Habitat models and assessment of habitat partitioning for Kemp’s ridley and loggerhead marine turtles foraging in Chesapeake Bay (USA)

Understanding the spatial distribution of a species is required to enact effective conservation. Complications to effective conservation can arise when the distributions of multiple target species are non-overlapping. Conservation efforts meant to protect one species may shift threats into the distribution of another species. Two species of marine turtle, loggerhead Caretta caretta and Kemp’s ridley Lepidochelys kempii, are common seasonally in Chesapeake Bay, a large estuary on the US east coast. Both species are protected under the US Endangered Species Act and face spatially complex threats in the region. We created habitat suitability models for these 2 species to inform conservation efforts in the region and explore the extent of overlap between their distributions. Argos satellite tags were deployed on 24 Kemp’s ridley and 10 loggerhead turtles to record animal locations within the Bay. Boosted regression tree models were created for each species using presence-only animal locations, predicting suitable habitat within the Bay. Habitat for Kemp’s ridley turtles was predicted in shallow, coastal areas of the southern Bay as well as in brackish areas of rivers. Loggerhead turtle habitat was predicted to extend farther north than Kemp’s ridley habitat and was generally found in deeper areas of the middle Bay. There is some evidence that these 2 species are partitioning habitat. Any conservation measures adopted to conserve marine turtles in the Chesapeake Bay should consider the habitat of both species holistically to avoid shifting impacts from one species to another.

Host and Bacterial Markers that Differ in Children with Cystitis and Pyelonephritis

OBJECTIVE

To determine whether treatment for urinary tract infections in children could be individualized using biomarkers for acute pyelonephritis.

STUDY DESIGN

We enrolled 61 children with febrile urinary tract infections, collected blood and urine samples, and performed a renal scan within 2 weeks of diagnosis to identify those with pyelonephritis. Renal scans were interpreted centrally by 2 experts. We measured inflammatory proteins in blood and urine using LUMINEX or an enzyme-linked immunosorbent assay. We evaluated serum RNA expression using RNA sequencing in a subset of children. Finally, for children with Escherichia coli isolated from urine cultures, we performed a polymerase chain reaction for 4 previously identified virulence genes.

RESULTS

Urinary markers that best differentiated pyelonephritis from cystitis included chemokine (C-X-C motif) ligand (CXCL)1, CXCL9, CXCL12, C-C motif chemokine ligand 2, INF γ, and IL-15. Serum procalcitonin was the best serum marker for pyelonephritis. Genes in the interferon-γ pathway were upregulated in serum of children with pyelonephritis. The presence of E coli virulence genes did not correlate with pyelonephritis.

CONCLUSIONS

Immune response to pyelonephritis and cystitis differs quantitatively and qualitatively; this may be useful in differentiating these 2 conditions.

Effect of Penalty Minute Rule Change on Injuries and Game Disqualification Penalties in High School Ice Hockey

BACKGROUND

Recent efforts have focused on eliminating dangerous hits in ice hockey. Fair play rule changes have successfully reduced injury risk but have not been widely implemented.

PURPOSE

To determine the effect of a penalty infraction minutes (PIM) rule change in high school boys' ice hockey on injuries and game disqualification penalties.

STUDY DESIGN

Cohort study; Level of evidence, 3.

METHODS

Injury data were collected from 2 Rhode Island hospital systems and game/penalty data through the Rhode Island Hockey Coaches Association website. Participants included high school boys' hockey varsity players aged 13 to 19 years presenting to 5 emergency departments for hockey injuries during 6 seasons (December 2012-April 2018). Rule change for the 2015-2016 season implemented varying suspensions for players accumulating ≥50 PIM and ≥70 PIM during regular season and playoffs. Injuries were classified as body checking or non-body checking related, and injury rates pre- versus post-rule change were compared via the Cochran-Mantel-Haenszel chi-square test with the odds ratio (OR) to measure risk reduction.

RESULTS

During the study period, 1762 boys' high school varsity hockey games were played. Of 134 game-related injuries, 82 (61.2%) were attributable to body checking. The PIM rule change was associated with a significant reduction in all injuries (OR, 0.55; 95% CI, 0.35-0.86; P = .008), concussion/closed head injury (OR, 0.44; 95% CI, 0.23-0.85; P = .012), and combined subgroups of concussion/closed head injury and upper body injury (OR, 0.50; 95% CI, 0.31-0.80; P = .003). Game disqualification penalties per season were not significantly reduced following the rule change, occurring in 5.2% of games before the rule change and 4.4% of games after (OR, 0.84; 95% CI, 0.54-1.31; P = .440).

CONCLUSION

Implementation of a statewide PIM restriction rule change effectively reduced the mean number of game-related injuries per season among high school boys' hockey varsity players.

The role of body image psychological flexibility on the treatment of eating disorders in a residential facility

OBJECTIVE

The purpose of this study was to test whether pre-treatment levels of psychological flexibility would longitudinally predict quality of life and eating disorder risk in patients at a residential treatment facility for eating disorders.

METHOD

Data on body image psychological flexibility, quality of life, and eating disorder risk were collected from 63 adolescent and 50 adult, female, residential patients (N=113) diagnosed with an eating disorder. These same measures were again collected at post-treatment. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects.

RESULTS

Pre-treatment psychological flexibility significantly predicted post-treatment quality of life with approximately 19% of the variation being attributable to age and pre-treatment psychological flexibility. Pre-treatment psychological flexibility also significantly predicted post-treatment eating disorder risk with nearly 30% of the variation attributed to age and pre-treatment psychological flexibility.

DISCUSSION

This study suggests that levels of psychological flexibility upon entering treatment for an eating disorder longitudinally predict eating disorder outcome and quality of life.

Pediatric Emergency Medicine (PEM) fellowship: essentials of a three-year academic curriculum. Three-Year Academic Subcommittee of the PEM Fellowship Committee of the Section of Emergency Medicine, American Academy of Pediatrics

This committee of fellowship directors has proposed guidelines for an academic curriculum for training fellows in PEM. The curriculum should be modified to each unique program, but is based on current expectation of the American Board of Pediatrics and the ACGME for graduate education. This is the first PEM academic curriculum document in publication. Ongoing refinement and adaptation based on feedback from fellows and directors is essential to provide the best fellowship experience to our trainees. The proposed curriculum is also subject to further change as more details are given for ACGME approval of the fellowship programs.

Improving the technique of nuclear cystography: the manometric approach

A simple technique of manometric scintigraphic retrograde cystography was applied prospectively to 125 patients (85 per cent children) with 142 studies. 99mTechnetium sulfur colloid (0.5 to 1 mCi.) was instilled in the bladder followed by increments of normal saline under manometric control. The sensitivity of the test was increased when the filling phase was concluded at 25 cm. water pressure rather than when the patient complained of fullness (usually at 15 cm.). The studies had a voiding phase that was essential for patients in whom pressures greater than 15 cm. could not be achieved. Reflux was not detected on the voiding phase alone in 5 patients and the voiding phase could not be performed in 5 of 34 positive studies. It was not possible to predict volumes of fluid instilled to achieve satisfactory pressures. Monitoring during the entire study was necessary to diagnose reflux, which may occur at low or high pressure, or while voiding only.