Combining genomics and epidemiology to investigate a zoonotic outbreak of rabies in Romblon Province, Philippines.

Rabies is a viral zoonosis that kills thousands of people annually in low- and middle-income countries across Africa and Asia where domestic dogs are the reservoir. 'Zero by 30', the global strategy to end dog-mediated human rabies, promotes a One Health approach underpinned by mass dog vaccination, post-exposure vaccination of bite victims, robust surveillance and community engagement. Using Integrated Bite Case Management (IBCM) and whole genome sequencing (WGS), we enhanced rabies surveillance to detect an outbreak in a formerly rabies-free island province in the Philippines.

Hybrid adaptation is hampered by Haldane's sieve.

Hybrids between species exhibit plastic genomic architectures that could foster or slow down their adaptation. When challenged to evolve in an environment containing a UV mimetic drug, yeast hybrids have reduced adaptation rates compared to parents. We find that hybrids and their parents converge onto similar molecular mechanisms of adaptation by mutations in pleiotropic transcription factors, but at a different pace.

The Essential Components of Adult Critical Care Neuroscience Nursing Orientation: A Delphi Study.

BACKGROUND: Critical care neuroscience nursing is a specialized field requiring a complex knowledge base and unique clinical orientation. A comprehensive orientation for nurses new to this specialty can improve retention, performance, and satisfaction. Critical care neuroscience orientations are often hospital based and regionally specific, and lack a systematic approach.

Ultrasound-guided percutaneous transjejunal creation of neoanastomosis for the treatment of bilioenteric anastomotic occlusion.

A stricture of the bilioenteric anastomosis is a known complication of pancreaticoduodenectomy surgery and pediatric liver transplant. Occasionally, a complete biliary occlusion is encountered that cannot be treated utilizing endoscopic or conventional interventional radiology blunt recanalization techniques. In this article, we report 2 cases of successful sharp percutaneous ultrasound-guided retrograde creation of bilioenteric neoanastomosis in the setting of a complete biliary occlusion following Whipple surgery and liver transplant respectively.

Pectoralis Major and Abdominis Rectus Musculocutaneous Flap Reconstruction for Sternal Wound Closure in Ectopia Cordis.

Ectopia cordis is a rare congenital condition resulting in extrathoracic positioning of the heart. The severity of presentation may vary with partial or complete displacement through sternal or diaphragmatic defects. Operative management is typically required, but due to the rarity of the condition, no standard exists for optimal closure.