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Introduction: There is a growing interest in utilizing seaweed in ruminant diets for mitigating enteric methane (CH4) emissions while improving animal health. Chondrus crispus is a red seaweed that grows in the Gulf of Maine (United States) and has shown to suppress CH4 production in vitro. Organic dairy producers in Maine are currently feeding seaweed due to herd health promoting benefits. However, large-scale adoption depends on technical and financial factors, as well as validation from pilot studies. Methods: A survey was developed to identify barriers and drivers towards the adoption of CH4-reducing algal-based feeds. Concurrently, a randomized complete block design study was conducted to investigate the effect of C. crispus on enteric CH4 emissions and milk production in a typical Maine organic dairy farm. Twenty-two organically certified Holstein and Jersey cows averaging 29 ± 6.8 kg of milk/d and 150 ± 69 days in milk, were blocked and randomly assigned to a control diet without C. crispus (0CC), or with 6% [dry matter (DM) basis] C. crispus (6CC). Samples were collected on the last week of the 2-wk covariate period, and wk 3, 5, 8, and 10 after initiation of treatments for a total of 12 weeks. Gaseous emissions were measured using a GreenFeed unit. Data were analyzed using the MIXED procedure of SAS with repeated measures over time. Results: All survey respondents (n = 35; 54% response rate) were familiar with seaweeds as feed, and 34% were already users. Producers who were willing to pay 0.64 USD/cow/d on average for a CH4-reducing algal-based feed, also stated the need for co-benefits in terms of cattle health and performance as a requirement for adoption. Feeding 6CC decreased enteric CH4 production by 13.9% compared with 0CC (401 vs. 466 g/d). Further, milk yield (mean = 27.1 kg/d), CH4 intensity (mean = 15.2 g of CH4/kg of energy corrected milk), and concentrations and yields of milk fat and true protein were not affected by treatments. Discussion: Producer receptiveness to CH4-reducing algal-based feeds will not only be dependent on purchase price, but also on co-benefits and simplicity of integration into existing feed practices. Feeding C. crispus at 6% of the diet DM decreased CH4 production in dairy cows by 13.9% without negative effects on milk yield and composition. Identifying the bioactive compounds in C. crispus is critical to understand the effect of this red seaweed on mitigating enteric CH4 emissions in dairy cows.

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BACKGROUND: Health care and public health professionals rely on accurate, real-time monitoring of infectious diseases for outbreak preparedness and response. Early detection of outbreaks is improved by systems that are comprehensive and specific with respect to the pathogen but are rapid in reporting the data. It has proven difficult to implement these requirements on a large scale while maintaining patient privacy. OBJECTIVE: The aim of this study was to demonstrate the automated export, aggregation, and analysis of infectious disease diagnostic test results from clinical laboratories across the United States in a manner that protects patient confidentiality. We hypothesized that such a system could aid in monitoring the seasonal occurrence of respiratory pathogens and may have advantages with regard to scope and ease of reporting compared with existing surveillance systems. METHODS: We describe a system, BioFire Syndromic Trends, for rapid disease reporting that is syndrome-based but pathogen-specific. Deidentified patient test results from the BioFire FilmArray multiplex molecular diagnostic system are sent directly to a cloud database. Summaries of these data are displayed in near real time on the Syndromic Trends public website. We studied this dataset for the prevalence, seasonality, and coinfections of the 20 respiratory pathogens detected in over 362,000 patient samples acquired as a standard-of-care testing over the last 4 years from 20 clinical laboratories in the United States. RESULTS: The majority of pathogens show influenza-like seasonality, rhinovirus has fall and spring peaks, and adenovirus and the bacterial pathogens show constant detection over the year. The dataset can also be considered in an ecological framework; the viruses and bacteria detected by this test are parasites of a host (the human patient). Interestingly, the rate of pathogen codetections, on average 7.94% (28,741/362,101), matches predictions based on the relative abundance of organisms present. CONCLUSIONS: Syndromic Trends preserves patient privacy by removing or obfuscating patient identifiers while still collecting much useful information about the bacterial and viral pathogens that they harbor. Test results are uploaded to the database within a few hours of completion compared with delays of up to 10 days for other diagnostic-based reporting systems. This work shows that the barriers to establishing epidemiology systems are no longer scientific and technical but rather administrative, involving questions of patient privacy and data ownership. We have demonstrated here that these barriers can be overcome. This first look at the resulting data stream suggests that Syndromic Trends will be able to provide high-resolution analysis of circulating respiratory pathogens and may aid in the detection of new outbreaks.

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BACKGROUND: The impact of the site where an obstetrician dresses in their surgical scrubs, home versus hospital, on total bacterial burden remains unknown. Therefore, our objective was to quantify the effect of dressing in surgical scrubs at home versus at the hospital on the bacterial contamination at the beginning of a scheduled shift. METHODS: This was a single blind randomized controlled trial. Eligible participants were resident physicians assigned to labor and delivery at a single institution during the study period, and participants were randomized daily to 1 of 4 arms based on the site where their scrubs were laundered (A) and where the resident dressed (B) (A/B): home/home, home/hospital, hospital/home, and hospital/hospital. At the beginning of the assigned shift, microbiologic samples from the chest pocket and pants' tie were collected with a sterile culture swab. Samples were plated on trypticase soy agar with 5% sheep blood before being incubated at 35°C-37°C for 48 hours, with observation every 24 hours. The primary outcome was total bacterial burden, defined as the sum of the colony forming units (CFUs) from the 2 sampling sites. RESULTS: There were 21 residents randomized daily for 4 days to 1 of 4 study arms, resulting in 84 observations. There were no baseline differences between the home- and hospital-dressed cohorts. Overall, 68% of sampled scrubs demonstrated some bacterial growth. There was no difference between the home- and hospital-dressed cohorts in percentage of samples demonstrating any bacterial growth after 72 hours (60% vs 76%, P = .14), nor in median bacterial burden at the beginning of a shift (2 [interquartile range, 0-7] vs 1 [interquartile range, 1-5] CFUs, P = .62). Finally, there was no difference in total bacterial burden at the beginning of a shift between the home- and hospital-dressed cohorts when stratified by site where the scrubs were laundered. CONCLUSIONS: There was no significant difference in total bacterial burden of surgical scrubs at the start of a shift between cohorts who dressed at home versus at the hospital.

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BACKGROUND: Healthcare-associated infections are a significant public health burden resulting in approximately 1.7 million infections each year. Much work is done to study the contributing factors in inpatient settings; however, little has been done to study outpatient facilities and their roles in healthcare-associated infections. While many pediatric outpatient offices utilize separated waiting areas for sick and well children to decrease the spread of disease, research has not been done to determine whether this practice is of benefit. In this study, we aimed to determine whether there is a difference in microbial burden between sick- and well-child waiting areas and to identify surfaces with the highest levels of contamination. METHODS: Touch surfaces in waiting rooms were swabbed and surveyed for total microbial growth, staphylococcal growth and Gram-negative enteric bacterial growth. Selected bacteria were identified to screen for pathogenic organisms. Surfaces sampled included seats, tables, children's tables, children's seats, magazines and books. RESULTS: We found seats, children's seats and children's books to have the highest microbial burden. No conclusions can be made on the differences in microbial contamination in sick- and well-child waiting areas because of high variation. Streptococcus pyogenes was isolated as were several opportunistic pathogens. CONCLUSIONS: This study suggests the need for better cleaning practices by pediatric outpatient facilities, to include the disinfection of additional surfaces as well as more frequent and thorough cleaning.

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Pursuit of the triple bottom line of economic, community and ecological sustainability has increased the complexity of fishery management; fisheries assessments require new types of data and analysis to guide science-based policy in addition to traditional biological information and modeling. We introduce the Fishery Performance Indicators (FPIs), a broadly applicable and flexible tool for assessing performance in individual fisheries, and for establishing cross-sectional links between enabling conditions, management strategies and triple bottom line outcomes. Conceptually separating measures of performance, the FPIs use 68 individual outcome metrics--coded on a 1 to 5 scale based on expert assessment to facilitate application to data poor fisheries and sectors--that can be partitioned into sector-based or triple-bottom-line sustainability-based interpretative indicators. Variation among outcomes is explained with 54 similarly structured metrics of inputs, management approaches and enabling conditions. Using 61 initial fishery case studies drawn from industrial and developing countries around the world, we demonstrate the inferential importance of tracking economic and community outcomes, in addition to resource status.

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