The genomic profiling of high-risk smoldering myeloma patients treated with an intensive strategy unveils potential markers of resistance and progression.

Smoldering multiple myeloma (SMM) precedes multiple myeloma (MM). The risk of progression of SMM patients is not uniform, thus different progression-risk models have been developed, although they are mainly based on clinical parameters. Recently, genomic predictors of progression have been defined for untreated SMM. However, the usefulness of such markers in the context of clinical trials evaluating upfront treatment in high-risk SMM (HR SMM) has not been explored yet, precluding the identification of baseline genomic alterations leading to drug resistance. For this reason, we carried out next-generation sequencing and fluorescent in-situ hybridization studies on 57 HR and ultra-high risk (UHR) SMM patients treated in the phase II GEM-CESAR clinical trial (NCT02415413). DIS3, FAM46C, and FGFR3 mutations, as well as t(4;14) and 1q alterations, were enriched in HR SMM. TRAF3 mutations were specifically associated with UHR SMM but identified cases with improved outcomes. Importantly, novel potential predictors of treatment resistance were identified: NRAS mutations and the co-occurrence of t(4;14) plus FGFR3 mutations were associated with an increased risk of biological progression. In conclusion, we have carried out for the first time a molecular characterization of HR SMM patients treated with an intensive regimen, identifying genomic predictors of poor outcomes in this setting.

Patient global assessment and inflammatory markers in patients with idiopathic inflammatory myopathies - A longitudinal study.

AIM: To explore if patient global assessment (PGA) is associated with inflammation over time and if associations are explained by other measures of disease activity and function in patients with idiopathic inflammatory myopathies (IIM). METHODS: PGA and systemic inflammatory markers prospectively collected over five years were retrieved from the International MyoNet registry for 1200 patients with IIM. Associations between PGA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and creatine kinase (CK) were analyzed using mixed models. Mediation analysis was used to test if the association between PGA and inflammatory markers during the first year of observation could be explained by measures of disease activity and function. RESULTS: PGA improved, and inflammatory markers decreased during the first year of observation. In the mixed models, high levels of inflammatory markers were associated with worse PGA in both men and women across time points during five years of observation. In men, but not in women, the association between elevated ESR, CRP and poorer PGA was explained by measures of function and disease activity. With a few exceptions, the association between improved PGA and reduced inflammatory markers was partially mediated by improvements in all measures of function and disease activity. CONCLUSION: Increased levels of systemic inflammation are associated with poorer PGA in patients with IIM. In addition to known benefits of lowered inflammation, these findings emphasize the need to reduce systemic inflammation to improve subjective health in patients with IIM. Furthermore, the results demonstrate the importance of incorporating PGA as an outcome measure in clinical practice and clinical trials.

Evaluation of a psychoeducational intervention including emotional intelligence to increase treatment adherence in rheumatoid arthritis (A pilot study).

Our objective was to perform two studies: a cross-sectional study in order to identify the main psychological variables associated to treatment adherence in rheumatoid arthritis and an intervention based on psychoeducation to assess its impact on the variables identified in the first study. We measured treatment adherence, self-efficacy, beliefs about medication, emotional intelligence and disability along with personal and disease variables in the cross-sectional study and the same variables were measured in the intervention before and after the program and 3 months later in 2 groups (an experimental group and an active control group). In the cross-sectional study (N=33) we found that the variables most associated with treatment adherence were emotional clarity (r=0.352, p<0.05) and emotional repair (r=0.363, p<0.05). In the intervention, we divided the patients into 2 groups: the control group (N=7) and the intervention group (N=10). At the end of the study and at follow-up, we found a significant increase in adherence and self-efficacy in the intervention group, when compared with the control group. Emotional clarity was increased only in the post-test, and at follow up a decrease in beliefs of concern about medication was found. Psychoeducational programs based on information about the disease and its treatment together with emotional management are effective in increasing treatment adherence in the long term.

Hydrogen Peroxide as an Adjuvant Therapy for COVID-19: A Case Series of Patients and Caregivers in the Mexico City Metropolitan Area.

Knowledge of the antiseptic effects of hydrogen peroxide (H2O2) dates back to the late 19th century, and its mechanisms of action has been amply described. Globally, many physicians have reported using H2O2 successfully, in different modalities, against COVID-19. Given its anti-infective and oxygenating properties, hydrogen peroxide may offer prophylactic and therapeutic applications for responding to the COVID-19 pandemic. We report a consecutive case series of twenty-three COVID-19 patients (of 36 initially enrolled) who had been diagnosed by their primary care physician (mean age: 39, range: 8 months-70 years; 74% male) and twenty-eight caregivers in the Mexico City Metropolitan Area who received a complementary and alternative medicine (CAM) telemedicine treatment with H2O2 taken by mouth (PO, at a concentration of 0.06%), oral rinse (mouthwash, 1.5%), and/or nebulization (0.2%). We describe the treatment program and report the response of the COVID-19 patients and their caregivers. The patients mainly recovered well, reporting feeling "completely better" at 9.5 days on average. Two (9%) were hospitalized prior to joining the study, and one did not fully recover. Patients frequently reported nausea and sometimes dizziness or vomiting related to the oral treatment. None of the twenty-eight caregivers in close contact with the patients reported contracting COVID-19. Given its low cost and medical potential and considering its relative safety if used properly, we suggest that randomized controlled trials should be conducted. These should include both SARS-CoV-2-positive and SARS-CoV-2-negative participants, with single or combined modes of administration of H2O2, to study the benefits of this simple molecule and offer safe guidance regarding its use by health professionals.

Características epidemiológicas y factores asociados a la parada cardiorrespiratoria extrahospitalaria atendida por espectadores antes de la llegada del primer recurso asistencial / Epidemiological characteristics and factors associated with out-of-hospital cardiac arrest attended by bystanders before ambulance arrival

Fundamento:. Comparar las características epidemiológicas de las paradas cardiacas extrahospitalarias enfunción de si fueron o no atendidas por espectadoresantes de la llegada de la ambulancia y describir los factores asociados a la reanimación por testigos. Metodología: Estudio observacional retrospectivo sobre los casos de parada cardiorrespiratoria extrahospitalaria ocurridos en el País Vasco durante cinco años.Se determinaron diferencias epidemiológicas de los casos en función de si la reanimación cardiopulmonar fueiniciada por espectadores. La relación entre la variabledependiente no se inicia reanimación por testigos y distintos factores de exposición se analizó con regresiónlogística multivariable. Resultados: Se revisaron 3278 eventos; en el 61,9 % delos casos no se practicó reanimación por testigos o espectadores y se asoció a inexistencia de instruccionestelefónicas (OR: 6,25; IC95 %: 5,15-7,58; p < 0,001), localización del evento en el domicilio (OR: 2,94; IC95 %: 2,48-3,48; p < 0,001), evento no presenciado (OR: 1,56; IC95 %:1,28-1,89; p < 0,001), víctima con edad superior a 64 años(OR: 1,48; IC95 %: 1,26-1,74; p < 0,001) y ámbito urbano(OR: 1,29; IC95 %: 1,04-1,62; p = 0,023). Conclusiones: Existen diferencias en las paradas cardiacas en función de si han sido o no reanimadas porespectadores y estas características podrían condicionar la decisión del rescatador al respecto de iniciar lareanimación y la evolución de la misma.(AU)

Background: The aim of this study is to analyze thecharacteristics of out of hospital cardiac arrests basedon whether patients received bystander resuscitationbefore ambulance arrival, and to describe the factorsassociated with resuscitation attempts by bystanders. Methods: A retrospective observational study was performed. Clinical data from cardiac arrest patients in theBasque Country (Spain) were collected over a periodof five years. Epidemiological characteristics comparedresuscitation started by bystanders with resuscitationcarried out by ambulance caregivers. The relation between no resuscitation started by bystander and different exposure factors was explored by multiple logisticregression analysis. Results: We analyzed 3,278 cardiac arrests. Of them,61.9 % were not attended by bystanders and this wasassociated with the absence of instructions from Emergency Centre (OR: 6.25, 95 % CI: 5.15-7.58, p < 0.001),home location (OR: 2.94, 95 %CI: 2.48-3.48, p < 0.001),unwitnessed cardiac arrest (OR: 1.56, 95 %CI 1.28-1.89,p < 0.001), victims of 65 years or older (OR: 1.48, 95 %CI:1.26-1.74, p < 0.001) and suburban locations (OR: 1.29,95 %CI: 1.04-1.62, p = 0.023). Conclusion: There are differences in cardiac arrestsdepending on whether they have been resuscitated bybystanders. These characteristics may influence thebystander’s decision to initiate resuscitation maneuvers (or not) and evolution.(AU)

Epidemiological characteristics and factors associated with out-of-hospital cardiac arrest attended by bystanders before ambulance arrival.

BACKGROUND: The aim of this study is to analyze the characteristics of out-of-hospital cardiac arrests based on whether patients received bystander resuscitation before ambulance arrival, and to describe the factors associated with resuscita-tion attempts by bystanders. METHODS: A retrospective observational study was performed. Clinical data from cardiac arrest patients in the Basque Country (Spain) were collected over a period of five years. Epidemiological characteristics compared resuscitation started by bystanders with resuscitation carried out by ambulance caregivers. The relation between no resuscitation started by bystander and different exposure factors was explored by multiple logistic regression analysis. RESULTS: We analyzed 3,278 cardiac arrests. Of them, 61.9?% were not attended by bystanders and this was associated with the absence of instructions from Emergency Centre (OR: 6.25, 95%CI: 5.15-7.58, p?

Mareo residual, una condición clínica frecuente posterior a maniobra de reposición exitosa en vértigo posicional paroxístico benigno: una revisión / Residual dizziness, a frequent clinical condition following successful repositioning maneuver for benign paroxysmal positional vertigo: a review

El vértigo posicional paroxístico benigno (VPPB) es reconocido como la principal causa de vértigo de origen periférico en adultos, ya que, si bien la etiología del VPPB aún no se ha demostrado plenamente y se clasifica como la mayoría de los casos, se puede identificar el desprendimiento de otolitos y su desplazamiento en uno de los tres canales semicirculares. Una anamnesis cuidadosa puede abordar el diagnóstico clínico del VPPB, pero la confirmación se obtendrá por medio de maniobras de diagnóstico especificas de acuerdo a cuál de los canales está involucrado. Este trastorno altera la capacidad de llevar a cabo actividades de la vida cotidiana que determinan un aumento significativo en el riesgo de caídas y las consiguientes lesiones. La mayoría de los pacientes se recuperan después del tratamiento, sin embargo, hasta dos tercios de éstos pueden percibir inestabilidad prolongada, aturdimiento y malestar definidos como mareo residual. Esta sintomatología residual después de la resolución del VPPB es variable entre los pacientes, siendo el tiempo de duración de los síntomas residuales de aproximadamente de 1 a 3 semanas, existiendo algunos pacientes que pueden recuperarse más tardíamente. En esta revisión analizaremos el mareo residual, describiendo su expresión clínica, diagnóstica, fisiopatológica y tratamientos actuales de esta entidad clínica.

Benign paroxysmal positional vertigo (BPPV) is recognized as the main cause of peripheral vertigo in adults, although the etiology of BPPV has not yet been fully demonstrated and is classified as idiopathicin most cases, detachment of otoliths and their displacement in one of the three semicircular canals can be identifie. A careful history can address the clinical diagnosis of BPPV, but confirmation will be obtained through specific diagnostic maneuvers according to which canal is involved. This disorder alters the ability to carry out activities of daily living that determine a significant increase in the risk of falls and consequent injuries. Most patients recover after treatment, however, up to two thirds of these patients may perceive prolonged instability, dizziness and discomfort defined as residual dizziness. This residual symptomatology following BPPV resolution is variable among patients, the duration of residual symptoms can last 1 to 3 weeks, with some patients may recover later on. In this review, we will analyze residual dizziness, describing its clinical presentation, diagnosis, pathophysiology and current treatments of this clinical entity.

Prognostic value of positive surgical margins after resection of cholangiocarcinoma. Experience at a high-volume hospital center specializing in hepatopancreatobiliary surgery. / Valor pronóstico del margen quirúrgico positivo tras la resección de un colangiocarcinoma. Experiencia en un centro de alto volumen en cirugía hepatopancreatobiliar.

INTRODUCTION AND AIMS: Cholangiocarcinoma accounts for 3% of gastrointestinal tumors and is the second most frequent hepatic neoplasia after hepatocellular carcinoma. The primary aim was to evaluate the median disease-free period and survival in patients with cholangiocarcinoma diagnosis through the comparison of R0 and R1 resection margins. MATERIAL AND METHODS: A retrospective analysis was conducted on 36 patients that underwent some type of surgical resection due to cholangiocarcinoma diagnosis, within the time frame of 2000-2017, at a center specializing in hepatopancreatobiliary surgery. Population, preoperative, and oncologic variables were included. The IBM Statistical Package for the Social Sciences for Mac, version 16.0, software (IBM SPSS Inc., Chicago, IL, USA) was employed. RESULTS: Thirty-one patients underwent hepatectomy, the Whipple procedure, or bypass surgery, depending on tumor location. The statistical significance of survival between patients with positive margins and those with negative margins was evaluated through the Mann-Whitney U test, with a P<.05 as the reference value. No statistically significant difference was found. The overall morbidity rate was 58.06% (n=18) and the mortality rate was 12.9% (n=4). CONCLUSIONS: No statistically significant difference in relation to the incidence of disease recurrence or general survival resulted from the comparison of microscopically positive surgical margins (R1) and negative surgical margins (R0). There was also no correlation between preoperative CA 19-9 levels and disease prognosis.

Percutaneous cholecystostomy as treatment for acute cholecystitis: What has happened over the last five years? A literature review. / Colecistostomía percutánea como tratamiento de colecistitis aguda: ¿qué ha pasado en los últimos 5 años? Revisión de la literatura.

Acute cholecystitis is one of the most frequent diseases faced by the general surgeon. In recent decades, different prognostic factors have been observed, and effective treatments described, to improve the results in patients with said pathology (lower morbidity and mortality, shorter hospital stay, and minimum conversion of laparoscopic to open procedures). In general, laparoscopic cholecystectomy is the standard treatment for acute cholecystitis, but it is not exempt from complications, especially in patients with numerous comorbidities or those that are critically ill. Percutaneous cholecystostomy emerged as a less invasive alternative for the treatment of acute cholecystitis in patients with organ failure or a prohibitive surgical risk. Even though it is an effective procedure, its usefulness and precise indications are subjects of debate. In addition, there is little evidence on cholecystostomy catheter management. We carried out a review of the literature covering the main aspects physicians involved in the management of acute cholecystitis should be familiar with.

Impacto de la rehabilitación vestibular en el riesgo de caída y la confianza del paciente / Impact of vestibular rehabilitation on the risk of falling and patient confidence

RESUMEN Introducción: Las alteraciones del sistema vestibular como la hipofunción vestibular unilateral, predisponen al usuario a sufrir caídas alterando así su confianza. Objetivo: Determinar el impacto de la rehabilitación vestibular en el riesgo de caídas y el grado de confianza en mujeres con hipofunción vestibular unilateral. Material y método: Se realiza estudio prospectivo en 20 pacientes de género femenino mayores de 60 años con diagnóstico de patología vestibular periférica. Se evalúa el riesgo de caídas con escala Tinetti y el grado de confianza al realizar actividades de la vida diaria por medio de la escala ABC (Activities-specific Balance Confidence), antes y después de realizar terapia de rehabilitación vestibular (RV). Resultados: Las dos variables estudiadas Tinetti y escala ABC demostraron mejoras significativas en la mayoría de las pacientes, demostrando que a medida que aumenta el grado de confianza disminuye el riesgo de caídas. Conclusión: Los resultados obtenidos de este estudio sugieren que la terapia de RV es eficiente en mejorar el riesgo de caídas y favorecer el aumento de confianza en las actividades de la vida diaria en el grupo de pacientes estudiadas.

ABSTRACT Introduction: Changes in the vestibular system, such as unilateral vestibular hypo-function, predispose the user to suffer falls, thus altering his confidence. Aim: To determine the impact of vestibular rehabilitation on the risk of falls and the degree of confidence in women with unilateral vestibular hypofunction. Material and method: A prospective study was conducted in 20 female patients over 60 years of age with a diagnosis of peripheral vestibular pathology. The risk of falls with a Tinetti scale and the degree of confidence in carrying out activities of daily living are evaluated through the ABC scale (Activities-specific Balance Confidence), before and after performing vestibular rehabilitation therapy (VRT). Results: The two variables studied, Tinetti and ABC scale showed significant improvements in most of the patients, demonstrating that as the degree of confidence increases the risk of falls decreases. Conclusion: The results obtained from this study suggest that VRT is efficient in improving the risk of falls and favoring an increase in confidence in the activities of daily life in the group of patients studied.

Efectividad de cinco sesiones de rehabilitación vestibular en mujeres mayores de 60 años con hipofunción vestibular / Effectiveness of five vestibular rehabilitation sessions in women over 60 years of age with vestibular hypofunction

RESUMEN Introducción: Los síntomas vestibulares son motivo frecuente de consulta en la atención médica, el adulto mayor y en especial el género femenino está expuesto a riesgo de caída por esta causa. Es común que el tratamiento de este grupo de pacientes sea los supresores vestibulares, y la terapia de rehabilitación vestibular (RV) se indique excepcionalmente, olvidando en ocasiones que los elementos anatomofuncionales involucrados en las disfunciones vestibulares son la integración del aparato visual, vestibular, y somatosensorial, pilares en los que se fundamenta la RV. Objetivo: El objetivo de este estudio es determinar si cinco sesiones RV son suficientes para disminuir la discapacidad funcional y el riesgo de caída en un grupo de pacientes con patología vestibular. Material y método: Estudio prospectivo con 14 pacientes de género femenino mayores de 61 años con diagnóstico de patología vestibular periférica. Se realizó evaluación de (dizziness handicap inventory) DHI, (timed up and go) TUG y (video head impulse test) vHIT previo y posterior a la intervención de cinco sesiones de RV. Resultados: Las tres variables estudiadas (DHI, TUG y vHIT) demostraron mejorías estadísticamente significativas en el grupo de pacientes. Conclusión: Los resultados obtenidos en este estudio permiten sugerir que la terapia de RV en pacientes adultos mayores, con patología vestibular periférica y sin medicación de supresores vestibulares, es una modalidad terapéutica adecuada y eficiente.

ABSTRACT Introduction: Vestibular symptoms are frequent reason for consultation in medical care, the elderly and especially the female gender is exposed to fall risk from this cause. It is common for the treatment of this group of patients to be vestibular suppressors while vestibular rehabilitation therapy is indicated exceptionally, sometimes forgetting that the anatomic and functional elements involved in vestibular dysfunctions are the integration of the visual, vestibular, and somatosensory, pillars in those that are based on vestibular rehabilitation (VR). Aim: The objective of this study is to determine if five VR sessions are sufficient to provide concrete quantitative data on the decrease of disability and risk of falling in a group of patients with vestibular pathology. Material and method: This prospective study included 14 female patients over 61 years of age with diagnoses of peripheral vestibular pathology. Dizziness handicap inventory (DHI), timed up and go (TUG) and video head impulse test (vHIT) were performed and after the intervention of five sessions of vestibular rehabilitation. Results: The three variables studied (DHI, TUG and vHIT) showed statistically significant improvements in the group of patients. Conclusions: The results obtained in this study allow us to suggest that VR therapy in elderly patients with peripheral vestibular pathology and without vestibular suppressor medication is an adequate, efficient and promising therapeutic modality.

Influence of land development on stormwater runoff from a mixed land use and land cover catchment.

Mitigating for the negative impacts of stormwater runoff is becoming a concern due to increased land development. Understanding how land development influences stormwater runoff is essential for sustainably managing water resources. In recent years, aggregate low impact development-best management practices (LID-BMPs) have been implemented to reduce the negative impacts of stormwater runoff on receiving water bodies. This study used an integrated approach to determine the influence of land development and assess the ecological benefits of four aggregate LID-BMPs in stormwater runoff from a mixed land use and land cover (LULC) catchment with ongoing land development. It used data from 2011 to 2015 that monitored 41 storm events and monthly LULC, and a Personalized Computer Storm Water Management Model (PCSWMM). The four aggregate LID-BMPs are: ecological (S1), utilizing pervious covers (S2), and multi-control (S3) and (S4). These LID-BMPs were designed and distributed in the study area based on catchment characteristics, cost, and effectiveness. PCSWMM was used to simulate the monitored storm events from 2014 (calibration: R2 and NSE>0.5; RMSE <11) and 2015 (validation: R2 and NSE>0.5; RMSE <12). For continuous simulation and analyzing LID-BMPs scenarios, the five-year (2011 to 2015) stormwater runoff data and LULC change patterns (only 2015 for LID-BMPs) were used. Results show that the expansion of bare land and impervious cover, soil alteration, and high amount of precipitation influenced the stormwater runoff variability during different phases of land development. The four aggregate LID-BMPs reduced runoff volume (34%-61%), peak flow (6%-19%), and pollutant concentrations (53%-83%). The results of this study, in addition to supporting local LULC planning and land development activities, also could be applied to input data for empirical modeling, and designing sustainable stormwater management guidelines and monitoring strategies.

Flower structure and developmental stages of the capitulum of Smallanthus sonchifolius (Asteraceae): reproductive implications.

Yacon (Smallanthus sonchifolius, Asteraceae) is an ancient andean crop that has numerous dietary and medicinal properties. Morphological and anatomical features and developmental changes of the capitulum were studied. A ray floret is a pistillate, female flower, while a disc floret is a staminate male flower, and the former opens before the latter, being pseudanthium protogynous. The capitulum presents interesting attributes for pollinators such as flower structure, nectaries and pollenkitt. Gynoecial nectaries were found on undeveloped ovary in the disc floret, but not in the ray floret. Glandular trichomes were observed on the abaxial epidermis of corolla in the ray floret, but not in the disc floret. Capitulum development was divided into eight stages. Stigma receptivity varied with these stages. Pollen viability was low (15%). In accordance with low viability, pollen grains exhibit diverse sizes and shapes, reduction in length of spines, and abnormal protoplasm. Examination of ovary development in the ray floret showed that a mature ovule was formed, but fertilization did not occur. In advanced developmental stages, the capitulum showed proliferation of the endothelium, degeneration of the embryo sac, and all harvested cypselae had aborted seeds. Problems found in pollen viability and aborted cypselae could be the result of a history of vegetative propagation in the domestication process.

[Cholestasic toxic hepatitis due to clopidogrel in a patient with multiple conditions]. / Hepatitis tóxica colestástica por clopidogrel en un pacientepluripatológico.

Clopidogrel is a thienopyridine-class antiplatelet drug commonly used in ischemic heart disease,cerebrovascular disease and peripheral artery disease.Liver toxicity due to this drug is very infrequent.We found 16 cases in the literature, and in only two of them liver biopsy was carried out. We report the case of a 78 year old patient with multiple conditions affected by severe toxic cholestatic hepatitis due to clopidogrel and the results of the liver biopsy performed. Hepatitis was resolved after discontinuing the drug.Based on the characteristics of this case and other previously published cases, we review the characteristics of toxic hepatitis due to clopidogrel and its diagnosis and treatment.

Síndrome de dehiscencia del canal semicircular superior: a propósito de un caso / Canal dehiscence syndrome of the superior semicircular: in a case purpose

El síndrome de dehiscencia de canal semicircular superior (DCSS) es una patología descrita en 1998 por Minor y cols, presenta síntomas diversos incluido vértigo inducido por el sonido, hipoacusia y autofonía por la falta de cobertura ósea en dicho canal. El diagnóstico se basa en la clínica y la confirmación se obtiene mediante la tomografía computarizada de peñasco. El tratamiento será expectante o reparación quirúrgica de la continuidad si la clínica es incapacitante. En este artículo se presenta un caso clínico de DCSS con síntomas auditivos y vestibulares al emitir el fonema "mmm".

The superior semicircular dehiscence síndrome is a pathology described en 1998 by Minor et al. Which presents several symptoms incluid sound induced vértigo, hearing loss and autophony due to bone dehiscense of this semicircular canal. The diagnosis was based on clinical and confirmation is given by the temporal bone CT. Treatment is expectant or surgical repair of continuity if the clinic is disabling. In this paper we present a case of DCSS with auditory and vestibular symptoms in issuing the phoneme "mmm".

Characterization of Feeding Injuries Caused by Ceresa nigripectus Remes Lenicov (Hemiptera: Membracidae) on Alfalfa Stems.

Piercing-sucking insects cause mechanical and physiological injury to plants. Ceresa nigripectus Remes Lenicov is a pest of alfalfa in subtropical regions of South America and a carrier of the ArAWB phytoplasma. The aim of this study was to determine the feeding habits of this treehopper and to describe the effects of the feeding injuries on stem vascular tissues in alfalfa. Adults and nymphs of C. nigripectus inserted their stylets repeatedly girdling the stem. One week after feeding, alfalfa stems exhibited numerous feeding canals with salivary deposits, most of which reached the phloem. Two weeks after feeding, cortex and phloem cells next to the salivary sheath collapsed, mature tracheal elements became sparse and appeared with an increased cross-section area, and phenolic compounds increased in cells and cell walls compared to undamaged plants. Three weeks after feeding, an annular callus, formed by abnormal cell division and hypertrophy of preexisting cortex and vascular cambium cells, appeared immediately above the stem girdle. Parenchyma cells from the outer layers of the callus differentiated to form secondary anomalous amphicribal bundles in the wound. The aerial parts above the stem girdle eventually withered and died.

Monitoring and predicting the fecal indicator bacteria concentrations from agricultural, mixed land use and urban stormwater runoff.

While the urban runoff are increasingly being studied as a source of fecal indicator bacteria (FIB), less is known about the occurrence of FIB in watershed with mixed land use and ongoing land use and land cover (LULC) change. In this study, Escherichia coli (EC) and fecal streptococcus (FS) were monitored from 2012 to 2013 in agricultural, mixed and urban LULC and analyzed according to the most probable number (MPN). Pearson correlation was used to determine the relationship between FIB and environmental parameters (physicochemical and hydrometeorological). Multiple linear regressions (MLR) were used to identify the significant parameters that affect the FIB concentrations and to predict the response of FIB in LULC change. Overall, the FIB concentrations were higher in urban LULC (EC=3.33-7.39; FS=3.30-7.36log10MPN/100mL) possibly because of runoff from commercial market and 100% impervious cover (IC). Also, during early-summer season; this reflects a greater persistence and growth rate of FIB in a warmer environment. During intra-event, however, the FIB concentrations varied according to site condition. Anthropogenic activities and IC influenced the correlation between the FIB concentrations and environmental parameters. Stormwater temperature (TEMP), turbidity, and TSS positively correlated with the FIB concentrations (p>0.01), since IC increased, implying an accumulation of bacterial sources in urban activities. TEMP, BOD5, turbidity, TSS, and antecedent dry days (ADD) were the most significant explanatory variables for FIB as determined in MLR, possibly because they promoted the FIB growth and survival. The model confirmed the FIB concentrations: EC (R(2)=0.71-0.85; NSE=0.72-0.86) and FS (R(2)=0.65-0.83; NSE=0.66-0.84) are predicted to increase due to urbanization. Therefore, these findings will help in stormwater monitoring strategies, designing the best management practice for FIB removal and as input data for stormwater models.