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Military medicine has a long history of humanitarian efforts globally, including responses to natural disasters and as planned medical civil action projects. However, ending two decades of war in Afghanistan, Walter Reed National Military Medical Center (WRNMMC) was tasked to receive up to 63 injured patients with less than 96-hour notice on August 27, 2021. As part of Operation Allies Refuge and transition to Operation Allies Welcome, this article highlights the complicated cross-organizational and multidisciplinary response at WRNMMC where ultimately 277 Afghan patients and nonmedical attendants received medical care and other requirements for resettlement. Lessons learned from coordinating the complex short suspense medical, cultural, and logistic efforts are noted as considerations and practical recommendations for future missions. [ABSTRACT FROM AUTHOR]

THE YOUTH MINISTRY INSTITUTE of New Orleans Baptist Theological Seminary launched the Youth Ministry Arenas (YMA) project with a primary goal of researching leader perceptions of effectiveness in three arenas of youth ministry: teenagers in the youth group, teenagers in families, and teenagers in the congregation. Stage one of a three-stage project included online surveys of 314 youth ministry leaders. Survey responses produced an overall score and three sub-scales. Stage two involved telephone interviews with respondents who scored high in each arena and discussion of initial results with an advisory panel. Stage three consisted of refinement of the YMA survey instrument for use as an online assessment tool for youth leaders. This article includes the survey design overview and initial insights from the quantitative survey data and qualitative thematic analysis of the phone interviews. [ABSTRACT FROM AUTHOR]

The extracellular colorants produced by Chlorociboria aeruginosa, Scytalidium cuboideum, and Scytalidium ganodermophthorum, three commonly utilized spalting fungi, were tested against a standard woodworker's aniline dye to determine if the fungal colorants could be utilized in an effort to find a naturally occurring replacement for the synthetic dye. Fungal colorants were delivered in two methods within a pressure treater--the first through solubilization of extracted colorants in dichloromethane, and the second via liquid culture consisting of water, malt, and the actively growing fungus. Visual external evaluation of the wood test blocks showed complete surface coloration of all wood species with all colorants, with the exception of the green colorant (xylindein) from C. aeruginosa in liquid culture, which did not produce a visible surface color change. The highest changes in external color came from noble fir, lodgepole pine, port orford cedar and sugar maple with aniline dye, cottonwood with the yellow colorant in liquid culture, lodgepole pine with the red colorant in liquid culture, red alder and Oregon maple with the green colorant in dichloromethane, and sugar maple and port orford cedar with the yellow colorant in dichloromethane. The aniline dye was superior to the fungal colorants in terms of internal coloration, although none of the tested compounds were able to completely visually color the inside of the test blocks. [ABSTRACT FROM AUTHOR]

Somatic BRAF mutations have been reported in 1-4% of non-small cell lung cancer (NSCLC), primarily in adenocarcinomas with the BRAF (V600E) mutation in about 50% of the cases. The role of BRAF mutation in NSCLC and the treatment for tumors with such mutations is still evolving. Our patient had metastatic NSCLC with metastases to her brain. Due to the BRAF (V600E) mutation in her tumor and her poor functional status, we offered her off-label treatment with vemurafenib, a BRAF inhibitor approved for use in metastatic melanoma. Our patient's visceral disease improved supporting vemurafenib's efficacy in the treatment of metastatic BRAF-mutated NSCLC. The regression of intracranial disease indicated vemurafenib was able to cross the blood-brain barrier and was efficacious in treating brain metastases in this patient with lung cancer. [ABSTRACT FROM AUTHOR]

In the article, the author discusses the importance of interprofessional collaboration among health care professionals like psychiatrists, therapists, and psychiatric mental health nurse practitioners (PMHNP) to optimize care for patients. Other topics include the anticipated shortage of mental health care professionals in the U.S. by 2025, the increasing number of retiring psychiatrists, and the specialized education, training and certification for PMHNPs.

Abstract: Wood-decay patterns are strongly influenced by the conditions of the wood substrate, and the pH of the substrate is one of the most important factors. As a reaction to a stressed environment, some lignicolous fungi respond with pigment formation that helps to isolate and protect their mycelia; other fungi, with high specificity, produce pigmentation regardless of the changes in the conditions in which the fungus grows. These changes result in only minor variation in the color intensity of the pigment. The occasional dark-colored reaction pigment, also known as melanin, is the most common pigment formed by wood-decay fungi. To investigate pigment formation under the influence of pH variation, sugar maple and beech samples adjusted with buffer solutions to different pH values were inoculated with various basidiomycetes and ascomycetes fungi, known to produce pigmentation. Based on the range and increments of the pH treatments tested on the wood substrate, maximum pigmentation and minimum mass loss occur at adjacent values of pH treatments for all wood–fungus combinations, and never coincide. Maximum pigment production occurred at treatment with pH 4.5 for beech and sugar maple inoculated with Trametes versicolor, while Xylaria polymorpha produced external pigmentation in beech treated with buffer at pH 5 and sugar maple at pH 4.5. Fungi tested in agar substrate produced maximum pigmentation at the pH range 4–5.5, except for Scytallidium cuboideum, which produce maximum intensity of red pigment at pH 6 and blue pigment at pH 8. [Copyright &y& Elsevier]

This research subjected four wood species pigmented with the red stain of Scytalidium cuboideum and Acer negundo wood pigmented with the tree's naturally occurring red stain to natural and artificial UV light. Several commercially available coatings were applied to determine the effect of coating on the degradation of both red stains over time. The red stain of Acer negundo was found to be significantly less stable in UV light than the red pigment produced by S. cuboideum on any wood species, even A. negundo. None of the tested coatings significantly increased the pigment retention time of the red stain produced by A. negundo. The red stain of S. cuboideum was significantly affected by both coating and wood species; Populus tremuloides retained pigment significantly longer than Fagus grandifolia or Acer saccharum, and the Danish oil coating retained pigment significantly longer than the lacquer, water-based polyurethane with UV inhibitors, or the uncoated samples. Overall, lacquer increased the degradation rate of the red pigment produced by S. cuboideum, with the most pronounced increase occurring on F. grandifolia. These results indicate that the red-pigmented wood produced by A. negundo may not be appropriate for applications involving UV exposure, regardless of coating utilized. However, P. tremuloides wood pigmented with S. cuboideum may be appropriate for such applications, especially if Danish oil is applied as a coating. [ABSTRACT FROM AUTHOR]

The role of test block placement within a modified decay jar system for promotion of fungal pigments was investigated. Beech and sugar maple blocks were inoculated with common pigment producing fungi and incubated for 10 weeks. Blocks were placed either below the vermiculite or resting on its surface; no feeder strips were utilized. Amount of pigmentation differed with block placement with Arthrographis cuboidea (on sugar maple and beech) and Xylaria polymorpha (only on sugar maple) producing more pigment when placed on the surface of the vermiculite. The differences in pigmentation, however, were not necessarily due to moisture content differences within test blocks, as moisture content did not vary significantly by block placement with A. cuboidea. Results indicate that placement of wood above vermiculite may increase pigmentation; however, reasons for the increase appear to differ among fungi. [ABSTRACT FROM AUTHOR]

The article discusses the influenza outbreaks at two correctional facilities in Maine in March 2011. It cites measures that correctional facilities should strongly consider during each influenza season. Case reports and outbreak investigation are explored. It was found that the two correctional facilities did not have enough supplies of vaccine and antiviral drugs. Maine Center for Disease Control and Prevention (CDC) supplied vaccine and the state stockpile supplied antiviral drugs.

The use of fungal pigments as color additives to wood as a method to increase forest revenue is a relatively new, but quickly developing field. Sugar maple ( Acer saccharum) is currently the primary utilized hardwood for spalting and appears to be the best suited North American hardwood for such purposes. The combination of Trametes versicolor and Bjerkandera adusta has been identified in several instances as a strong fungal pairing for zone line production; however, Xylaria polymorpha is capable of creating zone lines without the antagonism of a secondary fungus. Few fungal pigments have been developed for reliable use; Scytalidium cuboideum is capable of producing a penetrating pink/red stain, as well as a blue pigment after extended incubation, and Chlorociboria sp. produces a blue/green pigment if grown on aspen ( Populus tremuloides). Several opportunities exist for stimulation of fungal pigments including the use of copper sulfate and changes in wood pH. [ABSTRACT FROM AUTHOR]

American beech ( Fagus grandifolia) is an abundant, underutilized tree in certain areas of North America, and methods to increase its market value are of considerable interest. This research utilized pigment-producing fungi to induce color in American beech to potentially establish its use as a decorative wood. Wood samples were inoculated with Trametes versicolor, Xylaria polymorpha, Inonotus hispidus, and Arthrographis cuboidea to induce fungal pigmentation. Black pigmentation ( T. versicolor, X. polymorpha, I. hispidus) was sporadic, occurred primarily on the surfaces of the heartwood, but not internally. Pink pigmentation ( A. cuboidea) occurred throughout all of the tested beech samples, but was difficult to see in the heartwood due to the darker color of the wood. To increase the visibility of the pink stain, beech blocks were pretreated with T. versicolor for 4 weeks before being inoculated with A. cuboidea. This method significantly increased the saturation of the pink stain on both beech heartwood and sapwood, creating coloration similar to that found on sugar maple. This value-adding process should be particularly effective for small-scale wood pigmentation, and should help establish a market for this currently underutilized wood species. [ABSTRACT FROM AUTHOR]

Abstract: Five fungal species representing the three major spalting categories were inoculated onto wood of five different urban tree species with low to moderate economic value. Sugar maple (Acer saccharum) was also inoculated to serve as a control. Test samples were evaluated both internally and externally for spalting. The tested fungi had significant preferences for different wood species, and the preferences appeared to be related to sucrose availability. Specifically, zone line producing fungi preferred American elm (Ulmus americana), while Arthrographis cuboidea (pink stain) preferred tree-of-heaven (Ailanthus altissima). Wood species preference was also significant by decay class, with decay fungi preferring American elm, silver maple (Acer saccharinium), and horse chestnut (Aesculus hippocastanum). Staining fungi showed a preference for tree-of-heaven, while both decay classes readily colonized sugar maple and Norway maple (Acer platanoides). [Copyright &y& Elsevier]

This research investigated the use of red pigment producing fungi in controlled inoculation into woody substrates for decorative applications. Two species isolated from red-stained wood and two strains of capable of producing red stain in culture were inoculated onto sugar maple ( Marsh.), incubated for 6-14 weeks, and evaluated for their ability to produce a high-saturation, penetrating stain. Both Fusarium species failed to produce significant pigmentation either externally or internally. Both strains of A. cuboidea produced high amounts of surface and penetrating red stain within a moderate incubation period (over 80% of the wood samples stained by 10 weeks of incubation) but were capable of doing so only under sterile or semisterile conditions. Production of red stain did not differ between A. cuboidea isolates except at 6 and 8 weeks where isolate ELS-1 had significantly higher internal red stain. It was also found that an increase in incubation time for A. cuboidea past 8 weeks led to increasing amounts of blue pigment on external wood surfaces. The findings indicate that A. cuboidea is suitable for production of red pigmentation on decorative wood applications only if utilized under sterile or semisterile conditions and incubation is halted before blue pigment begins to form. [ABSTRACT FROM AUTHOR]

Recent Western preference for functional wooden objects has promoted an ideal of clear, smooth, straight-grained lumber. However, wood does not need to be free of defects to be functional. This paper explores the relationship between decay and functionality in terms of parergonal aesthetics by presenting the use of fungi to alter surface texture and color on wooden bowls. In addition, the bowls' altered but functional state forces the viewer to reconsider modern views on the role of defect-free wood within a functional context. [ABSTRACT FROM AUTHOR]

Abstract: This research attempted to determine conditions and wood species required to maximize xylindein production from a Chlorociboria sp. under laboratory conditions for use in induced spalting. A pure culture of a Chlorociboria species was isolated from fruiting bodies and grown on 2% malt extract agar. The colonies reached a maximum diameter of 18 mm in four weeks, although the blue-green xylindein pigment continued to diffuse through the culture media for at least eight months. In vermiculite jar tests, this Chlorociboria isolate colonized Populus tremuloides more heavily than Acer saccharum or Betula alleghaniensis, and did not colonize Tilia americana at all. Pre-inoculation of test blocks with white rot fungi did not significantly affect xylindein production, regardless of wood species. [Copyright &y& Elsevier]

Tebuconazole, didecyldimethylammonium chloride (DDAC), and boric acid are co-biocides frequently added to copper-based wood preservative systems. Although the performance thresholds of these biocides are well known, there is currently little information on the effects of subthreshold loadings of the co-biocides on common wood decay fungi. We tested five strains of Postia placenta on white pine cubes ( Pinus strobus) treated with subthreshold retentions of tebuconazole, DDAC, or boric acid. No stimulatory effects were observed on blocks treated with DDAC or boric acid. Decay stimulation, as measured by weight loss, occurred between loadings of 1.0×10-5 to 1.0×10-3 kg m-3 on blocks treated with tebuconazole. This effect should be taken into account during the design and use of wood preservative systems containing this fungicide. [ABSTRACT FROM AUTHOR]

Introduction: Pancreatic cancer has not been well studied, especially in developing countries. Materials and Methods: We studied the variations in genetic mutations in pancreatic adenocarcinoma between Moroccan and Egyptian populations. The molecular pathology of 30 tumors from a large hospital in Casablanca, Morocco were examined and compared with the findings of 44 tumors from the Gharbiah Governate in Egypt. K-ras mutations in codons12 and 13 in addition to p53 mutations in exons 5-8 were evaluated. Results: Overall, differences in the rates of K-ras mutations were not statistically significant (48.00 and 34.09%, respectively); however differences in rates of p53 mutations were statistically significant with p53 mutations more common in Moroccan tumors than in Egyptian tumors (46.67 and 16.28%, respectively). G→T mutations of the K-ras gene were most commonly seen Egyptian tumors, whereas G→Amutations were the most common type of mutations in Moroccan tumors. Logistic regression analysis showed that a p53 mutation in any exon as well as a p53 mutation in exon 5 predicted the country of residence and those mutations occurred more frequently in Moroccan patients. Conclusion: Our study shows that differences exist within the Arab population in the molecular pathology of both the K-ras and p53 genes. Further studies are necessary to clarify the differences in molecular pathways of pancreatic cancer in the Middle East and to investigate the role of environmental and/or genetic factors related to those pathways. [ABSTRACT FROM AUTHOR]

Abstract: Forty species of fungi, representing a range of ecological and taxonomic groups, were tested for their ability to grow on agar media amended with lithium chloride (LiCl) at 1.5, 3 and 6gl−1. Species of Trichoderma varied considerably in their sensitivity to LiCl; at one week on 6gl−1 LiCl medium, the growth of seven species of Trichoderma was considerably inhibited; however, by three weeks at this level, four of the species tested were able to attain ≥30% of control growth. Of the seven species tested, an isolate of T. viride was the most sensitive to LiCl in agar. Eleven other imperfect fungi also showed a range of ability to grow on agar amended with LiCl, from total inhibition to complete lack of inhibition. Six ascomycete fungi were greatly inhibited by LiCl at all levels; however, an isolate of Chaetomium globosum was highly tolerant of LiCl. Seven basidiomycete wood-decay fungi were quite sensitive to LiCl in agar, showing total to nearly total inhibition even at the lowest level; however, after three weeks, an isolate of Postia placenta was nearly uninhibited except at 6gl−1. Five ectomycorrhizal basidiomycete fungi were totally inhibited by all levels of LiCl; however, one ectomycorrhizal imperfect fungus (Cenococcum graniforme) was able to grow at 3gl−1 and was uninhibited at 1.5gl−1. Four zygomycete fungus isolates were nearly unaffected in their growth by all levels of LiCl. [Copyright &y& Elsevier]

Abstract: Background: Chlorhexidine and povidone iodine are both disinfectants used in the hospital setting. Chlorhexidine has been proven to be superior prior to the insertion of lines such as central venous catheters [Kinirons B, Mimoz O, Lafendi L, Naas T, Meunier J, Nordmann P. Chlorhexidine versus povidone iodine in preventing colonization of continuous epidural catheters in children: a randomized, controlled trial. Anesthesiology 2001;94(2):239–44]. The growing number of epidural insertions warrants a review of the literature to determine if chlorhexidine remains the superior skin disinfectant prior to epidural insertion, as well as being useful when impregnated in epidural dressings. Objectives: To summarize what is known regarding the effectiveness of disinfectants on skin preparation and dressings in patients receiving epidural analgesia. Methods: A systematic review of nine reports of trials was completed to examine the efficacy of disinfectants in patients with epidural analgesia. These reports included randomized controlled trials and clinical trials. Results: Findings indicated that chlorhexidine has been proven to be just as, if not more effective than povidone iodine in reducing microbial colonization of epidural catheters when utilized as a skin disinfectant [Kinirons B, Mimoz O, Lafendi L, Naas T, Meunier J, Nordmann P. Chlorhexidine versus povidone iodine in preventing colonization of continuous epidural catheters in children: a randomized, controlled trial. Anesthesiology 2001;94(2):239–44; Sato S, Sakuragi T, Dan K. Human skin flora as a potential source of epidural abscess. Anesthesiology 1996;85(6):1276–82; Sakuragi T, Higa K, Dan K, Okubo M. Skin floras on the human back and disinfection with alcoholic chlorhexidine, povidone iodine, and ethyl alcohol. Pain Clinic 1986/1987;1(3):183–8]. Moreover, when used in impregnated dressings, it may further reduce microbial colonization of epidural catheters [Mann T, Orlikowski C, Gurrin L, Keil, A. The effect of the biopatch, a chlorhexidine impregnated dressing, on bacterial colonization of epidural catheter exit sites. Anaesth Intensive Care 2001;29(6):600–3; Shapiro J, Bond E, Garman K. Use of a chlorhexidine dressing to reduce microbial colonization of epidural catheters. Anesthesiology 1990;73:625–31]. Conclusion: Chlorhexidine could be considered the cutaneous antiseptic of choice prior to epidural insertion, although further studies to confirm this are warranted. The additions of chlorhexidine impregnated dressings require further studies to validate its use, although early studies are promising. [Copyright &y& Elsevier]

The article discusses how to become a psychiatric mental health nurse practitioner (PMHNP) in the U.S. Other topics include how Hildegard Peplau and Doctor Harry Stack Sullivan developed and implemented the first master's-level role for advanced practical nurses to directly handle psychiatric patients, and how to obtain PMHNP certification from the American Nurses Credentialing Center.

Abstract: Deciduous wood pigmented by fungi (spalted wood) has a long history of use in decorative woodcraft dating back to at least the 15th century and is still routinely utilized by woodworkers today. With the prevalence of the mountain pine beetle in western North America, a large amount of bluestained wood is currently available but is not utilized for value-added applications like spalting. This study shows that bluestained lodgepole pine is an ideal wood for additional spalting treatment with Scytalidium species, resulting in additional pigments of pink or yellow on the wood. The results of this study show that not only can coniferous wood be spalted, but that bluestained pine is particularly well suited for additional pigmentation. Brightly pigmented spalted wood is rare within the current marketplace and offers a new potential market for bluestained lumber and a chance for areas affected by mountain pine beetle to recapture lost income from their forest stock. [Copyright &y& Elsevier]

Background: The risk of infection with avian influenza A viruses currently circulating in wild and domestic birds in the Americas is considered low for the general public; however, detections in humans have been reported and warning signs of increased zoonotic potential have been identified. In December 2022, two Canada geese residing on the grounds of an urban hospital in Maine tested positive for influenza A H5N1 clade 2.3.4.4b. Aims: Given the opportunity for exposure to staff and hospital visitors through potentially infected faeces on the property, public health authorities determined mitigation efforts were needed to prevent the spread of disease. The ensuing response relied on collaboration between the public health and animal health agencies to guide the hospital through efforts in preventing possible zoonotic transmission to humans. Materials and Methods: Mitigation efforts included staff communication and education, environmental cleaning and disinfection, enhanced illness surveillance among staff and patients, and exposure and source reduction. Results: No human H5N1 cases were identified, and no additional detections in birds on the property occurred. Hospital staff identified barriers to preparedness resulting from a lack of understanding of avian influenza A viruses and transmission prevention methods, including avian influenza risk in resident wild bird populations and proper wildlife management methods. Conclusion: As this virus continues to circulate at the animal‐human interface, this event and resulting response highlights the need for influenza A H5N1 risk awareness and guidance for facilities and groups not traditionally involved in avian influenza responses. [ABSTRACT FROM AUTHOR]

Incidence of human granulocytic anaplasmosis is rising in Maine, USA. This increase may be explained in part by adoption of tick panels as a frequent diagnostic test in persons with febrile illness and in part by range expansion of Ixodes scapularis ticks and zoonotic amplification of Anaplasma phagocytophilum. [ABSTRACT FROM AUTHOR]

Fungal pigments from spalting fungi Scytalidium cuboideum (red), Scytalidium ganodermophthorum (yellow) and Chlorociboria aeruginosa (green), were used to attenuate the presence of blue sap-stain in Pinus spp. samples. Pigments, filtered from liquid cultures of spalting fungi, were vacuum impregnated into pine samples with three different levels of blue staining: 1 [0–50%], 2 [50–90%] and 3 [100%]. The CIE L*a*b* color difference at wood surfaces, before vs. after treatment, was quantified with a chroma meter and the internal color coverage in the core of the samples with digital images. Light microscopy was used to observe the penetration of pigment in the microstructure of blue stained pine samples. Results show that fungal pigments are suitable candidates to attenuate the appearance of blue stain on the wood surface. Pigments produced by S . cuboideum showed a higher color difference regardless of the blue stain level, but the highest color difference was obtained in samples with staining level 1. The percentage of internal color coverage of pigments was significantly higher for green and red pigments in staining levels 1 and 2. The proposed treatment may be used to improve the value of blue stained wood allowing its commercialization into the niche of environmentally friendly products. [ABSTRACT FROM AUTHOR]