Susceptibility of Alabama argillacea and Chrysodeixis includens (Lepidoptera: Noctuidae) larvae to Beauveria bassiana associated with kaolin / Susceptibilidade de larvas de Alabama argillacea e Chrysodeixis includens (Lepidoptera: Noctuidae) a Beauveria bassiana associada com caulim

Abstract The mortality of the Alabama argillacea and Chrysodeixis includens (Lepidoptera: Noctuidae) larvae caused by the kaolin inert powder and the entomopathogenic fungus Beauveria bassiana were determined under laboratory conditions. Using the caterpillar submersion method, the CG 138 B. bassiana isolate was more pathogenic to A. argillacea than the CG 70, GC 82, ESALQ 634, and ESALQ 645. All five tested isolates caused similar mortality of C. includens. The mortality of first-instar larvae of A. argillacea and C. includens by feeding on leaf-disc impregnated with B. bassiana (CG 138) and kaolin was also determined. Higher A. argillacea mortalities were observed in the B. bassiana (CG 138) treatments, regardless of the presence of kaolin. However, the activity of kaolin + B. bassiana (CG 138) against C. includens was higher than each ingredient alone, indicating an additive action against C. includes larvae. The mortality of A. argillacea and C. includens larvae treated with kaolin + B. bassiana (CG 138) was similar, and the A. argillacea mortality was higher than that of C. includens with kaolin and B. bassiana (GC 138) separated. The treatment kaolin + B. bassiana (CG 138) is promising for the simultaneous management of these two defoliator pests, mainly A. includes. In addition, the monophagous A. argillacea is more susceptible to both kaolin and B. bassiana (GC 138) than the polyphagous C. includens, suggesting that the nutritional ecology plays an important role in the susceptibility of these defoliator species to alternative insecticides.

Resumo A mortalidade de larvas de Alabama argillacea e Chrysodeixis includens (Lepidoptera: Noctuidae), causada pelo pó inerte do caulim e pelo fungo entomopatogênico Beauveria bassiana, foi determinada em condições de laboratório. Usando o método de submersão da lagarta, o isolado CG 138 de B. bassiana foi mais patogênico para A. argillacea que os CG 70, GC 82, ESALQ 634 e ESALQ 645 desse fungo. Os cinco isolados testados causaram mortalidade semelhante de C. includens. A mortalidade de larvas de primeiro ínstar de A. argillacea e C. includens pelo método de alimentação em discos foliares impregnados com B. bassiana (CG 138) e caulim foi, também, determinada. A mortalidade de A. argillacea foi maior nos tratamentos com B. bassiana (CG 138), independentemente da presença do caulim. A atividade do caulim + B. bassiana (CG 138) contra C. includens foi maior que cada ingrediente isolado, indicando ação aditiva contra larvas desse Lepidoptera. A mortalidade de larvas de A. argillacea e C. includens, com caulim + B. bassiana (CG 138), foi semelhante e as de A. argillacea maiores que as de C. includens com caulim e B. bassiana (GC 138) isoladamente. O tratamento caulin + B. bassiana (CG 138) é promissor para o manejo simultâneo dessas duas pragas desfolhadoras, principalmente A. includens. Além disso, a monófaga, A. argilacea, é mais suscetível ao caulim e à B. bassiana (GC 138) que a polífaga, C. includens, sugerindo que a ecologia nutricional desempenha papel importante na suscetibilidade dessas espécies desfolhadoras a inseticidas alternativos.

Attitudes toward rehabilitating inmates among occupational therapy students in the United States / 보건의료교육평가

PURPOSE: This study was to examine occupational therapy (OT) students' attitudes toward rehabilitating inmates and validate an instrument used to measure their attitudes. METHODS: OT students (n=128) from one university in Alabama, United States, completed an online survey exploring their attitudes toward rehabilitating inmates, which was assessed using the Rehabilitation Orientation Scale (ROS), a 7-point scale. Dimensional structure, internal consistency reliability, construct validity, and relations to other variables of the ROS was evaluated using factor analyses, Cronbach's alpha, known-groups method, and univariable correlations, respectively. RESULTS: Unidimensionality of the ROS was confirmed with an alpha coefficient of 0.90. The mean ROS score of the respondents was 5.1; a score toward 7 indicated a more supportive attitude. About 60% of the respondents reported supportive attitudes (i.e., an ROS score ≥5). Respondents' ROS scores were significantly higher than those of the public and criminal justice professionals. Female students reported a more supportive attitude than males. Multiple regression analysis indicated that respondents' consideration of working in prison settings after graduation and their perception that OT has a role in prison settings were significantly associated with support for rehabilitating inmates, after controlling for gender and an acquaintance with someone who has been incarcerated. CONCLUSION: Results indicated that the ROS demonstrated adequate psychometric properties as it applied to this population. The majority of respondents reported supportive attitudes toward rehabilitating inmates. Consideration of working in prison settings after graduation and the perception that OT has a role in prison settings were 2 independent factors associated with respondents' attitudes toward rehabilitating inmates.

Follow-up of infants with congenital hypothyroidism and low total thyroxine/thyroid stimulating hormone on newborn screen

PURPOSE: Newborn screening (NBS) methods to detect congenital hypothyroidism (CH) vary regarding whether total thyroxine (T4), thyroid stimulating hormone (TSH), or both are measured. Neonates with low T4 and normal or low TSH (lowT4/TSH) may only be detected by T4-inclusive methods or age-dependent repeat screens. Premature neonates and those with pituitary-hypothalamic disorders frequently manifest lowT4/TSH.METHODS: This is a retrospective case-study of newborns who were screen-positive for lowT4/TSH in Alabama in 2009–2016 using a combined T4 and TSH method and 2 routine NBS. The clinical, laboratory, and final diagnosis after 3 years were determined.RESULTS: Over 8 years, 225 infants were referred to our institution for evaluation and treatment of CH. Twelve infants were screen-positive for lowT4/TSH by first or second NBS. Four of the 12 infants had permanent CH (30%): 2 with primary and 2 with central etiologies. One infant with moderately severe central CH was only detected by the routine second NBS. Six of 7 premature infants had elevated TSH on serum confirmation labs consistent with a delay in hypothalamic-pituitary maturation, yet 2 of these patients were later established to have permanent primary CH. While most cases of lowT4/TSH resolved by 3 years of age, several neonates had extended periods of moderate to severe hypothyroxinemia prior to detection and treatment.CONCLUSION: One third of the infants with lowT4/TSH on NBS in this study had permanent CH. These results emphasize the importance of T4-based assay methods, subsequent (repeat) screens and long-term follow-up in the management of neonates with lowT4/TSH on newborn screen.

Seroprevalence of Opsonophagocytic Antibodies against Serotype Ia, Ib, II, III, and V Group B Streptococcus among Korean Population

BACKGROUND: Invasive Streptococcus agalactiae (group B streptococcus, GBS) infection most commonly occurs in infants; however, cases of GBS infection in adults, particularly in the elderly with significant underlying diseases, are being increasingly reported. We analyzed the serotype specific opsonophagocytic antibodies (the major mechanism of protection against GBS) in infants, adults, and the elderly. METHODS: The opsonization indices (OIs) of antibodies against serotype Ia, Ib, II, III, and V GBS were studied in 89 infants, 35 adults (age, 30–50 years), and 62 elderly individuals (age, 65–85 years) according to the University of Alabama at Birmingham GBS opsonophagocytic killing assay protocol (www.vaccine.uab.edu). RESULTS: In infants, adults, and elderly groups respectively, geometric mean of OI against GBS serotype Ia were 3, 7, and 32; against GBS serotype Ib were 7, 242, and 252; against serotype II were 93, 363, and 676; against serotype III were 8, 212, and 609; and against serotype V were 4, 639, and 610. The seropositive rate (% of subjects with OI ≥ 4) increased significantly in older age group for all five serotypes. CONCLUSION: During infancy, only a limited proportion of infants have functional immunity against serotype Ia, Ib, II, III, and V GBS. Furthermore, a lack of opsonic activities against GBS observed in some adults and the elderly might predispose such individuals to the risk of invasive GBS infection. Epidemiological monitoring and development of suitable vaccine for these populations are needed.

Historical Origins of the Tuskegee Experiment: The Dilemma of Public Health in the United States / 의사학

The Tuskegee Study of Untreated Syphilis in the Negro Male was an observational study on African-American males in Tuskegee, Alabama between 1932 and 1972. The U. S. Public Health Service ran this study on more than 300 people without notifying the participants about their disease nor treating them even after the introduction of penicillin. The study included recording the progress of disease and performing an autopsy on the deaths. This paper explores historical backgrounds enabled this infamous study, and discusses three driving forces behind the Tuskegee Study. First, it is important to understand that the Public Health Service was established in the U. S. Surgeon General's office and was operated as a military organization. Amidst the development of an imperial agenda of the U.S. in the late 19th and early 20th centuries, the PHS was responsible for protecting hygiene and the superiority of “the American race” against infectious foreign elements from the borders. The U.S. Army's experience of medical experiments in colonies and abroad was imported back to the country and formed a crucial part of the attitude and philosophy on public health. Secondly, the growing influence of eugenics and racial pathology at the time reinforced discriminative views on minorities. Progressivism was realized in the form of domestic reform and imperial pursuit at the same time. Major medical journals argued that blacks were inclined to have certain defects, especially sexually transmitted diseases like syphilis, because of their prodigal behavior and lack of hygiene. This kind of racial ideas were shared by the PHS officials who were in charge of the Tuskegee Study. Lastly, the PHS officials believed in continuing the experiment regardless of various social changes. They considered that black participants were not only poor but also ignorant of and even unwilling to undergo the treatment. When the exposure of the experiment led to the Senate investigation in 1973, the participating doctors of the PHS maintained that their study offered valuable contribution to the medical research. This paper argues that the combination of the efficiency of military medicine, progressive and imperial racial ideology, and discrimination on African-Americans resulted in the Tuskegee Syphilis Experiment.

Establishment and Application of a Multibead Serotyping Assay for Pneumococci in Korea

PURPOSE: Serotyping pneumococcal isolates is important to monitor efficacy of pneumococcal vaccines. Because of difficulties of typing pnueumocci, a multiplex bead-based (multibead) serotyping assay was recently introduced. The aim of this study is to establish a new multibead serotyping assay and to apply this method to analyze clinical isolates of pneumococci in Korea. METHODS: To establish the multibead serotyping assay, six key reagents were transferred from University of Alabama at Birmingham (UAB) to Ewha Center for Vaccine Evaluation and Study (ECVES): bead set coated with polysaccharide and monoclonal antibody pool were used in one multiplex inhibition-type immunoassay and 2 bead sets coated DNA probe and 2 primer pools were used in two multiplex PCR-based assays. After multibead serotyping assay was set up, 75 test samples of pneumococci were analyzed whether ECVES is able to identify serotype correctly. After confirming the performance, serotyping assay was applied to identify serotypes of 528 clinical isolates of pneumococci collected from 3 different hospitals. RESULTS: After establishment of the multibead pneumococcal serotyping assay system at ECVES, 75 test samples were analyzed. There was no discrepancy of serotypes of 75 test samples between the results assigned at UAB and those at ECVES. The serotypes of 528 pneumococci isolated from patients or healthy subjects were determined in 94.3% of isolates (498/528). CONCLUSIONS: The multibead pneumococcal serotyping assay can be successfully established in Korea. With this method, surveillance of serotypes of pneumococci isolated from patients as well as healthy subjects could be studied.

United States medical students' knowledge of Alzheimer disease / 보건의료교육평가

PURPOSE: A knowledge gap exists between general physicians and specialists in diagnosing and managing Alzheimer disease (AD). This gap is concerning due to the estimated rise in prevalence of AD and cost to the health care system. Medical school is a viable avenue to decrease the gap, educating future physicians before they specialize. The purpose of this study was to assess the knowledge level of students in their first and final years of medical school. METHODS: Fourteen participating United States medical schools used e-mail student rosters to distribute an online survey of a quantitative cross-sectional assessment of knowledge about AD; 343 students participated. Knowledge was measured using the 12-item University of Alabama at Birmingham AD Knowledge Test for Health Professionals. General linear models were used to examine the effect of demographic variables and previous experience with AD on knowledge scores. RESULTS: Only 2.5% of first year and 68.0% of final year students correctly scored ten or more items on the knowledge scale. Personal experience with AD predicted higher knowledge scores in final year students (P=0.027). CONCLUSION: Knowledge deficiencies were common in final year medical students. Future studies to identify and evaluate the efficacy of AD education programs in medical schools are warranted. Identifying and disseminating effective programs may help close the knowledge gap.

Effects of short-term sediment nutrient enrichment and grazer (Neritina reclivata) removal on sediment microalgae in a shallow eutrophic estuary (Alabama, USA)

The olive snail (Neritina reclivata) is ubiquitous in tropical and sub-tropical systems of the Gulf of Mexico, however its impacts on sediment microalgae have been little studied. Many coastal systems around the world are being eutrophied due to human activities, and seemingly they will continue to be eutrophied to a further extent in the future. Exploring the single and combined impacts of further nutrient enrichment and grazing by the olive snail on sediment microalgae in such eutrophic systems is an important question for our understanding and management of these systems. Here we examine the effects of short-term nutrient enrichment and grazing by the olive snail N. reclivata on sediment microalgal biomass and composition in a shallow eutrophic estuary (Weeks Bay, Alabama, USA) of the Northern Gulf of Mexico. For this, we performed a series of factorial experiments adding or not nutrients and removing or not the snail, for a total of four treatments in each experiment: ambient grazing, ambient nutrients; ambient grazing, increased nutrients; no grazing, ambient nutrients; and no grazing, increased nutrients. We did not find any significant impact of nutrient addition in any of the eight short-term (i.e. four days) experiments carried out. Impacts by the snail were minor; we only found a decrease in biomass due to snail grazing in one of the eight experiments, and no impacts on microalgal (i.e. diatom) composition. High ambient nutrient concentrations in the sediment porewater and low snail abundances on the sediment could explain these findings. Our results suggest that ephemeral, short-term nutrient pulses into eutrophic coastal systems of the Northern Gulf of Mexico, such as Weeks Bay (Alabama, USA), should not greatly affect the abundance of sediment microalgae, even though those pulses occur in well-lit areas. The results further suggest the snail N. reclivata is not a major control of sediment microalgal populations in the subtidal sedimentary areas studied. Our findings contrast with the results of past work in sediments with well-lit and nutrient poor conditions, or sediments with high densities of other snail grazers. In conjunction this and other investigations indicate that the response of sediment microalgae to nutrient enrichment and modified grazer abundance depends to a large extent on the initial levels of nutrient availability and grazing before the system is altered.

El caracol Neritina reclivata está presente en los sistemas tropicales y subtropicales del Golfo de México, sin embargo, su impacto en los sedimentos de microalgas ha sido poco estudiado. Muchos de los sistemas costeros de todo el mundo están siendo eutrofizados debido a actividades humanas, y al parecer van a seguir siendo eutrofizados en mayor grado en el futuro. La exploración de los efectos individuales y combinados de un mayor enriquecimiento de nutrientes y la herviboría por este caracol en microalgas de sedimentos en estos sistemas eutróficos es una cuestión importante para la comprensión y el manejo de estos sistemas. Aquí se examinan los efectos a corto plazo del enriquecimiento de nutrientes y herviboría del caracol de olivo sobre la biomasa y composición de microalgas de sedimentos en un estuario eutrófico superficial (Weeks Bay. Alabama, USA) del norte del Golfo de México. Para esto se llevaron a cabo una serie de experimentos factoriales añadiendo o no nutrientes y removiendo o no el caracol, para un total de cuatro tratamientos en cada experimento: ambiente con herviboría sin nutrimentos añadidos, ambiente con herviboría y nutrimentos añadidos, ambiente sin herviboría sin nutrimentos añadidos, y ambiente sin herviboría con nutrimentos añadidos. No se encontró ningún impacto significativo por la adición de nutrimentos en ninguno de los ocho experimentos a corto plazo (i.e. cuatro días). Los impactos debidos al caracol fueron menores, sólo se encontró un decrecimiento en la biomasa por herviboría del caracol en uno de los ocho experimentos, y no hubo impacto en la composición de microalgas (i.e. diatomeas). Ambientes con alta concentración de nutrimentos del sedimento y baja abundancia del caracol sobre el sedimento pueden explicar estos resultados. Los resultados obtenidos sugieren que pulsos efímeros y de corto plazo en sistemas costeros eutrofizados del Norte del Golfo de México tal como Weeks Bay (Alabama, USA), no deberían afectar de gran manera la abundancia de microalgas sobre el sedimento, a pesar de que los pulsos ocurran en áreas bien iluminadas. Además los resultados sugieren que el caracol N. reclivata no ejerce mayor control sobre las poblaciones de microalgas en las áreas submareales y sedimentarias estudiadas. Nuestros hallazgos contrastan con resultados de trabajos anteriores en sedimentos con buena iluminación y pobres condiciones nutritivas, o sedimentos con altas densidades de otros caracoles herbívoros. En conjunto, esta y otras investigaciones indican que la respuesta de microalgas en sedimentos al enriquecimiento de nutrientes y abundancia modificada de herbívoros depende en gran medida de los niveles iniciales de disponibilidad de nutrientes y herviboría antes de que el sistema se vea alterado.

Muscle-Specific Receptor Tyrosine Kinase Antibody Positive Myasthenia Gravis Current Status

Muscle-specific tyrosine-kinase-antibody-positive myasthenia gravis (MuSK-MG) has emerged as a distinct entity since 2001. This disease has been reported worldwide, but with varying rates among patients with generalized acetylcholine-receptor-antibody-negative MG. MuSK-MG was detected in approximately 37% of generalized acetylcholine receptor antibody-negative MG. MuSK-MG patients were predominantly female with more prominent facial and bulbar involvement and more frequent crises. Disease onset tended to be earlier. Patients tended to have a relatively poor edrophonium response but showed prominent decrement in the repetitive nerve stimulation test in the facial muscles. Patients were more likely to display poor tolerance of, or a lack of improvement with, anticholinesterase agents. Somewhat better response was observed with steroids and plasma exchange. Most were managed successfully with aggressive immunomodulatory therapies, although a higher proportion of MuSK-MG patients had a refractory course when compared with other forms of generalized MG. I present here an up-to-date overview on MuSK-MG based on our experience at the University of Alabama at Birmingham and the existing literature.

An overview of reported youth violence in Puerto Rico

OBJECTIVES: The purpose of this paper is to describe the prevalence of school and youth violence in Puerto Rico based on several representative samples surveyed in the Island during the 1990's. BACKGROUND: Reviewing the available data on youth violence is necessary in order to decide the best strategies to follow in developing new ways to prevent and monitor it. METHODS: Three surveys were reviewed in this paper: The Youth Risk Behavior Survey conducted by the Center for Disease Control (1991, 1995, 1997); The Methods for the Epidemiology of Child and Adolescent Mental Disorders Study (1991); and the Youth Survey (1997-98). RESULTS: It was found that the prevalence of reported school violence in Puerto Rico tends to be somewhat lower than the prevalence reported in other sites of the U.S.A. Age and gender has a dramatic influence in the reports of youth violence in Puerto Rico. Male students are three times as likely to carry weapons than females and almost twice as likely to report hurting someone than females. Less than 10 per cent of the male students ages 12-13 report carrying a weapon while fully 30 per cent of those 18 year olds reported carrying a weapon. Being arrested also increases from only 3 per cent in the youngest students surveyed to 10 per cent on the oldest group (18 or older). CONCLUSION: The CDC has recently reported that since the early 90's there has been a decrease in reported school violence in the U.S.A. This analysis of youth surveys replicated a similar tendency for Puerto Rican youngsters. Implications for prevention programs are discussed.

Occult breast carcinoma presenting with axillary lymph node metastases

BACKGROUND AND OBJECTIVES: Occult primary breast carcinoma is uncommon. Most reported series encompass a large periods of time with great variability in diagnostic and treatment approaches. The objective of the present study was to review the recent experience with this type of presentation of breast cancer in the University of Alabama at Birmingham. METHODS: Retrospective review of clinicopathological data of female patients presenting with axillary metastasis of adenocarcinoma with unknown primary and normal clinical and mammographic breast exam seen at UAB between 1985 and 1998. RESULTS: Ten patients were identified. Mean age was 56 years. Sixty per cent were white and postmenopausal. All patients had biopsy proven adenocarcinoma consistent with breast primary. All but one patient underwent an axillary dissection. Nine out of ten patients received some type of local treatment to the breast. Three of them underwent mastectomy and no invasive carcinoma was demonstrated in the surgical specimens. Six patients received radiation therapy to the breast. All patients received chemotherapy. With mean follow-up time of 48 months, two patients developed local recurrence to the axilla and four developed distant metastasis and eventually died. At last follow-up six patients are alive with no evidence of disease. CONCLUSIONS: In presence of axillary metastasis from an unknown breast primary, an extensive work-up evaluation is not necessary. An axillary dissection is recommended to provide prognostic indicators as well as local control. A breast conservation approach seems to be feasible without affect the local control and survival.

Plasmodium vivax infection in a child residing in Mobile, Alabama

A previously healthy 4-year old male, born in India and residing in Mobile, Alabama since October 1996 came to the emergency department in April 1997 because of general malaise, fever and vomits of 5 days duration. A peripheral smear of the complete blood count revealed the presence of malarial parasites within the erythrocytes. Plasmodium vivax was later identified in serial thin peripheral smears. He defervesced after initial treatment with oral quinine and pyrimethamine-sulfadoxine, followed by primaquine for 14 days.