140 research outputs found
Putting a Sooty Blotch-Flyspeck Warning System into Practice
A sooty blotch flyspeck (SBFS) warning system, developed in North Carolina and modified in Kentucky, extends the period between first-cover and second-cover fungicide sprays until a total of 175 hours of wetness has been measured in the orchard canopy. After second cover,sprays are made at 2-week intervals until harvest. In our replicated field experiments, the warning system was consistently as effective as calendar based spray timing in suppressing SBFS and other summer diseases (secondary scab and fruit rots). But in our demonstration trials in commercial orchards, the warning system resulted in commercially unacceptable levels of SBFS in 12 of 28 site-years
Prediction of Neonatal Birthweight associated with Maternal Obesity and Diabetes
Introduction: To design a model that will predict neonatal birth weight within obese mothers by diabetic status.
Methods: A secondary data analysis of an RCT (NCT 02909582) was utilized to create a neonatal birth weight prediction model. Women (n=325) with a BMI \u3e 35 kg/m2 from a tertiary academic institution, 2016 – 2019, were included to estimate the risk of large for gestational age (LGA) infants and neonatal birth weight based on maternal prepregnancy BMI and diabetic status. LGA was defined as an infant birth weight \u3e 90th percentile. Analysis included Chi-square, t-test, multivariate logistic and linear regression.
Results: Mean birthweight did not differ in obese mothers based on diabetic status. The frequency of large for gestational age infants was significantly greater for diabetic mothers (17% vs 7% without diabetes, p=0.024). Total pregnancy weight gain (continuous, lbs) (OR 1.03; 95% CI 1.01, 1.05; p=0.016) and pre-pregnancy BMI (continuous, OR 1.08; 95% CI 1.01, 1.15; p=0.018) were associated with the risk of LGA infants when accounting for demographics (model R2 = 0.074). The presence of diabetes (RR 146; 95% CI 24, 268; p=0.019), total weight gain (lbs) (RR 4; 95% CI 1, 7; p=0.015), and gestational age (RR 197; 95% CI 175, 220; p\u3c0.001) were associated with neonatal birth weight when accounting for demographics (model R2 = 0.550).
Discussion: These models incorporate the joint effects of maternal obesity and diabetic status in predicting neonatal birthweight, thereby enabling clinicians to counsel their high-risk patients on risk for large for gestational age infants
Effect of Extended-Duration Row Covers on Muskmelons
Row covers have traditionally been used to increase crop earliness, leading to earlier harvest dates and higher market prices. However, row covers can also provide added benefits in protecting against damage by certain insects. Cucurbit crops, especially muskmelon and cucumber, attract cucumber beetles, which vector bacterial wilt, causing significant crop losses
Experiences using a multidisciplinary model for treating injection drug use associated infections: A qualitative study
Background: Over the past two decades, the United States has experienced a dramatic increase in the rate of injection drug use, injection associated infections, and overdose mortality. A hospital-based program for treating opioid use disorder in people who inject drugs presenting with invasive infections was initiated at an academic tertiary care center in 2020. The goal of this program was to improve care outcomes, enhance patient experiences, and facilitate transition from the hospital to longer term addiction care. The purpose of this study was to interview two cohorts of patients, those admitted before vs. after initiation of this program, to understand the program\u27s impact on care from the patient\u27s perspective and explore ways in which the program could be improved.
Methods: Thirty patients admitted to the hospital with infectious complications of injection drug use were interviewed using a semi-structured format. Interviews were transcribed and coded. Emergent themes were reported. Limited descriptive statistics were reported based on chart review.
Results: Thirty interviews were completed; 16 participants were part of the program (admitted after program implementation) while 14 were not participants (admitted prior to implementation). Common themes associated with hospitalization included inadequate pain control, access to medications for opioid use disorder (MOUD), loss of freedom, stigma from healthcare personnel, and benefits of having an interprofessional team. Participants in the program were more likely to report adequate pain control and access to MOUD and many cited benefits from receiving care from an interprofessional team.
Conclusions: Patients with opioid use disorder admitted with injection related infections reported improved experiences when receiving care from an interprofessional team focused on their addiction. However, perceived stigma from healthcare personnel and loss of freedom related to hospitalization were continued barriers to care before and after implementation of this program
Contractile force is enhanced in Aortas from pendrin null mice due to stimulation of angiotensin II-dependent signaling.
Pendrin is a Cl-/HCO3- exchanger expressed in the apical regions of renal intercalated cells. Following pendrin gene ablation, blood pressure falls, in part, from reduced renal NaCl absorption. We asked if pendrin is expressed in vascular tissue and if the lower blood pressure observed in pendrin null mice is accompanied by reduced vascular reactivity. Thus, the contractile responses to KCl and phenylephrine (PE) were examined in isometrically mounted thoracic aortas from wild-type and pendrin null mice. Although pendrin expression was not detected in the aorta, pendrin gene ablation changed contractile protein abundance and increased the maximal contractile response to PE when normalized to cross sectional area (CSA). However, the contractile sensitivity to this agent was unchanged. The increase in contractile force/cross sectional area observed in pendrin null mice was due to reduced cross sectional area of the aorta and not from increased contractile force per vessel. The pendrin-dependent increase in maximal contractile response was endothelium- and nitric oxide-independent and did not occur from changes in Ca2+ sensitivity or chronic changes in catecholamine production. However, application of 100 nM angiotensin II increased force/CSA more in aortas from pendrin null than from wild type mice. Moreover, angiotensin type 1 receptor inhibitor (candesartan) treatment in vivo eliminated the pendrin-dependent changes contractile protein abundance and changes in the contractile force/cross sectional area in response to PE. In conclusion, pendrin gene ablation increases aorta contractile force per cross sectional area in response to angiotensin II and PE due to stimulation of angiotensin type 1 receptor-dependent signaling. The angiotensin type 1 receptor-dependent increase in vascular reactivity may mitigate the fall in blood pressure observed with pendrin gene ablation
Neutrophilic Panniculitis Associated With Myelodysplastic Syndrome/Myeloproliferative Neoplasm: A Case Report and Literature Review
INTRODUCTION: Neutrophilic panniculitis (NP) is a rare subtype of neutrophilic dermatosis, a group of neutrophil-rich inflammatory skin disorders that can present in association with myeloid neoplasms. NP is defined by the presence of a neutrophilic infiltrate in the fat lobules of the subcutis in the absence of either infection or vasculitis. We herein describe a 65-year-old woman with a recent diagnosis of myelodysplastic syndrome/myeloproliferative neoplasm overlap syndrome (MDS/MPN) who abruptly developed painful, pruritic nodules consistent with NP.
CASE PRESENTATION: A 65-year-old woman with MDS/MPN presented for evaluation of painful and pruritic nodules on her upper and lower extremities. A biopsy revealed a lobular neutrophilic infiltrate in the subcutis without evidence of microorganisms or vasculitis. The patient was diagnosed with NP and treated with oral prednisone. Within 1 month of treatment, she reported complete resolution of the nodules.
DISCUSSION: Similar to other neutrophilic dermatoses, NP may arise in association with hematologic malignancies of myeloid origin, such as MDS/MPN. A literature review revealed that most cases of NP associated with MDS occur after the onset of MDS and respond to systemic corticosteroids, not antibiotics. Infection should be ruled out before initiating treatment with systemic steroids.
CONCLUSION: Although the mechanism is still unknown, it is important for clinicians to be aware that NP is associated with MDS; thus, hematological malignancies should be investigated upon diagnosis of NP. Once diagnosed, NP is easily treated and has an excellent response to systemic corticosteroids
Atezolizumab-Induced Psoriasiform Drug Eruption Successfully Treated with Ixekizumab: A Case Report and Literature Review
Immune-related cutaneous adverse events (ircAE) are commonly seen with immune checkpoint inhibitors such as atezolizumab. Atezolizumab-induced psoriasis has been previously reported as an ircAE, especially in patients with pre-existing psoriasis. The severity of the reaction influences treatment of the cutaneous eruption. Biologics should be considered as a treatment option for severe refractory psoriasiform eruptions even in patients with complex medical conditions like chronic infections and malignancy. This is the first reported case of successful treatment of atezolizumab-induced psoriasiform eruption with ixekizumab, a neutralizing IL17A monoclonal antibody, to the best of our knowledge. Herein, we present a 63-year-old man with a history of human immunodeficiency virus and psoriasis who presented with atezolizumab-induced psoriasiform eruption while being treated for metastatic hepatocellular carcinoma. After initiating ixekizumab, atezolizumab was restarted without cutaneous eruption
Chlormethine Gel in Combination With Other Therapies for Treatment of Mycosis Fungoides: A Review With Patient Cases
Topical chlormethine gel has been approved as monotherapy for treatment of adult patients with mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma. In clinical practice, chlormethine gel is often combined with other skin-directed or systemic therapies to optimize response and target recalcitrant lesions. Positive outcomes with combination regimens using chlormethine gel and topical corticosteroids, phototherapy, retinoids, methotrexate, or interferon-α have been reported in literature. However, there are no treatment guidelines on the use of combination regimens with chlormethine gel. To provide real-world evidence and guidance on the use of chlormethine gel combination regimens, several cases of patients treated with chlormethine gel combined with phototherapy (n = 5), retinoids (n = 16), or mogamulizumab (n = 3) are presented. These different combination regimens showed promising results. Most patients had a complete or partial response following treatment and the combinations were well-tolerated over extended treatment periods. Patients receiving chlormethine gel with retinoids had long-term periods of remission, even after treatment discontinuation. Durations of response of up to 3 years were observed in these patients. This long-term disease control may be the result of disease-modifying effects of chlormethine. Previous studies have shown targeted reductions in malignant T-cell clones in patients treated with chlormethine gel as well as improved post-treatment responses. Further research is needed to determine the effectiveness and safety of combination treatment regimens with chlormethine gel and to assess the impact chlormethine gel has on disease control
Recruitment and Retention of Underrepresented Populations in Alzheimer’s Disease Research: A Systematic Review
Introduction: Alzheimer’s disease and related dementias (ADRD) disproportionately impact racial
and ethnic minority and socioeconomically disadvantaged adults. Yet, these populations are significantly
underrepresented in research.
Methods: We systematically reviewed the literature for published reports describing recruitment and
retention of individuals from underrepresented backgrounds in ADRD research or underrepresented
participants’ perspectives regarding ADRD research participation. Relevant evidence was synthesized
and evaluated for quality.
Results: We identified 22 eligible studies. Seven studies focused on recruitment/retention approaches,
all of which included multifaceted efforts and at least one community outreach component.
There was considerable heterogeneity in approaches used, specific activities and strategies, outcome
measurement, and conclusions regarding effectiveness. Despite limited use of prospective evaluation
strategies, most authors reported improvements in diverse representation in ADRD cohorts. Studies
evaluating participant views focused largely on predetermined explanations of participation
including attitudes, barriers/facilitators, education, trust, and religiosity. Across all studies, the
strength of evidence was low.
Discussion: Overall, the quantity and quality of available evidence to inform best practices in recruitment,
retention, and inclusion of underrepresented populations in ADRD research are low. Further
efforts to systematically evaluate the success of existing and emergent approaches will require
improved methodological standards and uniform measures for evaluating recruitment, participation,
and inclusivity
- …