Incidence of Hospitalization for Respiratory Syncytial Virus Infection amongst Children in Ontario,Canada: A Population-Based Study Using Validated Health Administrative Data

Importance

RSV is a common illness among young children that causes significant morbidity and health care costs.

Objective

Routinely collected health administrative data can be used to track disease incidence, explore risk factors and conduct health services research. Due to potential for misclassification bias, the accuracy of data-elements should be validated prior to use. The objectives of this study were to validate an algorithm to accurately identify pediatric cases of hospitalized respiratory syncytial virus (RSV) from within Ontario’s health administrative data, estimate annual incidence of hospitalization due to RSV and report the prevalence of major risk factors within hospitalized patients.

Study Design and Setting

A retrospective chart review was performed to establish a reference-standard cohort of children from the Ottawa region admitted to the Children’s Hospital of Eastern Ontario (CHEO) for RSV-related disease in 2010 and 2011. Chart review data was linked to Ontario’s administrative data and used to evaluate the diagnostic accuracy of algorithms of RSV-related ICD-10 codes within provincial hospitalization and emergency department databases. Age- and sex-standardized incidence was calculated over time, with trends in incidence assessed using Poisson regression.

Results

From a total of 1411 admissions, chart review identified 327 children hospitalized for laboratory confirmed RSV-related disease. Following linkage to administrative data and restriction to first admissions, there were 289 RSV patients in the reference-standard cohort. The best algorithm, based on hospitalization data, resulted in sensitivity 97.9% (95%CI: 95.5–99.2%), specificity 99.6% (95%CI: 98.2–99.8%), PPV 96.9% (95%CI: 94.2–98.6%), NPV 99.4% (95%CI: 99.4–99.9%). Incidence of hospitalized RSV in Ontario from 2005–2012 was 10.2 per 1000 children under 1 year and 4.8 per 1000 children aged 1 to 3 years. During the surveillance period, there was no identifiable increasing or decreasing linear trend in the incidence of hospitalized RSV, hospital length of stay and PICU admission rates. Among the Ontario RSV cohort, 16.3% had one or more major risk factors, with a decreasing trend observed over time.

Conclusion

Children hospitalized for RSV-related disease can be accurately identified within population-based health administrative data. RSV is a major public health concern and incidence has not changed over time, suggesting a lack of progress in prevention.     

<Emphasis Type="Italic">In vitro</Emphasis> regeneration,flower and plant formation from petiolar and nodal explants of culantro (<Emphasis Type="Italic">Eryngium foetidum</Emphasis> L.)

Summary A procedure for plant regeneration, flower and plant formation from petiolar and inflorescence nodal explants of culantro is discribed. Leaf petioles were excised from young leaves of non-flowering plants while nodal explants were excised from the inflorescence. Explants were cultured in Murashige and Skoog (MS) medium alone or supplemented with 0.5μM naphthaleneacetic acid (NAA) and 0.9, 1.8, 4.5, or 9 μM thidiazuron (TDZ). All explants produced multiple shoots. In addition, nodal explants formed flowers. Shoot number, flower number and shoot length were influenced by TDZ and NAA. Rooted shoots from both types of explants were transferred to soil where plants were successfully established.     

Solutes in native plants in the Arabian Gulf region and the role of microorganisms: future research

Aims One of the outstanding challenges facing humankind is increasing crop production under various types of severe environmental conditions. Many measures have been taken to adopt molecular and biotechnological approaches that lead to the development of transgenic plants able to deal with such harsh and polluted environments. However, such solutions could be very expensive and require considerable efforts and time to achieve these objectives. The main objective of this review is to discuss the new biological solutions that have emerged in the last decade, as environmentally friendly approaches, perhaps to support and/or replace the present efforts. These solutions based on plant–microbe interactions could be a lifeline and promising alternative strategy to create plants with a high resistance to the extreme environments.     

Influence of agar and activated charcoal on uptake of gibberellin and plant morphogenesis In vitro

Summary Agar and activated charcoal (AC) are commonly used in tissue culture. However, their deeper actions and functions are largely unknown. This experiment investigated the effect of agar and AC, singly and jointly, on gibberellin (GA) uptake by corn shoots. Corn seeds were germinated on Murashige and Skoog medium (MS). Shoot excised from 1-wk-old seedlings were cultured on liquid (0.0 g l⁻¹ agar) or solid (8 g l⁻¹ agar) MS containing 3 μM indole-3-acetic acid, 13.3 μM N⁶-benzyladenine, and 6000 CPM ml⁻¹ [³H]GA₄ as tracer. Both liquid and solid media had two treatments, one without AC and one supplemented with 5 g l⁻¹AC. Uptake of [³H]GA₄ and morphogenesis of corn shoots were recorded after 2 wk of culture. Corn explants cultured in AC-free media acquired high levels of [³H]GA₄, while explants from AC-containing media showed only traces of [³H]GA₄. Explants cultured in AC-free liquid medium contained about twice the amount of [³H]GA₄ as those from AC-free solid medium. Addition of agar reduced shoot length, while addition of AC increased both shool and root length. It is concluded that: (1) agar reduced the uptake of GA₄; and (2) GA₄ was irreversibly adsorbed by AC, and thus became unavailable to corn explants.     

Somatic embryogenesis from leaf of witloof chicory through suspension culture

A procedure for regeneration of somatic embryogenesis from witloof chicory leaf has been developed. Explants were taken from the distal third part of leaf vein and cultured on Murashige and Skoog medium (MS) containing 100 mg/1 casein hydrolysate 1.3 M 2,4-D, and 1.3 M kinetin. A pale yellowisl nodular callus was formed after 4 weeks which was maintained in the same medium for 8–12 weeks with one change to a fresh medium every 4 weeks. Callus was then suspended in the same medium without agar for 4–6 weeks with one change to a fresh medium every 2 weeks. Embryo-like structures appeared upon transfer to liquid MS containing 1.8 M benzyladenine. Embryo germination was accomplished in half strength MS medium with or without 1 g/l activated charcoal.Abbreviations AC activated charcoal - BA benzyladenine - MS Murashige & Skoog (1962) medium     

Drug formulations that require less than 0.1 mL of stock solution to prepare doses for infants and children

Intravenous doses of medications require formulations that permit accurate preparation and administration. Current equipment does not permit accurate measurement of volumes less than 0.1 mL. In a study of four hypothetical standard pediatric patients, we found that 28 common medications required less than 0.1 mL of available formulation to prepare the dose. In a clinical study of actual use in a pediatric intensive care unit (ICU), 5245 (7.4%) of 71 218 intravenous doses required preparation from less than 0.1 mL of stock solution. For 28.5% of the 1531 ICU admissions, at least one dose was prepared from a volume of less than 0.1 mL. Our findings identify a substantial source of dosing error. Correction will require revision of preparation methods, regulatory requirements and manufacturing practices.Preparation of parenteral doses of medications from small volumes using commercially available syringes is imprecise and may result in serious dosing errors.^1–3 Previously, we showed that 60% of 116 doses prepared from 0.06 mL of stock solution had a dosing error of more than 10%, and 27% had a two-fold dosing error.² We hypothesized that small volumes of commercially available formulations are often required to prepare intravenous doses for infants and children.     

Rapid propagation of tuna (Opuntia ficus-indica) and plant establishment in soil

Explants from young joints of mature plants of tuna (Opuntia ficus-indica Mill.) were cultured on Murashige and Skoog (MS) medium containing 8.8 M benzyladenine (BA) and 0.5 M naphthaleneacetic acid (NAA). Shoots produced were utilized as secondary explants. Each shoot was cut longitudinally from apex to base into two explants, and some of these explants were cut transversely into proximal and distal explants. The size and number of shoots produced was affected by size and position of the explant within its source. The shoots were rooted in vitro or ex vitro and plants were successfully established in soil from both rooting methods.Abbreviations AC activated charcoal - BA benzyladenine - IBA indolebutyric acid - MS Murashige & Skoog (1962) medium - NAA naphthaleneacetic acid     

In vitro shoot proliferation and production of sets from garlic and shallot

A procedure is described to regenerate shoots and bulbs in vitro with high frequency from shoot tips of garlic and shallot plants using benzyladenine or thidiazuron. Regenerated shoots were induced to form bulbs in Murashige and Skoog medium (1962) containing 5 g l^-1 activated charcoal and 120 g l^-1 sucrose under a long-day photoperiod. Bulbs formed in vitro were transferred to soil without acclimatization and produced viable plants. This method could be useful to produce low-cost bulbs, which are easy to handle and store until needed.Abbreviations AC activated charcoal - BA benzyladenine - IBA indolebutyric acid - MS Murashige & Skoog's (1962) medium - NAA naphthaleneacetic acid - TDZ thidiazuron     

In vitro bulb production fromAllium spp.

Summary A procedure for bulb formation from onion, garlic, and shallot explants is described. Explants from cut stem bases were cultured in shoot induction medium composed of Murashige and Skoog (MS) medium with or without N⁶-benzyladenine. Shoots produced were then transferred to bulb induction medium composed of MS medium containing 5 g/liter activated charcoal and 120 g/liter sucrose under a long-day photoperiod and 28&#x00B0; C. Bulbs were also produced from onion and garlic directly, without passing through shoot formation, when explants were cultured in the bulb induction medium described above. Bulbs were transferred to soil without acclimatization and produced viable plants.     

Micropropagation of pitaya (<Emphasis Type="Italic">Hylocereus undatus</Emphasis> Britton et rose)

Summary A procedure for micropropagation of pitaya using thidiazuron (TDZ) and naphthaleneacetic acid (NAA) is described. Explants were excised from young joints of mature plants and cultured on Murashige and Skoog medium (MS) containing 0.5 μM NAA and 0.5 μM TDZ. Shoots produced from these first explants were cut up to produce secondary explants, either by decapitation or by longitudinal division into three parts. The decapitated and longitudinal explants were cultured on MS supplemented with 0.5 μM NAA and either 0.01, 0.09, 0.5, or 0.9 μM TDZ. Decapitated explants produced more shoots at higher frequency that the longitudinal explants. For both types of secondary explants, most shoots were developed from the distal parts. Shoots produced from secondary explants were rooted in MS and then transferred to soil where they produced normal plants.