Three-year Study Period Research Articles

Can Emergency Medical Services Utilization Rates Be Used to Measure the Success of An Alcohol Amnesty Policy?

Introduction Medical Amnesty/Good Samaritan (MAGS) policies, which eliminate legal charges when students call 9-1-1 for excessive drinking, have been implemented with the goal of reducing barriers to accessing Emergency Medical Services (EMS). This study investigated the impact of MAGS policy implementation on EMS calls on campus and if that EMS call volume could be used to measure policy success. The aim of this study was to compare the prevalence of alcohol-related EMS calls before and after MAGS implementation at a single large public university campus. Methods: A retrospective review of all 9-1-1 calls to on-campus locations was conducted using patient care records (PCRs) from a collegiate EMS agency responding exclusively to on-campus 9-1-1 calls. Calls were excluded if the PCR was marked “incomplete”, were outside the 2015 CBEMS response zone boundaries, or if patient age was <15 or >25 years old to ensure analysis was targeting the on-campus student population. The incidence of alcohol-related 9-1-1 calls was compared between one academic year (AY) prior to (pre-MAGS, AY2015) and two years after MAGS implementation (post-MAGS, AY2016/17). An alcohol-related 9-1-1 call was defined as an EMS provider primary or secondary impression of “Alcohol, Alcohol Intoxication, or Alcohol Ingestion” or a call in which the patient explicitly admitted to alcohol use. Relative risk (RR) with 95% confidence intervals (CI) were used to describe the results. Results: Over the three-year study period, the collegiate EMS agency responded to 2440 calls of which 1283 met inclusion criteria. 58 calls were excluded for being incomplete, 227 were outside the original boundaries and 872 were outside the defined age range. Of those calls, 351 were pre-MAGS and 932 were post-MAGS. Of the total 9-1-1 calls, 127 (36.2%) were related to alcohol pre-MAGS and 327 (35.1%) were related to alcohol post-MAGS policy implementation. The relative risk of a 9-1-1 call being made for alcohol-related issues after MAGS implementation was RR = 0.97 (95% CI 0.83-1.14; P = 0.713). Conclusion: Implementation of a MAGS policy was not associated with a significant change in the number of alcohol-related EMS responses. It is unclear if these results reflect ineffective policy implementation or a general reduction in on-campus alcohol consumption. However, using EMS call volume as a marker for policy success and quality improvement offers an innovative tool through which EMS agencies can provide valuable feedback to other system stakeholders.

Reintroducing Cuvier’s gazelle. Better than expected from captive-bred founders

The use of captive-bred animals as founder stock for reintroduction is sometimes discouraged due to their low genetic diversity and even accumulation of deleterious alleles. In October 2016, 43 Cuvier’s gazelles (12 males and 31 females), managed under a European Endangered Species Programme (EEP) and housed in captivity, formed the base of a reintroduction project in Tunisia. The project approach used soft-release techniques. Upon arrival, animals were released in acclimatisation pens, so they could adjust to the new conditions gradually before true release. This study reports on the three-year period gazelles were in the acclimatisation pens before release into the wild. To assess the suitability of captive-bred Cuvier’s gazelles as founder stock for reintroduction, the demographic parameters of the reintroduced population were studied for three reproductive seasons in Tunisia (2017–2019). The demographic parameters of the reintroduced population were also compared to those from the source captive population as a control during the first breeding season. If the animals used as founders were unsuited, a decrease in demographic parameters could be expected over time in the reintroduced population, as well as lower demographic variables compared to the source population. Contrary to expectations, during the three-year study period, all demographic variables increased in the population reintroduced in Tunisia, except juvenile mortality, which decreased. Moreover, none of the demographic values of the gazelles in Tunisia were significantly different from the source population. We hypothesize that in the extremely bottlenecked captive Cuvier’s gazelle population used as founder stock, genetic diversity was still high enough to surmount the presumably deleterious effects of inbreeding. This is probably due to very high heritability (h2), a parameter providing information on the quantitative genetic variation associated with multi-locus quantitative traits previously found in this population. Although reintroduction programs have traditionally been undertaken purely as management exercises, ours was designed to meet a research objective as well. We wanted to find out the adaptive variation in sex ratio in offspring of female Cuvier’s gazelles using the size of the enclosure as a proxy reflecting their body condition. As found in captivity using consanguinity level as a proxy of body condition, in the reintroduced population, mothers in large enclosures produced more daughters while those in the small ones produced more sons, which supports adaptive manipulation of the birth sex ratio favoured by natural selection in reintroduced Cuvier’s gazelles.

SAT-390 Preoperative Parathyroid Ultrasound Imaging - Pitfalls and Ways to Improve Diagnostic Accuracy

Introduction: Parathyroid ultrasound (US) is commonly used for pre-operative imaging to facilitate focused parathyroid surgery. It provides point-of-care imaging without ionizing radiation and is less expensive compared to nuclear scintigraphy or computed tomography (CT). Parathyroid US is, however, operator skill and experience dependent. Methods: The charts of all patient who underwent parathyroid surgery between 2016 and 2018 were reviewed. Investigators reviewed the pre-operative US images and correlated these findings with pathology reports, operative notes and with results of CT and nuclear scintigraphy imaging. The US characteristics of parathyroid lesions were described. Results: In total 146 patients underwent parathyroid surgery during the three-year study period. The average age of the cohort was 55.1 +/- 15.1 years and the male to female ratio was 1:2.6. The average pre-operative serum calcium and PTH levels were 11.6 +/- 0.9 mg/dL and 310.9 +/-305 pg/ml, respectively. 134 out of 138 patients with preoperative PTH US had images available for review by investigators. Compared to the pre-operative read that identified 106 lesions, 19 additional parathyroid lesions were identified: seven (36.8%) were easily identifiable lesions with typical US features, 3 (15.8%) were easily identifiable lesions with atypical US features, 5 (26.3%) were lesions adherent to the thyroid gland and 9 (47.4%) were small lesions that were likely only identified by the investigators due to knowledge of the final pathology and intraoperative findings. Forty-seven parathyroid lesions could not be identified by investigators and one or more of the following reasons were determined as possible explanations: lesion was small in size (14.9%), presence of a large thyroid gland (27.7%), location of the lesion deep in the neck or at an ectopic location (21.3%). The quality of stored images was inadequate in 31.9% of these cases. After review, 67.1% (compared to the actual detection rate of 61.3%) of parathyroid lesions should have been identified on preoperative US. Sixty percent of parathyroid lesions were left sided and 66.9% were inferior in location. The shapes observed were oval (48.8%), conforming (50.4%) or elongated (<1%) and echogenicity was hypoechoic (86.8%) or isoechoic (13.2%). Only a small percentage had a target sign (6.6%) or were partially cystic (7.4%). 74.8% demonstrated a feeding vessel and 33.6% had vascular arborization or scattered vascularity. Conclusions: While parathyroid lesions with typical US feature and locations are easily identified, the common reasons for failure to identify a lesion include atypical features, small size, slender configuration and adherence to the thyroid gland. Being aware of these possibilities can improve detection rate. Parathyroid lesions are also less likely to be identified when present deep in the neck or at an ectopic location outside of the neck.

Development of an infrared pollution index to identify ground-level compositional, particle size, and humidity changes using Himawari-8

Abstract Speciated air quality data informs health studies and quantitates impacts. However, monitoring is concentrated around populated regions whilst, large remote and rural regions remain unmonitored despite risks of dust-storms or wild-fires. Sub-hourly, infrared, geostationary data, such as the 10-min data from Himawari 8, could potentially be used to quantify regional air quality continually. Monitoring of Aerosol Optical Depth (AOD) is restricted to visible spectra (i.e. daytime only), while newer quantification methods using geostationary infrared (IR) data have focused on detecting the presence, or absence, of an event. Limited attention has been given to the determination of particle size and aerosol composition (such as sulfates, black carbon, sea-salt, and mineral dust), using IR exclusively, and more appropriate methods are required to improve the understanding of source impacts. Hourly data were collected for a three-year study period (July 2015 to July 2018) across the greater Sydney region in Eastern Australia from seventeen ground-based sites that measured meteorological data and quantified ambient concentrations of NO, NO2, SO2, PM2.5, PM10, and O3. This data was combined with source-apportioned categories (soil, sea-spray, smoke, secondary sulfates, and vehicles) from positive matrix factorization (PMF) of elemental aerosol collected on daily filters at five monitoring sites across the region. Regression analysis of five brightness temperature difference (BTD) infrared indices were used to determine a pollution index. The pollution index was shown to be related to humidity, particle size, and compositional changes. Unlike fixed thresholds, the continual index function can be aggregated spatially and temporarily. Good resolution is obtained between PM2.5 and O3. BTD appears insensitive to concentration, and the pollution index was used to detect and identify composition prior to determining concentration.

Pediatric Abdominal X-rays in the Acute Care Setting - Are We Overdiagnosing Constipation?

IntroductionConstipation represents 3% of all office visits to pediatricians and 10% - 45% of consultations with pediatric gastroenterologists. It has been reliably established that the role of abdominal x-rays (AXR) in the diagnosis of constipation in pediatrics is limited; yet, significant overdiagnosis of constipation exists when plain abdominal x-rays are used in the acute setting for abdominal pain or to screen for other disorders. This results in loss of time, resources, exposure to unnecessary radiation, and potentially missing the primary diagnosis. The purpose of this study is to determine the sensitivity and specificity of AXR in diagnosing constipation in the acute setting.ObjectivesTo determine 1) the sensitivity and specificity of plain AXR in the diagnosis of constipation and 2) the effect of age, race, gender, comorbid conditions, and practice setting on the diagnosis of constipation.MethodsThis study was a historical cohort study of children (two to 18 years of age) who were seen at Ascension St. John Children’s Hospital between March 2015 - March 2018 and who had a plain AXR performed during an emergency department (ED) visit or inpatient stay. If AXR results contained keywords, such as “constipation,” “stool load,” “fecal retention,” and “fecal load,” the ambulatory medical record, Athena® (http://www.athenahealth.com), was searched to determine if the child had an ambulatory visit in the ensuing 45 days. Chart review was conducted to assess if the diagnosis of constipation was later confirmed by history and physical examination by a pediatrician or gastroenterologist at that visit. By comparing data from both encounters, the sensitivity and specificity of plain AXR in diagnosing constipation was assessed. All data were analyzed using the Statistical Package for Social Sciences (SPSS), v. 25.0 (IBM SPSS Statistics, Armonk, NY) and a p-value of 0.05 or less was considered to indicate statistical significance.ResultsOver the three-year study period, 1,383 AXRs were performed on 1,116 patients. The sensitivity of AXR in the diagnosis of constipation was 73.8%, specificity 26.8%, positive predictive value 46.4%, and negative predictive value of 54.3%. Pediatric gastroenterologists were more likely to diagnose constipation (63.2%) compared to pediatricians (41.4%) and pediatric surgeons (33.3%) (p = 0.04).ConclusionsAXRs are not a reliable means of diagnosing constipation. Overall, we found similar sensitivity and specificity of AXR in diagnosing constipation compared to previous studies. Yet, our study gives new insight into the practices around diagnosing constipation in a single-center community hospital pediatric acute setting and the radiology department. This further emphasizes the need to review current practices and impart more education both in the acute care setting and radiology department.

Sexual risk behaviour and sexually transmitted infections in men who have sex with men

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; In India the estimated men who have sex with men (MSM) population is around 352, 000, among that 4.3% are living with HIV. The incidence of sexually transmitted infections (STIs) in MSM is greater than that reported in women and men who have sex with women only. The aim of the study is to determine the trends of sexual behaviour and the pattern of sexually transmitted infections in men who have sex with men.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective study of the data collected from the clinical records of all MSM, who had attended the STI clinic of Kilpauk Medical College, Chennai, Tamil Nadu, during the three-year study period, from July 2016 to June 2019. Demographic data, sexual risk behaviour, condom usage and STIs, among the MSM, were computed and analyzed.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; During the study period 489 MSM attended the STI clinic, 51.9% were bisexual and 48.1 % were homosexual. Among them, exclusive penetrative sex in 50.7%, exclusive receptive sex in 15.7% and both in 33.6% were reported. Condom usage was consistent in 18.8%, inconsistent in 28.8% and 52.9% never used condom. Unprotected sex is more common in oral sex than with anal sex. STIs were seen in 20.9% and HIV in 1.4% of MSM. Syphilis was the most common STI seen.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Our study elucidated the high prevalence of STIs among MSM and increasing trends of sexual risk behaviour. Health service providers must take necessary steps to improve the provision of biological and medical measures to screen, treat and prevent infections.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Cervical cancer screening in the Canadian armed forces: An estimation of screening participation rates using the CF-HERO surveillance system

BackgroundMilitary women are faced with unique circumstances, including frequent relocation and occupational factors that may influence their participation in routine cervical cancer screening. No data on programmatic participation in cervical cancer screening in Canadian Armed Forces women has been synthesized to date. ObjectiveTo estimate cervical cancer screening rates in Canadian military women using clinical and administrative data sources. MethodsActively serving Regular Force females who were >25 years of age between January 1st 2015 and December 31st 2017 were included in the study. Scanned documents containing Papanicolaou (Pap) test results were extracted from electronic health records and further linked to demographic data sources. Screening coverage rates were calculated over the three-year study period, and results were stratified by both military command and rank. ResultsThe study period yielded over 23,000 person-years of data. The average screening rate over this period was 77.7 %, and was highest in the 45−60 year age group. Variations in rates were observed by rank and command, with higher screening rates observed in Officers and Royal Canadian Navy staff. Overall, screening rates showed a declining trend for all groups across the study period. ConclusionsCervical cancer screening rates amongst CAF members are currently below recommended guidelines and appear to be declining. These trends mirror those observed more widely in the general Canadian population, and may be a consequence of recent changes to guidelines for both cervical cancer and human papillomavirus (HPV) screening.

Productivity and profitability of maize-legume cropping systems under conservation agriculture among smallholder farmers in Malawi

ABSTRACTA study was conducted from 2014 to 2017 in Malawi to elucidate the short-term effects of maize-legume intercropping and rotation systems under conservation agriculture (CA) and conventional tillage (CT) on crop productivity and profitability. Twelve farmers hosted on-farm trials per district, in three districts, with each farmer having six plots. The design of the study was randomised complete block design arranged in a split plot fashion with tillage as main plot and cropping systems as sub-plots, with each farmer acting as a replicate. CA had 1400 and 3200 kg ha−1 more maize grain yield in the second and third seasons, respectively compared with CT. In the first two seasons, CT had 310, 180 and 270 kg ha−1 more cowpea, soybean and pigeon pea grain yields in Salima, Mzimba and Mangochi districts, respectively, compared with CA. Similarly, CA had 1100 and 950 kg ha−1 more groundnut grain yields than CT in Salima and Mzimba districts in the second and third seasons, respectively. Over the three-year study period, partial land equivalent ratio for maize ranged from 0.78 to 1.24. Largest net returns were achieved by intercropping maize with pigeon pea in Mangochi and rotating maize and groundnut in Mzimba and Salima districts.

Evaluation of an interactive simulated patient educational tool on course performance among current pharmacy students

Background and purposeIn an accelerated doctor of pharmacy program, student examination performance on a key knowledge concept, the Cockcroft-Gault equation (CGE) for creatinine clearance estimation, was suboptimal. A scenario-based online tutorial using a virtual patient activity was developed to provide just-in-time access to an active-learning opportunity, consistent with Millennial learning styles. The purposes of this study were to assess the association between tutorial use and CGE examination performance and to explore learner characteristics that may affect this association, including student age group. Educational activity and settingCGE calculation is a required component of Renal and Cardiovascular System I, the fourth of a five-quarter intensive integrated course sequence. The tutorial used pretest-based branching, learner personalization, and virtual-patient scenarios in a realistic environment. Statistical analyses estimated the association of voluntary tutorial usage with CGE-calculation performance using Spearman's Rho correlations and linear regression analysis. Covariates included age group and course grade, excluding CGE points. FindingsOver a three-year study period (2015 to 2017), students (n = 436) accessed the tutorial a mean (median) of 5.64 (5.0) times. Tutorial access varied significantly, but not consistently, across age categories. In both bivariate and linear regression analyses, tutorial access was significantly associated with CGE grade only among students with non-CGE grades in the top 25% (i.e. top quartile). SummaryThe majority of learners took advantage of an interactive educational tool designed for active learner engagement. Frequency of tutorial access was associated with improvements in CGE calculation performance only among top-quartile students.

Development of anthropometric characteristics in professional Rugby League players: Is there too much emphasis on the pre-season period?

Rugby League is a team sport requiring players to experience large impact collisions, thus requiring high amounts of muscle mass. Many players (academy and senior) strive to increase muscle mass during the pre-season, however, quantification of changes during this period have not been thoroughly investigated. We therefore assessed changes in body-composition using Dual X-Ray Absorptiometry (DXA) in eleven academy players over three successive pre-seasons and ninety-three senior players from four different European Super League clubs prior to, and at the end of, a pre-season training period. There was no meaningful change in lean mass of the academy players during any of the pre-season periods (year 1 = 72.3 ± 7.1–73.2 ± 7.2kg; ES 0.05, year 2 = 74.4 ± 6.9–75.5 ± 6.9kg; ES 0.07, year 3 = 75.9 ± 6.7–76.8 ± 6.6kg; ES 0.06) with small changes only occurring over the three-year study period (72.3–75.9kg; ES = 0.22). Senior players showed trivial changes in all characteristics during the pre-season period (total mass = 95.1–95.0kg; ES −0.01, lean mass = 74.6–75.1kg; ES 0.07, fat mass = 13.6–12.9kg; ES −0.17, body fat percentage = 14.8–14.1%; ES −0.19). These data suggest that academy players need time to develop towards profiles congruent with senior players. Moreover, once players reach senior level, body-composition changes are trivial during the pre-season and therefore teams may need to individualise training for players striving to gain muscle mass by reducing other training loads.

Institutional differences in USMLE Step 1 and 2 CK performance: Cross-sectional study of 89 US allopathic medical schools.

The United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) are important for trainee medical knowledge assessment and licensure, medical school program assessment, and residency program applicant screening. Little is known about how USMLE performance varies between institutions. This observational study attempts to identify institutions with above-predicted USMLE performance, which may indicate educational programs successful at promoting students' medical knowledge. Self-reported institution-level data was tabulated from publicly available US News and World Report and Association of American Medical Colleges publications for 131 US allopathic medical schools from 2012-2014. Bivariate and multiple linear regression were performed. The primary outcome was institutional mean USMLE Step 1 and Step 2 CK scores outside a 95% prediction interval (≥2 standard deviations above or below predicted) based on multiple regression accounting for students' prior academic performance. Eighty-nine US medical schools (54 public, 35 private) reported complete USMLE scores over the three-year study period, representing over 39,000 examinees. Institutional mean grade point average (GPA) and Medical College Admission Test score (MCAT) achieved an adjusted R2 of 72% for Step 1 (standardized βMCAT 0.7, βGPA 0.2) and 41% for Step 2 CK (standardized βMCAT 0.5, βGPA 0.3) in multiple regression. Using this regression model, 5 institutions were identified with above-predicted institutional USMLE performance, while 3 institutions had below-predicted performance. This exploratory study identified several US allopathic medical schools with significant above- or below-predicted USMLE performance. Although limited by self-reported data, the findings raise questions about inter-institutional USMLE performance parity, and thus, educational parity. Additional work is needed to determine the etiology and robustness of the observed performance differences.

Strategi Desain Konsep Permakultur pada SMK Pertanian di Kabupaten Grobogan

&lt;em&gt;Grobogan Regency is one of the regions that has high agricultural potential. However, the existing educational facilities cannot accommodate all existing communities. Education in agriculture is found as lacking where not all regions who potentially in agriculture have agriculture-based educational institutions. Agricultural Vocational High School with the concept of permaculture in Grobogan provides five departments in agriculture with a three-year study period. Planning method in this design using planning, programming and designing which related to permaculture concept. Permaculture is the basis for ecological and independent building design by emphasizing the main principles of permaculture; energy planning, energy cycle, scale, biological sources and related locations that are in accordance with the needs of the education and agriculture regions. Design of agricultural vocational school emphasizes on zoning in building and sector. The result of the school design is to create an independent school area with maximum energy planning and to display related agricultural school buildings.&lt;/em&gt;

A matter of taste: Spatial and ontogenetic variations on the trophic ecology of the tiger shark at the Galapagos Marine Reserve.

Sharks are top predators across ocean food webs and have a major ecological role in marine ecosystems. Investigating the trophic ecology of this group of species is thus essential to understand ecosystem functioning and inform specific management actions aimed at shark conservation. The Galapagos Islands represent one of the last ocean wildernesses, where populations of sharks and other top marine predators come close to a pristine status. Here we provide the first study on the trophic ecology of the tiger shark (Galeocerdo cuvier) within the Galapagos Marine Reserve (GMR), using a combination of stable isotope analysis, satellite tracking, and passive acoustic telemetry to investigate ontogenetic and spatial variations at two regions. The mean estimated δ13C and δ15N at Isabela island (western region) were -13.9 ± 0.5‰ and 13.7 ± 0.7‰; and for Santa Cruz island (central region) were -13.8 ± 0.3‰ and 13.4 ± 0.7‰, respectively. Green sea turtles (Chelonia mydas) were the main prey item for large tiger sharks (>280 cm TL), while smaller sharks mainly fed on squid and pelagic fish. Tiger sharks exhibited a high degree of philopatry around green sea-turtle nesting areas, with the majority of sharks detected around green sea-turtle nesting areas for at least 10 months after their capture date, and some individuals were even present during the entire three-year study period. Although we did not report statistically significant differences between the two regions, isotopic and electronic tagging data suggest that tiger sharks in the Galapagos could be segregated into specific populations separated by geographical scales of <100 km. The high productivity of the archipelago, along with the protection from industrial fishing granted by the GMR, result in abundant and predictable sources of prey. This high food abundance, combined with the presence of suitable habitats throughout the tiger shark life cycle, might result in a reduction of migratory behaviours when compared to movement patterns of tiger sharks in other ocean basins. Additional studies using genetic tools could provide further evidence on the presence of separate management units, as it has been recently revealed for other shark species inhabiting the GMR.

Sputum microbiota and inflammation at stable state and during exacerbations in a cohort of chronic obstructive pulmonary disease (COPD) patients.

BackgroundExacerbations of chronic obstructive pulmonary disease (COPD) are debilitating events and spur disease progression. Infectious causes are frequent; however, it is unknown to what extent exacerbations are caused by larger shifts in the airways’ microbiota. The aim of the current study was to analyse the changes in microbial composition between stable state and during exacerbations, and the corresponding immune response.MethodsThe study sample included 36 COPD patients examined at stable state and exacerbation from the Bergen COPD Cohort and Exacerbations studies, and one patient who delivered sputum on 13 different occasions during the three-year study period. A physician examined the patients at all time points, and sputum induction was performed by stringent protocol. Only induced sputum samples were used in the current study, not spontaneously expectorated sputum. Sputum inflammatory markers (IL-6, IL-8, IL-18, IP-10, MIG, TNF-α) and antimicrobial peptides (AMPs, i.e. LL-37/hCAP-18, SLPI) were measured in supernatants, whereas target gene sequencing (16S rRNA) was performed on corresponding cell pellets. The microbiome bioinformatics platform QIIME2TM and the statistics environment R were applied for bioinformatics analyses.ResultsLevels of IP-10, MIG, TNF-α and AMPs were significantly different between the two disease states. Of 36 sample pairs, 24 had significant differences in the 12 most abundant genera between disease states. The diversity was significantly different in several individuals, but not when data was analysed on a group level. The one patient case study showed longitudinal dynamics in microbiota unrelated to disease state.ConclusionChanges in the sputum microbiota with changing COPD disease states are common, and are accompanied by changes in inflammatory markers. However, the changes are highly individual and heterogeneous events.

Integrated use of straw mulch with nitrogen fertilizer improves soil functionality and soybean production

Mulching can effectively maintain and improve soil health and functionality. The mechanisms, however, have not been fully elucidated. Therefore, the effects of temperature on the biogeochemical properties of soil were investigated in the present study in relation to nitrogen management and soil functionality. The results of the 3-year field experiments showed that integrated straw mulch (S) and nitrogen fertilizer (N) treatments enhanced the activities of soil urease, invertase, alkaline phosphatase, and catalase by >1.8, 2.1, 2.0 and 1.4 fold, respectively, compared with the control treatment. Furthermore, these treatments increased soil available N by 28%, phosphorus by 45%, and potassium by 55%. In general, the soil organic carbon, dissolved carbon and labile organic carbon content in the treated plot were approximately 1.2–2.9 folds greater than in the control plot. These improvements in soil fertility and carbon indices increased the biomass and grain yield of soybean (67 and 75%, respectively) during the three-year study period. During 2015–2017, the straw mulch and nitrogen fertilizer treatment increased the soil moisture (23%) and decreased the soil temperature (8%) in comparison to the control in the 0–0.2 m soil depth and, therefore, improved soil enzyme activities, nutrient availability, and carbon stocks, and ultimately, soil functionality and sustainability, in the semiarid region.

Social attraction used to establish Caspian tern nesting colonies in San Francisco Bay

Conservation of colonial waterbird breeding populations often includes restoring historic nesting habitat or establishing new nesting habitat in protected areas. However, colonization of new or restored nesting habitat may be hindered by the lack of social cues from nesting conspecifics to attract prospecting birds. Social attraction, whereby decoys and colony sound recordings are used to mimic active nesting colonies, has been used successfully to establish waterbird nesting colonies throughout the world. We constructed islands, modified the substrate so that it was attractive to nesting Caspian terns (Hydroprogne caspia), and then used social attraction to establish nesting colonies within two managed ponds in San Francisco Bay, California where Caspian terns had not previously nested. During the 2015–2017 breeding seasons, we deployed decoys of adult Caspian terns, broadcasted colony sound recordings, and monitored Caspian tern response. Caspian terns formed nesting colonies within weeks of social attraction deployment at each of the two ponds in 2015, and the size of these colonies increased in each subsequent year of the study. In 2017, the final year of the study, we estimated a minimum of 501 breeding pairs between the two colonies, making them two of the three largest Caspian tern colonies in the San Francisco Bay estuary. In total, these two colonies produced 1343 nests and 531 fledglings over the three-year study period. Nest densities were low (mean: 0.29 nests/m2 of active colony area) compared to other studies, and greater than 80% of the modified island habitat remained unused by nesting Caspian terns in 2017, suggesting that there is additional space for future colony growth. The successful establishment of two of the largest Caspian tern nesting colonies in the San Francisco Bay estuary in just three years demonstrates the potential of using island construction and habitat modifications, combined with social attraction measures to establish waterbird nesting colonies.

Complications after vascularized jejunal mesenteric lymph node transfer: A 3-year experience.

Vascularized lymph node transfer (VLNT) is a well-established method for the surgical management of refractory extremity lymphedema. Generally, donor lymph nodes are harvested from the axilla, groin, or supraclavicular area. However, these sites offer their own disadvantages and introduce risk for inducing lymphedema at the surgical donor site. In our experience, the jejunal mesentery can be an excellent source of lymph nodes without the risk of donor site lymphedema. Long term complications are unknown for this procedure; we report our experience, complication rates, and lessons learned. A retrospective review was performed for all patients at our institution undergoing surgical treatment of lymphedema using jejunal mesenteric VLNT from February 2015 to February 2018. Demographic data, length of follow up, and surgical complications were reviewed. Twenty-nine patients have undergone jejunal VLNT at our institution during the three-year study period, with a total of 30 transfers. Five patients had a concurrent omental lymph node transfer. Average length of follow up was 17.6 months (range 1.0-36.8 months). There was one flap loss in this time frame (3.3%). Four patients developed hernias post-operatively (13.8%), and three had nonoperative small bowel obstructions (10.3%). One patient had a postoperative wound infection at the abdominal incision (3.4%). Jejunal VLNT can be an effective option for surgical treatment of lymphedema, without the risk of postoperative donor site lymphedema. Patients and surgeons should be aware of the risks of hernia and small bowel obstruction with this method compared to other lymph node sources.

Characterization and subtyping of Listeria monocytogenes strains from butcher shops

We characterized L. monocytogenes strains isolated from ground beef (n = 40) and butcher shop environmental (n = 99) samples before and after implementing improvement actions. Strains were serotyped and subtyped by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) and ApaI-pulsed-field gel electrophoresis (PFGE) to establish their epidemiological relationships, clarify the contamination dynamics and assess the impact of improvement measures. Serotype distribution was as follows: 1/2c (57.6%), 1/2b (18.7%), 4b (12.9%), 1/2a (6.5%) and 4a/4c (4.3%). Thirteen clones were simultaneously isolated in different butcher shops; 73.5% of establishments shared the same beef supplier. Cross-contamination was detected in L. monocytogenes-positive samples from 20% of butcher shops, mostly at the evaluation stage (91.7%). Up to five strains were isolated from each butcher shop at the evaluation (37%) and verification (22%) stages. Seven persistent clones were isolated over the three-year study period. Serotypes 4b and 1/2b significantly decreased during the evaluation stage. Although part of the contamination with L. monocytogenes was introduced by the beef supplier, the pathogen spread profusely in butcher shops, suggesting the relevance of keeping good hygiene control and management of the environment to prevent the spread of L. monocytogenes in butcher shops.

THE INFLUENCE OF LIQUIDITY, CAPITAL STRUCTURE, PROFITABILITY AND CASH FLOWS ON THE COMPANY’S FINANCIAL DISTRESS

Financial distress is a complicated phase and multidimensional problem facing by the company. Since it leads the company on the possibility of bankruptcy, this situation needs immediately to be recovered. This study aims to determine the factors that influence the company's financial distress. There are ten variables in this study which are classified into four categories: liquidity, capital structure, profitability and cash flows. This study used financial statement data of manufacturing company which is listed in Indonesia Stock Exchange during the threeyear study period from 2011 to 2013. There are some criteria in choosing the representative sample so that the sum of the companies are 90 companies or equal to 270 financial statements data. The empirical findings show that there are only three variables that influence the company’s financial distress. The significant variables are current ratio (liquidity), return on assets (profitability) and cash flow ratio (cash flow).

The location of back pain as a factor differentiating the physical fitness of cadets of the Military Academy of Land Forces

Introduction. The training of candidates for officers-commanders is an important part of the training activities of the Polish Armed Forces. Currently, the basic path of obtaining this group of officers for the Polish Armed Forces is the education of graduates of secondary schools. The aim of the study is to evaluate the differentiation of the physical fitness level of cadets of the Military University of Land Forces depending on the back pain location. Material and methods. The research material was collected as a result of tests conducted among cadets of the Military University of Land Forces in Wroclaw in the years 2015–2018. Their cardiorespiratory endurance, functional strength, running speed and agility as well as body balance were determined. In addition, spirometric measurements and a survey were conducted. Results. The results obtained in the three-year study period indicate statistically significant differences in the level of only a small number of functional features of the selected groups of men depending on the location of back pain. Significant differences between the separate groups of cadets occurred in the cardiorespiratory endurance level, the forced expiratory volume in 1 second and the forced vital capacity in test I, the level of running speed and agility in test II as well as the forced expiratory volume in 1 second in test III. Conclusions. The pain in the lower back was not a factor significantly differentiating the somatic structure of the cadets. The location of the lower back pain syndromes also did not differentiate most of the cadets’ functional abilities. The three-year study period saw favorable changes in the somatic structure and physical fitness of the examined men.