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Despite the widespread use and perceived efficacy of cannabidiol (CBD) as an anxiolytic, few controlled studies have evaluated the effects of CBD on anxiety‐relevant indications, and only one has done so in the context of trauma‐related symptoms. The current study was designed to address this gap in the literature. Participants were 42 trauma‐exposed individuals (Mage = 23.12 years, SDage = 6.61) who endorsed elevated stress. They were randomly assigned to take 300 mg of oral CBD or placebo daily for 1 week. Acute (i.e., following an initial 300 mg dose) and repeated (i.e., following 1 week of daily 300 mg dosing) effects of CBD were evaluated in relation to indicators of anxious arousal (i.e., anxiety, distress, heart rate) in response to idiographic trauma script presentation. The results of the current study suggest that relative to placebo, 300 mg CBD did not significantly reduce anxiety, B = 13.37, t(37) = 1.71, p =.096, d = 0.09, Bayes factor (BF10) = 0.54; distress, B = 15.20, t(37) = 1.31, p =.197, d = 0.07, BF10 = 0.51; or heart rate, B = ‐1.09, t(36) = ‐0.32, p =.755, d = 0.02, BF10 = 0.29, evoked by idiographic trauma script presentation in the context of acute or repeated administration. These data suggest that CBD may not effectively reduce trauma‐relevant emotional arousal; however, more work is needed to confidently assert such claims due to the small sample size. The current study extends the groundwork for additional studies in this important area. [ABSTRACT FROM AUTHOR]

We show that at most a 2-cn3/2 proportion of graphs on n vertices have integral spectrum. This improves on previous results of Ahmadi, Alon, Blake, and Shparlinski (2009), who showed that the proportion of such graphs was exponentially small.

A scoping review of 45 peer-reviewed manuscripts involving intraocular pressure (IOP) change and concurrent optical coherence tomography angiography (OCTA) assessments was performed to aggregate knowledge, summarize major findings, and identify gaps in literature and methodology relating to the effect of IOP change on OCTA. Articles were identified through PubMed/Medline, Google Scholar, Cochrane, Web of Science, and article reference lists. A total of 838 results were identified, and 45 articles met the inclusion and exclusion criteria for detailed analysis. OCTA metrics including vessel density (VD), perfusion density, and flow density of the superficial capillary plexus and the radial peripapillary capillaries were analyzed in relation to relative temporal IOP changes. Overall, IOP changes were found to affect superficial vascular plexus (VD) measurements on OCTA, especially when IOP elevated above the physiologic normal range (10-21 mmHg). No significant association was found between diurnal IOP variation and OCTA metrics. Cataract surgery improved the whole-image signal strength and VD regardless of changes in IOP. Beta-blockers were associated with paradoxically reduced vessel density in normal tension glaucoma patients in two studies. Although glaucoma surgical intervention studies were inconsistent and limited by scan quality and low sample sizes, patients requiring glaucoma surgery exhibited attenuated postoperative superficial VD recovery despite significant IOP reductions with surgical intervention. In addition to ensuring near-perfect signal strength with minimal media opacities and controlling for high myopia, central corneal thickness, and the presence of retinopathy, clinicians should consider the statistically significant impact of IOP on OCTA metrics when interpreting results. [ABSTRACT FROM AUTHOR]

The article focuses on primary synovial sarcoma of the rectum, a rare and aggressive subtype of soft tissue sarcoma. The topics discussed include the atypical epidemiology of this type of sarcoma in the rectum, the potential for metastatic disease in primary rectal synovial sarcoma, and the importance of recognizing it as a differential diagnosis for any atypical rectal mass.

The path toward correcting the ecological situation is the recovery of a defining narrative to provide a direction through reconciliation between ourselves and God, the land, and within our communities. The disordered relationship between the producer and consumer and between the urban and rural communities has left those in agriculture economically vulnerable to the point that the most pressing challenge is not the sustainability of fertile soil but the existence of people to care for these soils. The path toward large-scale correction of the ecological crisis must be through reconciliation between the urban and rural to support the existence of the farmer, which ultimately requires a complete reimagining of our economy. There are practical steps that can be taken in both policy and practice to begin to bring reconciliation within God's created order. [ABSTRACT FROM AUTHOR]

Adams–Oliver syndrome is a developmental disorder caused by instability of embryonic vasculature. Because of early mortality when associated with ophthalmic sequelae, its retinal manifestations have not been well-characterized. We report on ophthalmic manifestations and describe our management of a 13-year-old with Adams–Oliver syndrome complicated by a proliferative retinopathy. Purpose: Adams–Oliver syndrome is a rare, inherited disorder of embryologic development that affects multiple systems. Ocular manifestations have been poorly characterized because of the low prevalence and high mortality of the disease when it is associated with internal organ and/or ophthalmic manifestations. We present a case of Adams–Oliver syndrome in a 13-year-old patient whose multimodal retinal imaging findings helped direct management. Methods: Single patient case report reviewing medical records and imaging. Results: Visual acuity upon presentation was 20/40 in each eye. Ultra-widefield fluorescein angiography revealed peripheral nonperfusion with terminal vascular bulbs, and leakage from a temporal fibrovascular complex in the left eye. Fundus autofluorescence imaging showed hyperautofluorescence associated with optic disc drusen and the fibrovascular complex. Treatment with targeted laser photocoagulation was associated with regression of the neovascularization. Conclusion: Retinal manifestations of Adams–Oliver syndrome as observed with ultra-widefield fundus imaging may resemble those of familial exudative vitreoretinopathy and retinopathy of prematurity. Treatment of avascular retina with panretinal photocoagulation can be considered. [ABSTRACT FROM AUTHOR]

An 80-year-old woman with a history of surgical aortic valve replacement with a 21 mm St. Jude Medical Biocor porcine aortic valve 14 years prior presented with New York Heart Association (NYHA) class III symptoms, severe aortic insufficiency from a degenerated prosthesis, and a large echocardiographic mobile mass representing a highly mobile prosthetic leaflet. The patient worsened to NYHA class IV symptoms despite medical management. The Society of Thoracic Surgery mortality risk score was extremely high. However, a valve-in-valve transcatheter aortic valve replacement (TAVR) was found to be a reasonable option. We used a 20 mm SAPIEN 3 Ultra valve (Edwards Lifesciences Inc., Irvine, CA, USA) with a SENTINEL embolic protection device (Boston Scientific, Marlborough, MA, USA). During valve deployment, the echocardiographic mobile mass was visually pinned between the new TAVR valve and the surgical bioprosthetic valve. No large embolic debris was noted within the embolic protection device, and the patient remained without any new focal neurologic deficits in the perioperative period and at the 30-day follow-up. The severe aortic insufficiency resolved, and the patient clinically improved to NYHA class II symptoms. [ABSTRACT FROM AUTHOR]

Cranberry fruitworm (Acrobasis vaccinii Riley (Lepidoptera: Pyralidae)) and blackheaded fireworm (Rhopobota naevana Hubner (Lepidoptera: Tortricidae)) threaten cranberry production annually by causing significant fruit damage. Up to four pesticide applications are made each year to control these insects, which are costly to producers and elevate pesticide residues in fruit. Pheromone-based mating disruption technology can provide control of these pests in cranberry production, with the potential to minimize, or eliminate, pesticide applications. In 2016, an uncrewed aerial vehicle (UAV) was investigated to apply a thick paraffin emulsion containing insect sex pheromones. Traditional agricultural equipment is not capable of applying the paraffin emulsion to cranberry beds due to the product's viscous, paste-like consistency. The first objective of this study was to retrofit an UAV (octocopter) with a novel extrusion device that had been engineered to deliver the pheromone-loaded paraffin at regular intervals during flight. The second objective was to confirm adequate distribution of the pheromones by measuring the mating disruption efficacy by monitoring male moth trap catches. The UAV was able to fly autonomously along a prescribed itinerary, deploying the paraffin product uniformly; however, the increased mass of the retrofitted UAV limited flight times to ∼12 min. The number of male cranberry fruitworm and blackheaded fireworm moths caught in lure-baited traps were reduced in the paraffin-treated beds compared with untreated beds, indicating adequate distribution of the pheromones. The UAV-applied pheromones concept could be developed into a production scale application method in the future, although issues of battery life and lifting capacity will need to be resolved. [ABSTRACT FROM AUTHOR]

Incidence of orbital fractures and associated ocular injuries has proven variable among literature worldwide. Such analysis has yet to be conducted in Detroit, Michigan. Due to the complexity and unpredictability of orbital fractures, we aim to further understand their epidemiology and association with ocular sequelae within this population.This retrospective study analyzed 204 eyes of 187 patients over a three-year and seven-month period within a Detroit, Michigan hospital system. The incidence of ocular injuries resulting from computed tomography-confirmed orbital bone fractures was quantified and categorized based on patient demographic, fracture location, specific ocular injury, and need for surgical intervention with analysis.It was determined that 84.8% of orbital fracture patients sustained some form of ocular injury. Most fractures occurred within the city (55.1%), and most often occurred in males (63.6%). Fractures of the orbital floor were most often encountered. Commonly injured bones were maxillary, ethmoid, and zygomatic bones, respectively. Approximately one-third of patients with concurrent orbital fracture and ocular trauma sustained severe vision-threatening injury. These traumas are found to peak within summer months. Presence of retinal detachment is significantly related to orbital roof fractures, while maxillary bone fractures are associated with decreased incidences of retinal detachment. Approximately 23% of patients underwent immediate surgery for osseous fractures, while 3.26% of patients underwent immediate ocular surgical repair.Our findings provide insight into the incidence of ocular injury in the setting of traumatic orbital fractures within a Midwest population. Both similarities and differences exist among our own results, and those of distinct geographical regions. These data shed light on Detroit's incidence of ocular sequelae in orbital fracture and contribute to a larger understanding of ocular and orbital trauma epidemiology. [ABSTRACT FROM AUTHOR]

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Background: Contact tracing is one of the key response activities necessary for halting Ebola Virus Disease (EVD) transmission. Key elements of contact tracing include identification of persons who have been in contact with confirmed EVD cases and careful monitoring for EVD symptoms, but the details of implementation likely influence their effectiveness. In November 2015, several months after a major Ebola outbreak was controlled in Liberia, three members of a family were confirmed positive for EVD in the Duport Road area of Monrovia. The cluster provided an opportunity to implement and evaluate modified approaches to contact tracing. Methods: The approaches employed for improved contact tracing included classification and risk-based management of identified contacts (including facility based isolation of some high risk contacts, provision of support to persons being monitored, and school-based surveillance for some persons with potential exposure but not listed as contacts), use of phone records to help locate missing contacts, and modifications to data management tools. We recorded details about the implementation of these approaches, report the overall outcomes of the contact tracing efforts and the challenges encountered, and provide recommendations for management of future outbreaks. Results: 165 contacts were identified (with over 150 identified within 48 hours of confirmation of the EVD cases) and all initially missing contacts were located. Contacts were closely monitored and promptly tested if symptomatic; no contacts developed disease. Encountered challenges related to knowledge gaps among contact tracing staff, data management, and coordination of contact tracing activities with efforts to offer Ebola vaccine. Conclusions: The Duport Road EVD cluster was promptly controlled. Missing contacts were effectively identified, and identified contacts were effectively monitored and rapidly tested. There is a persistent risk of EVD reemergence in Liberia; the experience controlling each cluster can help inform future Ebola control efforts in Liberia and elsewhere. [ABSTRACT FROM AUTHOR]

The article discusses the application of a heightened scrutiny standard of review to sexual orientation classifications in the wake of the U.S. Court of Appeals for the Ninth Circuit's ruling in the 2014 case SmithKline Beecham Corp. v. Abbott Laboratories which deals with an illegal peremptory strike during the voir dire process and a licensing agreement for Human Immunodeficiency Virus (HIV) medications. LGBT rights and opposition to an openly gay member of a jury pool are examined.

Alfalfa is a valuable and intensively produced forage crop in the United States, and the timely estimation of its yield can inform precision management decisions. However, traditional yield assessment approaches are laborious and time-consuming, and thus hinder the acquisition of timely information at the field scale. Recently, unmanned aerial vehicles (UAVs) have gained significant attention in precision agriculture due to their efficiency in data acquisition. In addition, compared with other imaging modalities, hyperspectral data can offer higher spectral fidelity for constructing narrow-band vegetation indices which are of great importance in yield modeling. In this study, we performed an in-season alfalfa yield prediction using UAV-based hyperspectral images. Specifically, we firstly extracted a large number of hyperspectral indices from the original data and performed a feature selection to reduce the data dimensionality. Then, an ensemble machine learning model was developed by combining three widely used base learners including random forest (RF), support vector regression (SVR) and K-nearest neighbors (KNN). The model performance was evaluated on experimental fields in Wisconsin. Our results showed that the ensemble model outperformed all the base learners and a coefficient of determination (R2) of 0.874 was achieved when using the selected features. In addition, we also evaluated the model adaptability on different machinery compaction treatments, and the results further demonstrate the efficacy of the proposed ensemble model. [ABSTRACT FROM AUTHOR]

Purpose: To present a novel case of exogenous Rahnella aquatilis endophthalmitis following an intravitreal injection., Methods: Case report., Results: A 74-year-old male presented with acute progressive vision loss and pain in the left eye, 5 days after an intravitreal injection for diabetic macular edema. The patient was diagnosed with exogenous endophthalmitis and empirically treated with intravitreal injections of vancomycin and ceftazidime as well as topical and oral ciprofloxacin. In follow up two days later, the patient was treated with preoperative povidone-iodine followed by prompt vitrectomy with additional vancomycin and ceftazidime due to pharmacy sterile hood issues that delayed antibiotic availability. Microbiological cultures and two mass spectrometry identification tests confirmed the diagnosis of exogenous Rahnella aquatilis endophthalmitis. Despite the presence of scattered retinal hemorrhagic infarcts involving the macula and subsequent full-thickness atrophic macular holes seen in follow up, the patient achieved a favorable anatomical and functional outcome of BCVA 20/80 at 1 year of follow-up., Conclusion: This case highlights the occurrence of exogenous Rahnella aquatilis endophthalmitis following an intravitreal injection for diabetic macular edema. Prompt diagnosis and treatment produced a favorable outcome relative to other typical Gram-negative Enterobacteriaceae organisms.

Purpose: This article analyzes 2 practice patterns our institution uses for genetic testing of patients with inherited retinal diseases (IRDs) and compares testing completion and diagnostic yield rates., Methods: A retrospective, consecutive chart review series was conducted of patients with a clinically diagnosed rod-mediated IRD. All IRDs were diagnosed between 2 intervals: November 1, 2015, through November 30, 2016 (referral to a medical genetics clinic for testing) or December 1, 2016, through December 30, 2017 (same-day, in-office genetic testing)., Results: A total of 189 patients were included in the study. Of patients who received an out-of-office referral for genetic testing, 10 of 84 (12%) patients proceeded with testing, whereas 74 of 84 (88%) patients did not complete testing. For patients who received in-office genetic testing, 104 of 105 (99%) completed testing. The difference in test completion was statistically significant ( P < .001). In addition, genetic testing for out-of-office referrals identified a causative mutation in 5 of 10 (50%) patients, whereas in-office genetic testing identified a causative mutation in 42 of 104 (40.4%) patients. The difference in causative mutation discovery was not statistically significant ( P = .18) between the 2 groups., Conclusions: In-office genetic testing is a novel practice pattern that provides a more consistent and accessible method for IRD genetic diagnosis. Compared with an out-of-office referral for genetic testing, in-office genetic testing offers a similar rate of causative gene mutation identification but a greatly higher rate of test completion, therefore potentially offering a much higher yield for genetic diagnosis of IRDs., 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) 2019.)