COVID-19 opens the door for right iliac fossa pain treatment pathway.

INTRODUCTION: The COVID-19 pandemic has increased the risks of surgery and management of common surgical conditions has changed, with greater reliance on imaging and conservative management. The negative appendectomy rate (NAR) in the UK has previously remained high. The aim of this study was to quantify pandemic-related changes in the management of patients with suspected appendicitis, including the NAR. METHODS: A retrospective study was performed at a single high volume centre of consecutive patients aged over five years presenting to general surgery with right iliac fossa pain in two study periods: for two months before lockdown and for four months after lockdown. Pregnant patients and those with previous appendectomy, including right colonic resection, were excluded. Demographic, clinical, imaging and histological data were captured, and risk scores were calculated, stratifying patients into higher and lower risk groups. Data were analysed by age, sex and risk subgroups. RESULTS: The mean number of daily referrals with right iliac fossa pain or suspected appendicitis reduced significantly between the study periods, from 2.92 before lockdown to 2.07 after lockdown (p<0.001). Preoperative computed tomography (CT) rates increased significantly from 22.9% to 37.2% (p=0.002). The NAR did not change significantly between study periods (25.5% prior to lockdown, 11.1% following lockdown, p=0.159). Twelve (75%) out of sixteen negative appendectomies were observed in higher risk patients aged 16-45 years who did not undergo preoperative CT. The NAR in patients undergoing CT was 0%. CONCLUSIONS: Greater use of preoperative CT should be considered in risk stratified patients in order to reduce the NAR.

Combination anti-coronavirus therapies based on nonlinear mathematical models.

Using nonlinear mathematical models and experimental data from laboratory and clinical studies, we have designed new combination therapies against COVID-19.

Impact of six transgenic Bacillus thuringiensis rice lines on four nontarget thrips species attacking rice panicles in the paddy field.

As a key component of ecological risk assessments, nontarget effects of Bacillus thuringiensis (Bt) rice have been tested under laboratory and field conditions for various organisms. A 2-yr field experiment was conducted to observe the nontarget effects of six transgenic rice lines (expressing the Cry1Ab or fused protein of Cry1Ab and Cry1Ac) on four nontarget thrips species including Frankliniella intonsa (Trybom), F. tenuicornis (Uzel), Haplothrips aculeatus (F.), and H. tritici (Kurd), as compared with their rice parental control lines. Two sampling methods including the beat plate and plastic bag method were used to monitor the population densities of the four thrips species for 2 yr. The results showed that the seasonal average densities of four tested thrips species in Bt rice plots were significantly lower than or very similar to those in the non-Bt rice plots depending on rice genotypes, sampling methods, and years. Among all six tested Bt rice lines, transgenic B1 and KMD2 lines suppressed the population of these tested thrips species the most. Our results indicate that the tested Bt rice lines are unlikely to result in high population pressure of thrips species in comparison with non-Bt rice. In some cases, Bt rice lines could significantly suppress thrips populations in the rice ecosystem. In addition, compatibility of Bt rice, with rice host plant resistance to nontarget sucking pests is also discussed within an overall integrated pest management program for rice.

Impacts of six bt rice lines on nontarget rice feeding thrips under laboratory and field conditions.

Nontarget impacts of six transgenic Bt rice lines (expressing the Cry1Ab or Cry1Ab/Cry1Ac protein) on the thrips, Stenchaetothrips biformis (Bagnall), attacking the rice seedling and tillering stages, were evaluated under laboratory and field conditions. Laboratory results showed relatively longer larval, pupal development and preoviposition durations of S. biformis. Although it had a shorter oviposition period, female adult longevity and less total laid eggs were found when fed on some tested Bt rice in comparison to non-Bt controls. S. biformis population dynamics in Bt and non-Bt plots were monitored using the plastic bag and beat plate methods. In the field, the temporal patterns of S. biformis population changes were similar between tested Bt rice lines and their respective control; however, the total number of S. biformis individuals collected from the Bt plots were significantly less or the same, varying from variety to variety, compared with those from the non-Bt plots. ELISA results showed that the Bt insecticidal protein could be transferred from Bt rice to the thrips, and the concentrations of the protein in rice leaves and thrips were not significantly correlated with some important biological parameters of the thrip. In addition, the potential effects of Bt rice on the abundance of S. biformis candidate predators are also discussed. In conclusion, our results show that the six Bt rice lines assessed may be less preferable host plants to S. biformis at the individual and population levels in comparison to the non-Bt rice plants.

Potential of exocellular carbohydrate antigens of Staphylococcus epidermidis in the serodiagnosis of orthopaedic prosthetic infection.

The potential of exocellular carbohydrate antigens of Staphylococcus epidermidis as markers of infection in bone was investigated by immunoblotting and enzyme-linked immunosorbent assay (ELISA). Exocellular antigens were prepared by gel filtration chromatography of concentrated brain heart infusion culture supernates. The antigenic material appeared as diffuse bands between 24 and 32 kDa on the immunoblots and was not susceptible to digestion with trypsin, indicating that the response in the patients was to non-protein (polysaccharide or teichoic acid, or both) exocellular material. Significant differences were detected between the immunoblot antigen profiles for serum IgG from patients with S. epidermidis bone infection and those with an uninfected prosthetic joint. Thirteen of 16 patients with S. epidermidis prosthetic joint infection showed an elevated serum IgG level by ELISA compared with controls with uninfected joints. However, the antigen was not specific for S. epidermidis bone infection; high levels of IgG were also detected in patients with other serious staphylococcal and streptococcal infections. The ELISA test may be valuable in distinguishing between staphylococcal infection of joints and aseptic loosening by excluding cases of infection.