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Racial disparities in Clostridioides difficile testing in three southeastern US hospitals
- Bobby G. Warren, Christopher D. Burch, Aaron Barrett, Amanda Graves, Erin Gettler, Nicholas A. Turner, Rebekah W. Moehring, Deverick J. Anderson
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 4 / April 2024
- Published online by Cambridge University Press:
- 20 November 2023, pp. 429-433
- Print publication:
- April 2024
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Objective:
To analyze Clostridioides difficile testing in 3 hospitals in central North Carolina to validate previous racial health-disparity findings.
Methods:We completed a retrospective analysis of inpatient C. difficile tests from 2015 to 2021 at 3 university-affiliated hospitals in North Carolina. We calculated the number of C. difficile tests per 1,000 patient days stratified by race: White, Black, and non-White, non-Black (NWNB). We defined a unique C. difficile test as one that occurred in an inpatient unit with a matching laboratory accession ID and on differing calendar days. Tests were evaluated overall, by hospital, by year, and by positivity rate.
Results:In total, 35,160 C. difficile tests and 2,571,850 patient days across all 3 hospitals from 2015 to 2021 were analyzed. The median number of C. difficile tests per 1,000 patient days was 13.85 (interquartile range [IQR], 9.88–16.07). Among all C. difficile tests, 5,225 (15%) were positive. White patients were administered more C. difficile tests (14.46 per 1,000 patient days) than Black patients (12.96; P < .0001) or NWNB race patients (10.27; P < .0001). Black patients were administered more tests than NWNB patients (P < .0001). White patients tested positive at a similar rate to Black patients (15% vs 15%; P = .3655) and higher than NWNB individuals (12%; P = .0061), and Black patients tested positive at a higher rate than NWNB patients (P = .0024).
Conclusion:White patients received more C. difficile tests than Black and NWNB patient groups when controlling for race patient days. Future studies should control for comorbidities and investigate community onset of C. difficile by race and ethnicity.
Relative uptake of organic and inorganic nitrogen by common weed species
- Nicholas D. Warren, Erik A. Hobbie, Janet Chen, Richard G. Smith
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- Journal:
- Weed Science / Volume 71 / Issue 5 / September 2023
- Published online by Cambridge University Press:
- 29 August 2023, pp. 470-477
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The extent to which weed species vary in their ability to acquire and use different forms of nitrogen (N) (inorganic and organic) has not been investigated but could have important implications for weed survival and weed–crop competition in agroecosystems. We conducted a controlled environment experiment using stable isotopes to determine the uptake and partitioning of organic and inorganic N (amino acids, ammonium, and nitrate) by seven common weed and non-weed species. All species took up inorganic and organic N, including as intact amino acids. Concentrations of 15N derived from both ammonium and amino acids in shoot tissues were higher in large crabgrass [Digitaria sanguinalis (L.) Scop.] and barnyardgrass [Echinochloa crus-galli (L.) P. Beauv] than in common lambsquarters (Chenopodium album L.), redroot pigweed (Amaranthus retroflexus L.), and sorghum-sudangrass [Sorghum bicolor (L.) Moench × Sorghum bicolor (L.) ssp. drummondii (Nees ex Steud.) de Wet & Harlan]. In contrast, the concentration of 15N derived from nitrate was higher in wild mustard (Sinapis arvensis L.) shoots than in wild oat (Avena fatua L.) shoots. Root concentration of 15N derived from ammonium was lower in sorghum-sudangrass compared with other species, except for A. retroflexus and A. fatua, while root concentration of 15N derived from nitrate was lower in A. retroflexus compared with other species, except for C. album and S. arvensis. Discriminant analysis classified species based on their uptake and partitioning of all three labeled N forms. These results suggest that common agricultural weeds can access and use organic N and differentially take up inorganic N forms. Additional research is needed to determine whether species-specific differences in organic and inorganic N uptake influence the intensity of competition for soil N.
Are cover crop mixtures better at suppressing weeds than cover crop monocultures?
- Richard G. Smith, Nicholas D. Warren, Stéphane Cordeau
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- Journal:
- Weed Science / Volume 68 / Issue 2 / March 2020
- Published online by Cambridge University Press:
- 28 January 2020, pp. 186-194
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Cover crops are increasingly being used for weed management, and planting them as diverse mixtures has become an increasingly popular strategy for their implementation. While ecological theory suggests that cover crop mixtures should be more weed suppressive than cover crop monocultures, few experiments have explicitly tested this for more than a single temporal niche. We assessed the effects of cover crop mixtures (5- or 6-species and 14-species mixtures) and monocultures on weed abundance (weed biomass) and weed suppression at the time of cover crop termination. Separate experiments were conducted in Madbury, NH, from 2014 to 2017 for each of three temporal cover-cropping niches: summer (spring planting–summer termination), fall (summer planting–fall termination), and spring (fall planting–subsequent spring termination). Regardless of temporal niche, mixtures were never more weed suppressive than the most weed-suppressive cover crop grown as a monoculture, and the more diverse mixture (14 species) never outperformed the less diverse mixture. Mean weed-suppression levels of the best-performing monocultures in each temporal niche ranged from 97% to 98% for buckwheat (Fagopyrum esculentum Moench) in the summer niche and forage radish (Raphanus sativus L. var. niger J. Kern.) in the fall niche, and 83% to 100% for triticale (×Triticosecale Wittm. ex A. Camus [Secale × Triticum]) in the winter–spring niche. In comparison, weed-suppression levels for the mixtures ranged from 66% to 97%, 70% to 90%, and 67% to 99% in the summer, fall, and spring niches, respectively. Stability of weed suppression, measured as the coefficient of variation, was two to six times greater in the best-performing monoculture compared with the most stable mixture, depending on the temporal niche. Results of this study suggest that when weed suppression is the sole objective, farmers are more likely to achieve better results planting the most weed-suppressive cover crop as a monoculture than a mixture.
Investigating tarps to facilitate organic no-till cabbage production with high-residue cover crops
- Natalie P Lounsbury, Nicholas D Warren, Seamus D Wolfe, Richard G Smith
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- Journal:
- Renewable Agriculture and Food Systems / Volume 35 / Issue 3 / June 2020
- Published online by Cambridge University Press:
- 26 September 2018, pp. 227-233
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High-residue cover crops can facilitate organic no-till vegetable production when cover crop biomass production is sufficient to suppress weeds (>8000 kg ha−1), and cash crop growth is not limited by soil temperature, nutrient availability, or cover crop regrowth. In cool climates, however, both cover crop biomass production and soil temperature can be limiting for organic no-till. In addition, successful termination of cover crops can be a challenge, particularly when cover crops are grown as mixtures. We tested whether reusable plastic tarps, an increasingly popular tool for small-scale vegetable farmers, could be used to augment organic no-till cover crop termination and weed suppression. We no-till transplanted cabbage into a winter rye (Secale cereale L.)-hairy vetch (Vicia villosa Roth) cover crop mulch that was terminated with either a roller-crimper alone or a roller-crimper plus black or clear tarps. Tarps were applied for durations of 2, 4 and 5 weeks. Across tarp durations, black tarps increased the mean cabbage head weight by 58% compared with the no tarp treatment. This was likely due to a combination of improved weed suppression and nutrient availability. Although soil nutrients and biological activity were not directly measured, remaining cover crop mulch in the black tarp treatments was reduced by more than 1100 kg ha−1 when tarps were removed compared with clear and no tarp treatments. We interpret this as an indirect measurement of biological activity perhaps accelerated by lower daily soil temperature fluctuations and more constant volumetric water content under black tarps. The edges of both tarp types were held down, rather than buried, but moisture losses from the clear tarps were greater and this may have affected the efficacy of clear tarps. Plastic tarps effectively killed the vetch cover crop, whereas it readily regrew in the crimped but uncovered plots. However, emergence of large and smooth crabgrass (Digitaria spp.) appeared to be enhanced in the clear tarp treatment. Although this experiment was limited to a single site-year in New Hampshire, it shows that use of black tarps can overcome some of the obstacles to implementing cover crop-based no-till vegetable productions in northern climates.
Environmental Correlates with Germinable Weed Seedbanks on Organic Farms across Northern New England
- Richard G. Smith, Sonja K. Birthisel, Sidney C. Bosworth, Bryan Brown, Thomas M. Davis, Eric R. Gallandt, Ann Hazelrigg, Eric Venturini, Nicholas D. Warren
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- Journal:
- Weed Science / Volume 66 / Issue 1 / January 2018
- Published online by Cambridge University Press:
- 24 August 2017, pp. 78-93
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The northern New England region includes the states of Vermont, New Hampshire, and Maine and encompasses a large degree of climate and edaphic variation across a relatively small spatial area, making it ideal for studying climate change impacts on agricultural weed communities. We sampled weed seedbanks and measured soil physical and chemical characteristics on 77 organic farms across the region and analyzed the relationships between weed community parameters and select geographic, climatic, and edaphic variables using multivariate procedures. Temperature-related variables (latitude, longitude, mean maximum and minimum temperature) were the strongest and most consistent correlates with weed seedbank composition. Edaphic variables were, for the most part, relatively weaker and inconsistent correlates with weed seedbanks. Our analyses also indicate that a number of agriculturally important weed species are associated with specific U.S. Department of Agriculture plant hardiness zones, implying that future changes in climate factors that result in geographic shifts in these zones will likely be accompanied by changes in the composition of weed communities and therefore new management challenges for farmers.
Cover-Crop Species as Distinct Biotic Filters in Weed Community Assembly
- Richard G. Smith, Lesley W. Atwood, Fredric W. Pollnac, Nicholas D. Warren
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- Journal:
- Weed Science / Volume 63 / Issue 1 / March 2015
- Published online by Cambridge University Press:
- 20 January 2017, pp. 282-295
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Cover crops represent a potentially important biological filter during weed community assembly in agroecosystems. This filtering could be considered directional if different cover-crop species result in weed communities with predictably different species composition. We examined the following four questions related to the potential filtering effects of cover crops in a field experiment involving five cover crops grown in monoculture and mixture: (1) Do cover crops differ in their effect on weed community composition? (2) Is competition more intense between cover crops and weeds that are in the same family or functional group? (3) Is competition more intense across weed functional types in a cover-crop mixture compared with cover crops grown in monocultures? (4) Within a cover-crop mixture, is a higher seeding rate associated with more effective biotic filtering of the weed community? We found some evidence that cover crops differentially filtered weed communities and that at least some of these filtering effects were due to differential biomass production across cover-crop species. Monocultures of buckwheat and sorghum–sudangrass reduced the number of weed species relative to the no-cover-crop control by an average of 36 and 59% (buckwheat) and 25 and 40% (sorghum–sudangrass) in 2011 and 2012, respectively. We found little evidence that competition intensity was dependent upon the family or functional classification of the cover crop or weeds, or that cover-crop mixtures were stronger assembly filters than the most effective monocultures. Although our results do not suggest that annual cover crops exert strong directional filtering during weed community assembly, our methodological framework for detecting such effects could be applied to similar future studies that incorporate a greater number of cover-crop species and are conducted under a greater range of cover-cropping conditions.
The Last Interglacial Ocean
- Rose Marie L. Cline, James D. Hays, Warren L. Prell, William F. Ruddiman, Ted C. Moore, Nilva G. Kipp, Barbara E. Molfino, George H. Denton, Terence J. Hughes, William L. Balsam, Charlotte A. Brunner, Jean-Claude Duplessy, Ann G. Esmay, James L. Fastook, John Imbrie, Lloyd D. Keigwin, Thomas B. Kellogg, Andrew McIntyre, Robley K. Matthews, Alan C. Mix, Joseph J. Morley, Nicholas J. Shackleton, S. Stephen Streeter, Peter R. Thompson
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- Journal:
- Quaternary Research / Volume 21 / Issue 2 / February 1984
- Published online by Cambridge University Press:
- 20 January 2017, pp. 123-224
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The final effort of the CLIMAP project was a study of the last interglaciation, a time of minimum ice volume some 122,000 yr ago coincident with the Substage 5e oxygen isotopic minimum. Based on detailed oxygen isotope analyses and biotic census counts in 52 cores across the world ocean, last interglacial sea-surface temperatures (SST) were compared with those today. There are small SST departures in the mid-latitude North Atlantic (warmer) and the Gulf of Mexico (cooler). The eastern boundary currents of the South Atlantic and Pacific oceans are marked by large SST anomalies in individual cores, but their interpretations are precluded by no-analog problems and by discordancies among estimates from different biotic groups. In general, the last interglacial ocean was not significantly different from the modern ocean. The relative sequencing of ice decay versus oceanic warming on the Stage 6/5 oxygen isotopic transition and of ice growth versus oceanic cooling on the Stage 5e/5d transition was also studied. In most of the Southern Hemisphere, the oceanic response marked by the biotic census counts preceded (led) the global ice-volume response marked by the oxygen-isotope signal by several thousand years. The reverse pattern is evident in the North Atlantic Ocean and the Gulf of Mexico, where the oceanic response lagged that of global ice volume by several thousand years. As a result, the very warm temperatures associated with the last interglaciation were regionally diachronous by several thousand years. These regional lead-lag relationships agree with those observed on other transitions and in long-term phase relationships; they cannot be explained simply as artifacts of bioturbational translations of the original signals.
Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp xv-xxviii
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