Many species of Pseudomonas have the ability to use a variety of resources and habitats, and as a result Pseudomonas are often characterized as having broad fundamental niches. We questioned whether actual habitat use by Pseudomonas species is equally broad. To do this, we sampled extensively to describe the biogeography of Pseudomonas within the human home, which presents a wide variety of habitats for microbes that live in close proximity to humans but are not part of the human flora, and for microbes that are opportunistic pathogens, such as Pseudomonas aeruginosa. From 960 samples taken in 20 homes, we obtained 163 Pseudomonas isolates. The most prevalent based on identification using the SepsiTest BLAST analysis of 16S rRNA (http://www.sepsitest-blast.de) were Pseudomonas monteilii (42 isolates), Pseudomonas plecoglossicida, Pseudomonas fulva, and P. aeruginosa (approximately 25 each). Of these, all but P. fulva differed in recovery rates among evaluated habitat types (drains, soils, water, internal vertebrate sites, vertebrate skin, inanimate surfaces, and garbage/compost) and all four species also differed in recovery rates among subcategories of habitat types (e.g., types of soils or drains). We also found that at both levels of habitat resolution, each of these six most common species (the four above plus Pseudomonas putida and Pseudomonas oryzihabitans) were over- or under-represented in some habitats relative to their contributions to the total Pseudomonas collected across all habitats. This pattern is consistent with niche partitioning. These results suggest that, whereas Pseudomonas are often characterized as generalists with broad fundamental niches, these species in fact have more restricted realized niches. Furthermore, niche partitioning driven by competition among Pseudomonas species may be contributing to the observed variability in habitat use by Pseudomonas in this system.

Purpose To compare dosimetric parameters of intensity modulated radiation therapy (IMRT) and three-dimensional conformal radiation therapy (3DCRT) in patients with intermediate risk rhabdomyosarcoma (RMS), and to analyze their effect on local-regional control (LRC) and failure-free survival (FFS). Methods and Materials The study population consisted of 375 patients enrolled on Children’s Oncology Group protocol D9803, receiving IMRT or 3DCRT. Dosimetric data was collected from 179 patients with an available composite plan. Chi-square or Fisher’s exact tests were used to compare patient characteristics and radiotherapy (RT) parameters between the two groups. Time-to- event outcomes were estimated using the Kaplan-Meier method and compared using log-rank tests. Cox analysis was used to examine the effect of RT technique on FFS after adjusting for primary site and risk group. Results The median follow-up time was 5.7 and 4.2 years for patients receiving 3DCRT and IMRT respectively. No differences in 5 year failure of LRC (18% vs. 15%) and FFS (72% vs. 76%) were noted between the two groups. Multivariate analysis revealed no association between RT technique and FFS. Patients with primary tumors in parameningeal (PM) sites were more likely to receive IMRT than 3DCRT. IMRT became more common during the later years of the study. Patients receiving IMRT were more likely to receive >50Gy, photon energy of ≤6MV, and >5 RT fields than those who received 3DCRT. There was improved coverage of the IMRT planning target volume (PTV) by the prescription dose compared to the 3DCRT with similar target dose heterogeneity. Conclusions IMRT improved target dose coverage when compared to 3DCRT, though an improvement in LRC or FFS could not be demonstrated in this population. Future studies comparing integral dose to non-target tissue and late RT toxicity between the two groups is warranted.

Background: The COVID-19 pandemic poses a critical global public health crisis. Operating room (OR) best practice in this crisis is poorly defined. This systematic review was performed to identify contemporary evidence relating to OR practice in the context of COVID-19.Methods: MEDLINE was searched systematically using PubMed (search date 19 March 2020) for relevant studies in accordance with PRISMA guidelines. Documented practices and guidance were assessed to determine Oxford Centre for Evidence-Based Medicine (OCEBM) levels of evidence, and recommendations for practice within five domains were extracted: physical OR, personnel, patient, procedure, and other factors.Results: Thirty-five articles were identified, of which 11 met eligibility criteria. Nine articles constituted expert opinion and two were retrospective studies. All articles originated from the Far East (China, 9; Singapore, 2); eight of the articles concerned general surgery. Common themes were identified within each domain, but all recommendations were based on low levels of evidence (median OCEBM level 5 (range 4-5)). The highest number of overlapping recommendations related to physical OR (8 articles) and procedural factors (13). Although few recommendations related to personnel factors, consensus was high in this domain, with all studies mandating the use of personal protective equipment.Conclusion: There was little evidence to inform this systematic review, but there was consensus regarding many aspects of OR practice. Within the context of a rapidly evolving pandemic, timely amalgamation of global practice and experiences is needed to inform best practice.

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The results of this investigation show that, in the absence of histologic or clinical indications of allograft rejection, pediatric intestinal transplant recipients do not have primary disaccharidase deficiencies. Similarly, absorption of usual dietary lipid content is adequate once weaning from parenteral nutrition is complete. In contrast, early assimilation of vitamin E is poor. Vitamin E absorption subsequently improves, but the mechanism is obscure.

Although communicable diseases have hitherto played a small part in illness associated with Olympic Games, an outbreak of infection in a national team, Games venue or visiting spectators has the potential to disrupt a global sporting event and distract from the international celebration of athletic excellence. Preparation for hosting the Olympic Games includes implementation of early warning systems for detecting emerging infection problems. Ensuring capability for rapid microbiological diagnoses to inform situational risk assessments underpins the ability to dispel rumours. These are a prelude to control measures to minimize impact of any outbreak of infectious disease at a time of intense public scrutiny. Complex multidisciplinary teamwork combined with laboratory technical innovation and efficient information flows underlie the Health Protection Agency's preparation for the London 2012 Olympic and Paralympic Games. These will deliver durable legacies for clinical and public health microbiology, outbreak investigation and control in the coming years.

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BACKGROUND SARS-CoV-2, has been implicated in the largest recorded CoV outbreak to date. Initially the majority of COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide with the United States currently having more cases than any other country. OBJECTIVEWith person-to-person spread expanding in the United States, this study aims to describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN Cross-sectional survey focused on various elements of respiratory disease preparedness SETTING Critical access hospital (CAHs) and acute care hospitals (ACHs) in Idaho METHODS The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho RESULTSIn all, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents-specifically COVID-19-as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONSHospitals covered by the survey have varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. While the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.