Search

While SARS-CoV-2 has sporadically infected a wide range of animal species worldwide1, the virus has been repeatedly and frequently detected in white-tailed deer in North America2â€"7. The zoonotic origins of this pandemic virus highlight the need to fill the vast gaps in our knowledge of SARS-CoV-2 ecology and evolution in non-human hosts. Here, we detected SARS-CoV-2 was introduced from humans into white-tailed deer more than 30 times in Ohio, USA during November 2021-March 2022. Subsequently, deer-to-deer transmission persisted for 2-8 months, which disseminated across hundreds of kilometers. We discovered that alpha and delta variants evolved in white-tailed deer at three-times the rate observed in humans. Newly developed Bayesian phylogenetic methods quantified how SARS-CoV-2 evolution is not only faster in white-tailed deer but driven by different mutational biases and selection pressures. White-tailed deer are not just short-term recipients of human viral diversity but serve as reservoirs for alpha and other variants to evolve in new directions after going extinct in humans. The long-term effect of this accelerated evolutionary rate remains to be seen as no critical phenotypic changes were observed in our animal model experiments using viruses isolated from white-tailed deer. Still, SARS-CoV-2 viruses have transmitted in white-tailed deer populations for a relatively short duration, and the risk of future changes may have serious consequences for humans and livestock. ispartof: Res Sq ispartof: location:United States status: Published online

The internationally accepted definition of PHC is qualitatively different from that of PC. Both PC, which produces professionally and institutionally driven services, and PHC, which creates community-based and community-driven services, can serve Nursing's Agenda for Health Care Reform.

Although economic impoverishment has long been recognized as a health risk, it has not generally been targeted as a modifiable risk factor. A number of methodologic and conceptual issues have impeded and obscured explanation of the nature and characteristics of the relationship between socioeconomic status and health. Further investigation is needed to address directional effects, confounding factors, and measurement difficulties. Conceptual representations of the links between economic impoverishment and health need to be clarified and expanded. Until this relationship is better understood, development of effective strategies to improve health for the economically disadvantaged will be problematic.

This study was designed to assess the comparative efficacy of normal saline (NS) and 5% albumin (ALB) for treatment of hypotension in the acutely ill newborn.Newborn infants who were24 hours old and were admitted to the Holden Neonatal Intensive Care Unit at the University of Michigan were randomized to receive one of the two solutions for volume expansion. Hypotension was defined as a sustained (or =30 minutes) mean arterial pressure (MAP) of30 mmHg for infants weighingor =2500 g, or a MAP of40 mmHg for those weighing2500 g. The short-term outcome measure was the resolution of hypotension defined as a MAP over the minimum limits set for birthweight sustained foror =30 minutes.In total 41 infants met criteria and were entered. Of these, 21 infants received ALB and 20 received NS. Successful treatment was seen in 17/21 (81%) of infants in the ALB group and 17/20 (85%) of infants in the NS group. There was no statistically significant difference in response to treatment (p=0.30). In addition, there was no statistically significant difference in the magnitude of change in MAP between the two (p=0.41).NS was shown to be as effective as ALB for the correction of acute hypotension in the newborn infant. Given comparable efficacy of NS, along with its relatively low cost and availability, it should be considered the initial treatment of choice in this setting.

Researcher/participant matching has been used in nursing research as a strategy for the development of culturally competent knowledge. In this manuscript, the complexities inherent in matching in nursing research are discussed. In raising and discussing issues and questions related to matching, we argue that although matching may be one of the strategies used to generate culturally competent knowledge, it is frequently too complex for operationalization. Therefore, we propose that researchers reflect on questions related to their knowledge of culture, their cultural sensitivity, and the nature of collaboration during every phase of the research. Reflecting on and responding to these questions in every research project may facilitate the development of more culturally competent knowledge.

70 patients admitted to the University of Michigan Holden NICU from 21/1/93 through 11/15/96 received inhaled nitric oxide (NO) therapy. 62/70 patients were diagnosed with persistent pulmonary hypertension of the newborn (PPHN) as documented by echocardiogram and/or pre- and postductal PaO2 gradients. 8/70 patients were treated for persistent, intractable hypoxemia thought secondary to intrapulmonary shunt. A positive response was defined as an increase in postductal PaO2 to avoid ECMO. Permanent responders (28/70; 40%) were those who sustained a significant enough increase in postductal PaO2 to avoid ECMO. Transient responders (15/70; 21%) were those who had an initial positive response to inhaled NO, but could not sustain an adequate postductal PaO2, and required ECMO. Non-responders (27/70; 39%) were those who did not respond with an adequate increase in postductal PaO2 to an initial NO test of 40-80 ppm. Non-responders had a mean (+/- SD) baseline PaO2 of 45.6 (+/- 15.3) Torr. Mean baseline PaO2 in transient responders (38.6 +/- 14 Torr) was not significantly different from non-responders (P