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Brown kiwi (Apteryx mantelli Bartlett), a ratite endemic to New Zealand, is currently listed as “Vulnerable” under the IUCN classification system due to predation by introduced mammals. Operation Nest Egg (ONE) raises chicks and juveniles in predator-proof enclosures until they are large enough to defend themselves. These facilities experience an environmental accumulation of coccidial oocysts, which leads to severe morbidity and mortality of these kiwi. Four species of coccidia have been morphologically described from sporulated oocysts with additional opportunistic descriptions of endogenous stages. This research continues the morphological descriptions of these species of Eimeria with an additional novel morphotype also morphologically described. It also provides the first genetic characterisation targeting the mitochondrial cytochrome c oxidase I (COI) gene. Based on these findings, it was determined there are at least five morphotypes of Eimeria that infect brown kiwi and co-infections are common at the ONE facilities surveyed. The COI amplicon targeted for this study was sufficient to provide differentiation from other members of this genus. Sanger sequencing yielded ambiguous bases, indicating the need for more in-depth sequencing.

Thomas’s Rope Squirrel (Funisciurus anerythrus) and Gambian Sun Squirrel (Heliosciurus gambianus) are two of the eight squirrel species found in Nigeria with overlapping habitats in Southwestern Nigeria. Squirrels are involved in pollination, seed dispersal, vectors of human and domestic animal diseases as well as crop and household pests. These species and the crucial ecosystem services they render are threatened by habitat destruction, human encroachment and the fact that they are being used as a source of protein in Nigeria. Their conservation would be enhanced by availability of accurate genetic information which are scarce for these species. This study seeks to provide baseline data on genetic variation at three allozyme loci in the two species in University of Ibadan, Ibadan, Nigeria. Twenty-nine individual squirrels including eighteen F. anerythrus species and eleven H. gambianus were used in this study. These were obtained from the wild within the University of Ibadan. Observed and expected heterozygosity (Ho and He), Hardy-Weinberg equilibrium (HWE), genetic distance between the species, and inbreeding coefficients were performed using POPGENE and Tools for Population Genetic Analyses (TFPGA). In F. anerythrus, Ho and He were 0.6092 and 0.5635, respectively, while, for H. gambianus, Ho and He were 0.6242 and 0.5745, respectively. There were no deviations from HWE in all the tested loci (p>0.05). Nei genetic distance between the species was 0.0070 and the populations showed fairly high level of outbreeding (FST = 0.0029 ± 0.0017). More robust genetic markers would be required to further ascertain the genetic status of the species.

Many countries do not have a newborn screening (NBS) program, and immigrants from such countries are at risk for late diagnosis of phenylketonuria (PKU). In this international survey, 52 of 259 patients (20%) with late diagnosed PKU were immigrants, and 145 of the 259 (55%) were born before NBS or in a location without NBS. ispartof: JOURNAL OF PEDIATRICS vol:239 pages:231-+ ispartof: location:United States status: published

Aim There is compelling evidence that magnesium sulfate (MgSO4) given antenatally in threatened preterm labour is neuroprotective and reduces risk of cerebral palsy in offspring. National Neonatal Audit Programme (NNAP) in the UK monitors compliance to antenatal magnesium uptake in births Methods A multidisciplinary improvement team comprising of neonatologists, obstetricians and midwives was formed. This team process mapped a preterm mother’s admission to understand enablers and barriers to timely MgSO4 administration. A driver diagram conceptualised overall aim, primary & secondary drivers to inform change ideas. Change ideas (MgSO4 awareness sessions, clear guideline, preterm labour proforma, Think Mg posters, ward level champions, daily safety huddles, monthly display of compliance figures) were tested in iterative PDSA cycles. Number of preterm births Results In 2016, only 3/20 (15%) preterm mothers received antenatal MgSO4. With improvement efforts and monitoring via PDSA cycles and g charts we saw a steady increase in MgSO4 uptake. In 2017 10/18 (56%) and in 2018, 14/18 (77%) received antenatal MgSO4. Opportunities between events ‘g’ chart tracked number of eligible births between a noncompliant episode. There were a few deliveries with short arrival to delivery intervals in late 2018, with drop in our compliance. Further analysis of these cases highlighted certain delays in triage ward, and they were addressed. Overall, in a 3-year period MgSO4 compliance rose from 16% to 77%. We also involved service users, by providing a parental information leaflet and including a check box in golden hour care checklist. Conclusion Using a well-structured quality improvement plan, we were able to understand the barriers to MgSO4 use and systematically introduce changes that resulted in improved compliance. Collaborative working between multidisciplinary staff across specialties was key to our success and we hope to further scale up and sustain the improvement.

In urban environments, road-side catch basins are common larval habitats of Culex spp. (Diptera: Culicidae) mosquitoes and important targets of larval control in areas subject to West Nile virus (WNv) transmission. We quantified the impact of larviciding basins on Culex spp. populations and WNv infection prevalence by treating basins in and around urban parks in Atlanta, GA, using Mosquito Dunks and Bits (active ingredient, a.i., Bacillus thuringiensis subsp. isrealensis, Dunks-10.31%, Bits-2.86%) and Altosid 30-Day Briquets (a.i., S-methoprene 8.62%) in two separate seasons. Treatments were coupled with WNv surveillance using gravid traps and aspiration of adults resting in basins. Larviciding led to >90% reductions in Culex spp. larval and pupal collections (Dunks/Bits) and >90% pupal mortality (Briquets) in treated sites during treatment periods; however, we did not observe significant reductions in Culex spp. collections in gravid traps (general linear mixed-effects model [GLMM] result, P > 0.1) or in adults collected resting in basins (GLMM, P > 0.5). In addition, WNv infection prevalence in Culex spp. mosquitoes was similar between treated and untreated sites (GLMM, P > 0.05). Larval control remains important for controlling WNv in Atlanta; however, at the scale and frequency applied in our study, larval control alone may not lead to meaningful reductions in adult populations and WNv infection prevalence. A greater understanding of the annual dynamics of Culex spp. breeding and the importance of basins as Culex spp. larval habitats are needed to meaningfully affect WNv in cities such as Atlanta.

Annual decreases in soybean (Glycine max L. Merrill) yield caused by diseases were estimated by surveying university-affiliated plant pathologists in 28 soybean-producing states in the United States and in Ontario, Canada, from 2010 through 2014. Estimated yield losses from each disease varied greatly by state or province and year. Over the duration of this survey, soybean cyst nematode (SCN) (Heterodera glycines Ichinohe) was estimated to have caused more than twice as much yield loss than any other disease. Seedling diseases (caused by various pathogens), charcoal rot (caused by Macrophomina phaseolina (Tassi) Goid), and sudden death syndrome (SDS) (caused by Fusarium virguliforme O’Donnell & T. Aoki) caused the next greatest estimated yield losses, in descending order. The estimated mean economic loss due to all soybean diseases, averaged across U.S. states and Ontario from 2010 to 2014, was $60.66 USD per acre. Results from this survey will provide scientists, breeders, governments, and educators with soybean yield-loss estimates to help inform and prioritize research, policy, and educational efforts in soybean pathology and disease management.

The last several decades have seen dramatic advances in the use of technology in everyday life. As expected, these technological advancements have affected all areas of human existence, including s...

Annual decreases in corn yield caused by diseases were estimated by surveying members of the Corn Disease Working Group in 22 corn-producing states in the United States and in Ontario, Canada, from 2012 through 2015. Estimated loss from each disease varied greatly by state and year. In general, foliar diseases such as northern corn leaf blight, gray leaf spot, and Goss's wilt commonly caused the largest estimated yield loss in the northern United States and Ontario during non-drought years. Fusarium stalk rot and plant-parasitic nematodes caused the most estimated loss in the southern-most United States. The estimated mean economic loss due to yield loss by corn diseases in the United States and Ontario from 2012 to 2015 was $76.51 USD per acre. The cost of disease-mitigating strategies is another potential source of profit loss. Results from this survey will provide scientists, breeders, government, and educators with data to help inform and prioritize research, policy, and educational efforts in corn pathology and disease management. Accepted for publication 26 August 2016.

To demonstrate the feasibility of an innovative technique for the surgical management of rectal cancer, we performed transanal minimally invasive surgery assisted low anterior resection with total mesorectal excision (TAMIS-assisted LAR with TME) in a cadaver model. Transanal LAR via natural orifice transluminal endoscopic surgery has been reported in cadaveric series using rigid transanal platforms. This procedure has not been described using a combination of a single incision laparoscopy and TAMIS transanal endoscopic platform. We describe the first cadaveric series of TAMIS-assisted LAR with TME.TAMIS-assisted LAR with TME was successfully performed in five fresh human cadavers. The procedure was performed using the mini-Gelpoint single incision platform and the Gelpoint Path TAMIS platform (Applied Medical, Rancho Santa Margarita, CA). The variables recorded were age, body mass index (BMI), operative time, complications, and specimen length. The grade of the TME was determined by evaluation of the specimen by photo documentation by a gastrointestinal pathologist.All cadavers were male with a mean age of 71 ± 8 years and mean BMI of 28 ± 3 kg/m(2). The mean operative time was 200 ± 55 min (range 128-249 min). The quality of the TME was grade I (complete) with intact mesorectum in all five cases. The mean specimen length was 36.8 ± 3.4 cm.TAMIS-assisted LAR with TME was feasible. A high-quality TME can be achieved using this innovative technique. Transanal endoscopic total mesorectal dissection may revolutionize the surgical management of rectal cancer. However, multicenter clinical trials are needed to further evaluate the oncologic safety and surgical outcomes of transanal endoscopic TME using various platforms before widespread application of this new technique.

Laparoscopic and endoluminal surgical techniques have evolved and allowed improvements in the methods for treating benign and malignant gastrointestinal diseases. To date, only case reports have been reported on the application of a laparo-endoscopic approach for resecting gastric submucosal tumors (SMT). In this study, we aimed to evaluate the efficacy, safety, and oncologic outcomes of a laparo-endoscopic transgastric approach to resect tumors that would traditionally require either a laparoscopic or open surgical approach. Herein, we present the largest single institution series utilizing this technique for the resection of gastric SMT in North America.We performed a retrospective review of a prospectively collected patient database. Patients who presented for evaluation of gastric SMT were offered this surgical procedure and informed consents were obtained for participation in the study.Fourteen patients were included in this study between August/2010 and January/2013. Eight (8) patients (57.1 %) were female and the median age was 56 years (range 29-78). Of the 14 cases, 8 patients (57.1 %) underwent laparo-endoscopic resection of SMTs with transgastric extraction, 5 patients (35.7 %) had conversions to traditional laparoscopic surgery, and 1 patient (7.2 %) was abandoned intraoperatively. The median operative time for this cohort was 80 min (range 35-167). Ten patients (71.4 %) had GISTs, 3 (21.4 %) had leiomyomas, and 1 (7.1 %) had schwannoma. There were no intraoperative complications. Two patients had postoperative staple line bleeding that required repeat endoscopy. The median hospital stay was 1 day (range 1-6) and there were no postoperative mortalities. At 12-month follow-up visit, only one GIST patient (10 %) had tumor recurrence.Our experience suggests that this surgical approach is safe and efficient in the resection of gastric SMT with transgastric extraction. This study found no intraoperative complications and optimal oncologic outcomes during the follow-up period. Minimally invasive surgical approaches are emerging as a valid and potentially better approach for resecting malignancies; however, continued investigation is underway to further validate this data.

The diagnosed incidence of pancreatic neuroendocrine tumors (pNETs) is increasing; however, their etiology remains poorly understood. PNETs are a rare, heterogeneous group of tumors arising from the endocrine cells of the pancreas, and genetic risk factors for sporadic pNETs are inadequately understood. It is known that pNETs secrete biogenic amines, hormones and growth factors, tumor necrosis factor-a (TNF-α) being one of them. Furthermore, cytokines and other proinflammatory mediators have been implicated in inflammatory pancreatic diseases including pancreatitis and cancer. The aim of our study was to analyze TNF-α promoter gene polymorphisms as risk factors for pNETs using germline DNA collected in a population-based case–control study of pancreatic cancer [42 pNET cases, 78 pancreatic ductal adenocarcinoma (PDAC) cases, 17 intraductal papillary mucinous neoplasm (IPMN) and 98 healthy controls] conducted in the Athens, Greece and Izmir, Turkey areas. For subsequent analysis, we excluded cases and controls with known genetic syndromes. The CC genotype at the −1031 position was more frequent in pNET and IPMN patients (p = 0.0002 and p = 0.009, respectively), suggesting its possible role in pNET development. Furthermore, the AA genotype at the −308 position was overrepresented in IPMN cases (p = 0.03), and AA genotype at the −238 position was more frequent in PDAC cases (p = 0.03) compared to healthy individuals. With regard to tumor characteristics, no statistically significant association was detected. Our findings suggest the putative role of TNF-α −1031 polymorphism in the development of pNET and IPMN, whereas the −308 polymorphism seems to be overrepresented among IPMN cases and −238 polymorphism among PDAC cases. © 2014, Springer Science+Business Media New York.

Ferroelectric liquid crystals can be optimized for speed, but such materials tend to have small switching angles and consequently low contrast in the smectic A(*) phase. We describe a method whereby such a low-contrast but fast-switching effect can be enhanced, in theory giving the same contrast as a material with a switching angle of 22.5 degrees . This method therefore promises liquid-crystal modulators of high contrast and with speeds of the order of hundreds of nanoseconds. The theoretical basis of this method and initial results that support this analysis are presented.

Enucleation is a technique which can be applied to benign and low grade lesions of the liver such as select neuroendocrine tumors (NET), cysts, hemangiomas and focal nodular hyperplasia. The benefits of enucleation include the preservation of maximal hepatic parenchyma, as well as the low likelihood that underlying vascular or biliary structures will be compromised. A laparoscopic approach to enucleation not only offers the benefits of minimal access surgery, but also allows simultaneous access to multiple regions of the abdomen. This may be ideal for managing certain scenarios such as the patient with distal pancreatic NET and synchronous liver metastases. Illustrative cases are shown.

Surgical resection for benign subepithelial tumors near the gastroesophageal junction is difficult, often leading to esophagectomy. Here we demonstrate the feasibility of a novel technique of dual endoscopic resection using retroflexed standard adult upper endoscope and second smaller caliber (baby) endoscope to resect benign GE junction leiomyomas (26 cm size) in four patients. Maneuvering the small caliber endoscope allowed offaxis retraction of the mass while the adult endoscope was used to carry out the dissection from the submucosal tissue. Our experience highlights the feasibility of this minimally invasive approach by enabling triangulation using endoscopic tools.

Enhanced recovery (ER) pathways improve clinical outcomes, the Department of Health (DoH) suggesting several applications. Current published data within obstetrics is limited. Increased pressure on maternity beds; 39% of maternity units in England closing to admissions on one or more occasions in the year to 31 March 2007 [2], highlights a pivotal throughput parameter to benefit from an ER pathway. Methods Survey of patients following elective caesarean section (CS) over a five-month period. Questionnaire designed against DoH guidelines [1]. Results 50 surveys completed. 100% of patients were awake in recovery with regular analgesia prescribed. Mean pain score was 0.1/10. 28% of respondents were nauseated or vomited in recovery. Mean time until discharge criteria were met was 153 minutes. Mean time for actual discharge from recovery was 213 minutes. 15% of patients were eating before discharge. 97% had a motor block on discharge. Urinary catheter remained in situ after 12 hours in 79% of patients. 100% of patients remained in hospital after 36 hours. Discussion Patients delayed from returning to the ward may follow delayed discharges on the receiving ward, staff requirements to permit safe transfer and prolonged presence of an epidural (7%) and urinary catheters (79% after 12 hours). Promoting urinary catheter removal at 6 hours on a dedicated ‘receiving bay’ may reduce length of stay. DoH suggests a change of culture may accompany discharges at 24 hours (providing all recovery factors have been cleared). We plan to implement a formal ER programme and re-audit in six months.

Modern biomedical psychiatry is the product not only of scientific enterprise but also of the progressive secularisation and medicalisation of moral life in the West (Jimenez, 1987). Psychiatry is an evolving cultural product. Its diagnostic categories represent pathologies rooted in Western notions of self, identity, normality and abnormality (Gaines, 1991). Psychiatric practice in Egypt, on the other hand, is the product of two different and often incompatible world views, namely Western psychiatry and Egyptian concepts of self, identity, normality and abnormality. The task of the psychiatrist in Egypt is to negotiate symptoms and diagnoses in a way that is sensitive to the demands of these two competing cultural streams. Analysis of this process provides a unique view of the ways in which culture can have an impact on professional psychiatry in any society or ethnic context.

tially nonimmune to Trichinella spiralis infection, and, in addition, seemed to prevent in these mice the gain of acquired immunity that nonimmunized mice ordinarily develop between 11 to 14 days following infection. Associated with these findings were those showing that the hormone had a demonstrable effect upon the lymphoid-macrophage system; it caused a reduction in spleen size, a lymphocytopenia and an eosinopenia. A cellular response in the intestine of mice has been shown to be associated with immunity to T. spiralis (Larsh and Race, 1954). In view of this, and the results of the previous experiment of this series mentioned above, it seemed advisable to study directly the effect of cortisone upon the cellular response in the intestine and its relation to the operation of this immunity. Provided that cortisone produced a demonstrable depression of the cellular response in the intestine, this approach would afford an opportunity to test the hypothesis of Larsh (1953) that the operation of acquired immunity against T. spiralis in mice is dependent upon the "primary action(s) of specific antibodies with secondary cellular cooperation." The present experiment was designed, therefore, with the hope that further light might be shed on the mechanism of this im

One hundred and forty eight patients (69 women and 79 men) with often recurring genital herpes were observed for two months. Men had 119 observed recurrences and women 104. The attacks were significantly longer in men than women (8.7 days v 6.6 days, p = 0.005). Significantly more women complained of symptoms, however, and when symptoms occurred they were more severe. Other significant differences between men and women included age (men were older than women); more men had previously had sexually transmitted diseases; more men had infected a sexual partner, but fewer knew the source of their infection; and men had more lesions at each attack. Positive viral culture results were shown to depend on the amount of erythema, the number of lesions, and the presence of vesicles.