TREATMENT THRESHOLDS FOR BOLLWORM (\u3ci\u3eHelicoverpa zea\u3c/i\u3e) IN DUAL-GENE \u3ci\u3eBt\u3c/i\u3e COTTON

Dual-gene Bt cotton has reduced the need for insecticide treatments for bollworm, Helicoverpa zea (Boddie), compared with original single-gene Bt technology. Bollgard II¨ (Monsanto, St. Louis, MO) and WideStrike¨ (Dow AgroSciences, Indianapolis, IN), both produce the Cry1Ac protein and a second protein, Cry2Ab or Cry1F, respectively. These dual-gene Bt cottons provide enhanced control of lepidopteran pests, but remain less than 100% effective against bollworm, particularly when population pressure is high. Current recommended treatment thresholds for bollworm on cotton in South Carolina are as follows: treat with insecticides when three or more large larvae are found per 100 plants or when 5% boll damage is detected. Studies were conducted in an area prone to high bollworm pressure near Blackville, South Carolina, in 2010 and 2011 to develop appropriate thresholds in Bollgard II and WideStrike cotton. Plots containing non-Bt, WideStrike, and Bollgard II cotton varieties were examined weekly and treated according to treatment threshold protocols for one of the following: bollworm eggs, larvae in white blooms, or boll damage. Although yields increased with insecticide applications in non-Bt cotton, statistical differences in yield among thresholds were not evident within the Bt technologies. The conclusion drawn from this limited study was that insecticide applications exclusively targeting bollworm were not necessary in dual-gene Bt cotton. Higher levels of bollworm infestation and damage occurred in WideStrike cotton, however, WideStrike lint yields in this study did not differ among varying thresholds and so did not support the conclusion that protection strategies be amended for each technology

Evaluation of Risk Factors and Postoperative Outcomes in Surgical Laryngectomies with Intraoperative Hypothermia

PURPOSE: The purpose of this study is to determine whether intraoperative hypothermia exposure would be identified as an independent risk factor for surgical laryngectomy patients’ rate of postoperative complications within their surgical admission. The findings would help to justify the institution of “pre-warming” laryngectomy patients to prevent detrimental effects postoperatively. METHODS: Retrospective chart review of 245 patients who had laryngectomies at the University of Kentucky from 2010-2017. Rate of complication and variables predictability of postoperative complications was evaluated. RESULTS: In the sample, 157 patients developed complications. Complications included 35 transpharyngeal fistulas, 29 free flap failures, 43 hematomas, 50 wound infections/ wound breakdowns. Patients who were hypothermic had a significantly higher rate of complications than normothermic patients among all complications. Logistic regression identified intraoperative hypothermia as a significant predictor for the development of postoperative complications TPF (p=0.01) and SSI (p=0.012; odds ratio [OR], 2.80; 95% confidence interval, 1.02-12.66; OR, 2.44, CI, 0.78-7.58), and Chi-square analysis found significance among patients who experienced intraoperative hypothermia and who experienced both TPF and SSI. CONCLUSION: Intraoperative hypothermia in head and neck surgery is positively correlated with postoperative complications in the development of complications, especially TPF and SSI. Maintaining normothermia through aggressive warming prior to intraoperative transport may decrease the incidence of perioperative morbidity for these patients

Primary goals, information-giving and men\u27s understanding: A qualitative study of Australian and UK doctors\u27 varied communication about PSA screening

Objectives: (1) To characterise variation in general practitioners’ (GPs’) accounts of communicating with men about prostate cancer screening using the prostate-specific antigen (PSA) test, (2) to characterise GPs’ reasons for communicating as they do and (3) to explain why and under what conditions GP communication approaches vary. Study design and setting: A grounded theory study. We interviewed 69 GPs consulting in primary care practices in Australia (n=40) and the UK (n=29). Results: GPs explained their communication practices in relation to their primary goals. In Australia, three different communication goals were reported: to encourage asymptomatic men to either have a PSA test, or not test, or alternatively, to support men to make their own decision. As well as having different primary goals, GPs aimed to provide different information (from comprehensive to strongly filtered) and to support men to develop different kinds of understanding, from population-level to ‘gist’ understanding. Taking into account these three dimensions (goals, information, understanding) and building on Entwistle et al’s Consider an Offer framework, we derived four overarching approaches to communication: Be screened, Do not be screened, Analyse and choose, and As you wish. We also describe ways in which situational and relational factors influenced GPs’ preferred communication approach. Conclusion: GPs’ reported approach to communicating about prostate cancer screening varies according to three dimensions—their primary goal, information provision preference and understanding sought—and in response to specific practice situations. If GP communication about PSA screening is to become more standardized in Australia, it is likely that each of these dimensions will require attention in policy and practice support interventions

Extracellular vesicles produced in B cells deliver tumor suppressor miR-335 to breast cancer cells disrupting oncogenic programming in vitro and in vivo.

The successful implementation of miRNA (miR) therapies in humans will ultimately rely on the use of vehicles with improved cellular delivery capability. Here we tested a new system that leverages extracellular vesicles (EVs) laden with a tumor suppressor miRNA (miR-335) produced in B cells by plasmid DNA induction (iEVs). We demonstrate that iEVs-335 efficiently and durably restored the endogenous miR-335 pool in human triple negative breast cancer cells, downregulated the expression of the miR-335 target gene SOX4 transcription factor, and markedly inhibited tumor growth in vivo. Remarkably, iEVs-335 mediated transcriptional effects that persisted in tumors after 60 days post orthotopic implantation. Genome-wide RNASeq analysis of cancer cells treated in vitro with iEVs-335 showed the regulation of a discrete number of genes only, without broad transcriptome perturbations. This new technology may be ideally suited for therapies aimed to restore tumor suppressor miRNAs in cancer cells, disrupting the oncogenic program established after escape from miRNA control

Reverse Genetics System for Mouse Hepatitis Virus Strain 1

MHV strains are routinely used as models for various diseases. MHV-1, which has been known for some time to be highly pneumotropic, has been shown to reproduce the clinical and pathological symptoms seen in humans infected with SARS in A/J mice, providing a convenient animal model that can be investigated without the restrictions necessary to work with the SARS-coronavirus. A reverse genetic cDNA assembly system was developed for the betacoronavirus mouse hepatitis virus strain A59 (MHVA59), in 2002. A similar approach was used to assemble a full-length infectious cDNA of MHV-1. Our system was designed so that it would be compatible with the previouslydeveloped MHV-A59 system in order to allow for the creation of chimeric viruses to identify virulence factors in MHV-1. Seven cDNA fragments representing the entire MHV-1 genome will be generated by RT-PCR, long-accurate PCR, and cloning. These fragments are designed such that the restriction site recognition sequences are removed during restriction enzyme digestion, which creates unique 4 base overhangs to allow for sequential ligation of the cDNAs. Mutations that will not affect the coding sequence were introduced into these plasmid cDNA overhangs to make them compatible with MHV-A59 fragments, which had been previously generated by the Baric lab. Once all seven genomic fragments are cloned, this work will allow for the genetic modification of the entire genome and will make it possible to identify and study the genes that have been hypothesized to be responsible for pneumovirulence in MHV-1 and may lead to more insight to the pathogenesis of SARS-CoV

General Practitioners’ Experiences of, and Responses to, Uncertainty in Prostate Cancer Screening : Insights from a Qualitative Study

Acknowledgments We thank the General Practitioners for their participation in this research. The project was funded by NHMRC grant 1023197. Stacy Carter is supported by NHMRC Career Development Fellowship 1032963. Funding: The project was funded by a National Health and Medical Research Council grant 1023197 (https://www.nhmrc.gov.au/). SMC and LR obtained funding and are CIs on the NHMRC funded project grant. SMC is supported by NHMRC Career Development Fellowship 1032963. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewedPublisher PD

Flight and Dietary Antioxidants Influence Antioxidant Expression and Activity in A Migratory Bird

Ecologically-relevant factors such as exercise and diet quality can directly influence how physiological systems work including those involved in maintaining oxidative balance; however, to our knowledge, no studies to date have focused on how such factors directly affect expression of key components of the endogenous antioxidant system (i.e., transcription factors, select antioxidant genes, and corresponding antioxidant enzymes) in several metabolically active tissues of a migratory songbird. We conducted a 3-factor experiment that tested the following hypotheses: (H1) Daily flying over several weeks increases the expression of transcription factors NRF2 and PPARs as well as endogenous antioxidant genes (i.e., CAT, SOD1, SOD2, GPX1, GPX4), and upregulates endogenous antioxidant enzyme activities (i.e., CAT, SOD, GPx). (H2) Songbirds fed diets composed of more 18:2n-6 PUFA are more susceptible to oxidative damage and thus upregulate their endogenous antioxidant system compared to when fed diets with less PUFA. (H3) Songbirds fed dietary anthocyanins gain additional antioxidant protection and thus upregulate their endogenous antioxidant system less compared to songbirds not fed anthocyanins. Flight training increased the expression of 3 of the 6 antioxidant genes and transcription factors measured in the liver, consistent with H1, but for only one gene (SOD2) in the pectoralis. Dietary fat quality had no effect on antioxidant pathways (H2) whereas dietary anthocyanins increased the expression of select antioxidant enzymes in the pectoralis, but not in the liver (H3). These tissue-specific differences in response to flying and dietary antioxidants are likely explained by functional differences between tissues as well as fundamental differences in their turnover rates. The consumption of dietary antioxidants along with regular flying enables birds during migration to stimulate the expression of genes involved in antioxidant protection likely through increasing the transcriptional activity of NRF2 and PPARs, and thereby demonstrates for the first time that these relevant ecological factors affect the regulation of key antioxidant pathways in wild birds. What remains to be demonstrated is how the extent of these ecological factors (i.e., intensity or duration of flight, amounts of dietary antioxidants) influences the regulation of these antioxidant pathways and thus oxidative balance

Eating As Treatment (EAT): A Stepped-Wedge, Randomized Controlled Trial of a Health Behavior Change Intervention Provided by Dietitians to Improve Nutrition in Patients With Head and Neck Cancer Undergoing Radiation Therapy (TROG 12.03)

Purpose: Malnutrition in head and neck cancer (HNC) treatment is common and associated with poorer morbidity and mortality outcomes. This trial aimed to improve nutritional status during radiation therapy (RT) using a novel method of training dietitians to deliver psychological techniques to improve nutritional behaviors in patients with HNC. Methods and Materials: This trial used a stepped-wedge, randomized controlled design to assess the efficacy of the Eating As Treatment (EAT) program. Based on motivational interviewing and cognitive behavioral therapy, EAT was designed to be delivered by oncology dietitians and integrated into their clinical practice. During control steps, dietitians provided treatment as usual, before being trained in EAT and moving into the intervention phase. The training was principles based and sought to improve behavior-change skills rather than provide specific scripts. Patients recruited to the trial (151 controls, 156 intervention) were assessed at 4 time points (the first and the final weeks of RT, and 4 and 12 weeks afterward). The primary outcome was nutritional status at the end of RT as measured by the Patient-Generated Subjective Global Assessment. Results: Patients who received the EAT intervention had significantly better scores on the primary outcome of nutritional status at the critical end-of-treatment time point (β = −1.53 [−2.93 to −.13], P =.03). Intervention patients were also significantly more likely than control patients to be assessed as well-nourished at each time point, lose a smaller percentage of weight, have fewer treatment interruptions, present lower depression scores, and report a higher quality of life. Although results were not statistically significant, patients who received the intervention had fewer and shorter unplanned hospital admissions. Conclusions: This trial is the first of its kind to demonstrate the effectiveness of a psychological intervention to improve nutrition in patients with HNC who are receiving RT. The intervention provides a means to ameliorate malnutrition and the important related outcomes and consequently should be incorporated into standard care for patients receiving RT for HNC

Behavioral Health Integration in Primary Care

Behavioral Health Integration in Primary Care Casey Zapata, Depts. of Psychology and English, Demetrius Carter, & MaryKate Crawford, and Samantha Mladen, Emily Donovan, Amber Fox, & Kristen O’Loughlin, Dept. of Psychology Graduate Students, with Dr. Bruce Rybarczyk, Dept. of Psychology Background/Aims: Due to limited access to mental health care, many patients present to primary care with mental health concerns, such as depression and anxiety. Integrated primary care (IPC), an emerging practice model that integrates behavioral health providers with medical providers in primary care, has been demonstrated to improve patient outcomes. This project aims to characterize patients being seen in safety-net IPC, both demographically and clinically. Methods: The data were collected across three safety-net clinics in the Richmond area. The sample consisted of 96 adult patients: 68 female (71%), 24 male (25%), 1 non binary (1%), and 3 not collected (3%); 54 African-American (56%), 29 White (30%), 1 Asian (1%), 1 Other (1%), and 11 not collected (12%). Measures included a patient-completed checklist of patients’ behavioral health concerns, the PHQ-9 for depression, the GAD-7 for anxiety, and clinician-completed chart review for demographic factors. Results: Of the 72 patients who completed the GAD-7, patients reported 13 (18%) severe symptoms of anxiety, 11 (15%) moderate symptoms, 15 (21%) mild symptoms, and 33 (46%) subclinical symptoms. For the 37 patients who completed the PHQ-9, patients reported 7 (19%) severe depressive symptoms, 10 (27%) moderately severe symptoms, 12 (32%) moderate symptoms, 6 (16%) mild symptoms, and 2 (5%) subclinical symptoms. The six most commonly patient-reported problems were stress (n= 73), anxiety (n= 70), depression (n= 65), sleep (n = 55), grief (n = 53), and irritability (n= 53). When asked to rank their top three concerning problems, the five concerns most commonly ranked as top problems were: : (1) anxiety (n = 29), (2) stress (n = 28), (3) depression (n = 27), (4) sleep (n=16), and (5) weight (n=15). Further, 56 (58%) participants reported both depression and anxiety as among their top three concerns. Discussion: Anxiety and depression were reported by the majority of patients, with 33% experiencing at least moderate anxiety and 78% experiencing at least moderate depression. Additionally, anxiety and depression were cited as the third most commonly reported concerns, respectively, as well as ranked within the top three most concerning problems for most participants. Stress, anxiety, depression, and sleep were included in both the most commonly reported problems and the most common top three concerns of participants, suggesting that these concerns are both pervasive and troublesome for participants. Over time, this project will prioritize increasing sample size and tracking longitudinal trends. The continued study of safety-net IPC may allow for increasing access to behavioral health, identifying common behavioral health concerns in primary care, and meeting unmet patient needs.https://scholarscompass.vcu.edu/uresposters/1340/thumbnail.jp

Critical thinking development in undergraduate midwifery students: An Australian validation study using Rasch analysis

Background: Well-developed critical thinking skills are required to provide midwifery care that is safe, evidence-based, and woman-centred. A valid, reliable tool to measure is required the application of critical thinking in midwifery practice. The Carter Assessment of Critical Thinking in Midwifery (CACTiM) has previously been psychometrically assessed using classical methods at a single site. This study aims to further evaluate the properties of CACTiM tools using Rasch analysis in a diverse group of midwifery students and preceptors. Methods: The CACTiM tools were completed by undergraduate midwifery students studying at three Australian universities and their preceptors. Midwifery students’ critical thinking was evaluated separately through student self-assessment and preceptor assessment and then matched. Rasch analysis was used to evaluate the validity of the tools. Results: Rasch analysis confirmed both the preceptor and student CACTiM tools demonstrated good reliability and unidimensionality. The items can differentiate between students’ ability to apply critical thinking in midwifery practice. Person reliability and item reliability were above.92 for both scales indicating excellent reliability and internal consistency. Several improvements were identified to the tools, including enhanced wording to some items, and reduction to a 5-point Likert scale. Through analysis of lower-scoring items, midwifery programs can identify curricula enhancements. Conclusion: The CACTiM student and preceptor tools are valid and reliable measures of critical thinking in midwifery practice. The tools can assess students’ critical thinking abilities and identify areas for development for individuals and across student cohorts through curricula enhancements