Status of IPM Practice Adoption in Vermont Apple Orchards in 2017

Apples are among the most important agricultural crops produced in Vermont. Despite research on and advances in IPM implementation in northeastern U.S. apple systems, pesticide applications remain a primary practice. Adoption of IPM implementation by Vermont apple growers was evaluated in a 2017 survey. Questions covered topics including farm demographics, self-reporting of IPM knowledge and status, relative importance of arthropod posts and diseases, practices that impact pollinators and crop pollination, use of electronic IPM decision support systems, scouting practices used in orchards, and tolerance of pest damage on fruit sold to alternative markets. Respondents reported apple scab (Venturia inaequalis ((Cooke) Wint.) and fire blight (Erwinia amylovora (Burrill)) as their most important diseases and apple maggot (Rhagoletis pomonella (Walsh)) and codling moth (Cydia pomonella (L.)) insect pests of concern. A mean 10.9 and 5.7 fungicide and insecticide applications were made to manage pests and diseases. Growers reported high adoption of pollinator protection practices, and over half of respondents reported reliance of wild pollinators. All respondents used the regional NEWA decision support system and rated its usefulness highly overall. However, on-farm pest monitoring programs showed lower levels of adoption, and respondents indicated a lack of comfort with protocols for monitoring certain key pests. Survey response information may be useful in tailoring educational and outreach materials to improve IPM practice adoption and reduce grower risk

On-Farm New England Hemp Pest & Disease Scouting Report

A survey of arthropod pests and disease was conducted on farms throughout the Northeast during the 2021 field season to qualify the species composition of disease and insect pests on industrial hemp. Hemp is a non-psychoactive variety of cannabis sativa L. The crop is one of historical importance in the U.S. and reemerging in worldwide importance as manufacturers seek hemp as a renewable and sustainable resource for a wide variety of consumer and industrial products. Today, industrial hemp is re-emerging as a locally grown product in the U.S. There is little information on insect pests and diseases of industrial hemp in the Northeast, and this survey was intended to help identify common pests that growers may encounter. Participation in the scouting program allowed growers to develop scouting schedules and become effective in disease and insect identification and management, leading to higher quality crops

The efficacy and non-target impacts of an organic disease management system containing biostimulants compared with two sulfur-based systems on four apple cultivars in Vermont

Disease management in organic apple orchards in Vermont is focused on controlling diseases with sulfur fungicides. The objective of this two year study was to evaluate the target and non-target effects of an organic disease management system containing agricultural biostimulants compared to two sulfur-based systems on foliar and fruit diseases, pest and beneficial arthropods, tree growth, yield and fruit quality on four cultivars, `Ginger Gold\u27, `Honeycrisp\u27 and `Liberty\u27 and `Zestar!\u27. Trees were arranged in a complete randomized design of five three-tree replications in a certified organic orchard. The two sulfur-based systems differed in the number of applications; in the third system, sulfur was replaced with biostimulants including pure neem oil, liquid fish, an activated microbial inoculant plus equisetum and stinging nettle teas. Each biostimulant application also included kelp meal, unsulfured organic molasses and yucca extract emulsifier. The biostimulant system did not successfully manage apple scab and rust diseases as well as the sulfur-based fungicide systems, and had variable results with other diseases. No differences were observed among the three systems in tree growth parameters; however, the length of the study may not have been sufficient to determine effects. Differences in the incidence of disease among the three systems were reflected in extrapolated figures for gross income per hectare which takes into account fruit yield and quality. In the higher fruit-bearing year of the study, it was estimated that the gross income per hectare of the biostimulant system would be significantly lower than the reduced-sulfur system and the full-sulfur system by at least $5,800 and$12,000, respectively. In that same year, it is estimated that the full-sulfur system would have generated approximately $6,500 more gross income per hectare than the reduced-sulfur system suggesting the number of sulfur sprays can influence fruit quality and income. The use of the agricultural biostimulants had very limited non-target effects and when present, they were beneficial in suppressing insect pest incidence and/or damage on foliage compared to one or both of the sulfur-based fungicide systems. However, many insect pests or their damage were not observed on the foliage or had incidence of less than 1% in any of the systems. The biostimulant system did appear to suppress European red mites in both years compared to both sulfur-based systems when data were averaged across cultivars. On fruit, no differences in non-target impacts on arthropod pests were observed among the three systems except for surface-feeding Lepidoptera and San Jose scale damage. In a separate phytophagous mite study on the cultivar `Zestar!\u27 leaf samples were evaluated for the number of motile phytophagous mites every 14 days from 1 July through 26 August each year. When there were differences, the biostimulant system had less mite incidence per leaf than one or both of the sulfur-based systems in both years. The difference in the number of sulfur sprays did not have a major effect on the mite populations. In summary, the use of the biostimulant system resulted in insufficient disease management which led to lower estimated gross income compared to the sulfur-based systems. These results show more research and further evaluation of new organic disease management tools, including the use of agricultural biostimulants, are necessary before growers consider replacing the use of standard sulfur fungicides for disease management in Vermont orchards

The Role of the Pharmacy Team in Atrial Fibrillation Detection in Nonclinical Settings

Atrial Fibrillation (AF) is a common cardiac/heart disease that increases a person’s risk of death, making early identification significant in overall disease management. Throughout my time in pharmacy school, I [Brian] have developed an interest in cardiology and research. During my last year of pharmacy school, I spent eight weeks at St. Bartholomew’s Hospital, in London, England, one of the largest cardiac centers within Europe, on an experiential training experience. While there, I had the opportunity to study specifics about many cardiac illnesses, with a focus on atrial fibrillation, and provide education to patients living with this disease. In addition to working with patients and expanding my knowledge, I participated in an exciting research project that allowed me to connect with the general population and share my knowledge about arrhythmias, which is something I’d like to continue to do after graduation. Our research project aimed to identify the role pharmacists could play in early detection of arrhythmias, particularly atrial fibrillation, and increase the population’s awareness and understanding of this illness. For our project, a pharmacist or student pharmacist was partnered with nursing staff to provide opportunities for heart rate and rhythm monitoring as well as individualized education to help ensure interested patients were more aware of the risks, signs, and symptoms of atrial fibrillation going forward. When patients met with the team, they had their heart rhythms assessed using the AliveCor Kardia ™ single-lead electrocardiogram (ECG) system. This new technology allows patients to place their fingers on a small strip that is able to accurately assess a person’s heart rate and rhythm to identify any irregularities/arrhythmias. Participants were also provided education about atrial fibrillation in hopes of preventing significant morbidity and mortality, raising awareness about this particular disease and connecting patients with care. Part of this education included us showing the patients how to manually take an accurate pulse reading, and how to differentiate between a normal and irregular rate and rhythm. By teaching the patients these skills, they now know what to look for, how to monitor their own pulse, and when to seek help in the event they, or someone they know, experience symptoms of atrial fibrillation

Hybrid endoscopic thymectomy : combined transesophageal and transthoracic approach in a survival porcine model with cadaver assessment

BACKGROUND: Video-assisted thoracoscopic surgery thymectomy has been used in the treatment of Myastenia Gravis and thymomas (coexisting or not). In natural orifice transluminal endoscopic surgery, new approaches to the thorax are emerging as alternatives to the classic transthoracic endoscopic surgery. The aim of this study was to assess the feasibility and reliability of hybrid endoscopic thymectomy (HET) using a combined transthoracic and transesophageal approach. METHODS: Twelve consecutive in vivo experiments were undertaken in the porcine model (4 acute and 8 survival). The same procedure was assessed in a human cadaver afterward. For HET, an 11-mm trocar was inserted in the 2nd intercostal space in the left anterior axillary line. A 0° 10-mm thoracoscope with a 5-mm working channel was introduced. Transesophageal access was created through a submucosal tunnel using a flexible gastroscope with a single working channel introduced through the mouth. Using both flexible (gastroscope) and rigid (thoracoscope) instruments, the mediastinum was opened; the thymus was dissected, and the vessels were ligated using electrocautery alone. RESULTS: Submucosal tunnel creation and esophagotomy were performed safely without incidents in all animals. Complete thymectomy was achieved in all experiments. All animals in the survival group lived for 14 days. Thoracoscopic and postmortem examination revealed pleural adhesions on site of the surgical procedure with no signs of infection. Histological analysis of the proximal third of the esophagus revealed complete cicatrization of both mucosal defect and myotomy site. In the human cadaver, we were able to replicate all the procedure even though we were not able to identify the thymus. CONCLUSIONS: Hybrid endoscopic thymectomy is feasible and reliable. HET could be regarded as a possible alternative to classic thoracoscopic approach for patients requiring thymectomy.This project was funded by the FCT Grants project PTDC/SAU-OSM/105578/2008

Intra aortic balloon pump: literature review of risk factors related to complications of the intraaortic balloon pump

The increasing use of the intra aortic balloon pump is attributed to the relatively easy percutaneous insertion and the low threshold of use over the past few years, especially in elderly patients with multi-vessel diseases and an affected ejection fraction

Several clinical interests regarding lung volume reduction surgery for severe emphysema: meta-analysis and systematic review of randomized controlled trials

<p>Abstract</p> <p>Objectives</p> <p>We aim to address several clinical interests regarding lung volume reduction surgery (LVRS) for severe emphysema using meta-analysis and systematic review of randomized controlled trials (RCTs).</p> <p>Methods</p> <p>Eight RCTs published from 1999 to 2010 were identified and synthesized to compare the efficacy and safety of LVRS vs conservative medical therapy. One RCT was obtained regarding comparison of median sternotomy (MS) and video-assisted thoracoscopic surgery (VATS). And three RCTs were available evaluating clinical efficacy of using bovine pericardium for buttressing, autologous fibrin sealant and BioGlue, respectively.</p> <p>Results</p> <p>Odds ratio (95%CI), expressed as the mortality of group A (the group underwent LVRS) versus group B (conservative medical therapies), was 5.16(2.84, 9.35) in 3 months, 3(0.94, 9.57) in 6 months, 1.05(0.82, 1.33) in 12 months, respectively. On the 3^rd, 6^thand 12^thmonth, all lung function indices of group A were improved more significantly as compared with group B. PaO2 and PaCO2 on the 6^thand 12^thmonth showed the same trend. 6MWD of group A on the 6^thmonth and 12^thmonth were improved significantly than of group B, despite no difference on the 3^rdmonth. Quality of life (QOL) of group A was better than of group B in 6 and 12 months. VATS is preferred to MS, due to the earlier recovery and lower cost. And autologous fibrin sealant and BioGlue seems to be the efficacious methods to reduce air leak following LVRS.</p> <p>Conclusions</p> <p>LVRS offers the more benefits regarding survival, lung function, gas exchange, exercise capacity and QOL, despite the higher mortality in initial three postoperative months. LVRS, with the optimization of surgical approach and material for reinforcement of the staple lines, should be recommended to patients suffering from severe heterogeneous emphysema.</p

Perioperative outcome of laparoscopic left lateral liver resection is improved by using a bioabsorbable staple line reinforcement material in a porcine model

Hypothesis Laparoscopic liver surgery is significantly limited by the technical difficulty encountered during transection of substantial liver parenchyma, with intraoperative bleeding and bile leaks. This study tested whether the use of a bioabsorble staple line reinforcement material would improve outcome during stapled laparoscopic left lateral liver resection in a porcine model. Study design A total of 20 female pigs underwent stapled laparoscopic left lateral liver resection. In group A (n = 10), the stapling devices were buttressed with a bioabsorbable staple line reinforcement material. In group B (n = 10), standard laparoscopic staplers were used. Operative data and perioperative complications were recorded. Necropsy studies and histopathological analysis were performed at 6 weeks. Data were compared between groups with the Student's t-test or the chi-square test. Results Operating time was similar in the two groups (64 +/- 11 min in group A versus 68 +/- 9 min in group B, p = ns). Intraoperative blood loss was significantly higher in group B (185 +/- 9 mL versus 25 +/- 5 mL, p <0.05). There was no mortality. There was no morbidity in the 6-week follow-up period; however, two animals in group B had subphrenic bilomas (20%) at necropsy. At necropsy, methylene blue injection via the main bile duct revealed leakage from the biliary tree in four animals in group B and none in group A (p <0.05). Histopathological examination of the resection site revealed minor abnormalities in group A while animals in group B demonstrated marked fibrotic changes and damaged vascular and biliary endothelium. Conclusion Use of a bioabsorbable staple line reinforcement material reduces intraoperative bleeding and perioperative bile leaks during stapled laparoscopic left lateral liver resection in a porcine model