Characterization of Phytophthora infestans resistance to mefenoxam using FTIR spectroscopy.

Phytophthora infestans (P. infestans) is the causal agent of late blight in potato and tomato. This pathogen devastated the potato crops in Ireland more than a century years ago and is still causing great losses worldwide. Although fungicides controlling P. infestans have been used successfully for almost 100 years, some isolates have developed resistance to most common fungicides. Identification and characterization of these resistant isolates is required for better control of the disease. Current methods that are based on microbiological and molecular techniques are both expensive and time consuming. Fourier Transform Infra-Red spectroscopy (FTIR) is an inexpensive and reagent-free technique that provides accurate results in only a few minutes. In this study the infrared absorption spectra of the sporangia of P. infestans were measured to evaluate the potential of FTIR spectroscopy in tandem with multivariate analysis in order to classify those sporangia into those that were resistant and those that were non-resistant to the phenylamide fungicide mefenoxam. Based on individual measurements, our results show that FTIR spectroscopy enables classification of P. infestans isolates into mefenoxam resistant and mefenoxam non-resistant types with specificity of 81.9% and sensitivity of 75.5%. Using average spectra per leaf, it was possible to improve the classification results to 88% sensitivity and 95% specificity.

Utilizing FTIR-ATR spectroscopy for classification and relative spectral similarity evaluation of different Colletotrichum coccodes isolates.

Colletotrichum coccodes (C. coccodes) is a pathogenic fungus which causes anthracnose on tomatoes and black dot disease in potatoes. It is important to differentiate among these isolates and to detect the origin of newly discovered isolates, in order to treat the disease in its early stages. However, distinguishing between isolates using common biological methods is time-consuming, and not always available. We used Fourier Transform Infra-Red (FTIR)-Attenuated Total Reflectance (ATR) spectroscopy and advanced mathematical and statistical methods to distinguish between different isolates of C. coccodes. To our knowledge, this is the first time that FTIR-ATR spectroscopy was used, combined with multivariate analysis, to classify such a large number of 15 isolates belonging to the same species. We obtained a success rate of approximately 90% which was achieved using the region 800-1775 cm(-1). In addition we succeeded in determining the relative spectral similarity between different fungal isolates by developing a new algorithm. This method could be an important potential diagnostic tool in agricultural research, since it may outline the extent of the biological similarity between fungal isolates. Based on the PCA calculations, we grouped the fifteen isolates included in this study into four different degrees of similarity.

Distinction of Fusarium oxysporum fungal isolates (strains) using FTIR-ATR spectroscopy and advanced statistical methods.

Fusarium is a large fungi genus of a large variety of species and strains which inhabits soil and vegetation. It is distributed worldwide and affiliated to both warm and cold weather. Fusarium oxysporum species, for instance, cause the Fusarium wilt disease of plants, which appears as a leaf wilting, yellowing and eventually plant death. Early detection and identification of these pathogens are very important and might be critical for their control. Previously, we have managed to differentiate among different fungi genera (Rhizoctonia, Colletotrichum, Verticillium and Fusarium) using FTIR-ATR spectroscopy methods and cluster analysis. In this study, we used Fourier-transform infrared (FTIR) attenuated total reflection (ATR) spectroscopy to discriminate and differentiate between different strains of F. oxysporum. The result obtained was of spectral patterns distinct to each of the various examined strains, which belong to the same species. These differences were not as significant as those found between the different genera species. We applied advanced statistical techniques: principal component analysis (PCA) and linear discriminant analysis (LDA) on the FTIR-ATR spectra in order to examine the feasibility of distinction between these fungi strains. The results are encouraging and indicate that the FTIR-ATR methodology can differentiate between the different examined strains of F. oxysporum with a high success rate. Based on our PCA and LDA calculations performed in the regions [900-1775 cm(-1), 2800-2990 cm(-1), with 9 PCs], we were able to classify the different strains with high success rates: Foxy1 90%, Foxy2 100%, Foxy3 100%, Foxy4 92.3%, Foxy5 83.3% and Foxy6 100%.

A proposed rural healthcare ethics agenda.

The unique context of the rural setting provides special challenges to furnishing ethical healthcare to its approximately 62 million inhabitants. Although rural communities are widely diverse, most have the following common features: limited economic resources, shared values, reduced health status, limited availability of and accessibility to healthcare services, overlapping professional-patient relationships and care giver stress. These rural features shape common healthcare ethical issues, including threats to confidentiality, boundary issues, professional-patient relationship and allocation of resources. To date, there exists a limited focus on rural healthcare ethics shown by the scarcity of rural healthcare ethics literature, rural ethics committees, rural focused ethics training and research on rural ethics issues. An interdisciplinary group of rural healthcare ethicists with backgrounds in medicine, nursing and philosophy was convened to explore the need for a rural healthcare ethics agenda. At the meeting, the Coalition for Rural Health Care Ethics agreed to a definition of rural healthcare ethics and a broad-ranging rural ethics agenda with the ultimate goal of enhancing the quality of patient care in rural America. The proposed agenda calls for increasing awareness and understanding of rural healthcare ethics through the development of evidence--informed, rural-attuned research, scholarship and education in collaboration with rural healthcare professionals, healthcare institutions and the diverse rural population.

The influence of client characteristics on psychologists' ethical beliefs: an empirical investigation.

Do psychologists' ethical beliefs depend upon client characteristics? In the current study, licensed psychologists were surveyed regarding their ethical beliefs using an adaptation of a frequently used list of therapist behaviors rated for ethicality (Pope, Tabachnick, & Keith-Spiegel, 1987). In the current survey, the age, sex, and diagnostic severity of the hypothetical client were specified and varied between participants. Results indicated a significant interaction between client age and client sex, such that older male clients elicited lower overall ethicality ratings than did younger male clients, but older female clients elicited higher overall ethicality ratings than did younger female clients. This finding was especially robust when a subset of therapist behaviors involving assertive or discomforting therapist actions was considered.

Ethical beliefs of mental-health professionals and undergraduates regarding therapist practices.

Psychotherapists should be aware of any discrepancies of opinion between themselves and those outside the mental-health profession regarding the ethicality of therapist actions. In this study, the beliefs of mental-health professionals and nonprofessionals (represented by undergraduate students) regarding the ethicality of therapist behaviors were compared. Factor analysis of 82 specific therapist behaviors yielded three factors: nonsexual dual relationships, assertive or discomforting therapist actions, and sexual dual relationships. A comparison of factor composite scores indicated that undergraduates, in relation to professionals, rated nonsexual dual relationships as more ethical and assertive or discomforting actions as less ethical. Although these effects may diminish with age, these results nonetheless suggest that mental-health professionals may hold ethical beliefs that are inconsistent with those who seek their services. Implications of these findings are discussed.

Ethical behaviors of psychologists: changes since 1987.

Licensed psychologists (n = 92) in Illinois were surveyed regarding the frequency with which they engage in 82 behaviors of varying ethical appropriateness. For about one-third of the behaviors studied, results differed significantly from a similar national survey published in 1987, such that the current sample reported never engaging in the behavior more frequently than did the previous sample. These differences may be due to increased involvement of managed care in professional practice, the revised ethical code, or regional or sampling factors. Implications of these results, including the need to assess ethical norms frequently, are discussed.

What if prospective clients knew how managed care impacts psychologists' practice and ethics? An exploratory study.

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics (Murphy, DeBernardo, & Shoemaker, 1998) were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed.

Transient postictal psychosis associated with a course of ECT.

Postictal psychoses, defined as episodic, time-limited psychiatric disturbances of diverse phenomenology, temporally related to a seizure or cluster of seizures, have been well described in patients with focal and generalized epilepsies. Although similar disturbances have been reported in patients undergoing electroconvulsive therapy (ECT), the syndrome of ECT-associated postictal psychosis has not been well described. We review the literature defining the syndrome of postictal psychosis (PIP) associated with the epilepsies, as well as reports of confusional and manic disturbances meeting accepted criteria for PIP, which have been reported to occur as complications of ECT. In addition, we report a case of delusional and hallucinatory psychosis associated with a course of ECT, also having the characteristics of a PIP. We conclude that time-limited psychiatric disturbances, phenomenologically (and possibly pathophysiologically) similar to the PIP of epilepsy can occasionally occur as complications of ECT, and that they may have confusional, manic, delusional, or hallucinatory symptoms. The implications of these occurrences for the use and continuation of ECT are discussed.

Toxocariasis: a diagnostic dilemma.

Visceral larva migrans (VLM) is endemic in Israel; therefore, a positive serology is not unusual in our general population. The clinical manifestations of the disease may mimic other clinical conditions. Sometimes life-threatening disorders have to be considered in the differential diagnosis. This diagnostic dilemma can be solved occasionally only by histological examination. We report two patients, one with a lymphoma-like presentation and the other with an intraocular tumoral mass suggesting retinoblastoma, and discuss the diagnostic difficulties.

Preceptors' strategies for correcting residents in an ambulatory care medicine setting: a qualitative analysis.

PURPOSE: To understand the interactional strategies preceptors use as they relate to and occasionally correct interns in a general internal medicine teaching clinic. METHOD: An observational, cohort study was carried out from May 1990 through May 1993 of the precepting conversations between 11 pairs of interns and faculty preceptors in the general internal medicine ambulatory care clinic of the Hospital of the University of Pennsylvania. All interactions were videotaped and transcribed. The interactions provided numerous examples of preceptors' correcting of interns. These were analyzed qualitatively by ethnographic and conversation-analytic methods. RESULTS: The strategies the preceptors used to correct the interns were complicated and quite indirect, and tended to minimize exposing the interns' errors. These strategies revealed the dilemmas inherent in being a preceptor and also the beliefs the preceptors brought to their task. The preceptors' strategies demonstrated their high regard for maintaining the interns' self-esteem and sense of responsibility, as well as the preceptors' willingness to forego, at least for the moment, correctional strategies that might have been more explicit and direct. CONCLUSION: The preceptors' general approach to correcting interns was consistent with pedagogic norms favoring discovery learning and with societal norms favoring egalitarianism and respect for individuals. This approach, however, may not be free of problems, and raises questions regarding the effects such strategies have upon the interns' capacity for accurate self-assessment, including the assessment of their own knowledge bases.

Resolution of depressive symptoms in medical inpatients after discharge.

OBJECTIVE: Most studies to date demonstrate a high prevalence of depressive symptoms and depressive disorders in general medical inpatients. In order to determine whether these symptoms represent a self limited epiphenomenon of medical illness or evidence of psychiatric comorbidity, assessment of the natural history of such symptoms in this population is necessary. In this study we focused on resolution versus persistence of depressive symptoms in hospitalized medical patients following medical, but not psychiatric, treatment. METHOD: Every second admission to the acute care medical ward of a VA teaching hospital was assessed for inclusion in the study. Fifty-seven were screened, fifty participated initially, forty-two remained in the study for the one-week post-discharge follow-up, and thirty-three remained at the one-month follow-up. Depressive symptomatology was measured with the Beck Depression Inventory at each time point. Subjects whose scores at follow-ups were above threshold were considered to have persistent symptoms and those whose scores fell below threshold were considered to have resolved. No patients were treated with antidepressants prior to or during the study. RESULTS: With a conventionally accepted threshold score (14) on the BDI as representing clinically significant depression, roughly half of those patients identified as depressed at the time of admission were nondepressed at both follow-ups. The BDI predicted persistence of depression with a sensitivity of .64 and specificity of .74 at one week and .71 and .73 at one month. Raising the threshold score to 20 raised the sensitivity to 1.00 and the specificity to .95 at one week and 1.00 and .93 at one month. CONCLUSIONS: Depressive symptoms seen in acutely-ill medical patients can be expected to resolve without potentially-hazardous antidepressant treatment in a significant number of patients. Persistence of depressive symptoms may be better predicted by raising the threshold on commonly used self-report scales.

Informed consent, competency, and the illusion of rationality.

Since the advent of informed consent, patients have become more involved in treatment decisions than ever before. To give an informed consent or refusal a patient must be competent to understand the information being presented. Although most authors agree on the need for a structured format for assessing competency, in practice this step is often omitted if the patient's decision "makes sense." In this paper we present two cases in which acutely ill patients gave apparently rational refusals of potentially life-prolonging treatment. Following their recovery, both viewed their earlier decisions as irrational. These cases demonstrate some of the difficulties in assessing competency and rationality in gravely ill patients, and the need for careful evaluation regardless of the apparent rationality of expressed desires.

Early post-pneumonectomy bronchial stump fistula.

Bronchial stump fistula occurred on the seventh postoperative day in a 45-year-old man who underwent right pneumonectomy for T2N2M0 adenocarcinoma of the lung. It was attributable to ventilator-related barotrauma during treatment of ARDS from multiple pulmonary emboli. A frequently lethal complication, its presentation, management and prevention in the early postoperative period are discussed.

Results of surgical treatment of stage III lung cancer invading the mediastinum.

From 1974 to 1984, 225 patients underwent thoracotomy at Memorial Sloan-Kettering Cancer Center for primary non-small cell lung cancer invading only the mediastinum (T3). The perioperative mortality was 2.7 per cent, and the nonfatal complication rate 13 per cent. Forty-nine patients underwent complete resection of all intrathoracic disease, with a median survival of 17 months, 3-year survival of 21 per cent, and 5-year survival of 9 per cent. Thirty-three patients underwent pulmonary resection with simultaneous iodine-125 interstitial implantation or iridium-192 delayed afterloading to areas of unresectable primary or nodal disease, with a median survival of 12 months, 3-year survival of 22 per cent, and 5-year survival of 22 per cent. One hundred and one patients underwent interstitial implantation without resection, with a median survival of 11 months, 3-year survival of 9 per cent, and no 5-year survivors. Forty-two patients had incomplete resection without intraoperative radiation therapy and fared no better than a cohort group of 44 unoperated patients with clinical evidence of mediastinal invasion--both groups had a median survival of 8 months and no 3-year survivors. An aggressive surgical approach with pulmonary resection and/or brachytherapy appears to offer some survival advantage to this group of patients. In particular, 5-year survival rates ranging from 7 to 15 per cent were observed in subsets of intraoperatively treated patients with invasion of pulmonary vein, phrenic nerve, esophagus, or pericardium and in those with clinically occult T3 disease.

Insemination of Holstein heifers at a preset time after estrous cycle synchronization using progesterone and prostaglandin.

Two experiments were conducted to study estrous cycle control regimens that combine progesterone administration via an intravaginal device ( PRID ) with a single injection of prostaglandin F2 alpha (PG). In Exp. I, 242 Holstein heifers were assigned randomly to one of three treatment groups at 14 to 18 mo of age. Treatments were: 1) control, 2) PRID -6 + PG-6 ( PRID in place for 6 d plus PG on the day of PRID removal) and 3) PRID -7 + PG-6 ( PRID in place for 7 d plus PG on the day before PRID removal). Heifers were observed for estrous activity and were inseminated at 8 to 20 h after estrus was detected. Estrus and ovulation were effectively synchronized after both PRID + PG treatments. Ninety-nine percent of the heifers in each group were in estrus within 168 h after PG injection. However, the interval from PG administration to the onset of estrus was longer after PRID -7 + PG-6 (75 +/- 2 h) than after PRID -6 + PG-6 (66 +/- 2 h). A lower variance in the interval from PG treatment to estrus was observed after PRID -7 + PG-6, suggesting that the 24 h delay in PRID withdrawal improved the synchrony of the onset of estrus. Pregnancy rates (72 to 82%) did not vary across treatment groups. Two-hundred seventy-four heifers were assigned to Exp. II. Treatments were 1) control, 2) 2 X PG (two injections of PG at an 11 d interval) and 3) PRID -7 + PG-6.(ABSTRACT TRUNCATED AT 250 WORDS)