Transgenerational plasticity can help organisms respond rapidly to changing environments. Most prior studies of transgenerational plasticity in host–parasite interactions have focused on the host, ...leaving us with a limited understanding of transgenerational plasticity of parasites. We tested whether exposure to elevated temperatures while spores are developing can modify the ability of those spores to infect new hosts, as well as the growth and virulence of the next generation of parasites in the new host. We exposed Daphnia dentifera to its naturally co-occurring fungal parasite Metschnikowia bicuspidata, rearing the parasite at cooler (20°C) or warmer (24°C) temperatures and then, factorially, using those spores to infect at 20 and 24°C. Infections by parasites reared at warmer past temperatures produced more mature spores, but only when the current infections were at cooler temperatures. Moreover, the percentage of mature spores was impacted by both rearing and current temperatures, and was highest for infections with spores reared in a warmer environment that infected hosts in a cooler environment. In contrast, virulence was influenced only by current temperatures. These results demonstrate transgenerational plasticity of parasites in response to temperature changes, with fitness impacts that are dependent on both past and current environments.
Individuals with unmet social needs experience adverse health outcomes and are subject to greater inequities in health and social outcomes. Given the high prevalence of unmet needs among Medicaid ...enrollees, many Medicaid managed care organizations (MCOs) are now screening enrollees for unmet social needs and connecting them to community-based organizations (CBOs) with knowledge and resources to address identified needs. The use of screening and referral technology and data sharing are often considered key components in programs integrating health and social services. Despite this emphasis on technology and data collection, research suggests substantial barriers exist in operationalizing effective systems.
We used qualitative methods to examine cross-sector perspectives on the use of data and technology to facilitate MCO and CBO partnerships in Kentucky, a state with high Medicaid enrollment, to address enrollee social needs. We recruited participants through targeted sampling, and conducted 46 in-depth interviews with 26 representatives from all six Kentucky MCOs and 20 CBO leaders. Qualitative descriptive analysis, an inductive approach, was used to identify salient themes.
We found that MCOs and CBOs have differing levels of need for data, varying incentives for collecting and sharing data, and differing valuations of what data can or should do. Four themes emerged from interviewees' descriptions of how they use data, including 1) to screen for patient needs, 2) to case manage, 3) to evaluate the effectiveness of programs, and 4) to partner with each other. Underlying these data use themes were areas of alignment between MCOs/CBOs, areas of incongruence, and areas of tension (both practical and ideological). The inability to interface with community partners for data privacy and ownership concerns contributes to division. Our findings suggest a disconnect between MCOs and CBOs regarding terms of their technology interfacing despite their shared mission of meeting the unmet social needs of enrollees.
While data and technology can be used to identify enrollee needs and determine the most critical need, it is not sufficient in resolving challenges. People and relationships across sectors are vital in connecting enrollees with the community resources to resolve unmet needs.
Organisms are increasingly facing multiple stressors, which can simultaneously interact to cause unpredictable impacts compared with a single stressor alone. Recent evidence suggests that phenotypic ...plasticity can allow for rapid responses to altered environments, including biotic and abiotic stressors, both within a generation and across generations (transgenerational plasticity). Parents can potentially “prime” their offspring to better cope with similar stressors or, alternatively, might produce offspring that are less fit because of energetic constraints. At present, it remains unclear exactly how biotic and abiotic stressors jointly mediate the responses of transgenerational plasticity and whether this plasticity is adaptive. Here, we test the effects of biotic and abiotic environmental changes on within‐ and transgenerational plasticity using a Daphnia–Metschnikowia zooplankton‐fungal parasite system. By exposing parents and their offspring consecutively to the single and combined effects of elevated temperature and parasite infection, we showed that transgenerational plasticity induced by temperature and parasite stress influenced host fecundity and lifespan; offsprings of mothers who were exposed to one of the stressors were better able to tolerate elevated temperature, compared with the offspring of mothers who were exposed to neither or both stressors. Yet, the negative effects caused by parasite infection were much stronger, and this greater reduction in host fitness was not mitigated by transgenerational plasticity. We also showed that elevated temperature led to a lower average immune response, and that the relationship between immune response and lifetime fecundity reversed under elevated temperature: the daughters of exposed mothers showed decreased fecundity with increased hemocyte production at ambient temperature but the opposite relationship at elevated temperature. Together, our results highlight the need to address questions at the interface of multiple stressors and transgenerational plasticity and the importance of considering multiple fitness‐associated traits when evaluating the adaptive value of transgenerational plasticity under changing environments.
Different environmental stressors, including biotic and abiotic, can interact and cause unpredictable impacts. Yet, it is unclear when transgenerational effects might help or hinder the fitness of the next generation. Our study shows the evidence of stressor‐induced transgenerational plasticity, but its adaptive significance depends on the identity and combinations of environmental stressors.
Microbial aerobic cometabolism is a possible treatment approach for large, dilute trichloroethene (TCE) plumes at groundwater contaminated sites. Rapid microbial growth and bioclogging pose a ...persistent problem in bioremediation schemes. Bioclogging reduces soil porosity and permeability, which negatively affects substrate distribution and contaminant treatment efficacy while also increasing the operation and maintenance costs of bioremediation. In this study, we evaluated the ability of acetylene, an oxygenase enzyme-specific inhibitor, to decrease biomass production while maintaining aerobic TCE cometabolism capacity upon removal of acetylene. We first exposed propane-metabolizing cultures (pure and mixed) to 5% acetylene (v v
) for 1, 2, 4, and 8 d and we then verified TCE aerobic cometabolic activity. Exposure to acetylene overall decreased biomass production and TCE degradation rates while retaining the TCE degradation capacity. In the mixed culture, exposure to acetylene for 1-8 d showed minimal effects on the composition and relative abundance of TCE cometabolizing bacterial taxa. TCE aerobic cometabolism and incubation conditions exerted more notable effects on microbial ecology than did acetylene. Acetylene appears to be a viable approach to control biomass production that may lessen the likelihood of bioclogging during TCE cometabolism. The findings from this study may lead to advancements in aerobic cometabolism remediation technologies for dilute plumes.
Explantation of iris-sutured intraocular lens Elhusseiny, Abdelrahman M.; Sanders, Riley N.; Sallam, Ahmed B.
Canadian journal of ophthalmology,
April 2023, 2023-04-00, 20230401, Letnik:
58, Številka:
2
Journal Article
Total knee arthroplasty (TKA) is now considered an outpatient procedure, yet advanced age impacts patients’ ability to achieve outpatient discharge. Therefore, the purpose of this study is to ...determine the rate of successful outpatient discharge for TKA patients above 70 years of age and identify potential barriers to success.
This retrospective review included 352 unilateral TKA patients. The rapid discharge protocol was followed for all patients with the intention of discharge within a 24-hour period. Successful outpatient discharge was classified as ≤24-hour stay and failure was any stay exceeding a 24-hour period in the hospital. Univariate logistic regressions were performed to determine the influence of independent variables on discharge status for all patients and only patients >70 years old.
Overall, 46 patients (13%) failed to achieve outpatient discharge, with 35 (76%) patients being ≥70 years old. For patients ≥70, age was not a predictive variable for failure to achieve outpatient discharge (P = .484). However, being female (odds ratio 3.273, 95% confidence interval 1.286-8.325, P = .013) and the use of an assistive walking device (odds ratio 3.031, 95% confidence interval 1.387-6.625, P = .005) remained independent contributors to prolonged hospital stay.
With patients ≥70 years old more likely to require >24-hour stays, age should be an evaluated metric for justifying higher levels of reimbursement. Although TKA is now considered an outpatient procedure, greater consideration should be given to patients ≥70 years old for higher levels of reimbursement as outpatient discharge is less likely to be successful.
Background
This study provides an integrative review of existing risk factors and models for bulimia nervosa (BN) in young girls. We offer a new model for BN that describes two pathways of risk that ...may lead to the initial impulsive act of binge eating and purging in children and adolescents.
Scope
We conducted a selective literature review, focusing on existing and new risk processes for BN in this select population.
Findings
We identify two ways in which girls increase their risk to begin engaging in the impulsive behavior of binge eating and purging. The first is state‐based: the experience of negative mood, in girls attempting to restrain eating, leads to the depletion of self‐control and thus increased risk for loss of control eating. The second is personality‐based: elevations on the trait of negative urgency, or the tendency to act rashly when distressed, increase risk, particularly in conjunction with high‐risk psychosocial learning. We then briefly discuss how these behaviors are reinforced, putting girls at further risk for developing BN.
Conclusions
We highlight several areas in which further inquiry is necessary, and we discuss the clinical implications of the new risk model we described.
Infections with any pathogen can be severe and present with numerous complications caused by the pathogen or the host immune response to the invading microbe. However, coinfections, also called ...polymicrobial infections or secondary infections, can further exacerbate disease. Coinfections are more common than is often appreciated. In this review, we focus specifically on coinfections between viruses and other viruses, bacteria, parasites, or fungi. Importantly, innate immune signaling and innate immune cells that facilitate clearance of the initial viral infection can affect host susceptibility to coinfections. Understanding these immune imbalances may facilitate better diagnosis, prevention, and treatment of such coinfections.
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