Seed Transmission of Pseudomonas Syringae PV. Aptata, and Efficacy of Bactericides for Control of the Pathogen in Beet and Swiss Chard Seed Production

Bacterial leaf spot (BLS), caused by Pseudomonas syringae pv. aptata (Psa), is an economically important disease in beet and Swiss chard production. Psa is a splash-dispersed, seedborne, and seed-transmitted pathogen, and BLS is favored by cool and moist conditions. The economic impact of BLS has increased with expansion of baby leaf beet and chard production because of the dense plantings (>7 million seed/ha) and overhead irrigation. Baby leaf production also has increased the demand for seed. Management practices for BLS are limited, e.g., disinfection of Psa-infected seed lots, use of drip irrigation (where feasible, but impractical for baby leaf crops), selection of planting sites, and foliar applications of copper bactericides. Disinfection of seed is costly. Copper bactericides are not systemic or curative, and have limited efficacy, including a risk of pathogen populations developing tolerance to copper. This study evaluated: i) thresholds for seedborne Psa that result in development of BLS in baby leaf beet and chard crops, ii) the duration of survival of Psa in beet and chard seed, and iii) the efficacy of foliar applications of various bactericides for control of BLS in seed crops. Four baby leaf field trials planted with seed naturally infected at a range of concentrations of Psa revealed the threshold for seedborne Psa that resulted in ≥5% severity of BLS ranged from 0 to ~6 x 104 CFU/g seed, depending on environmental conditions. Recovery of seedborne Psa in naturally infected beet (n = 3) and chard (n = 3) seed lots tested at 3-month intervals after harvest of seed crops revealed the amount of seedborne Psa (log10CFU)/g seed) declined by 0.07 to 0.19 X months of storage. Therefore, storing seed for 12 to 24 months may be a viable option to reduce Psa to negligible levels prior to selling the seed. Of ten bactericides evaluated in five chard seed crops, none reduced severity of BLS symptoms or Psa infection levels of the harvested seed, except ManKocide in only one trial with moderate BLS severity. Further research on seed treatments and bactericides is needed to facilitate effective management of Psa in beet and chard production

AN ESSENTIAL TOOL TO BE OPTIMIZED: SYNDROMIC MANAGEMENT OF VAGINAL DISCHARGE IN HAITI

Background: Haiti, like many low-income countries in crisis, has limited resources for etiologic diagnosis of vaginal discharge. As such, we sought to characterize variability in diagnoses of women presenting with vaginal discharge syndrome, with the goal to improve standardization of syndromic management. Materials and Methods: Participants aged 18 years and older endorsing vaginitis, or dysuria were recruited at Jerusalem Clinic over two, one-week periods in April 2018 and July 2019. We calculated Spearman rank correlations among history, exam findings, and diagnoses based on clinical presentation, to understand presentation groupings and their management. Results: Among 98 women, median age was 33.5 years, and most frequent symptoms were: vaginal discharge (97%), vaginal itch (73%), and/or suprapubic pain (68%). Most common physical exam findings were vaginal discharge (86%), suprapubic/lower quadrant tenderness (29%), cervical motion tenderness (24%), and cervical erythema (20%). Most symptoms and physical exam findings were weakly correlated with each other. Nearly one-third (31%) were diagnosed with normal physiologic vaginal discharge or no diagnosis, followed by Bacterial vaginosis (31%), vulvovaginal candidiasis (15%), cervicitis/PID (13%), and STI (7%). No reported symptoms strongly differentiated diagnostic categories. Diagnoses varied considerably by exam findings. Conclusions: The weak correlations between symptoms, exam findings, and diagnoses could represent variability in assessment. In the absence of reliable and accessible laboratory testing, the importance of standardizing syndromic management becomes increasingly relevant. Results from our study support the utility of speculum examination and more standardized documentation of physical exam findings. Next steps include the development of local algorithms to promote standardization of treatment of vaginal discharge syndrome

Teaching Can Be Taught... Wisdom Will Follow

Robert Gagne proposed that instruction can be framed into nine events, and these “events” still endure as one of the standards for designing presentations. In the Information Literacy course at Valdosta State University, students learn to create lessons based on Gagne’s approach. The presenters are graduates from that program and one current student. They will demonstrate how to develop teaching presentations based on the Gagne model. Their follow‐up remarks will center upon how this type of formulaic teaching can precipitate deeper thinking about the art of teaching. Links to lesson plans will be included

Evaluation of the Performance of a Point-of-Care Test for Chlamydia and Gonorrhea

Importance: Rates of chlamydial and gonococcal infection continue to increase in the United States, as do the associated costs of untreated infections. Improved diagnostic technologies that support testing and treating in 1 clinical visit are critical to advancing efforts to control the rates of chlamydial and gonococcal infection. Objective: To evaluate the clinical performance of a point-of-care (POC) molecular diagnostic assay for the detection of chlamydia and gonorrhea. Design, setting, and participants: A noninterventional, cross-sectional clinical study was conducted from September 18, 2018, through March 13, 2019, at sexually transmitted infection (STI), HIV, family planning, and obstetrics and gynecology clinics where STI screening is routine, using a convenience sample and comparing commercially available assays with a new 30-minute POC assay. Patients included were those eligible for STI screening or diagnostic testing who had not taken antibiotics effective against chlamydia or gonorrhea within the previous 28 days. Four vaginal swab samples were collected from women and a first-catch urine sample was obtained from men. Main outcomes and measures: A composite infection status was used to classify participants as infected if 2 or more comparator results were positive, as not infected if 2 or more comparator samples were negative, and as unevaluable if 1 result was invalid and the other 2 results did not agree with each other. Results: Swab samples from 1523 women (median age, 27 years [interquartile range, 17-37 years]), 817 (53.6%) of whom presented with symptoms, and 922 men (median age, 29 years [interquartile range, 17-41 years]), 308 (33.4%) of whom were symptomatic, were tested. For chlamydia, sensitivity of the new POC assay was 96.1% (95% CI, 91.2%-98.3%) for women and 92.5% (95% CI, 86.4%-96.0%) for men. For gonorrhea, sensitivity estimates were 100.0% (95% CI, 92.1%-100.0%) for women and 97.3% (95% CI, 90.7%-99.3%) for men. For chlamydia, specificity of the new POC assay was 99.1% (95% CI, 98.4%-99.5%) for women and 99.3% (95% CI, 98.4%-99.7%) for men. For gonorrhea, specificity estimates were 99.9% (95% CI, 99.5%-100%) for women and 100% (95% CI, 95.5%-100%) for men. Non-laboratory-trained personnel performed 94.8% of all tests (2318 of 2445) during the study. Conclusions and relevance: This study suggests that self-obtained vaginal swab samples were associated with performance equivalent to laboratory-based molecular diagnostics, which can support use of this POC assay in many settings. The availability of an easy-to-use, rapid (30-minute) molecular test for accurate detection of chlamydia and gonorrhea has the power to facilitate testing and treatment in a single patient visit for these STIs

FORENSIC EVALUATION AND LESSONS LEARNED OF PRESTRESSED CONCRETE POLE FAILURES IN PUERTO RICO DURING HURRICANE MARIA

This article summarizes the lessons learned from the evaluation of failed concrete utility poles in Puerto Rico as a consequence of Hurricane Maria. Teams were deployed between October 3rd to 11th 2017, to cover the west, northwest, south, and east of the island. The evaluation presents sample cases of the failed poles around the island but does not attempt to conduct an inventory. The Puerto Rico building code was being updated based on changes in the International Building Code and the effects of Hurricane Georges. However, many poles made from previous designs are still in service, and many of them failed as a consequence of design deficiencies and improper construction practices. Poles manufactured under the updated codes failed mostly due to foundation issues or structural overload from nearby vegetation impact and the failure of in-line poles, especially wood poles and pre-Georges concrete poles

The Response to September 11: A Disaster Case Study

Background: The response to 9/11 continues into its 14th year. The World Trade Center Health Program (WTCHP), a long-term monitoring and treatment program now funded by the Zadroga Act of 2010, includes >60,000 World Trade Center (WTC) disaster responders and community members (“survivors”). The aim of this review is to identify several elements that have had a critical impact on the evolution of the WTC response and, directly or indirectly, the health of the WTC-exposed population. It further explores post-disaster monitoring efforts, recent scientific findings from the WTCHP, and some implications of this experience for ongoing and future environmental disaster response. Findings: Transparency and responsiveness, site safety and worker training, assessment of acute and chronic exposure, and development of clinical expertise are interconnected elements determining efficacy of disaster response. Conclusion: Even in a relatively well-resourced environment, challenges regarding allocation of appropriate attention to vulnerable populations and integration of treatment response to significant medical and mental health comorbidities remain areas of ongoing programmatic development