Best Practices among Certain Classes of Pennsylvania Destination Marketing Organizations (DMOs)

The researchers originally became aware of the existence of DMOs (previously known as tourism promotion agencies or TPAs) when reading materials in the Gettysburg Times. The two student-authors plan to work in local government following graduation, and they were curious about perspectives shared in the Gettysburg Times about the local DMO. Thereafter, a representative from the Gettysburg Borough Council approached the faculty-author about conducting research on DMOs’ policies, procedures, and practices, and, relatedly, the “pillow tax,” a hotel room occupancy tax that is administered by counties and disbursed to DMOs, among others. Specifically, the Borough Council representative was curious about best practices with respect to allocation of the pillow tax; how DMOs use pillow tax revenue; and how DMOs account for such use. The Borough representative also was curious about general business practices among DMOs. The faculty-author applied for and obtained approval from the Gettysburg College Institutional Review Board for research among Pennsylvania DMOs and their representatives on these issues. This white paper briefly summarizes the history of the relationship between Pennsylvania DMOs and the pillow tax then describes the researchers’ methodology. Next, the white paper describes what Study DMOs appear to believe are best practices, or most commonly accepted practices, in six categories: Boards of Directors; Revenue; Grant Making; Spending; Assessment; and Future Planning. All data are reported in aggregate to minimize the risk of revealing individually identifiable data. These findings may inform DMO, community, and county decision-making

British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis - part 3: special circumstances

\ua9 2023 BMJ Publishing Group. All rights reserved.The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Part 1 addresses outpatient management of compensated cirrhosis: screening for hepatocellular cancer, varices and osteoporosis, vaccination and lifestyle measures. Part 2 concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. In this, the third part of the guidance, we focus on special circumstances encountered in managing people with cirrhosis, namely surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis

Development of high-throughput methods to screen disease caused by Rhizoctonia solani AG 2-1 in oilseed rape

Background: Rhizoctonia solani (Kühn) is a soil-borne, necrotrophic fungus causing damping off, root rot and stem canker in many cultivated plants worldwide. Oilseed rape (OSR, Brassica napus) is the primary host for anastomosis group (AG) 2-1 of R. solani causing pre- and post-emergence damping-off resulting in death of seedlings and impaired crop establishment. Presently, there are no known resistant OSR genotypes and the main methods for disease control are fungicide seed treatments and cultural practices. The identification of sources of resistance for crop breeding is essential for sustainable management of the disease. However, a high-throughput, reliable screening method for resistance traits is required. The aim of this work was to develop a low cost, rapid screening method for disease phenotyping and identification of resistance traits. Results: Four growth systems were developed and tested: (1) nutrient media plates, (2) compost trays, (3) light expanded clay aggregate (LECA) trays, and (4) a hydroponic pouch and wick system. Seedlings were inoculated with virulent AG 2-1 to cause damping-off disease and grown for a period of 4–10 days. Visual disease assessments were carried out or disease was estimated through image analysis using ImageJ. Conclusion: Inoculation of LECA was the most suitable method for phenotyping disease caused by R. solani AG 2-1 as it enabled the detection of differences in disease severity among OSR genotypes within a short time period whilst allowing measurements to be conducted on whole plants. This system is expected to facilitate identification of resistant germplasm

British Society of Gastroenterology Best Practice Guidance: outpatient management of cirrhosis - part 1: compensated cirrhosis

\ua9 2023 BMJ Publishing Group. All rights reserved.The prevalence of cirrhosis has risen significantly over recent decades and is predicted to rise further. Widespread use of non-invasive testing means cirrhosis is increasingly diagnosed at an earlier stage. Despite this, there are significant variations in outcomes in patients with cirrhosis across the UK, and patients in areas with higher levels of deprivation are more likely to die from their liver disease. This three-part best practice guidance aims to address outpatient management of cirrhosis, in order to standardise care and to reduce the risk of progression, decompensation and mortality from liver disease. Here, in part one, we focus on outpatient management of compensated cirrhosis, encompassing hepatocellular cancer surveillance, screening for varices and osteoporosis, vaccination and lifestyle measures. We also introduce a compensated cirrhosis care bundle for use in the outpatient setting. Part two concentrates on outpatient management of decompensated disease including management of ascites, encephalopathy, varices, nutrition as well as liver transplantation and palliative care. The third part of the guidance covers special circumstances encountered in managing people with cirrhosis: surgery, pregnancy, travel, managing bleeding risk for invasive procedures and portal vein thrombosis

Agronomic Management of Indigenous Mycorrhizas

Many of the advantages conferred to plants by arbuscular mycorrhiza (AM) are associated to the ability of AM plants to explore a greater volume of soil through the extraradical mycelium. Sieverding (1991) estimates that for each centimetre of colonized root there is an increase of 15 cm3 on the volume of soil explored, this value can increase to 200 cm3 depending on the circumstances. Due to the enhancement of the volume of soil explored and the ability of the extraradical mycelium to absorb and translocate nutrients to the plant, one of the most obvious and important advantages resulting from mycorrhization is the uptake of nutrients. Among of which the ones that have immobilized forms in soil, such as P, assume particular significance. Besides this, many other benefits are recognized for AM plants (Gupta et al, 2000): water stress alleviation (Augé, 2004; Cho et al, 2006), protection from root pathogens (Graham, 2001), tolerance to toxic heavy metals and phytoremediation (Audet and Charest, 2006; Göhre and Paszkowski, 2006), tolerance to adverse conditions such as very high or low temperature, high salinity (Sannazzaro et al, 2006), high or low pH (Yano and Takaki, 2005) or better performance during transplantation shock (Subhan et al, 1998). The extraradical hyphae also stabilize soil aggregates by both enmeshing soil particles (Miller e Jastrow, 1992) and producing a glycoprotein, golmalin, which may act as a glue-like substance to adhere soil particles together (Wright and Upadhyaya, 1998). Despite the ubiquous distribution of mycorrhizal fungi (Smith and Read, 2000) and only a relative specificity between host plants and fungal isolates (McGonigle and Fitter, 1990), the obligate nature of the symbiosis implies the establishment of a plant propagation system, either under greenhouse conditions or in vitro laboratory propagation. These techniques result in high inoculum production costs, which still remains a serious problem since they are not competitive with production costs of phosphorus fertilizer. Even if farmers understand the significance of sustainable agricultural systems, the reduction of phosphorus inputs by using AM fungal inocula alone cannot be justified except, perhaps, in the case of high value crops (Saioto and Marumoto, 2002). Nurseries, high income horticulture farmers and no-agricultural application such as rehabilitation of degraded or devegetated landscapes are examples of areas where the use of commercial inoculum is current. Another serious problem is quality of commercial available products concerning guarantee of phatogene free content, storage conditions, most effective application methods and what types to use. Besides the information provided by suppliers about its inoculum can be deceiving, as from the usually referred total counts, only a fraction may be effective for a particular plant or in specific soil conditions. Gianinazzi and Vosátka (2004) assume that progress should be made towards registration procedures that stimulate the development of the mycorrhizal industry. Some on-farm inoculum production and application methods have been studied, allowing farmers to produce locally adapted isolates and generate a taxonomically diverse inoculum (Mohandas et al, 2004; Douds et al, 2005). However the inocula produced this way are not readily processed for mechanical application to the fields, being an obstacle to the utilization in large scale agriculture, especially row crops, moreover it would represent an additional mechanical operation with the corresponding economic and soil compaction costs. It is well recognized that inoculation of AM fungi has a potential significance in not only sustainable crop production, but also environmental conservation. However, the status quo of inoculation is far from practical technology that can be widely used in the field. Together a further basic understanding of the biology and diversity of AM fungi is needed (Abbott at al, 1995; Saito and Marumoto, 2002). Advances in ecology during the past decade have led to a much more detailed understanding of the potential negative consequences of species introductions and the potential for negative ecological consequences of invasions by mycorrhizal fungi is poorly understood. Schwartz et al, (2006) recommend that a careful assessment documenting the need for inoculation, and the likelihood of success, should be conducted prior to inoculation because inoculations are not universally beneficial. Agricultural practices such as crop rotation, tillage, weed control and fertilizer apllication all produce changes in the chemical, physical and biological soil variables and affect the ecological niches available for occupancy by the soil biota, influencing in different ways the symbiosis performance and consequently the inoculum development, shaping changes and upset balance of native populations. The molecular biology tools developed in the latest years have been very important for our perception of these changes, ensuing awareness of management choice implications in AM development. In this context, for extensive farming systems and regarding environmental and economic costs, the identification of agronomic management practices that allow controlled manipulation of the fungal community and capitalization of AM mutualistic effect making use of local inoculum, seem to be a wise option for mycorrhiza promotion and development of sustainable crop production

Arbuscular mycorrhizal colonisation of roots of grass species differing in invasiveness

Recent research indicates that the soil microbial community, particularly arbuscular mycorrhizal fungi (AMF), can influence plant invasion in several ways. We tested if 1) invasive species are colonised by AMF to a lower degree than resident native species, and 2) AMF colonisation of native plants is lower in a community inhabited by an invasive species than in an uninvaded resident community. The two tests were run in semiarid temperate grasslands on grass (Poaceae) species, and the frequency and intensity of mycorrhizal colonisation, and the proportion of arbuscules and vesicles in plant roots have been measured. In the first test, grasses representing three classes of invasiveness were included: invasive species, resident species becoming abundant upon disturbance, and non-invasive native species. Each class contained one C3 and one C4 species. The AMF colonisation of the invasive Calamagrostis epigejos and Cynodon dactylon was consistently lower than that of the non-invasive native Chrysopogon gryllus and Bromus inermis, and contained fewer arbuscules than the post-disturbance dominant resident grasses Bothriochloa ischaemum and Brachypodium pinnatum. The C3 and C4 grasses behaved alike despite their displaced phenologies in these habitats. The second test compared AMF colonisation for sand grassland dominant grasses Festuca vaginata and Stipa borysthenica in stands invaded by either C. epigejos or C. dactylon, and in the uninvaded natural community. Resident grasses showed lower degree of AMF colonisation in the invaded stand compared to the uninvaded natural community with F. vaginata responding so to both invaders, while S. borysthenica responding to C. dactylon only. These results indicate that invasive grasses supposedly less reliant on AMF symbionts have the capacity of altering the soil mycorrhizal community in such a way that resident native species can establish a considerably reduced extent of the beneficial AMF associations, hence their growth, reproduction and ultimately abundance may decline. Accumulating evidence suggests that such indirect influences of invasive alien plants on resident native species mediated by AMF or other members of the soil biota is probably more the rule than the exception

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis B-related fibrosis: a leading meta-analysis

<p>Abstract</p> <p>Background</p> <p>The aspartate aminotransferase-to-platelet ratio index (APRI), a tool with limited expense and widespread availability, is a promising noninvasive alternative to liver biopsy for detecting hepatic fibrosis. The objective of this study was to systematically review the performance of the APRI in predicting significant fibrosis and cirrhosis in hepatitis B-related fibrosis.</p> <p>Methods</p> <p>Areas under summary receiver operating characteristic curves (AUROC), sensitivity and specificity were used to examine the accuracy of the APRI for the diagnosis of hepatitis B-related significant fibrosis and cirrhosis. Heterogeneity was explored using meta-regression.</p> <p>Results</p> <p>Nine studies were included in this meta-analysis (n = 1,798). Prevalence of significant fibrosis and cirrhosis were 53.1% and 13.5%, respectively. The summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.79 and 0.75, respectively. For significant fibrosis, an APRI threshold of 0.5 was 84% sensitive and 41% specific. At the cutoff of 1.5, the summary sensitivity and specificity were 49% and 84%, respectively. For cirrhosis, an APRI threshold of 1.0-1.5 was 54% sensitive and 78% specific. At the cutoff of 2.0, the summary sensitivity and specificity were 28% and 87%, respectively. Meta-regression analysis indicated that the APRI accuracy for both significant fibrosis and cirrhosis was affected by histological classification systems, but not influenced by the interval between Biopsy & APRI or blind biopsy.</p> <p>Conclusion</p> <p>Our meta-analysis suggests that APRI show limited value in identifying hepatitis B-related significant fibrosis and cirrhosis.</p

UK guideline on transition of adolescent and young persons with chronic digestive diseases from paediatric to adult care

The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section. Electronic searches for English-language articles were performed with keywords relating to digestive system diseases and transition to adult care in the Medline (via Ovid), PsycInfo (via Ovid), Web of Science and CINAHL databases for studies published from 1980 to September 2014. The quality of evidence and grading of recommendations was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The limited number of studies in gastroenterology and hepatology required the addition of relevant studies from other chronic diseases to be included. These guidelines deal specifically with the transition of AYP living with a diagnosis of chronic digestive disease and/or liver disease from paediatric to adult healthcare under the following headings; 1. Patient populations involved in AYP transition 2. Risks of failing transition or poor transition 3. Models of AYP transition 4. Patient and carer/parent perspective in AYP transition 5. Surgical perspectiv

Mycorrhizas in South American Anthropic Environments

The agricultural expansion has leaded to increase the irrigated cropland area and the use of fertilizers, resulting in water degradation, increased energy use, and common pollution. Of particular concern is the increased interest to reduce the environmental impacts of high quantities of water dedicated to irrigation by agricultural activities We are now truly recognizing the importance of sustainable measures in agriculture such as conservation of the vegetation cover and management approach to understand surface and deep soil responses to global change. The agroecology management based on key processes from natural ecosystems can help to solve some agricultural difficulties. Increasing studies on the Arbuscular mycorrhizal fungi (AMF) has showed their importance for soil ecology and studies on their biodiversity have spread in some agro-ecosystems such as corn and soybean monocultures. Therefore, it is needed to deeply study the mycorrhizal functions under global change. In this chapter, we examine the major developments and advances on mycorrhizal fungi based on recent research from South American countries. New reports on the occurrence of mycorrhizas in Amazonian dark earth, as well as the inoculum production of arbuscular mycorrhizal fungi native of soils under native forest covers, have resulted in a more detailed understanding of the soil biology from South America. Reports from Amazonian dark earth or “Terra preta do índio” soil has stimulated the use of biochar worldwide as a soil conditioner that can add value to non-harvested agricultural products and promote plant growth. Few reports from Brazil showed that the addition of inorganic fertilizer, compost and chicken manure resulted in increases in plant cover and plant species richness. In this sense, the biochar/mycorrhizae interactions also can be prioritized for sequestration of carbon in soils to contribute to climate change mitigation