Addressing a real-life problem: treatment with intravenous thrombolysis and mechanical thrombectomy in acute stroke patients with an extended time window beyond 4.5 h based on computed tomography perfusion imaging.

BACKGROUND AND PURPOSE: Acute ischemic stroke treatment with intravenous thrombolysis (IVT) is restricted to a time window of 4.5 h after known or presumed onset. Recently, magnetic resonance imaging-guided treatment decision-making in wake-up stroke (WUS) was shown to be effective. The aim of this study was to determine the safety and outcome of IVT in patients with a time window beyond 4.5 h selected by computed tomography perfusion (CTP) imaging. METHODS: We analyzed all consecutive patients last seen well beyond 4.5 h after stroke onset treated with IVT based on CTP between January 2015 and October 2018. CTP was visually assessed to estimate the mismatch between cerebral blood flow and cerebral blood volume maps. Early infarct signs were documented according to Alberta Stroke Program Early CT Score (ASPECTS). Safety data were obtained for mortality and symptomatic intracerebral hemorrhage (sICH). Follow-up was assessed with the modified Rankin Scale (mRS). RESULTS: A total of 70 patients fulfilled the inclusion criteria (mean age ± SD 77.6 ± 11.5 years, 50.0% female). Median National Institutes of Health Stroke Scale score on admission was 8.0 [interquartile range (IQR), 4-14]. The most frequent reasons for an extended time window were WUS (60.0%) and delayed hospital admission (27.1%). Median time from last seen well to IVT was 11.4 h. Median ASPECTS was 10 (IQR, 9-10) and CTP mismatch 90% (IQR, 80%-100%). A total of 24 patients (34.3%) underwent additional mechanical thrombectomy. sICH occurred in four patients (5.7%). At follow-up, 49.3% had an mRS score of 0-2 and 22.4% had an mRS score of 0-1. CONCLUSIONS: In patients presenting in an extended time window beyond 4.5 h, IVT treatment with decision-making based on CTP might be a safe procedure. Further evaluation in clinical trials is needed.

Seasonality and Distribution Pattern of Brown Marmorated Stink Bug (Hemiptera: Pentatomidae) in Virginia Vineyards.

Brown marmorated stink bug, Halyomorpha halys (Stål) (Hemiptera: Pentatomidae), is a highly polyphagous invasive insect pest from eastern Asia that feeds on numerous fruit, vegetable, and field crops. Four commercial vineyards in Virginia were sampled in 2012 and 2013 to study the basic biology, seasonality, and distribution pattern of H. halys in vineyards. At each vineyard, two blocks were selected. Weekly 3-min timed count visual samplings were performed in border and interior sections from late May until mid-September. Overwintering adult bugs were first detected in vineyards in May; however, the timing of first detection differed among vineyards. Egg masses were found primarily in June and July, and were usually found on the lower surface of grape leaves, although they were occasionally on the upper leaf surface, on the berry, or on the rachis. All developmental stages of H. halys were found in vineyards, suggesting that grape can serve as a reproductive host for H. halys. Substantial variation in H. halys densities was found among vineyards and throughout the growing season. The first instars were found on egg masses and after molting, dispersed throughout the grape vines. The date on which the first egg mass was collected was considered as a biofix. Based on a degree-day model, there were sufficient degree-days for completion of a generation in Virginia vineyards. Significantly higher numbers of H. halys were collected in border sections compared with interior sections. These results are discussed in relation to the potential pest status of H. halys in vineyards and implications for possible control strategies.

A technique using reusable components for hand-infesting cornstalks with European corn borer (Lepidoptera: Crambidae) larvae.

Field trials were conducted in 2005 and 2006 to evaluate the use of reusable wire nuts and nonreusable gelatin capsules for hand-infesting cornstalks with European corn borer, Ostrinia nubilalis (Hübner), (Lepidoptera: Crambidae) larvae. The reusable technique, which consists of a modified WingGard plastic wire connector (i.e., wire nut) as a containment device for larvae, was compared over three plant growth stages to a gelatin capsule technique. In 2005 and 2006, the wire nut technique resulted in significantly higher number of wire nuts still intact (i.e., undamaged, with or without a larva) on the stalk at 72 h after infestation compared with the gelatin capsule technique. In addition, the wire nut technique resulted in significantly higher number of tunnels per stalk compared with the gelatin capsule technique at all three corn growth stages during both years. In 2005, the mean +/- SEM number of tunnels per stalk was 0.53 +/- 0.03 in the wire nut technique compared with 0.13 +/- 0.03 tunnels per stalk in the gelatin capsule technique. In 2006, the mean number of tunnels per stalk was 0.45 +/- 0.03 in the wire nut technique compared with 0.08 +/- 0.02 tunnels per stalk in the gelatin capsule technique. In addition, the relative net precision in the wire-nut technique was approximately 2 times higher compared with the gelatin capsule technique.

European corn borer (Lepidoptera: Crambidae) infestation level and plant growth stage on whole-plant corn yield grown for silage in Virginia.

Field experiments were conducted in 2004 and 2005 to determine the effect of different levels of hand-infested third instar European corn borer, Ostrinia nubilalis (Hiibner) (Lepidoptera: Crambidae), on whole-plant yield and plant growth stage in corn, Zea mays L., grown for silage. In 2004 and 2005, European corn borer infestation level had a significant negative impact on whole-plant yield (grams of dry matter per plant) with increasing infestation; however, whole-plant yield was not significantly affected by plant growth stage in either year. In 2004, the six larvae per plant treatment caused the greatest percentage of reduction (23.4%) in mean (+/-SEM) whole-plant yield (258.5 +/- 21.0 g dry matter per plant) compared with the Bacillus thuringiensis (Bt) CrylAb control (337.3 +/- 11.1 g dry matter per plant). In 2005, the five larvae per plant treatment caused the greatest percentage of reduction (8.3%) in mean whole-plant yield (282.3 +/- 10.8 g dry matter per plant) compared with the Bt CrylAb control (307.8 +/- 8.3 g dry matter per plant). The relationship between mean whole-plant yield and European corn borer larvae infestation level from the pooled data of both years was described well by using an exponential decay model (r2 = 0.84, P = 0.0038). The economic injury level for silage corn was estimated to be approximately 73% higher than for corn grown for grain based on similar control costs and crop values. In addition, plant growth stage and European corn borer infestation level had no effect on percentage of acid detergent fiber, neutral detergent fiber, and crude protein values in either year of the study.

Targeting "risky" gender ideologies: constructing a community-driven, theory-based HIV prevention intervention for youth.

Since the beginning of the HIV epidemic, school-based HIV prevention education targeting youth has taken many forms. Although there has been some success, educators continue to be challenged by situations in which youth are knowledgeable about HIV but continue to engage in risky sexual behavior. In this article, the authors propose that the underlying or implicit theories about teenagers' sexual risk behavior that guide most of these prevention activities are not accurate descriptions or valid explanations of sexual risk in this population. The article is divided into three major sections. First, the authors articulate the theories underlying HIV prevention activities that are typically found in standard school-based prevention curricula, discussing both their limitations and strengths. Second, they discuss their increased awareness of the role of gender ideologies and sexual scripts in the sexual lives of youth. Finally, the authors describe their current HIV prevention activity ("The Game") as it emerges and is shaped by their increasing understanding of the critical role of gender-based ideologies and sexual scripts in young people's sexual risk behavior.

Molecular distances from dipolar coupled spin-labels: the global analysis of multifrequency continuous wave electron paramagnetic resonance data.

For immobilized nitroxide spin-labels with a well-defined interprobe geometry, resolved dipolar splittings can be observed in continuous wave electron paramagnetic resonance (CW-EPR) spectra for interelectron distances as large as 30 A using perdeuterated probes. In this work, algorithms are developed for calculating CW-EPR spectra of immobilized, dipolar coupled nitroxides, and then used to define the limits of sensitivity to the interelectron distance as a function of geometry and microwave frequency. Secondly, the CW-EPR spectra of N epsilon-spin-labeled coenzyme NAD+ bound to microcrystalline, tetrameric glyceraldehyde-3-phosphate dehydrogenase (GAPDH) have been collected at 9.8, 34, and 94 GHz. These data have been analyzed, using a combination of simulated annealing and global analysis, to obtain a unique fit to the data. The values of the intermitroxide distance and the five angles defining the relative orientation of the two nitroxides are in reasonable agreement with a molecular model built from the known crystal structure. Finally, the effect of rigid body isotropic rotational diffusion on the CW-EPR spectra of dipolar coupled nitroxides has been investigated using an algorithm based on Brownian dynamics trajectories. These calculations demonstrate the sensitivity of CW-EPR spectra to dipolar coupling in the presence of rigid body rotational diffusion.

Child illness, the parenting alliance, and parenting stress.

Assessed relationship between children's minor illnesses during the first 3 years of life and parenting stress in the 4th year. Also examined whether a good parenting alliance would compensate for or moderate this relationship. Parents of 56 3- to 4-year-olds completed parenting alliance and stress questionnaires. Child morbidity, assessed from medical records, was directly related to mothers' but not fathers' feelings of stress. The parenting alliance was more strongly related to parenting stress for fathers than for mothers. However, child morbidity and parenting alliance interacted in predicting child-related paternal stresses. While fathers in a poor alliance reported more stress, stress was unrelated to their children's illnesses; for fathers in a moderate to strong alliance, illness and stress were positively correlated. Even minor child illnesses appear to be a source of stress for parents.