Potential and Actual Terrestrial Rabies Exposures in People and Domestic Animals, Upstate South Carolina, 1994–2004: A Surveillance Study

<p>Abstract</p> <p>Background</p> <p>Although there has been a reduction of rabies in pets and domestic animals during recent decades in the United States, rabies remains enzootic among bats and several species of terrestrial wildlife. Spillover transmission of wildlife rabies to domestic animals therefore remains a public health threat</p> <p>Methods</p> <p>Retrospective analysis of surveillance data of reported animal incidents (bites, scratches, mucous membrane contacts) from South Carolina, 1995 to 2003, was performed to assess risk factors of potential rabies exposures among human and animal victims.</p> <p>Results</p> <p>Dogs and cats contributed the majority (66.7% and 26.4%, respectively) of all reported incidents, with stray dogs and cats contributing 9.0% and 15.1 respectively. Current rabies vaccination status of dogs and cats (40.2% and 13.8%, respectively) were below World Health Organization recommended levels. Owned cats were half as likely to be vaccinated for rabies as dogs (OR 0.53, 95% CI 0.48, 0.58). Animal victims were primarily exposed to wildlife (83.0%), of which 27.5% were rabid. Almost 90% of confirmed rabies exposures were due to wildlife. Skunks had the highest prevalence of rabies among species of exposure animals (63.2%). Among rabid domestic animals, stray cats were the most commonly reported (47.4%).</p> <p>Conclusion</p> <p>While the majority of reported potential rabies exposures are associated with dog and cat incidents, most rabies exposures derive from rabid wildlife. Stray cats were most frequently rabid among domestic animals. Our results underscore the need for improvement of wildlife rabies control and the reduction of interactions of domestic animals, including cats, with wildlife.</p

Does clinical examination aid in the diagnosis of urinary tract infections in women? A systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Clinicians should be aware of the diagnostic values of various symptoms, signs and antecedents. This information is particularly important in primary care settings, where sophisticated diagnostic approaches are not always feasible. The aim of the study is to determine the probability that various symptoms, signs, antecedents and tests predict urinary tract infection (UTI) in women.</p> <p>Methods</p> <p>We conducted a systematic search of the MEDLINE and EMBASE databases to identify articles published in all languages through until December 2008. We particularly focused on studies that examined the diagnostic accuracy of at least one symptom, sign or patient antecedent related to the urinary tract. We included studies where urine culture, a gold standard, was preformed by primary care providers on female subjects aged at least 14 years. A meta-analysis of the likelihood ratio was performed to assess variables related to the urinary tract symptoms.</p> <p>Results</p> <p>Of the 1, 212 articles identified, 11 met the selection criteria. Dysuria, urgency, nocturia, sexual activity and urgency with dysuria were weak predictors of urinary tract infection, whereas increases in vaginal discharge and suprapubic pain were weak predictors of the absence of infection. Nitrites or leukocytes in the dipstick test are the only findings that clearly favored a diagnosis of UTI.</p> <p>Conclusions</p> <p>Clinical findings do not aid in the diagnosis of UTI among women who present with urinary symptoms. Vaginal discharge is a weak indicator of the absence of infection. The urine dipstick test was the most reliable tool for detecting UTI.</p

Measurements of calcium transients in ventricular cells during discontinuous action potential conduction

The L-type calcium current ( I Ca) is important in sustaining propagation during discontinuous conduction. In addition, I Ca is altered during discontinuous conduction, which may result in changes in the intracellular calcium transient. To study this, we have combined the ability to monitor intracellular calcium concentration ([Ca2+]i) in an isolated cardiac cell using confocal scanning laser fluorescence microscopy with our “coupling clamp” technique, which allows action potential propagation from the real cell to a real-time simulation of a model cell. Coupling a real cell to a model cell with a value of coupling conductance ( G C = 8 nS) just above the critical value for action potential propagation results in both an increased amplitude and an increased rate of rise of the calcium transient. Similar but smaller changes in the calcium transient are caused by increasing G C to 20 nS. The increase of [Ca2+]i by discontinuous conduction is less than the increase of I Ca, which may indicate that much of [Ca2+]i is the result of calcium released from the sarcoplasmic reticulum rather than the integration of I Ca. </jats:p

Development and Usability Testing of a Web-based COVID-19 Self-triage Platform

Introduction: The development and deployment of a web-based, self-triage tool for severe respiratory syndrome coronavirus 2 (COVID-19 disease) aimed at preventing surges in healthcare utilization could provide easily understandable health guidance with the goal of mitigating unnecessary emergency department (ED) and healthcare visits. We describe the iterative development and usability testing of such a tool. We hypothesized that adult users could understand and recall the recommendations provided by a COVID-19 web-based, self-triage tool.Methods: We convened a multidisciplinary panel of medical experts at two academic medical schools in an iterative redesign process of a previously validated web-based, epidemic screening tool for the current COVID-19 pandemic. We then conducted a cross-sectional usability study over a 24-hour period among faculty, staff, and students at the two participating universities. Participants were randomly assigned a pre-written health script to enter into the self-triage website for testing. The primary outcome was immediate recall of website recommendations. Secondary outcomes included usability measures. We stratified outcomes by demographic characteristics.Results: A final sample of 877 participants (mean age, 32 years [range, 19-84 years]; 65.3% female) was used in the analysis. We found that 79.4% of the participants accurately recalled the recommendations provided by the website. Almost all participants (96.9%) found the website easy to use and navigate.Conclusion: Adult users of a COVID-19 self-triage website, recruited from an academic setting, were able to successfully recall self-care instructions from the website and found it user-friendly. This website appears to be a feasible way to provide evidence-based health guidance to adult patients during a pandemic. Website guidance could be used to reduce unnecessary ED and healthcare visits

Latrine ecology of nilgai antelope

Abstract The use of scent for communication is widespread in mammals, yet the role of scent-marking in the social system of many species is poorly understood. Nilgai antelope (Boselaphus tragocamelus) are native to India, Nepal, and Pakistan. They were introduced to Texas rangelands in the United States during the 1920s to 1940s, and have since expanded into much of coastal South Texas and northern Mexico. The nilgai social system includes the use of latrines or repeated defecation at a localized site. We quantified and described physical and behavioral characteristics of nilgai latrine ecology to investigate drivers of latrine use at three sites in South Texas, during April 2018 to March 2019. Latrines were abundant (2.6–8.7 latrines/ha on unpaved roads, 0.4–0.9 latrines/ha off-roads), with no evidence for selection as to vegetation communities; latrines were dynamic in persistence and visitation rates. We found higher densities of latrines in Spring surveys, just after the peak of nilgai breeding activity, compared to Autumn surveys. Density of nilgai latrines was 3–10 times greater than estimated population densities, indicating individual nilgai must use multiple latrines. Camera traps and fecal DNA analysis revealed latrines were mainly (70%) visited by bulls and defecated on by bulls (92% in photos, 89% for DNA samples). The greatest frequency of visits occurred during the peak in the nilgai breeding season, from December–February; latrines were visited every 2–3 days on average. Body characteristics of photographed individuals and genetic analysis of feces indicated repeated visits from the same individuals. Nilgai cows occasionally used latrines; their use was sometimes followed by bulls showing flehmen responses after a female defecated or urinated on the latrine. We propose that dominant bulls use latrines for territory demarcation to display social dominance to both cows in estrus and subordinate bulls. Cows likely use latrines to communicate reproductive status. This study is the first intensive assessment focused on latrine ecology in nilgai. Our results directly contradict anecdotal descriptions of latrine use and behavior in nilgai but are consistent with predictions of antelope social systems based on body size, feeding type, and group dynamics.</jats:p