Geographic distribution and genetic diversity of the Ehrlichia sp. from Panola Mountain in Amblyomma americanum

Background: A novel Ehrlichia, closely related to Ehrlichia ruminantium, was recently discovered from Panola Mountain State Park, GA, USA. We conducted a study to determine if this agent was recently introduced into the United States. Methods: We developed a sensitive PCR assay based on the conserved gltA (citrate synthase) gene and tested DNA samples extracted from 1964 field-collected and 1835 human-biting Amblyomma americanum from 23 eastern states of the USA. Results: The novel agent was detected in 36 ticks collected from 10 states between 1998 and 2006. Infected ticks were collected both from vegetation (n = 14, 0.7%) and from humans (n = 22, 1.2%). Fragments of the conserved gltA gene and the variable map1 gene were sequenced from positive samples. Two distinct clades, with 10.5% nucleic acid divergence over the 730 bp map1 sequence, were identified. Conclusion: These data suggest that the Panola Mountain Ehrlichia was not recently introduced to the United States; this agent has an extensive distribution throughout the range of its tick vector, has been present in some locations for several years, and displays genetic variability. Furthermore, people in several states were exposed to this agent through the bite of infected ticks, underscoring the potential public health risk of this emerging ehrlichiosis

Light-toned salty soils and coexisting Si-rich species discovered by the Mars Exploration Rover Spirit in Columbia Hills

Light-toned soils were exposed, through serendipitous excavations by Spirit Rover wheels, at eight locations in the Columbia Hills. Their occurrences were grouped into four types on the basis of geomorphic settings. At three major exposures, the light-toned soils are hydrous and sulfate-rich. The spatial distributions of distinct types of salty soils vary substantially: with centimeter-scaled heterogeneities at Paso Robles, Dead Sea, Shredded, and Champagne-Penny, a well-mixed nature for light-toned soils occurring near and at the summit of Husband Hill, and relatively homogeneous distributions in the two layers at the Tyrone site. Aeolian, fumarolic, and hydrothermal fluid processes are suggested to be responsible for the deposition, transportation, and accumulation of these light-toned soils. In addition, a change in Pancam spectra of Tyrone yellowish soils was observed after being exposed to current Martian surface conditions for 175 sols. This change is interpreted to be caused by the dehydration of ferric sulfates on the basis of laboratory simulations and suggests a relative humidity gradient beneath the surface. Sirich nodules and soils were observed near the major exposures of S-rich soils. They possess a characteristic feature in Pancam visible near-infrared (Vis-NIR) spectra that may be diagnostic of hydrated species, and this spectral feature can be used to search for additional Si-rich species. The exposures of hydrated salty soils within various geomorphic settings imply the potential existence of hydrous minerals in similar settings over a much wider area. Hydrous sulfates represent one of the candidates that may contribute the high level of water equivalent hydrogen in equatorial regions detected by the Neutron Spectrometer on Mars Odyssey.We thank NASA for funding the MER Athena Science team and the JPL engineering team for continuing to successfully operate the Mars Exploration rovers.https://agupubs.onlinelibrary.wiley.com/doi/abs/10.1029/2008JE00312

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Posttraumatic Stress Following Acute Medical Trauma in Children: A Proposed Model of Bio-Psycho-Social Processes During the Peri-Trauma Period

Millions of children worldwide experience acute medical events. Children’s responses to these events range from transient distress to significant posttraumatic stress disorder symptoms (PTSS). While many models suggest explanations for the development and maintenance of PTSS in adults, very few have focused on children. Current models of child PTSS are primarily restricted to the post-trauma period, thus neglecting the critical peri-trauma period when screening and preventive interventions may be most easily implemented. Research on PTSS in response to pediatric medical trauma typically examines predictors in isolation, often overlooking potentially important interactions. This paper proposes a new model utilizing the bio-psycho-social framework and focusing on peri-trauma processes of acute medical events. Understanding the relationships among bio-psycho-social factors during peri-trauma can inform early identification of at-risk children, preventive interventions, and clinical care. Recommendations for future research, including the need to examine PTSS in the context of multiple influences, are discussed