the rural areas. In urban counties, the death rate dropped from 100.5 to 81.5/100,000 population, whereas in rural counties, the drop was only from 93.3 to 84.3. The greater increase in cases diagnosed in rural areas of Pennsylvania is only partially explained by the relatively greater increase in rural population. There are undoubtedly other issues at work in rural areas: environmental factors, diffusion of resources, less access to surveillance programs. In addition, though the death rate has dropped in both rural and urban areas, this is much less pronounced in rural counties. Coupled with the increase in prevalence in those areas, this suggests that breast cancer care may be lagging in rural areas. There is a need to examine allocation of resources and surveillance programs.

How are healthcare institutions using Facebook to interact with online communities? Results from a case study in Central Pennsylvania

Social media tools and applications are increasingly being integrated into modern medicine. However, little is known about how healthcare institutions are interacting online with their populations. In this case study, we identified a convenience sample of 11 institutions in Central Pennsylvania with Facebook Pages and evaluated their interactions with online communities. From May-June 2013, we noted type of healthcare institution (e.g. hospital, family practice); number of overall “likes” accrued by the healthcare facility; number of overall posts and “likes”, “comments”, and “content shares” associated with those posts; as well as number of location check-ins by “followers”. We thematically categorized each institutional post. Average number of Facebook Page “likes” was 2,261, and average number of overall posts was 28.9, or about one post every three days. On average, each post generated 16 “likes”, 1 comment, and 2.4 shares. Average number of location “check-ins” by visiting patients was 6,348. Most commonly published content across all Pages was advertisements (89%) and institutional news (89%). Patient populations in Central Pennsylvania are seeking out healthcare institutions on Facebook, although most communication appears unidirectional and involves institutional advertising and promotion. There are opportunities for institutions to focus on health promotion and undertake “social” preventive health strategies using social media.

A rare case report of Ellis Van Creveld syndrome in an Indian patient and literature review

Ellis Van Creveld syndrome (EVC) is a rare genetic disorder having autosomal recessive inheritance affecting the Amish population of Pennsylvania in USA with incidence of 1:244,000 for the general population. This syndrome consists of characteristic features such as bilateral postaxial polydactyly, chondroectodermal dysplasia, congenital heart defects and hypoplastic nails and teeth. There are few case reports of this syndrome reported in dental literature. We report a case of a 17 year old female presenting typical features of this syndrome and the oral findings of this patient which are the key diagnostic features.

Variation in Drosophila melanogaster central metabolic genes appears driven by natural selection both within and between populations.

In this report, we examine the hypothesis that the drivers of latitudinal selection observed in the eastern US Drosophila melanogaster populations are reiterated within seasons in a temperate orchard population in Pennsylvania, USA. Specifically, we ask whether alleles that are apparently favoured in northern populations are also favoured early in the spring, and decrease in frequency from the spring to autumn with the population expansion. We use SNP data collected for 46 metabolic genes and 128 SNPs representing the central metabolic pathway and examine for the aggregate SNP allele frequencies whether the association of allele change with latitude and that with increasing days of spring-autumn season are reversed. Testing by random permutation, we observe a highly significant negative correlation between these associations that is consistent with this expectation. This correlation is stronger when we confine our analysis to only those alleles that show significant latitudinal changes. This pattern is not caused by association with chromosomal inversions. When data are resampled using SNPs for amino acid change the relationship is not significant but is supported when SNPs associated with cis-expression are only considered. Our results suggest that climate factors driving latitudinal molecular variation in a metabolic pathway are related to those operating on a seasonal level within populations.

Sex-selective Abortion Bans are Not Associated with Changes in Sex Ratios at Birth among Asian Populations in Illinois and Pennsylvania.

Legal prohibitions on sex-selective abortions are proliferating in the United States. Eight state legislatures have banned abortions sought on the basis of the sex of the fetus, 21 states have considered such laws since 2009, and a similar bill is pending in U.S. Congress. These laws have been introduced and enacted without any empirical data about their impact or effectiveness. Prior studies of U.S. Census data found sex ratios among foreign-born Chinese, Korean and Indian immigrants were skewed in favor of boys, but only in families where there were already one or two girls. Using the variation in the timing of bans in Illinois and Pennsylvania as natural experiments, we compare the pre-ban and post-ban sex ratios of certain Asian newborn children in these states over 12-year periods. We then compare these ratios with the sex ratios of Asian newborn children in neighboring states during the same period. We find that the bans in Illinois and Pennsylvania are not associated with any changes in sex ratios at birth among Asians. In Illinois and its neighboring states, the sex ratio at birth of Asian children was not male-biased during our study period. On the other hand, the sex ratio at birth among Asians in Pennsylvania and its neighboring states was skewed slightly in favor of boys, but the enactment of the ban did not normalize the sex ratio. This strongly suggests that sex-selective abortion bans have had no impact on the practice of sex selection, to the extent that it occurs, in these states. This finding is highly relevant to legislative and policy debates in the U.S. Congress and state legislatures where sex-selective abortion laws are being considered.

Beyond the Borderlands: Migration and Belonging in the United States and Mexico

[...]the townspeople of kennett Square seek to affirm their reputation as a pro- gressive community while maintaining their cultural dominance in an emerging mexican population. throughout the book, lattanzi Shutika attempts to answer how these negotia- tions are reconciled. lattanzi Shutika's access to the mexican populations in Pennsylvania and mexico pro- vide a compelling ethnographic portrait of mexican migrants living within the context of dual countries. in the book's introduction, the author describes how a short term research project evolved into a 10-year study that spanned two nations, resulting in a comprehen- sive study of mexican migrants who leave fam- ily and friends in mexico to pursue a better fi- nancial future in the community of kennett Square, Pennsylvania. chapter 2, "'i give thanks to God, after that, the united States': everyday life in textitlan," uses historical data and statistics to provide a demographic profile of the textitlan popula- tion. lattanzi Shutika also provides readers with valuable personal observations of the living conditions in textitlan.

Sex-Selective Abortion Bans are Not Associated with Changes in Sex Ratios at Birth Among Asian Populations in Illinois and Pennsylvania

Legal prohibitions on sex-selective abortions are proliferating in the United States. Eight state legislatures have banned abortions sought on the basis of the sex of the fetus, 21 states have considered such laws since 2009, and a similar bill is pending in U.S. Congress. These laws have been introduced and enacted without any empirical data about their impact or effectiveness. Prior studies of U.S. Census data found sex ratios among foreign-born Chinese, Korean and Indian immigrants were skewed in favor of boys, but only in families where there were already one or two girls. Using the variation in the timing of bans in Illinois and Pennsylvania as natural experiments, we compare the pre-ban and post-ban sex ratios of certain Asian newborn children in these states over 12-year periods. We then compare these ratios with the sex ratios of Asian newborn children in neighboring states during the same period. We find that the bans in Illinois and Pennsylvania are not associated with any changes in sex ratios at birth among Asians. In Illinois and its neighboring states, the sex ratio at birth of Asian children was not male-biased during our study period. On the other hand, the sex ratio at birth among Asians in Pennsylvania and its neighboring states was skewed slightly in favor of boys, but the enactment of the ban did not normalize the sex ratio. This strongly suggests that sex-selective abortion bans have had no impact on the practice of sex selection, to the extent that it occurs, in these states. This finding is highly relevant to legislative and policy debates in the U.S. Congress and state legislatures where sex-selective abortion laws are being considered.

Mark‐resight abundance estimation under incomplete identification of marked individuals

Summary Often less expensive and less invasive than conventional mark–recapture, so‐called 'mark‐resight' methods are popular in the estimation of population abundance. These methods are most often applied when a subset of the population of interest is marked (naturally or artificially), and non‐invasive sighting data can be simultaneously collected for both marked and unmarked individuals. However, it can often be difficult to identify marked individuals with certainty during resighting surveys, and incomplete identification of marked individuals is potentially a major source of bias in mark‐resight abundance estimators. Previously proposed solutions are ad hoc and will tend to underperform unless marked individual identification rates are relatively high (>90%) or individual sighting heterogeneity is negligible. Based on a complete data likelihood, we present an approach that properly accounts for uncertainty in marked individual detection histories when incomplete identifications occur. The models allow for individual heterogeneity in detection, sampling with (e.g. Poisson) or without (e.g. Bernoulli) replacement, and an unknown number of marked individuals. Using a custom Markov chain Monte Carlo algorithm to facilitate Bayesian inference, we demonstrate these models using two example data sets and investigate their properties via simulation experiments. We estimate abundance for grassland sparrow populations in Pennsylvania, USA when sampling was conducted with replacement and the number of marked individuals was either known or unknown. To increase marked individual identification probabilities, extensive territory mapping was used to assign incomplete identifications to individuals based on location. Despite marked individual identification probabilities as low as 67% in the absence of this territorial mapping procedure, we generally found little return (or need) for this time‐consuming investment when using our proposed approach. We also estimate rookery abundance from Alaskan Steller sea lion counts when sampling was conducted without replacement, the number of marked individuals was unknown, and individual heterogeneity was suspected as non‐negligible. In terms of estimator performance, our simulation experiments and examples demonstrated advantages of our proposed approach over previous methods, particularly when marked individual identification probabilities are low and individual heterogeneity levels are high. Our methodology can also reduce field effort requirements for marked individual identification, thus, allowing potential investment into additional marking events or resighting surveys.

Factors That Affect Decisions to Receive (or Not Receive) Life-Sustaining Treatment in Advance Care Planning

This study identifies factors that affect decisions people make regarding whether they want to receive life-sustaining treatment. It is an interpretive-descriptive study based on qualitative data from three focus groups (N = 23), representing a diverse population in central Pennsylvania. Study sites included a suburban senior center serving a primarily White, middle-class population; an urban senior center serving a frail, underserved, African American population; and a breast cancer support group. The most important factors affecting whether participants wished to receive life-sustaining medical treatment were prognosis, expected quality of life, burden to others, burden to oneself in terms of the medical condition and treatment, and effect on mental functioning and independence. Our findings contribute to the knowledge of the complex factors that influence how people make decisions about advance care planning and life-sustaining treatments. This understanding is critical if nurses are to translate the patient's goals, values, and preferences into an actionable medical plan.

Human Exposure to Rabid Free‐Ranging Cats: A Continuing Public Health Concern in Pennsylvania

Rabid free-ranging cats have been a public health concern in Pennsylvania since raccoon variant rabies first was recognized in the state in the early 1980s. Over the last decade, between 1.5 and 2.5% of cats submitted to Pennsylvania's state laboratories for rabies testing have been positive. In this report, we describe the extent of rabies in free-ranging cats in Pennsylvania. We also present two examples of human exposure to rabid free-ranging cats that occurred in Pennsylvania during 2010-2011 and the public health actions taken to address rabies exposure in the humans and animals. We then describe the concerns surrounding the unvaccinated and free-ranging cat population in Pennsylvania and possible options in managing this public and animal health problem.

Historical specimens reveal past relationships and current conservation status of populations in a declining species: the regal fritillary butterfly

Abstract. 1. The regal fritillary butterfly, Speyeria idalia Drury 1773, was once widespread across eastern North America, but has declined significantly and rapidly over the past half‐century. Although more stable in the western portion of its range, only two populations survive east of the Great Lakes, one in eastern Pennsylvania and the other in Virginia.2. Previous studies have found that the remnant Pennsylvania population is genetically differentiated from populations in the west, and have suggested the designation of separate eastern and western subspecies. However, the historical pattern of genetic variation from which the current distinctness of the Pennsylvania population has arisen was not known, nor was the relationship with the remnant Virginia population.3. We amplified and sequenced two mitochondrial loci (COI/II and ND4) from preserved specimens to infer historical patterns of genetic variation in this species, and we used non‐lethally obtained tissue samples to assess the relationship of the two eastern remnant populations.4. We found very consistent patterns between the two loci. Both had a very shallow haplotype network with few mutations separating most haplotypes. At both loci, we observed distinct groups of haplotypes in the western and far eastern (i.e. New England) portions of the range; a region of transition was centred on Ohio, western Pennsylvania, and the Virginias, where both groups, and intermediate haplotypes, were represented.5. Importantly, the extant Virginia population shared haplotypes with western populations of S. idalia and not with the extant Pennsylvania population. We discuss the implications of this result for the taxonomy and translocations/introductions of the species.

Pulmonary embolism in sickle cell disease: a case–control study

A pulmonary embolism (PE) is a leading cause of mortality in hospitalized patients, yet the prevalence of PE in sickle cell disease (SCD) and its relation to disease severity or intrinsic hypercoagulability are not established. We estimated inpatient PE incidence and prevalence among SCD and non-SCD populations in Pennsylvania, and compared severity of illness and mortality, using Pennsylvania Health Care Cost Containment Council (PHC4) discharge data, 2001-2006. Risk factors for PE were assessed in a case-control study of discharges from the University of Pittsburgh Medical Archival Records System (MARS). The incidence of inpatient PE was higher in the SCD PA population than in the non-SCD Pennsylvania population, 2001-2006. The PE prevalence among SCD discharges ≤ 50 years of age, 0.57%, was similar to that in non-SCD Pennsylvania discharges, 0.60%, and unchanged after adjustment for race. Among SCD discharges, those developing PE were significantly older, with a longer length of stay, greater severity of illness and higher mortality, P < 0.001, than SCD without a PE. Among PE discharges, SCD had a similar severity of illness, P = 0.77, and mortality, P = 0.39, but underwent fewer computerized tomographic scans, P = 0.006, than non-SCD with PE. In the local case-control study, no clinical or laboratory feature was associated with PE. The incidence of PE is higher and chest computed tomography (CT) utilization is lower in SCD than non-SCD inpatients, suggesting that PE may be under-diagnosed.