Laboratory studies assessing the microbial biocontrol potential of diverse strains of Beauveria bassiana isolated from coffee berry borer, with emphasis on strains from Hawai'i Island and comparisons to commercial strain GHA.

A series of experiments investigated genetically diverse strains of Beauveria bassiana (Bb) isolated from coffee berry borer (CBB). Objectives included assessment of their biocontrol potential, particularly in comparison to Bb commercial strain GHA currently applied for CBB control, and identification of various attributes potentially contributing to their comparatively greater epizootic potential in CBB populations. Bioassays identified one strain from Hawai'i Island and one from Puerto Rico with virulence greater than GHA based on equal weights of unformulated conidial powder (CP); however, the greater potency of the CPs was ultimately explained by their 2.4-fold greater conidial densities (ca. 3.1 vs 1.3 × 1011 viable conidia/g CP). Density was explained, in large part, by conidial size, but not by size alone. Bb-inoculated CBB held on moist filter paper were more susceptible to infection than those held on cooked green coffee bean (CGCB). A Bb strain representative of the most common Hawaiian haplotype produced 2.6x more conidia after death of CGCB-held beetles than GHA (19.1 vs 7.3 x106 conidia/cadaver). Following host death, no difference was observed in time to emergence and initial conidial production by GHA and a selected group of Hawaiian strains; however, mass sporulation was initiated within 2 days by strain GHA compared to 4-5 days by the Hawaiian strains. In a preliminary evaluation of conidial mass-production potential, CP yields of several strains were comparable to GHA on a weight basis and significantly greater than GHA on a conidial basis (1.3-1.6 vs 0.7 × 1013 viable conidia/kg barley substrate).

Collection, isolation, in vitro culture, and laboratory transmission of Hirsutella eleutheratorum (Hypocreales: Ophiocordycipitaceae) from coffee berry borer on Hawai'i Island.

The insect pathogenic fungus Hirsutella eleutheratorum was first reported as a pathogen of coffee berry borer (CBB) Hypothenemus hampei in Colombia in 1993. A similar CBB pathogen identified as Hirsutella sp. was reported also from Colombia in 2007; attempts at isolation and in vitro culture of this fungus were unsuccessful. During 2016 and 2017 on the island of Hawai'i, extensive sampling of CBB populations was conducted in coffee fields treated with Beauveria bassiana-based biopesticides and in untreated fields. Among the samples collected from two high-elevation sites in the district of South Kona were rare findings of adult foundress CBB infected with a species of Hirsutella fitting the description of H. eleutheratorum. Prevalence of the pathogen was, in all cases, very low (<1%), having no significant impact on pest populations, even under conditions supporting epizootics of B. bassiana. The fungus was readily isolated from freshly-killed CBB and cultured on potato dextrose agar (PDA). Molecular characterization identified the fungus as a member of the Hirsutella citriformis clade, which includes species recently placed in the genus Ophiocordyceps. Adult CBB exposed to fungus-killed beetles or to PDA cultures of the fungus succumbed to infection within 10-14 days. Under high-humidity laboratory conditions, the fungus emerged from the killed host and produced long, conidia-bearing synnemata characteristic of the species. To our knowledge, this is the first record of H. eleutheratorum from CBB in Hawai'i and the first account of isolation, in vitro culture, genetic characterization, host-to-host transfer, and culture-to-host transfer of this fungal pathogen.

Development and evaluation of a decision aid on mammography screening for women 75 years and older.

IMPORTANCE: Guidelines recommend that women 75 years and older should be informed of the benefits and risks of mammography before being screened. However, few are adequately informed. OBJECTIVES: To develop and evaluate a mammography screening decision aid (DA) for women 75 years and older. DESIGN: We designed the DA using international standards. Between July 14, 2010, and April 10, 2012, participants completed a pretest survey and read the DA before an appointment with their primary care physician. They completed a posttest survey after their appointment. Medical records were reviewed for follow-up information. SETTING AND PARTICIPANTS: Boston, Massachusetts, academic primary care practice. Eligible women were aged 75 to 89 years, English speaking, had not had a mammogram in 9 months but had been screened within the past 3 years, and did not have a history of dementia or invasive or noninvasive breast cancer. Of 84 women approached, 27 declined to participate, 12 were unable to complete the study for logistical reasons, and 45 participated. INTERVENTIONS: The DA includes information on breast cancer risk, life expectancy, competing mortality risks, possible outcomes of screening, and a values clarification exercise. MAIN OUTCOMES AND MEASURES: Knowledge of the benefits and risks of screening, decisional conflict, and screening intentions; documentation in the medical record of a discussion of the risks and benefits of mammography with a primary care physician within 6 months; and the receipt of screening within 15 months. We used the Wilcoxon signed rank test and McNemar test to compare pretest-posttest information. RESULTS: The median age of participants was 79 years, 69% (31 of 45) were of non-Hispanic white race/ethnicity, and 60% (27 of 45) had attended at least some college. Comparison of posttest results with pretest results demonstrated 2 findings. First, knowledge of the benefits and risks of screening improved (P < .001). Second, fewer participants intended to be screened (56% [25 of 45] afterward compared with 82% [37 of 45] before, P = .03). Decisional conflict declined but not significantly (P = .10). In the following 6 months, 53% (24 of 45) of participants had a primary care physician note that documented the discussion of the risks and benefits of screening compared with 11% (5 of 45) in the previous 5 years (P < .001). While 84% (36 of 43) had been screened within 2 years of participating, 60% (26 of 43) were screened within 15 months after participating (≥ 2 years since their last mammogram) (P = .01). Overall, 93% (42 of 45) found the DA helpful. CONCLUSIONS AND RELEVANCE: A DA may improve older women's decision making about mammography screening.

Defendants with intellectual disabilities and mental health diagnoses: faring in a mental health court.

BACKGROUND: Begun in the late 1990s, mental health courts are specialty criminal courts developed to address the needs of persons with mental illness. METHODS: As many persons with intellectual disabilities (IDs) may overlap in the mental health court system, we used mental health court records to examine the phenomenology and outcomes of 224 defendants with and without co-occurring IDs in the mental health court. This study had two goals: (1) to examine the prevalence of defendants with IDs in the court and (2) to compare defendants with dual diagnoses with defendants with lone mental health disorders. RESULTS: Approximately 11% of defendants in the mental health court also had IDs. Compared with individuals with mental health disorders alone, individuals with dual diagnoses were more likely to be younger, male, African-American and less well-educated; these defendants were also more likely to show externalising, 'turning-against-others' symptoms, less likely to show internalising, 'turning-against-self' symptoms. Defendants with IDs (vs. those without) more often received behavioural, vocational rehabilitation and other services, although the two groups did not differ on most outcome variables. CONCLUSION: Directions for future research are discussed.

An educational improvement project to track patient encounters: toward a more complete understanding of third-year medical students' experiences.

BACKGROUND: At the University of Missouri School of Medicine (MUSOM), "commitment to improving quality and safety in healthcare" is one of eight key characteristics set as goals for our graduates. As educators, we have modelled our commitment to continuous improvement in the educational experiences through the creation of a method to monitor and analyse patient encounters in the third year of medical school. This educational improvement project allowed course directors to (1) confirm adequate clinical exposure, (2) obtain prompt information on student experiences, (3) adjust individual student rotations to meet requirements and (4) ascertain the range of clinical experiences available to students. DISCUSSION: Data illustrate high levels of use and satisfaction with the educational innovation. We are in our second year using the new Patient Log (PLOG) process and are now considering expanding the use of PLOG into the fourth year of medical school.

Vegetative compatibility groups in indigenous and mass-released strains of the entomopathogenic fungus Beauveria bassiana: likelihood of recombination in the field.

Using nitrate non-utilizing (nit) mutants, we determined vegetative compatibility groups (VCG) among strains of Beauveria bassiana representing strains indigenous to North America, isolated from diverse insect hosts, and strains that have been mass released for insect control. Genetic similarity among these strains was analyzed using random amplified polymorphic DNA (RAPD) markers. Our data revealed 23 VCGs among the 34 strains tested, with most of these groups comprised of only a single strain. We also observed a VCG comprised of eight genetically similar strains isolated from Colorado potato beetles (CPB). Co-inoculation studies of CPB larvae with complementary nit mutants from the same or from different VCGs revealed heterokaryosis in four out of five same-VCG pairs, with only 5-17% of the sporulating cadavers generating few parasexual recombinants. In contrast, none of the infected beetles treated with non-compatible pairs generated recombinants. The large number of VCGs observed and the low frequency of in vivo recombination limited to vegetatively compatible strains indicate that this self/non-self recognition system may be an effective barrier preventing genetic exchange between dissimilar strains in the field.

Effect of relative humidity on viability of primary conidia of Zoophthora radicans.

Four isolates of the entomopathogenic fungus Zoophthora radicans were compared in a laboratory study to evaluate the effect of relative humidity (RH) on duration of primary conidial viability. Primary conidia were showered onto agar-coated glass microscope slides within an enclosed chamber equilibrated to one of five test RH levels (60, 75, 80, 95, or 100%). Target RH levels were achieved by recirculating air through a glycerin/water solution, of controlled specific gravity, contained in a reservoir within the chamber. Conidial samples of each isolate incubated for 5, 10, 30, 60, 120, 180, or 240 min at each RH were removed and inspected using a technique of simultaneous vital fluorochrome staining to determine percentage conidial viability. At 60% RH, isolates did not differ significantly and average viability dropped to less than 10% within the first 60 min. At 75% RH, viability did not change significantly over 4 h. However, average viabilities at 75% RH differed significantly for the four isolates and ranged from 24 to 63%. At 80% RH, viability differed significantly among isolates and declined slowly over time, remaining above 80% for 2 h and above 50% for 4 h. At 95 and 100% RH, average viability was near 95% and did not vary significantly with time or isolate. These data can be used to assist selection of appropriate isolates for biological control.

Identification and referral of hospitalized patients in need of home care.

Given current concerns about the cost-effectiveness of home health care, better targeting of home health services for high risk groups is viewed as one way to provide controls on both service delivery and costs. The purpose of this exploratory study was to determine the degree to which patients with identifiable levels of need for services were referred for home health care and if selected clinical and functional status measures are useful in distinguishing need for service. Using a convenience sample of 145 patients ready for hospital discharge, data were collected on physical function, dependency at discharge, perceived helpfulness of others, social support, readiness for self-care, and planned adherence to treatment as well as demographic and medical variables. Using a combination of study variables, 93% of patients not in need of services could be correctly classified. In addition, patients in need of service but not referred by their physicians were found to differ significantly from patients not in need of care on all dimensions. Suggestions are offered for further research to determine if and what systematic factors influence referral decisions for home health care and which specific patient characteristics are associated with the most cost-effective long-term outcomes.

Spirituality in aging: spiritual need or spiritual journey?

1. The current approach to spiritual assessment often makes the older client uncomfortable discussing his or her spiritual and religious orientation. 2. To provide therapeutic interventions, nurses must first become aware of themselves and their clients as spiritual beings. 3. A spiritual journey perspective views the nurse as one who can enhance the unique journey and growth of the individual client.

A comparison of surface doses for two immobilizing systems.

To achieve accurate and reproducible treatments, many types of immobilizing systems have been used. Two of these systems: Alpha Cradle and VacFix, conform around the patient to improve day-to-day treatment repositioning. The Alpha Cradle system has been in clinical use for several years. The system involves two polyurethane chemicals which upon mixing in a latex bag will expand and harden around the patient. The second system (VacFix) uses a 0.15 mm thick plastic bag loosely filled with 1 mm polysterol spheres. The patient lays on the bag in the treatment position and the air is evacuated from the bag. This system retains its shape for the entire treatment and can be re-used. In some patient set-ups, it is possible that the beam is modified as it passes through these devices, causing a potential change in the target dose and an increase in the patient surface dose. CT scans of the Alpha Cradle and VacFix systems were performed and relative densities were calculated and compared to air. Material densities and surface dose data for a Cobalt-60 teletherapy unit and a dual photon linear accelerator are presented.

Effect of thyroid hormone on gentamicin accumulation in rat proximal tubule lysosomes.

T4 decreases gentamicin nephrotoxicity, but the mechanism is unknown. This study investigated whether T4 affects renal processing of gentamicin by examining renal cortical gentamicin accumulation and proximal tubular lysosomal volume after 48 h of gentamicin (30 mg/kg twice daily) in rats (GT4) that had previously received 10 days of T4 (10 micrograms/100 g body wt). The pair-fed control group received only gentamicin. A T4-treated control group and an untreated control group were also pair fed and studied. At the end of the 12-day study the four groups did not differ in food intake, body weight, urine volume, urinary Na+ excretion, or urinary K+ excretion. Plasma creatinine, inulin clearance, and serum clearance of gentamicin were not different among the groups. Gentamicin accumulation was higher in G vs. GT4 (2.1 +/- 0.1 vs. 1.7 +/- 0.1 micrograms/mg protein, P less than 0.01). Blinded, computer-assisted electron microscopic analysis of outer cortical proximal tubules showed that lysosomes occupied a significantly smaller fraction of the cell volume in GT4 (8.1 +/- 0.5 vs. 11.6 +/- 1.1%, P less than 0.02). Thyroxine had no effect on lysosomal volume in non-gentamicin-treated rats. Except for scatter foci of apical vacuolization, proximal tubular cells of both groups were otherwise normal. The results show that chronic T4 administration decreases renal tubular accumulation of gentamicin, and this effect may in part explain its protective effect against gentamicin nephrotoxicity.

Components of moribund American elm trees as attractants to elm bark beetles,Hylurgopinus rufipes and Scolytus multistriatus.

Hylurgopinus rufipes male and female beetles were attracted to American elms infected with Dutch elm disease, and to American elms killed by injection of cacodylic acid.H. rufipes was also attracted to solvent extracts of elm, or to Porapak Q-trapped volatiles from elm. The major components of attractive fractions of Porapak Q-trapped volatiles were isolated, identified, and tested in field bioassays. Several artificially compounded mixtures of sesquiterpenes were attractive toH. rufipes, although no bait tested was as attractive as diseased tree controls. Laboratory bioassays with H. rufipes were marginally successful. In laboratory bioassays, nine of 14 sequiterpenes identified from active fractions of Porapak extracts elicited significant response from Scolytus multistriatus male and female beetles: δ- and γ-cadinene, α-cubebene, γ-muurolene, and ß-elemene were most active. However, in field tests, none of the sesquiterpenes alone or in combination significantly attracted S. multistriatus, nor did they significantly enhance the attraction of S. multistriatus to female-produced pheromone components (4-methyl-3-heptanol [H] and α-multistriatin [M]). In other field tests, α-cubebene (C) significantly enhanced response of S. multistriatus to H plus M, but foliage, logs, or chips of healthy elm did not enhance trap catch to HMC.

Measurement of air pollutants from satellites. 1: feasibility considerations.

The feasibility of observing air pollutants from satellite-borne sensors has been investigated. Radiative transfer calculations, using both line-by-line and band-model methods, have been made to establish the signal changes that originate from the presence of various amounts of pollutants in the atmosphere. The effect of interfering species has been considered.

Measured and Calculated Earth-Atmosphere Radiance in the 8-14-mu Window as a Function of Altitude.

Aircraft measurements of the earth-atmosphere radiance in the 8-14-mu window are compared with calculated values as a function of altitude. Two instruments, the Barnes PRT-4 radiometer and the Block 16T interferometer spectrometer, were used. The theoretical model is found to describe satisfactorily the integrated radiance from the earth and lower atmosphere.

Measurements of temperature profiles at the exit of small rockets.

The sodium line reversal technique was used to determine the reversal temperature profile across the exit of small rockets. Measurements were made on one 73-kg thrust rocket, and two 23-kg thrust rockets with different injectors. The large rocket showed little variation of reversal temperature across the plume. However, the 23-kg rockets both showed a large decrease of reversal temperature from the axis to the edge of the plume. In addition, the sodium line reversal technique of temperature measurement was compared with an infrared technique developed in these laboratories.