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Sangmi Kim,1 Carolyn Martin,2 John White,2 Maureen Carlyle,2 Bonnie Bui,2 Shiyao Gao,1 Claudia A Salinas1 1Global Patient Safety Pharmacoepidemiology, Eli Lilly and Company, Indianapolis, IN, USA; 2Health Economics and Outcomes Research, Optum Life Sciences, Eden Prairie, MN, USACorrespondence: Claudia A Salinas, Global Patient Safety Pharmacoepidemiology, Eli Lilly and Company, Lilly Corporate Center, 893 Delaware St, Indianapolis, IN, 46285, USA, Tel +1 317 433 9188, Email claudia.salinas@lilly.comPurpose: Health insurance claims databases provide an opportunity to study uncommon events, such as venous thromboembolism (VTE), in large patient populations. This study evaluated case definitions for identifying VTE among patients treated for rheumatoid arthritis (RA) using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes in claims data.Patients and Methods: Study participants were insured adults who received treatment for and had a diagnosis of RA between 2016 and 2020. After a 6-month covariate assessment window, patients were observed for ≥ 1 month until health plan disenrollment, occurrence of a presumptive VTE, or end of the study (12/31/2020). Presumptive VTEs were identified using predefined algorithms based on ICD-10-CM diagnosis codes, anticoagulant use, and care setting. Medical charts were abstracted to confirm the VTE diagnosis. Performance of primary and secondary (less stringent) algorithms was assessed by calculating the positive predictive value (PPV; primary and secondary objectives). Additionally, a linked electronic health record (EHR) claims database and abstracted provider notes were used as a novel alternative source to validate claims-based outcome definitions (exploratory objective).Results: A total of 155 charts identified with the primary VTE algorithm were abstracted. The majority of patients were female (73.5%), with mean (standard deviation) age 66.4 (10.7) years and Medicare insurance (80.6%). Obesity (46.8%), ever smoking (55.8%), and prior evidence of VTE (28.4%) were commonly reported in medical charts. The PPV for the primary VTE algorithm was 75.5% (117/155; 95% confidence interval [CI], 68.7%, 82.3%). A less stringent secondary algorithm had a PPV of 52.6% (40/76; 95% CI, 41.4%, 63.9%). Using an alternative EHR-linked claims database, the primary VTE algorithm PPV was lower, potentially due to the unavailability of relevant records for validation.Conclusion: Administrative claims data can be used to identify VTE among patients with RA in observational studies.Keywords: algorithm validation, rheumatoid arthritis, venous thromboembolism, positive predictive value, administrative claims data, ICD-10-CM

Currently, many sugarcane mills face the challenge of obtaining sufficient raw material. This work analyzes and compares the land access forms to cane production in Brazil (big producer) and Peru (small producer). Data from Agricultural Censuses of the two countries are used. In the analyzed period, there was an increase in sugarcane production in both countries. It is observed that in Brazil, the tendency is for sugar mills to use land leasing or sharecropping contracts. In Peru, new sugarcane mills mainly use their own land. The access to land through agrarian contracts can be a factor of sustainability of the sugarcane agribusiness.

Peruvian regions for sugarcane planting produce sugarcanes throughout the year with a high average productivity. The objective of this article is to analyze the role of agents in the sugarcane supply chain to Peruvian mills and their relationship with the practice of agrarian contracts to sugarcane production. The perception of landowners and farmers about bioenergy and their predisposition to plant energy crops is also investigated. Field interviews are conducted with the main agents of the sugarcane production chain in the major producing regions. Statistical analysis of data from field interviews indicates that the relationship between owners and sugarcane producers is of land leasing. Intermediate agents act as a fundamental part of the sugarcane supply chain. The sharecropping or sugarcane purchase contract is an instrument that is established between middlemen and small independent producers, whether they are owners or tenants. The middlemen participation in commercialization can reach 30–40% of the sugarcane production. Most mills prefer to produce sugarcane in own lands. A relatively high degree of inequity in favor of the middlemen appears in the intermediation process because, in general, the mills prefer this intermediation in their commercial practice. A large number of landowners and tenants are familiar with notions of energy crops, particularly in relation to sugarcane and have a positive vision about them for the environmental sustainability. However, their interest in planting bioenergy crops is less. Friendly and equitable relations between agents will provide more economic and social stability to the Peruvian sugarcane agroindustry.

OBJECTIVES: To determine the relationship between apolipoprotein E (APOE) epsilon4 and Alzheimer's disease (AD) in the Mexican Mestizo population, as well as its effects on the cognitive profile of AD and elderly Mestizos without dementia. DESIGN: Cross-sectional analysis of a cohort study. SETTING: Evaluations were conducted at the geriatrics clinic of an academic medical hospital in Mexico City. PARTICIPANTS: Forty-nine elderly subjects with AD and 141 controls selected from a representative sample of Mexican Mestizos aged 65 to 96 who participated in the Prevalence Survey of Dementia in the Mexico City Elderly Population cohort. MEASUREMENTS: All subjects underwent APOE genotypification and a comprehensive clinical and neuropsychological evaluation. RESULTS: There were no significant differences in epsilon3 and epsilon4 frequencies between the subjects with and without AD and a tendency toward higher epsilon4 and lower epsilon3 allele frequencies in subjects aged 75 and older. No association was found between APOE epsilon4 and the presence of AD. The age-, sex-, and education-adjusted risk for AD associated with at least one epsilon4 allele was 1.01 (95% confidence interval=0.45-2.23). Performance on a long-term visual memory test was significantly worse in APOE epsilon4 carriers than in APOE epsilon3 carriers only in the group with AD. CONCLUSION: APOE epsilon4 did not increase the risk for AD in this Mexican Mestizo elderly urban population sample, although the presence of this allele seems to modify its clinical expression. [ABSTRACT FROM AUTHOR]

Although ATP-binding cassette transporter A1 (ABCA1) is well known for its role in cholesterol efflux and HDL formation, it is expressed in various tissues, where it may have different functions. Because hypoalphalipoproteinemia is highly prevalent in Mexico, we screened the ABCA1 coding sequence in Mexican individuals with low and high HDL cholesterol levels to seek functional variants. A highly frequent nonsynonymous variant (R230C) was identified in low-HDL cholesterol but not in high-HDL cholesterol individuals (P = 0.00006). We thus assessed its frequency in the Mexican-Mestizo general population, seeking possible associations with several metabolic traits. R230C was screened in 429 Mexican Mestizos using Taqman assays, and it was found in 20.1% of these individuals. The variant was significantly associated not only with decreased HDL cholesterol and apolipoprotein A-I levels but also with obesity (odds ratio 2.527, P = 0.005), the metabolic syndrome (1.893, P = 0.0007), and type 2 diabetes (4.527, P = 0.003). All of these associations remained significant after adjusting for admixture (P = 0.011, P = 0.001, and P = 0.006, respectively). This is the first study reporting the association of an ABCA1 variant with obesity and obesity-related comorbidities as being epidemiologically relevant in the Mexican population. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical characteristics of the diabetic population that formed part of a population-based survey conducted in México.Research Design and Methods: In 2000, information was obtained from 42,886 subjects aged > or =20 years using a multistage sampling procedure. Standardized questionnaires were used. Anthropometric measurements, blood pressure, and capillary glucose concentrations were taken.Results: Type 2 diabetes was found in 3,597 subjects (age-adjusted prevalence 8.18%), of which 2,878 (80%) had previously been diagnosed. The average age of the diabetic participants was 55.2 +/- 13.5 years; 13% were <40 years of age. Nine percent had been diagnosed for >10 years. The average BMI was 29.2 +/- 5.7 kg/m(2); three-quarters of the cases had BMI >25 kg/m(2). The average waist circumference was 102 +/- 13.4 cm, and increased waist circumference was more common among women. Arterial hypertension was found in half of the cases and, of those on treatment, only one-third had a blood pressure <140/90 mmHg. Smoking was reported in 34% of the diabetic group, a higher rate than in the nondiabetic subjects. There was at least one modifiable coronary risk factor in 67.6% of the cases. Very few followed an exercise or dietary regimen and a small percentage used insulin.Conclusions: Diabetes affects a large proportion of Mexican adults (8.18%). This figure may be underestimated. The majority of the subjects had modifiable risk factors for the chronic complications of diabetes. Only a few achieved adequate blood pressure control and other treatment goals. [ABSTRACT FROM AUTHOR]

Many agroindustries that process sugarcane raw to produce sugar and ethanol, and for energy cogeneration have difficulties to obtain all the necessary raw material. The agrarian contract practice can allow access to land in order to increase the production of sugarcane, without immobilizing resources in terms of the purchase of land, reducing the idle capacity of industrial plant, and increasing the cogeneration of energy by burning bagasse and sugarcane straw. It appears that the form of production of sugarcane (i.e., through land leasing, sharecropping, independent producers, etc.) can significantly affect the total costs of the industrial process. This work looks to find an empirical relation between the type of sugarcane producers and the energy produced by the mill based on data of the Agricultural Census of Brazil and monitoring data of power plant operation parameters of a typical mill in Brazil. It was found that the sugarcane raw coming from lands worked for tenants and sharecroppers increased his participation 112% and 469% respectively in the energy generation in the period 2006 to 2017.

This work presents a numerical and experimental study in a laboratorial rig to measure local flame temperature and alkali emission during the combustion of sugarcane bagasse and straw. Tubular combustion chamber to simulate combustion in grate is used. A spectral analysis method in the visible spectrum was used for measurement of local temperatures in a sugarcane bagasse flame and sugarcane straw flame. The two-color method is used to calculate flame temperature. In flame reactive zone, the bagasse and straw flame temperatures in the range of 1420 to 1510 K and in the range of 1450 to 1550 K respectively are calculated. The intensity of alkali emission during the sugarcane bagasse and straw combustion is calculated using data of the spectrum in visible range. It was found that potassium emission is correlated with the instantaneous bagasse flame temperature in the reactive combustion zone. Emission of potassium and sodium during straw combustion is higher than in bagasse combustion. Temperature and alkali emissions along the flame height are measured.

PURPOSE: The purpose of this study was to measure the level of diabetes knowledge in a representative group of Mexican individuals with diabetes and to identify the factors that influence it. METHODS: A validated questionnaire was administered to 570 outpatients, 11.2 % had Type 1 diabetes, 36.4 % had Type 2 diabetes treated with insulin, and 52.2 % had Type 2 diabetes treated with oral agents. Samples for HbA1c determination also were obtained. RESULTS: The percentage of correct answers in each section of the questionnaire was low. Type I patients had the highest scores, followed by the insulin-treated Type 2 patients; those with chronic complications also had high scores. Educational background, attendance at diabetes courses, age, and HbA1c concentration were the main predictors of knowledge. Attendance at courses was influenced by the severity of the disease. CONCLUSIONS: The amount of patient knowledge about diabetes-related issues was low in this representative Mexican population. The educational efforts were focused on those with the worst metabolic control and/or with diabetes complications. [ABSTRACT FROM AUTHOR]

We evaluated factors associated with fetal losses in patients with severe lupus in a nested case-control study. We assessed separately 73 pregnancies that occurred in 46 women from a cohort of 633 Systemic Lupus Erythematosus (SLE) patients. They had at least one preg nancy after SLE diagnosis, one or more of our severity criteria and all had taken immuno suppressive drugs. Included data were related to disease severity, anti-phospholipid syndrome (APS), anticardiolipin antibodies (a-CL ab), and drugs received during preg nancy. Cases were pregnancies with fetal wastage; controls were pregnancies with live-born children.The mean age at pregnancy was 26.6 ± 4.5 years. Cases had longer disease duration, 6.1 ± 3.5 years vs 4.5 ± 4.3 of controls (p = 0.02); higher prevalence of renal involvement, hemolysis and recurrent venous thrombosis (p < 0.05); they also tended to have a greater prevalence of a-CL ab, and previous fetal losses (p = 0.06). Cases used azathioprine more frequently than controls (p = 0.04). Univariate analysis showed an association of renal involvement, hemolytic anemia, azathioprine or cyclophosphamide prescription during pregnancy, previous fetal losses and APS with fetal wastage. Immunosuppressive drugs and the APS remained significant in the multivariate analysis (p = 0.05; F = 0.01). Factors related with fetal losses in women with severe SLE were: longer disease duration, ingestion of immunosuppressive drugs during pregnancy and any related manifestation of APS. We did not find macroscopic malformations in live-children of women that took azathioprine during pregnancy. [ABSTRACT FROM PUBLISHER]

Abstract Pheochromocytomas are catecholamine producing tumors arising mostly from chromaffin cells of the adrenal medulla. The most common clinical presentation is hypertension, mainly in the form of paroxymal episodes. Cardiovascular manifestations include malignant arrhythmia and catecholamine cardiomyopathy, mimicking acute coronary syndromes and acute heart failure. There are reports of pheochromocytomas presenting as acute coronary syndrome and rapidly leading to cardiogenic shock; the failure of intensive medical treatment in these cases has prompted the need for emergency adrenalectomy as the only remaining option. We report on a case of complicated pheochromocytoma presenting as cardiogenic shock, in which emergency adrenalectomy was performed following a total lack of response to intensive medical treatment.

Omar Yaxmehen Bello-Chavolla,1,2 Arsenio Vargas-Vázquez,1,3,* Neftali Eduardo Antonio-Villa,1,3,* Fabiola Mabel Del Razo-Olvera,1 Daniel Elías-López,1 Carlos A Aguilar-Salinas1,4,5 For the Metabolic Syndrome Study Group1Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 2Division of Research, Instituto Nacional de Geriatría, Mexico City, Mexico; 3MD/PhD (PECEM) Program, Facultad de Medicina, UNAM, Mexico City, Mexico; 4Division of Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 5Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico*These authors contributed equally to this workCorrespondence: Carlos A Aguilar-SalinasUnidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Tlalpan, Distrito Federal, CP 14080, MéxicoTel +525554870900, 5703Email caguilarsalinas@yahoo.comIntroduction: Metabolic Syndrome (MS) is a construct relating to a series of metabolic dysfunctions attributable to insulin resistance and obesity. Here, we estimate the incidence of MS according to their individual components using a Mexican open-population cohort.Methods: We evaluated data of 6144 Mexicans amongst whom 3340 did not have MS either by IDF or ATP-III definitions using data from an open-population cohort. We estimated the incidence of MS and each of its traits after a median follow-up of 2.24 (IQR 2.05– 2.58) years and evaluated risk factors for MS incidence and each of its traits. We also explored individuals without any MS trait to evaluate trait and MS incidence after follow-up.Results: We observed a high incidence of MS-IDF (115.11 cases per 1000 person-years, 95% CI 107.76– 122.47), followed by MS-ATP-III (75.77 cases per 1000 person-years, 95% CI). The MS traits with the highest incidence were low HDL-C and abdominal obesity, which was consistent for subjects without MS and those without any MS trait. When assessing predictors of MS incidence, obesity, insulin resistance, and increased apolipoprotein B levels predicted MS incidence. Weight loss > 5% of body weight and physical activity were the main protective factors. Obesity was a main determinant for incident MS traits in our population, with weight loss being also a protective factor for most MS traits.Conclusion: We observed a high incidence of MS in apparently healthy Mexican adults. Low HDL-C and abdominal obesity were the most frequent incident MS traits, with obesity being the main determinant of its incidence.Keywords: metabolic syndrome, obesity, incidence, Mexicans, metabolic risk

Donají V Gómez-Velasco,1 Paloma Almeda-Valdes,1,2 Alexandro J Martagón,1,3 Gabriela A Galán-Ramírez,1 Carlos A Aguilar-Salinas1–31Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 2Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 3Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, MexicoAbstract: Patient empowerment is a continuous process in which knowledge, motivation, and capacity to take control of their disease are built within a person. This concept is not always well understood and applied. This review describes the strategies to induce empowerment in patients with diabetes. In addition, the most common scales used to evaluate empowerment in diabetes is described. Furthermore, the effectiveness of the empowerment-based interventions for improving metabolic control and diabetes knowledge are described. Finally, we discuss opportunities for empowerment implementation in clinical practice and current needs on research that can be translated into public policies.Keywords: empowerment, motivation, self-care, Diabetes Empowerment Scale, depression

Daniel Cuevas Ramos1, Roopa Mehta1, Julieta De La Luz Castro2, Rutila Castañeda Limones3, Ernesto García Rubí4, Carlos A Aguilar-Salinas11Department of Endocrinology, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran" (INCMNSZ); 2Cardiodiabetes Unit, Sanofi-Aventis de México; 3Clinical Epidemiology Research Unit, Hospital General Regional No 1 Dr Carlos Mac Gregor Sánchez Navarro; 4Department of Endocrinology, Hospital Angeles Metropolitano, Mexico City, MexicoBackground: The Awareness of Abdominal Adiposity as a Cardiometabolic Risk Factor Study assesses the prevalence of cardiometabolic risk factors in adults with abdominal obesity (waist circumference ≥90 cm in men and ≥80 cm in women) and evaluates how physicians manage these patients.Methods: This is an observational cross-sectional study. Internists, cardiologists, and endocrinologists contributed patients to the study. A standardized questionnaire was completed and registered demographics, anthropometric measurements, lab results from the medical files, and any treatment utilized to manage dyslipidemia, arterial hypertension, diabetes, and cardiovascular disease.Results: A total of 1312 patients was included. The mean age was 49.3 ± 14.6 years and 834 (63.6%) were female. The primary reason for the physician consultation was treatment of obesity (47.5%), followed by management of arterial hypertension (27.7%), diabetes (18.3%), dyslipidemia (14.2%), and cardiovascular disease (7.1%). The majority of patients identified excess body weight as a health problem (81.4%). However, patients had lost a mean of 4.3 ± 3.5 kg. Only 63.4% of patients with arterial hypertension were on drug therapy. Few of them had reached target values for diastolic (24.1%) and systolic/diastolic (13.3%) pressure. Less than half of the patients with dyslipidemia were receiving lipid-lowering medication. Only 32.2% were at their target low-density lipoprotein cholesterol levels. In patients with type 2 diabetes, mean fasting plasma glucose level (8.9 ± 3.4 mmol/L) was above the threshold recommended by current guidelines.Conclusions: The study describes the medical care given to individuals with abdominal obesity during daily clinical practice by general practitioners, cardiologists, and endocrinologists in urban Mexico. Our data confirm that a large proportion of patients are undertreated. Only a small percentage of patients with obesity-related comorbidities reach treatment targets. Interventions proven to be effective in the prevention of chronic complications have in general not been implemented.Keywords: abdominal obesity, waist circumference, dyslipidemia, type 2 diabetes, pattern of care

Verticillium dahliae is a soilborne phytopathogenic fungus causing Verticillium wilt on hundreds of plant species. Several sequenced genomes of V . dahliae are available, but functional characterization of most genes has just begun. Based on our previous comparison of the transcriptome from the wild-type and Δ VdCf2 strains, a significant upregulation of the gene cassette, Vd276-280 , in the Δ VdCf2 strain was observed. In this study, the functional characterization of the Vd276-280 gene cassette was performed. Agrobacterium -mediated knockout of this gene cassette in V. dahliae significantly inhibited conidiation, melanized microsclerotium formation in the mutant strains, and their virulence toward cotton. Furthermore, deletion of individual genes in the Vd276-280 gene cassette identified that the disruption of VDAG&#95;07276 and VDAG&#95;07280 delayed microsclerotium formation, inhibited conidiation, and reduced virulence toward cotton. Our data suggest that VDAG&#95;07276 and VDAG&#95;07280 in the Vd276-280 gene cassette mainly act as positive regulators of development and virulence in V. dahliae ., Competing Interests: The author(s) declare no conflict of interest.

Fennel is a popular culinary herb known for its unique flavor. In this study, we identified key aroma-active compounds in fresh fennel (Foeniculum vulgare Mill.) and its microgreens. Fennel was cultivated hydroponically with soilless substrates. Upon harvesting, samples were ground with liquid nitrogen, and headspace solid phase microextraction (SPME) gas chromatography-mass-spectrometry-olfactometry (GC-MS-O) was used for volatile analysis. Thirty-two and 28 key aroma-active compounds were identified in fennel microgreens and mature leaves, respectively. Phenylpropenes, especially (E)-anethole, were the predominant aroma-active compound in all samples (36.3-83.4 %). Quantitation results showed that fennel microgreens contained a significantly higher amount of monoterpenes, showing an 81.4-98.1 % increase when compared to mature fennel. Principal component analysis (PCA) of identified volatiles indicated a distinctive difference in the overall aroma profile between microgreens and mature leaf. The changes in aroma contents over different growth stages revealed the underlying volatile biosynthesis discrepancy. This study provided baseline information for understanding the aroma evolution from microgreen to mature fennel herbs., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Eyelid ptosis may present with upper lid dermatochalasis and brow ptosis. When indicated, ptosis correction (PC) is advocated during upper blepharoplasty (UB). In this study, the authors aimed to report their outcomes following UB and PC., Methods: A retrospective review of patients who underwent UB from November of 2018 to March of 2020 was performed. Patient demographics, clinical characteristics, and revisions were recorded. Cox regression was performed to assess predictors of revision., Results: Overall, 278 patients with 533 UB were included. The mean patient age was 67.3 years. The mean follow-up was 8.3 months. In 169 cases (31.7%), a brow lift was performed. UB and PC were performed in 109 cases (20.5%), of which 60 (55%) involved Müller muscle conjunctival resection and 49 (45%) were levator repairs. New dry eye symptoms lasting 3 months or longer occurred in 4 cases (0.8%), all of which resolved. The revision rate was 3.8% after UB (residual skin [ n = 11], hypertrophic scar [ n = 4], and Herring law-related ptosis [ n = 1]) versus 9.2% after UB and PC (overcorrection [ n = 4], residual skin [ n = 4], and asymmetry [ n = 2]). Multivariable analysis demonstrated increased revision rates after UB and PC ( P = 0.008). There was no difference in revision rates between different techniques of PC., Conclusions: In this study of 278 patients presenting for dermatochalasis, up to 21% of cases required ptosis correction in addition to upper blepharoplasty. Ptosis correction is a safe procedure when combined with upper blepharoplasty, regardless of technique used. The revision rate in our series was 9.2% after the combined procedure, which is greater than the revision rate of upper blepharoplasty only but comparable to that in the literature., Clinical Question/level of Evidence: Risk, III., (Copyright © 2024 by the American Society of Plastic Surgeons.)

The mirid bugs Lygus hesperus (Knight) and L. elisus (van Duzee) are key pests of forage, fiber, and fruit crops. Our goals were to identify pheromone components produced by females of both species and to develop practical pheromone dispensers for use in monitoring these pests. Volatiles collected from virgin female L. elisus contained (E)-2-hexenyl butyrate (E2HB) as the major component with lesser amounts of hexyl butyrate (HB) and (E)-4-oxo-2-hexenal (E4OH) (ratio 117.2:100:17.1, respectively), whereas volatiles and solvent extracts from L. hesperus contained HB and E4OH as major components, with only small amounts of E2HB (100:23.6:3.4, respectively in volatiles). Dispensers fabricated from pipette tips released the components at ~10 µg/d in a ratio similar to the loading ratio. These lures were used to optimize the pheromone blends in field studies from 2012 to 2017. Blends of E2HB and E4OH attracted L. elisus, and a 100:60 blend was optimal. Blends of HB and E4OH attracted L. hesperus, and a 100:60 blend was adopted as a base blend. The additions of possible minor components such as (Z)-3-hexenyl butyrate, (E)-2-hexenal, or 1-hexanol did not improve the attraction of L. hesperus. In trials in alfalfa and strawberry, traps baited with blends of HB:E4OH (100:60) were equally or more effective for monitoring L. hesperus than sweep or vacuum samples, with pipette tip dispensers lasting 2-3 weeks under field conditions. The numbers of L. hesperus captured were lower than expected as compared with reports of pheromone trapping for other Lygus spp. Some possible reasons were investigated., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America.)

Competing Interests: The authors declare no competing interests. No funding source was required for this article.

The impact of limited water availability on lettuce growth has been well documented. However, the mechanisms by which lettuce controls seed germination under water stress remain unknown. Germination percentage was evaluated in the cv. Salinas (Lactuca sativa) (L. sativa) × US96UC23 (Lactuca serriola) (L. serriola) recombinant inbred line (RIL) population and USDA germplasm collection using 10% polyethylene glycol (PEG). About 50% of both populations displayed less than 90% germination. The average broad-sense heritability (H 2 ) for germination percentage was 0.81 across both populations. Two quantitative trait loci (QTL) for germination percentage were identified on chromosomes 4 and 8 in the RIL population. The RNA-Seq and network analyses of wild lettuce, US96UC23, were performed using the control (distilled water, dH 2 O) and treatment (10% PEG) datasets. The number of differentially expressed genes (DEGs) was 4,095. The top 20 gene ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were assessed by enrichment analysis. The consensus network analysis captured 44 modules. Gene networks were constructed for the top 20 hub genes in 10 significant modules from each dataset. This study comprehensively explains QTL, GO terms, KEGG pathways, and gene networks associated with lettuce seed germination under osmotic stress., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

The expanding availability of real-world data (RWD) has led to an increase in both the interest and possibilities for using this information in postmarketing safety analyses and signal management. While there is enormous potential value from the safety insights generated through RWD, the analysis preparation, execution, and communication required to reliably deliver the evidence can be time consuming. Since the safety signal assessment process is a regulated and timebound process, any supporting RWD analyses require a rapid turnaround of well-designed and informative results. To address this challenge, a TransCelerate BioPharma working group was formed and developed a framework to help teams responsible for safety signal assessment overcome the challenges of working with RWD rapidly to deliver analyses within regulatory timelines. Here, a previously performed safety assessment was evaluated within the context of the developed framework to illustrate how the framework may be adopted in practice., (© 2024. The Author(s).)

Developing lettuce varieties with salt tolerance at the seed germination stage is essential since lettuce seeds are planted half an inch deep in soil where salt levels are often highest in the salinity-affected growing regions. Greater knowledge of genetics and genomics of salt tolerance in lettuce will facilitate breeding of improved lettuce varieties with salt tolerance. Accordingly, we conducted a genome-wide association study (GWAS) in lettuce to identify marker-trait association for salt tolerance at the seed germination stage. The study involved 445 diverse lettuce accessions and 56,820 single nucleotide polymorphism (SNP) markers obtained through genotype-by-sequencing technology using lettuce reference genome version v8. GWAS using two single-locus and three multi-locus models for germination rate (GR) under salinity stress, 5 days post seeding (GR5d&#95;S) and a salinity susceptibility index (SSI) based on GR under salinity stress and control conditions, 5 days post seeding (SSI&#95;GR5d) revealed 10 significant SNPs on lettuce chromosomes 2, 4, and 7. The 10 SNPs were associated with five novel QTLs for salt tolerance in lettuce, explaining phenotyping variations of 5.85%, 4.38%, 4.26%, 3.77%, and 1.80%, indicating the quantitative nature of these two salt tolerance-related traits. Using the basic local alignment search tool (BLAST) within 100 Kb upstream and downstream of each of the 10 SNPs, we identified 25 salt tolerance-related putative candidate genes including four genes encoding for major transcription factors. The 10 significant salt tolerance-related SNPs and the 25 candidate genes identified in the current study will be a valuable resource for molecular marker development and marker-assisted selection for breeding lettuce varieties with improved salt tolerance at the seed germination stage., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Sulfur dioxide (SO2) fumigation was studied in laboratory to determine its potential as an alternative treatment for postharvest control of stored product insects, confused flour beetle, Tribolium confusum Jacquelin du Val (Coleoptera: Tenebrionidae), and rice weevil, Sitophilus oryzae (L.) (Coleoptera: Curculionidae). Three-hour fumigations with 0.1%-2.0% SO2 were conducted against eggs, immature stages, and adults of the 2 insects at 20 °C. Effective control of both insects was achieved. However, there were considerable variations between the 2 insects and among different life stages. Confused flour beetle was more susceptible to SO2 fumigation than rice weevil. Complete control of adults and all life stages of confused flour beetle was achieved in 3-h fumigations with 0.5% and 2.0% SO2, respectively. For rice weevil, 3-h fumigation with 1.5% SO2 resulted in 96.5% adult mortality and the fumigation with 2.0% SO2 resulted in 99.27% mortality of adults and 87.5% mortality of immature stages. Three-hour fumigations with 1% SO2 resulted in <5% egg survival to adults. The study demonstrated high efficacy of SO2 fumigation against the insects and suggested that SO2 fumigation has good potential for postharvest pest control on stored products., (Published by Oxford University Press on behalf of Entomological Society of America 2024.)

Background: Spinach downy mildew, caused by the obligate oomycete pathogen, Peronospora effusa remains a major concern for spinach production. Disease control is predominantly based on development of resistant spinach cultivars. However, new races and novel isolates of the pathogen continue to emerge and overcome cultivar resistance. Currently there are 20 known races of P. effusa. Here we characterized the transcriptomes of spinach, Spinacia oleracea, and P. effusa during disease progression using the spinach cultivar Viroflay, the near isogenic lines NIL1 and NIL3, and P. effusa races, R13 and R19, at 24 h post inoculation and 6 days post inoculation. A total of 54 samples were collected and subjected to sequencing and transcriptomic analysis., Results: Differentially expressed gene (DEG) analysis in resistant spinach interactions of R13-NIL1 and R19-NIL3 revealed spinach DEGs from protein kinase-like and P-loop containing families, which have roles in plant defense. The homologous plant defense genes included but were not limited to, receptor-like protein kinases (Spiol0281C06495, Spiol06Chr21559 and Spiol06Chr24027), a BAK1 homolog (Spiol0223C05961), genes with leucine rich repeat motifs (Spiol04Chr08771, Spiol04Chr01972, Spiol05Chr26812, Spiol04Chr11049, Spiol0084S08137, Spiol03Chr20299) and ABC-transporters (Spiol02Chr28975, Spiol06Chr22112, Spiol06Chr03998 and Spiol04Chr09723). Additionally, analysis of the expression of eight homologous to previously reported downy mildew resistance genes revealed that some are differentially expressed during resistant reactions but not during susceptible reactions. Examination of P. effusa gene expression during infection of susceptible cultivars identified expressed genes present in R19 or R13 including predicted RxLR and Crinkler effector genes that may be responsible for race-specific virulence on NIL1 or NIL3 spinach hosts, respectively., Conclusions: These findings deliver foundational insight to gene expression in both spinach and P. effusa during susceptible and resistant interactions and provide a library of candidate genes for further exploration and functional analysis. Such resources will be beneficial to spinach breeding efforts for disease resistance in addition to better understanding the virulence mechanisms of this obligate pathogen., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

We present the complete sequence of the genomic RNA of an isolate of squash vein yellowing virus ( Ipomovirus cucurbitavenaflavi ) from California (SqVYV-CA) and show it is a recombinant virus with a highly divergent 5' UTR and proximal P1a gene. The evolution of SqVYV-CA involved an intrageneric event between unknown potyviruses, related to isolates of papaya ringspot virus ( Potyvirus papayanuli ) from the Old World, and an intergeneric event between this recombinant potyvirus (minor parent) and an isolate of SqVYV from Israel (SqVYV-IL) (major parent). These events occurred in mixed infections and in the potyvirus P1 and ipomovirus P1a recombination hotspots and resulted in SqVYV-CA having a potyvirus 5' UTR and chimeric P1-P1a gene/protein and the remainder of the genome from SqVYV-IL. The SqVYV-CA chimeric P1-P1a gene is under positive selection, and the protein is intrinsically disordered and may localize to the nucleus via nuclear localization signals in the P1 part. The C-terminal SqVYV-IL P1a part also diverged but retained the conserved serine protease motif. Furthermore, substantial divergence in SqVYV isolates from the Middle East was associated with genetic drift and a long evolutionary history in this region. The finding that the host range and symptomatology in cucurbits of SqVYV-CA is similar to those of SqVYV from Florida and SqVYV-IL, indicated that the recombinant part of the genome had no obvious effect on the virus-host interaction. A divergent part of the P1 sequence of the SqVYV-CA P1-P1a gene was used to develop a primer pair and RT-PCR test for specific detection of SqVYV-CA. This test was used to detect spread of SqVYV-CA to a new production area of California in 2021 and 2022. Together, these results demonstrate (i) a high level of genetic diversity exists among isolates of SqVYV and involved intra- and intergeneric recombination and genetic drift (mutation), (ii) evidence that SqVYV originated in the Middle East and that there were independent introductions into the New World and (iii) the remarkable genetic flexibility of the 5' proximal genes of these viruses.

The assessment of medical decision-making capacity as part of the process of clinical informed consent has been considered a bioethical housekeeping matter for decades. Yet in practice, the reality bears little resemblance to what is described in the medical literature and professed in medical education. Most literature on informed consent refers to medical decision-making capacity as a precondition to the consent process. That is, a clinician must first determine if a patient has capacity, and only then may the clinician engage with the patient for the rest of informed consent. The problem with this two-step approach is that it makes no sense in actual practice. We see the assessment of medical decision-making capacity within the process of informed consent as a spiral staircase, not just two steps, requiring clinicians to keep circling up and around, making progress, until they get to where they need to be: 1. Clinicians start with a general presumption of capacity for most adults, sometimes having a provisional appraisal of capacity based on prior patient contact. 2. Then, they begin performing informed consent for the current situation and intervention options. 3. Next, they must reassess capacity during this process. 4. After that, they continue with informed consent. 5. If capacity is not yet clear, they repeat 1-4., Competing Interests: Declaration of Competing Interest On behalf of David Satin, Philip Day and myself, I wish to declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The Schnur scale used body surface area (BSA) to determine the amount of breast tissue resection in reduction mammaplasty, resulting in a greater requirement of breast weight removal in patients with larger BSA. The authors aimed to demonstrate BSA variance among women with similar mastectomy weights and the range of mastectomy weights among women with comparable BSAs., Methods: A retrospective chart review of patients who underwent mastectomy from October of 2021 to June of 2022 was performed. Patients were included if they underwent skin-sparing or nipple-sparing mastectomy with a minimum specimen weight of 700 g. Patient's BSA, body mass index (BMI), mastectomy weight, and Schnur weight requirement (SWR) were collected., Results: A total of 130 patients (194 breasts) were included. There was significant variance in mean BSA, BMI, SWR, and SWR-to-mastectomy weight ratio among women with similar mastectomy weights. BSA varied by as much as 0.82 units, BMI varied by as much as 32 kg/m 2 , and SWR varied by as much as 1365 g within the same mastectomy weight group. There was also significant variance in mastectomy weights among women with comparable BSA, especially in BSA groups greater than 2.20, with the greatest range in mastectomy weights being 1684 g., Conclusions: Analysis of mastectomy patients showed no predictable relationship between BSA and breast weight. There was significant variance in the BSA of patients with similar breast weights, and conversely in breast weights of patients with comparable BSA. Therefore, strict adherence to the Schnur weight requirement can prevent patients with macromastia from receiving breast reductions., (Copyright © 2024 by the American Society of Plastic Surgeons.)

Composite produce leaf samples from commercial production rarely test positive for pathogens, potentially due to low pathogen prevalence or the relatively small number of plants sampled. Aggregative sampling may offer a more representative alternative. This pilot study investigated whether aggregative swab samples performed similarly to produce leaf samples in their ability to recover quality indicators (APCs and coliforms), detect Escherichia coli , and recover representative microbial profiles. Aggregative swabs of the outer leaves of romaine plants ( n = 12) and composite samples consisting of various grabs of produce leaves ( n = 14) were collected from 60 by 28 ft sections of a one-acre commercial romaine lettuce field. Aerobic plate counts were 9.17 ± 0.43 and 9.21 ± 0.42 log(CFU/g) for produce leaf samples and swabs, respectively. Means and variance were not significantly different ( p = 0.38 and p = 0.92, respectively). Coliform recoveries were 3.80 ± 0.76 and 4.19 ± 1.15 log(CFU/g) for produce leaf and swabs, respectively. Means and variances were not significantly different ( p = 0.30 and p = 0.16, respectively). Swabs detected generic E. coli in 8 of 12 samples, more often than produce leaf samples (3 of 14 positive, Fisher's p = 0.045). Full-length 16S rRNA microbial profiling revealed that swab and produce leaf samples did not show significantly different alpha diversities ( p = 0.75) and had many of the most prevalent bacterial taxa in common and in similar abundances. These data suggest that aggregative swabs perform similarly to, if not better than, produce leaf samples in recovering indicators of quality (aerobic and coliform bacteria) and food safety ( E. coli ), justifying further method development and validation.

The plant virus, Impatiens necrotic spot virus (INSV), is an economically important pathogen of vegetables, fruits, and ornamental crops. INSV is vectored by the western flower thrips, Frankliniella occidentalis, a small insect pest that is globally distributed. In recent years, INSV outbreaks have reached epidemic levels in the Salinas Valley of California-an agriculturally rich region where most of the lettuce (Lactuca sativa) is produced in the United States. Due to the obligate nature in which virus transmission occurs, new tools that could rapidly detect INSV from thrips vectors would enhance our ability to predict where virus outbreaks may occur. Here, we report on the development of a reverse transcription-recombinase polymerase amplification (RT-RPA) assay that can detect INSV from individual thrips. The assay uses crude extraction methods, is performed at a single temperature of 42 °C, can be completed in 25 min, and provides sensitivity levels that are comparable to other available detection methods. When the assay was used on field populations of thrips, INSV was successfully identified and quantified from individual larvae and adults. The work provides a new cost-effective surveillance tool that can rapidly detect INSV from its insect vector and from plants., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background: Implant-based breast reconstruction following radiotherapy can lead to significant postoperative complications. Closed-incision negative pressure wound therapy (ciNPWT) has emerged as a potential intervention to reduce these complications., Objectives: To assess the effectiveness of ciNPWT in reducing postoperative complications in patients undergoing implant-based breast reconstruction after radiotherapy., Methods: A retrospective single-center cohort study was conducted, including patients who underwent implant-based breast reconstruction after mastectomy and radiotherapy between January 1, 2015, and December 31, 2022. We utilized a procedure-level analysis model with patients contributing distinct observations for multiple procedures. Our primary outcome measures included fluid collection, infection, and wound complications. Propensity score analysis was employed to adjust for potential confounders, such as BMI, smoking history, and diabetes history, creating a balanced comparison between the ciNPWT-treated and untreated groups., Results: In our study of 301 breast reconstructions postradiotherapy from 2015 to 2022, encompassing 218 unique patients, we found significant benefits of ciNPWT. During an average of 2.2-year follow-up, the ciNPWT group demonstrated no infections, contrasting with a 10.4% rate in the non-ciNPWT group ( P < .0001). Wound complications were also significantly lower in the ciNPWT group (1.9% vs 11.2%; P = .00848). Demographic differences were adjusted using inverse probability of treatment weights. The findings suggest ciNPWT's promising role in enhancing postoperative outcomes in breast reconstruction postradiotherapy., Conclusions: Our study suggests that the use of ciNPWT in implant-based breast reconstruction postradiotherapy can potentially reduce postoperative complications. This intervention can improve patient outcomes and may offer cost-saving benefits in the long run., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society.)

Background: Adipose tissue excess is associated with adverse health outcomes, including type 2 diabetes. Body mass index (BMI) is used to evaluate obesity but is inaccurate as it does not account for muscle mass, bone density, and fat distribution. Accurate measurement of adipose tissue through dual-energy X-ray absorptiometry (DXA) and computed axial tomography (CT) is crucial for managing and monitoring adiposity-related diseases. Still, these are not easily accessible in most hospitals in Mexico. Bioelectrical impedance analysis (BIA) is non-invasive and low-cost but may not be reliable in conditions affecting the body's hydration status, like diabetes., Objectives: To assess fat mass concordance between BIA and DXA in Hispanic-American adults with type 2 diabetes mellitus (T2DM)., Methods: Cross-sectional study of a non-probabilistic sample of subjects over 18 years with type 2 diabetes. We used DXA as the reference method., Results: We evaluated the accuracy of FM estimation through BIA and DXA in 309 subjects with type 2 diabetes. Results showed a trend of overestimating the diagnosis of obesity using BIA, especially in individuals with a higher fat mass index (FMI). At the group level, we found BIA accurate; however, at the individual level, it is not. The bias between the 2 methods showed a statistically significant overestimation of body fat by BIA (P ⩽ .01) in both sexes. BIA demonstrated high precision in estimating fat mass. We were able to provide a correction factor of 0.55 kg in men., Conclusion: BIA is inaccurate compared to DXA for body composition assessment in patients with diabetes. Inaccurate measurements can result in misclassification. However, BIA is precise for body composition assessment in patients with diabetes, so it is reliable for tracking patient progress over time., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

There is a gap of knowledge about the clinical and pathophysiological implications resulting from the interaction between primary hyperlipidemias and type 2 diabetes (T2D). Most of the existing evidence comes from sub-analyses of cohorts; scant information derives from randomized clinical trials. The expected clinical implications of T2D in patients with primary hyperlipidemias is an escalation of their already high cardiovascular risk. There is a need to accurately identify patients with this dual burden and to adequately prescribe lipid-lowering therapies, with the current advancements in newer therapeutic options. This review provides an update on the interactions of primary hyperlipidemias, such as familial combined hyperlipidemia, familial hypercholesterolemia, multifactorial chylomicronemia, lipoprotein (a), and type 2 diabetes., (© 2024. The Author(s).)

Introduction: The burden of multimorbidity is recognised increasingly in low- and middle-income countries (LMICs), creating a strong emphasis on the need for effective evidence-based interventions. Core outcome sets (COS) appropriate for the study of multimorbidity in LMICs do not presently exist. These are required to standardise reporting and contribute to a consistent and cohesive evidence-base to inform policy and practice. We describe the development of two COS for intervention trials aimed at preventing and treating multimorbidity in adults in LMICs., Methods: To generate a comprehensive list of relevant prevention and treatment outcomes, we conducted a systematic review and qualitative interviews with people with multimorbidity and their caregivers living in LMICs. We then used a modified two-round Delphi process to identify outcomes most important to four stakeholder groups (people with multimorbidity/caregivers, multimorbidity researchers, healthcare professionals and policymakers) with representation from 33 countries. Consensus meetings were used to reach agreement on the two final COS., Registration: https://www.comet-initiative.org/Studies/Details/1580., Results: The systematic review and qualitative interviews identified 24 outcomes for prevention and 49 for treatment of multimorbidity. An additional 12 prevention and 6 treatment outcomes were added from Delphi round 1. Delphi round 2 surveys were completed by 95 of 132 round 1 participants (72.0%) for prevention and 95 of 133 (71.4%) participants for treatment outcomes. Consensus meetings agreed four outcomes for the prevention COS: (1) adverse events, (2) development of new comorbidity, (3) health risk behaviour and (4) quality of life; and four for the treatment COS: (1) adherence to treatment, (2) adverse events, (3) out-of-pocket expenditure and (4) quality of life., Conclusion: Following established guidelines, we developed two COS for trials of interventions for multimorbidity prevention and treatment, specific to adults in LMIC contexts. We recommend their inclusion in future trials to meaningfully advance the field of multimorbidity research in LMICs., Prospero Registration Number: CRD42020197293., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

The Asian citrus psyllid (ACP), Diaphorina citri Kuwayama (Hemiptera: Psyllidae), is a major pest of citrus due to its role as the vector of the bacterium that causes huanglongbing. In commercial citrus, ACP control currently relies on the application of insecticides, which may not be sustainable long-term, nor practical in urban areas. The sterile insect technique (SIT) is an alternative strategy in which large numbers of pests are reared, sterilized using radiation, and then released into the field to compete with wild individuals for matings, suppressing population growth. As a fundamental step toward the development of SIT for ACP, this study sought to identify the optimum radiation dose required to sterilize ACP without affecting their survival and mating capacity. Virgin adult ACP of both sexes were subjected to doses of X-ray irradiation ranging from 40 to 480 Gy, then paired with a nonirradiated mate and allowed to produce offspring. Fecundity was estimated as the number of eggs laid, and fertility as the proportion of those eggs that hatched. Females were more radio-sensitive than males, exhibiting a major drop in fecundity at even the lowest dose and 100% sterility at 80 Gy. In contrast, a fivefold higher dose (400 Gy) did not achieve complete sterility in males, with around 5% offspring survival. However, F1 progeny of males exposed to 320 Gy or higher were subsequently found to be 100% sterile. This confirmation of inherited sterility suggests that balancing the sterilizing effects of radiation against its mortality-inducing effects may warrant further evaluation., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background and Aims: Remnant cholesterol (RC) and insulin resistance (IR) have been independently associated with cardiovascular risk. Here, we evaluated the role of IR and RC on cardiovascular disease (CVD) mortality., Methods: We conducted an analysis of 16,113 individuals ≥20 years without diabetes from the National Health and Nutrition Examination Survey (NHANES-III/IV). RC levels were calculated using total cholesterol, non-HDL-c, and LDL-c; IR was defined as HOMA2-IR≥2.5 and CVD mortality as a composite of cardiovascular and cerebrovascular mortality. Multiple linear regression was used to assess the relationship between HOMA2-IR and RC and Cox regression models to assess their joint role in CVD mortality. Causally ordered mediation models were used to explore the mediating role of IR in RC-associated CVD mortality., Results: We identified an association between higher HOMA2-IR and higher RC levels. The effect of IR on CVD mortality was predominant (HR 1.32, 95%CI 1.18-1.48) and decreased at older ages (HR 0.934, 95%CI 0.918-0.959) compared to RC (HR 0.983, 95%CI 0.952-1.014). Higher risk of CVD mortality was observed in individuals with IR but normal RC (HR 1.37, 95%CI 1.25-1.50) and subjects with IR and high RC (HR 1.24, 95%CI 1.13-1.37), but not in subjects without IR but high RC. In mediation models, HOMA2-IR accounted for 78.2% (95%CI 28.11-98.89) of the effect of RC levels on CVD mortality., Conclusions: Our findings suggest that RC potentiates the risk of CVD mortality through its effect on whole-body insulin sensitivity, particularly among younger individuals., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Purpose: To inquire into clinical practices perceived to mitigate patients' intraoperative distress during awake craniotomies., Methods: This mixed-methods study involved administration of Amsterdam Preoperative Anxiety and Information Scale and PTSD Checklist prior to the awake craniotomy to evaluate anxiety and information-seeking related to the procedure and symptoms of PTSD. Generalized Anxiety Disorder Scale and Depression Module of the Patient Health Questionnaire were administered before and after the procedure to evaluate generalized anxiety and depression. Patient interviews were conducted 2-weeks postprocedure and included a novel set of patient experience scales to assess patients' recollection of intraoperative pain, overall distress, anxiety, distress due to noise, perception of empowerment, perception of being well-prepared, overall satisfaction with anaesthesia management, and overall satisfaction with the procedure. Qualitative data were analysed using conventional content analysis., Results: Participants ( n  = 14) had undergone an awake craniotomy for tissue resection due to primary brain tumours or medically-refractory focal epilepsy. Validated self-report questionnaires demonstrated reduced levels of generalized anxiety (pre mean = 8.66; SD  = 6.41; post mean= 4.36; SD  = 4.24) following the awake craniotomy. Postprocedure interviews revealed very high satisfaction with the awake craniotomy and anaesthesia management and minimal levels of intraoperative pain, anxiety, and distress. The most stressful aspects of the procedure included global recognition of medical diagnosis, anxiety provoked by unfamiliar sights, sounds, and sensations, a perception of a lack of information or misinformation, and long periods of immobility. Important factors in alleviating intraoperative distress included the medical team's ability to promote patient perceptions of control, establish compassionate relationships, address unfamiliar intraoperative sensations, and deliver effective anaesthesia management., Conclusion: Compassion, communication, and patient perception of control were critical in mitigating intraoperative distress. Clinical practice recommendations with implications for all clinicians involved in patient care during awake craniotomies are provided. Use of these interventions and strategies to reduce distress are important to holistic patient care and patient experiences of care and may improve the likelihood of optimal brain mapping procedures to improve clinical outcomes during awake craniotomies.

Background: Sclerotinia spp. are generalist fungal pathogens, infecting over 700 plant hosts worldwide, including major crops. While host resistance is the most sustainable and cost-effective method for disease management, complete resistance to Sclerotinia diseases is rare. We recently identified soft basal stem as a potential susceptibility factor to Sclerotinia minor infection in lettuce (Lactuca sativa) under greenhouse conditions., Results: Analysis of stem and root cell wall composition in five L. sativa and one L. serriola accessions with varying growth habits and S. minor resistance levels revealed strong association between hemicellulose constituents, lignin polymers, disease phenotypes, and basal stem mechanical strength. Accessions resistant to basal stem degradation consistently exhibited higher levels of syringyl, guaiacyl, and xylose, but lower levels of fucose in stems. These findings suggest that stem cell wall polymers recalcitrant to breakdown by lignocellulolytic enzymes may contribute to stem strength-mediated resistance against S. minor., Conclusions: The lignin content, particularly guaiacyl and syringyl, along with xylose could potentially serve as biomarkers for identifying more resistant lettuce accessions and breeding lines. Basal stem degradation by S. minor was influenced by localized microenvironment conditions around the stem base of the plants., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

In the face of carbon, nitrogen, and phosphorus starvation, microorganisms have evolved adaptive mechanisms to maintain growth. In a previous study, we identified a protein predicted to contain acyl-CoA-binding domains in the plant pathogenic fungus Verticillium dahliae . The predicted protein, designated VdAcb1, possesses an atypical signal peptide. However, the functions of this acyl-CoA-binding protein in V. dahliae are not clear. In this research, in vivo or in vitro assays confirmed that VdAcb1 is secreted extracellularly from V. dahliae , although it does not have the typical signal peptide. Furthermore, the unconventional secretion of VdAcb1 was dependent on VdGRASP, a member of the compartment for unconventional protein secretion (CUPS). The deletion mutant strain of VdAcb1 (Δ VdAcb1) exhibited significant sensitivity to carbon starvation. RNA-seq revealed that the expression of genes related to filamentous growth (MSB2 pathway) and sugar transport were regulated by VdAcb1 under conditions of carbon starvation. Yeast one-hybrid experiments further showed that the expression of VdAcb1 was positively regulated by the transcription factor VdMsn4. The Δ VdAcb1 strain showed significantly reduced virulence on Gossypium hirsutum and Nicotiana benthamiana . We hypothesize that under conditions of carbon starvation, the expression of VdAcb1 is activated by VdMsn4 and VdAcb1 is secreted into the extracellular space. In turn, this activates the downstream MAPK pathway to enhance filamentous growth and virulence of V. dahliae ., Supplementary Information: The online version contains supplementary material available at 10.1007/s42994-024-00175-3., Competing Interests: Conflict of interestThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All authors declare that they have no competing interests., (© The Author(s) 2024.)

Atherosclerotic cardiovascular disease (ASCVD) represents the primary cause of mortality among patients with Type 2 Diabetes Mellitus (T2DM). In this population, High-Density Lipoprotein (HDL) particles exhibit abnormalities in number, composition, and function, culminating in diminished anti-atherosclerotic capabilities despite normal HDL cholesterol (HDL-C) concentrations. Hyperglycemic conditions contribute to these alterations in HDL kinetics, composition, and function, causing T2DM patients' HDL particles to exhibit decreased concentrations of diverse lipid species and proteins. Treatment of hyperglycemia has the potential to correct abnormal HDL particle attributes in T2DM; however, pharmacological interventions, including metformin and thiazolidinediones, yield inconsistent outcomes with respect to HDL-C concentrations and functionality. Despite numerous attempts with diverse drugs, pharmacologically augmenting HDL-C levels has not resulted in clinical benefits in mitigating ASCVD risk. In contrast, reducing Low Density Lipoprotein cholesterol (LDL-C) via statins and ezetimibe has demonstrated significant efficacy in curtailing CVD risk among T2DM individuals. Promising results have been observed in animal models and early-phase trials utilizing recombinant HDL and Lecitin Cholesterol Acyl Transferase (LCAT) -enhancing agents, but the evaluation of their efficacy and safety in large-scale clinical trials is ongoing. While aberrant HDL metabolism constitutes a prevalent aspect of dyslipidemia in T2DM, HDL cholesterol concentrations and composition no longer offer valuable insights for informing therapeutic decisions. Nevertheless, HDL metabolism remains a critical research area in T2DM, necessitating further investigation to elucidate the role of HDL particles in the development of diabetes-associated complications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2023 Elsevier B.V. All rights reserved.)

Verticillium wilt, caused by Verticillium dahliae , is one of the most devastating soilborne diseases of lettuce ( Lactuca sativa L.). There are three races of V. dahliae , and each race has been characterized by markers representing race-specific effectors. Race 1 is differentiated by the presence of the functional secretory Ave1 effector. Similarly, races 2 and 3 are differentiated by effectors VdR2e and VdR3e , respectively. Although the presence of race 1 in coastal California was well established, the presence of effector-based races 2 and 3 was uncertain. This study therefore focused on characterizing 727 isolates collected from 142 ranches of symptomatic lettuce and other crops from coastal California. Based on this evaluation, 523 isolates were designated as race 1, 20 isolates as race 2, 23 isolates as race 3, and 17 as race undefined. Isolates representing other Verticillium species totaled 110, and 34 were non- Verticillium fungal species. Because the use of resistant cultivars is a key strategy to manage this disease, we evaluated 48 lettuce germplasm lines and 1 endive ( Cichorium endivia L.) line, comprising commercial cultivars and breeding lines, including the race 1-resistant heirloom cultivar La Brillante and the susceptible cultivar Salinas as controls. Resistance against races 1, 2, and 3 along with VdLs17, a virulent isolate of V. dahliae from lettuce that is currently not assigned to a race, was evaluated in replicated greenhouse experiments. Two crisphead lettuce lines, HL28 and HL29, exhibited resistance against race 1 and a partial resistance against race 2, whereas all other lines were highly susceptible to races 1 and 2 and VdLs17. The majority of lines exhibited higher resistance to race 3 relative to the other two races. This study documents the current distribution of the different races in coastal California. In addition, the sources of resistance currently being developed should be effective or partially effective against these races for targeted deployment as soon as they are available., Competing Interests: The author(s) declare no conflict of interest.

Background: Pirfenidone has demonstrated significant anti-inflammatory and antifibrotic effects in both animal models and some clinical trials. Its potential for antifibrotic activity positions it as a promising candidate for the treatment of various fibrotic diseases. Pirfenidone exerts several pleiotropic and anti-inflammatory effects through different molecular pathways, attenuating multiple inflammatory processes, including the secretion of pro-inflammatory cytokines, apoptosis, and fibroblast activation., Objective: To present the current evidence of pirfenidone's effects on several fibrotic diseases, with a focus on its potential as a therapeutic option for managing chronic fibrotic conditions., Findings: Pirfenidone has been extensively studied for idiopathic pulmonary fibrosis, showing a favorable impact and forming part of the current treatment regimen for this disease. Additionally, pirfenidone appears to have beneficial effects on similar fibrotic diseases such as interstitial lung disease, myocardial fibrosis, glomerulopathies, aberrant skin scarring, chronic liver disease, and other fibrotic disorders., Conclusion: Given the increasing incidence of chronic fibrotic conditions, pirfenidone emerges as a potential therapeutic option for these patients. However, further clinical trials are necessary to confirm its therapeutic efficacy in various fibrotic diseases. This review aims to highlight the current evidence of pirfenidone's effects in multiple fibrotic conditions., (© 2024 The Author(s). Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

Background: Targeted therapies like denosumab have revolutionized multiple myeloma (MM) treatment, improved patient outcomes while introducing long-term complications. This study explores a rare instance of delayed maxillary osteonecrosis post-denosumab therapy, delving into its pathophysiology and management. Methods: A 40-year-old male MM patient who developed a painful palatal lesion post denosumab treatment and diagnosed of maxillary osteonecrosis by computed tomography scan and surgical biopsy is presented. Treatment history, symptom progression, and response to the PENTOCLO protocol were analyzed. Results: Post-denosumab discontinuation osteonecrosis highlights its prolonged impact on bone metabolism. PENTOCLO treatment protocol led to significant improvement. Genetic factors influencing osteonecrosis susceptibility have been discussed and considered. Conclusions: This case underscores the need for vigilance regarding long-term complications in MM survivors, preventive strategies, including regular dental evaluations and reducing invasive dental procedures, are crucial. We advocate for an interdisciplinary approach and further research into tailored prevention and management of osteonecrosis in cancer survivors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.