Existing technologies, institutions, and behavioral norms together act to constrain the rate and magnitude of carbon emissions reductions in the coming decades. The inertia of carbon emissions due to ...such mutually reinforcing physical, economic, and social constraints is referred to as carbon lock-in. Carbon lock-in is a special case of path dependency, which is common in the evolution of complex systems. However, carbon lock-in is particularly prone to entrenchment given the large capital costs, long infrastructure lifetimes, and interrelationships between the socioeconomic and technical systems involved. Further, the urgency of efforts to avoid dangerous climate change exacerbates the liability of even small lock-in risks. Although carbon lock-in has been recognized for years, efforts to characterize the types and causes of carbon lock-in, or to quantitatively assess and evaluate its policy implications, have been limited and scattered across a number of different disciplines. This systematic review of the literature synthesizes what is known about the types and causes of carbon lock-in, including the scale, magnitude, and longevity of the effects, and policy implications. We identify three main types of carbon lock-in and describe how they coevolve: (
a
) infrastructural and technological, (
b
) institutional, and (
c
) behavioral. Although each type of lock-in has its own set of processes, all three are tightly intertwined and contribute to the inertia of carbon emissions. We outline the conditions, opportunities, and strategies for fostering transitions toward less-carbon-intensive emissions trajectories. We conclude by proposing a carbon lock-in research agenda that can help bridge the gaps between science, knowledge, and policy-making.
This part of the review aims to reduce the start-up burden of data collection and descriptive analytics for statistical modeling and route optimization of risk associated with motor vehicles. From a ...data-driven bibliometric analysis, we show that the literature is divided into two disparate research streams: (a) predictive or explanatory models that attempt to understand and quantify crash risk based on different driving conditions, and (b) optimization techniques that focus on minimizing crash risk through route/path-selection and rest-break scheduling. Translation of research outcomes between these two streams is limited. To overcome this issue, we present publicly available high-quality data sources (different study designs, outcome variables, and predictor variables) and descriptive analytic techniques (data summarization, visualization, and dimension reduction) that can be used to achieve safer-routing and provide code to facilitate data collection/exploration by practitioners/researchers. Then, we review the statistical and machine learning models used for crash risk modeling. We show that (near) real-time crash risk is rarely considered, which might explain why the optimization models (reviewed in Part 2) have not capitalized on the research outcomes from the first stream.
Bacteremia can progress to septic shock and death without appropriate medical intervention. Increasing evidence supports the role of molecular diagnostic panels in reducing the clinical impact of ...these infections through rapid identification of the infecting organism and associated antimicrobial resistance genes. We report the results of a multicenter clinical study assessing the performance of the GenMark Dx ePlex investigational-use-only blood culture identification Gram-negative panel (BCID-GN), a rapid diagnostic assay for detection of bloodstream pathogens in positive blood culture (PBC) bottles. Prospective, retrospective, and contrived samples were tested. Results from the BCID-GN were compared to standard-of-care bacterial identification methods. Antimicrobial resistance genes (ARGs) were identified using PCR and sequence analysis. The final BCID-GN analysis included 2,444 PBC samples, of which 926 were clinical samples with negative Gram stain results. Of these, 109 samples had false-negative and/or -positive results, resulting in an overall sample accuracy of 88.2% (817/926). After discordant resolution, overall sample accuracy increased to 92.9% (860/926). Pre- and postdiscordant resolution sample accuracy excludes 37 Gram-negative organisms representing 20 uncommon genera, 10 Gram-positive organisms, and 1
species present in 5% of samples that are not targeted by the BCID-GN. The overall weighted positive percent agreement (PPA), which averages the individual PPAs from the 27 targets (Gram-negative and ARG), was 94.9%. The limit of detection ranged from 10
to 10
CFU/ml, except for one strain of Fusobacterium necrophorum at 10
CFU/ml.
Despite improvements in hospital infection prevention and control, healthcare associated infections (HAIs) remain a challenge with significant patient morbidity, mortality, and cost for the ...healthcare system. In this review, we use a One Health framework (human, animal, and environmental health) to explain the epidemiology, demonstrate key knowledge gaps in infection prevention policy, and explore improvements to control Gram-positive pathogens in the healthcare environment. We discuss patient and healthcare worker interactions with the hospital environment that can lead to transmission of the most common Gram-positive hospital pathogens - methicillin-resistant Staphylococcus aureus, Clostridioides (Clostridium) difficile, and vancomycin-resistant Enterococcus - and detail interventions that target these two One Health domains. We discuss the role of animals in the healthcare settings, knowledge gaps regarding their role in pathogen transmission, and the absence of infection risk mitigation strategies targeting animals. We advocate for novel infection prevention and control programs, founded on the pillars of One Health, to reduce Gram-positive hospital-associated pathogen transmission.
The Asian longhorned tick (Haemaphysalis longicornis) was first reported in the United States in 2017 and has since been detected in at least 17 states. This tick infests cattle and can produce large ...populations quickly due to its parthenogenetic nature, leading to significant livestock mortalities and economic losses. While H. longicornis has not been detected in Texas, species distribution models have identified southern Texas as a possible hospitable region for this tick. Southern Texas is currently home to the southern cattle tick (Rhipicephalus microplus), which can transmit the causative agent of cattle fever (Babesia bovis). With the potential for H. longicornis and B. bovis to overlap in southern Texas and their potential to negatively impact the national and global livestock industry, it is imperative to identify the role H. longicornis may play in the cattle fever disease system. A controlled acquisition and transmission experiment tested whether H. longicornis is a vector for B. bovis, with the R. microplus-B. bovis system used as a positive control. Transstadial (nymphs to adults) and transovarial (adults to larvae) transmission and subsequent transstadial maintenance (nymphs and adults) routes were tested in this study. Acquisition-fed, splenectomized animals were used to increase the probability of tick infection. Acquisition nymphs were macerated whole and acquisition adults were dissected to remove midguts and ovaries at five time points (4, 6, 8, 10, and 12 days post-repletion), with 40 ticks processed per time point and life stage. The greatest percentage of nymphs with detectable B. bovis DNA occurred six days post-repletion (20.0 %). For adults, the percentage of positive midguts and ovaries increased as days post-repletion progressed, with day 12 having the highest percentage of positive samples (67.5 % and 60.0 %, respectively). When egg batches were tested in triplicate, all H. longicornis egg batches were negative for B. bovis, while all R. microplus egg batches were positive for B. bovis. During the transmission phase, the subsequent life stages for transstadial (adults) and transovarial transmission/transstadial maintenance (larvae, nymphs, and adults) were fed on naïve, splenectomized calves. All life stages of H. longicornis ticks tested during transmission were negative for B. bovis. Furthermore, the transmission fed animals were also negative for B. bovis and did not show signs of bovine babesiosis during the 45-day post tick transmission period. Given the lack of successful transstadial or transovarial transmission, it is unlikely that H. longicornis is a vector for B. bovis.
In the first part of the review, we observed that there exists a significant gap between the predictive and prescriptive models pertaining to crash risk prediction and minimization, respectively. In ...this part, we review and categorize the optimization/ prescriptive analytic models that focus on minimizing crash risk. Although the majority of works in this segment of the literature are related to the hazardous materials (hazmat) trucking problems, we show that (with some exceptions) many can also be utilized in non-hazmat scenarios. In an effort to highlight the effect of crash risk prediction model on the accumulated risk obtained from the prescriptive model, we present a simulated example where we utilize four risk indicators (obtained from logistic regression, Poisson regression, XGBoost, and neural network) in the
shortest path algorithm. From our example, we demonstrate two major designed takeaways: (a) the shortest path may not always result in the lowest crash risk, and (b) a similarity in overall predictive performance may not always translate to similar outcomes from the prescriptive models. Based on the review and example, we highlight several avenues for future research.
Central nervous system (CNS) histoplasmosis is a life-threatening condition and represents a diagnostic and therapeutic challenge. Isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF) ...or brain tissue is diagnostic; however, culture is insensitive and slow growth may result in significant treatment delay. We performed a retrospective multicenter study to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis, the primary objective of the study. The secondary objective was to determine the effect of improvements in the Histoplasma galactomannan antigen detection EIA on the diagnosis of Histoplasma meningitis.
Residual CSF specimens from patients with Histoplasma meningitis and controls were tested for Histoplasma antigen and anti-Histoplasma immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody using assays developed at MiraVista Diagnostics.
A total of 50 cases and 157 controls were evaluated. Fifty percent of patients with CNS histoplasmosis were immunocompromised, 14% had other medical conditions, and 36% were healthy. Histoplasma antigen was detected in CSF in 78% of cases and the specificity was 97%. Anti-Histoplasma IgG or IgM antibody was detected in 82% of cases and the specificity was 93%. The sensitivity of detection of antibody by currently available serologic testing including immunodiffusion and complement fixation was 51% and the specificity was 96%. Testing for both CSF antigen and antibody by EIA was the most sensitive approach, detecting 98% of cases.
Testing CSF for anti-Histoplasma IgG and IgM antibody complements antigen detection and improves the sensitivity for diagnosis of Histoplasma meningitis.
Amorphous silicates in meteoritic samples are significant as potential surviving interstellar dust from the formation of the Solar System. Amorphous silicate-rich grains called GEMS, glass with ...embedded metal and sulfides, are abundant in anhydrous interplanetary dust particles and some ultracarbonaceous Antarctic micrometeorites that have high presolar grain abundances. Some GEMS within these objects have been confirmed to be presolar. GEMS-like material, consisting of amorphous silicate with opaque inclusions, has been identified in the matrices of some primitive meteorites. We use specialized thin specimen preparation and transmission electron microscopy methods to compare the GEMS-like material in Paris (CM) and Acfer 094 (ungrouped) chondrites with GEMS in anhydrous, chondritic interplanetary dust particles. Specifically, we compared the amorphous silicate morphology, degree of partial ordering, elemental composition and dominant iron oxidation state. We find that the amorphous silicates in the GEMS-like materials in Paris and Acfer 094 show incipient ordering and are Fe-rich and highly oxidized, while those in GEMS are fully amorphous, Fe-poor, and anhydrous. From examination of various formation routes for the amorphous silicates, we conclude that the GEMS-like material in Paris and Acfer 094 is not GEMS and that it is unlikely that GEMS-like material accreted as primary amorphous material that retained its original amorphous structure since accretion. We also conclude that the presence of GEMS-like amorphous silicates in chondrite matrix is not a reliable indicator for high degrees of primitivity or pristinity since even mild, complex alteration processes may significantly alter silicate structure. Finally, we propose searches for presolar amorphous silicates in chondrite matrix samples that have been precharacterized by transmission electron microscopy methods to enable direct comparisons of presolar amorphous silicate abundances.
Rapid identification from positive blood cultures is standard of care (SOC) in many clinical microbiology laboratories. The GenMark Dx ePlex Blood Culture Identification Gram-Positive (BCID-GP) Panel ...is a multiplex nucleic acid amplification assay based on competitive DNA hybridization and electrochemical detection using eSensor technology. This multicenter study compared the investigational-use-only (IUO) BCID-GP Panel to other methods of identification of 20 Gram-positive bacteria, four antimicrobial resistance genes, and both Pan
and Pan Gram-Negative targets that are unique to the BCID-GP Panel. Ten microbiology laboratories throughout the United States collected residual, deidentified positive blood culture samples for analysis. Five laboratories tested both clinical and contrived samples with the BCID-GP Panel. Comparator identification methods included each laboratory's SOC, which included matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and automated identification systems as well as targeted PCR/analytically validated real-time PCR (qPCR) with bidirectional sequencing. A total of 2,342 evaluable samples (1,777 clinical and 565 contrived) were tested with the BCID-GP Panel. The overall sample accuracy for on-panel organisms was 89% before resolution of discordant results. For pathogenic Gram-positive targets (
group,
spp.,
,
,
spp.,
,
,
,
spp.,
,
spp.,
,
group,
, and
), positive percent agreement (PPA) and negative percent agreement (NPA) ranged from 93.1% to 100% and 98.8% to 100%, respectively. For contamination rule-out targets (
group,
,
,
, and
), PPA and NPA ranged from 84.5% to 100% and 99.9% to 100%, respectively. Positive percent agreement and NPA for the Pan
and Pan Gram-Negative targets were 92.4% and 95.7% for the former and 99.9% and 99.6% for the latter. The PPAs for resistance markers were as follows:
, 97.2%;
, 100%;
, 96.8%; and
, 100%. Negative percent agreement ranged from 96.6% to 100%. In conclusion, the ePlex BCID-GP Panel compares favorably to SOC and targeted molecular methods for the identification of 20 Gram-positive pathogens and four antimicrobial resistance genes in positive blood culture bottles. This panel detects a broad range of pathogens and mixed infections with yeast and Gram-negative organisms from the same positive blood culture bottle.
Bovine babesiosis is caused by infection with the protozoal parasite Babesia bovis, which is transmitted by Rhipicephalus (Boophilus) spp. It can cause mortality rates up to 90% in immunologically ...naive Bos taurus cattle. In south Texas, R. (B.) microplus is known to infest nilgai antelope (Boselaphus tragocamelus); however, their susceptibility to infection with B. bovis and their role in the transmission of the parasite remain unknown. In this study, we challenged nilgai antelope with B. bovis and evaluated their susceptibility to infection.
Nilgai were needle inoculated with ≈10
B. bovis-parasitized erythrocytes (merozoites) or a homogenate of B. bovis-infected larval ticks (sporozoite) delivered intravenously. Bos taurus beef calves were inoculated in parallel, as this strain of B. bovis is lethal to cattle. Temperature and hematocrit were monitored daily over the course of each study, and whole blood was collected for molecular polymerase chain reaction (PCR) and serological indirect enzyme-linked immunosorbent assay (ELISA) diagnostic evaluation. Histological sections of nilgai cerebral tissue were examined for evidence of infection. Recipient bovine calves were sub-inoculated with blood from nilgai challenged with either stage of the parasite, and they were monitored for clinical signs of infection and evaluated by a PCR diagnostic assay. Red blood cells (RBCs) from prechallenged nilgai and B. taurus beef cattle were cultured with an in vitro B. bovis merozoite culture to examine colonization of the RBCs by the parasite.
Nilgai did not display clinical signs of infection upon inoculation with either the merozoite or sporozoite stage of B. bovis. All nilgai were PCR-negative for the parasite, and they did not develop antibodies to B. bovis. No evidence of infection was detected in histological sections of nilgai tissues, and in vitro culture analysis indicated that the nilgai RBCs were not colonized by B. bovis merozoites. Cattle subinoculated with blood from challenged nilgai did not display clinical signs of infection, and they were PCR-negative up to 45 days after transfer.
Nilgai do not appear to be susceptible to infection with a strain of B. bovis that is lethal to cattle. Tick control on these alternative hosts remains a critical priority, especially given their potential to disseminate ticks over long distances.