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This second Guideline for Reasonable and Appropriate Care in the Emergency Department (GRACE-2) from the Society for Academic Emergency Medicine is on the topic "low-risk, recurrent abdominal pain in the emergency department." The multidisciplinary guideline panel applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding four priority questions for adult emergency department patients with low-risk, recurrent, undifferentiated abdominal pain. The intended population includes adults with multiple similar presentations of abdominal signs and symptoms recurring over a period of months or years. The panel reached the following recommendations: (1) if a prior negative computed tomography of the abdomen and pelvis (CTAP) has been performed within 12 months, there is insufficient evidence to accurately identify populations in whom repeat CTAP imaging can be safely avoided or routinely recommended; (2) if CTAP with IV contrast is negative, we suggest against ultrasound unless there is concern for pelvic or biliary pathology; (3) we suggest that screening for depression and/or anxiety may be performed during the ED evaluation; and (4) we suggest an opioid-minimizing strategy for pain control. EXECUTIVE SUMMARY: The GRACE-2 writing group developed clinically relevant questions to address the care of adult patients with low-risk, recurrent, previously undifferentiated abdominal pain in the emergency department (ED). Four patient-intervention-comparison-outcome-time (PICOT) questions were developed by consensus of the writing group, who performed a systematic review of the literature and then synthesized direct and indirect evidence to formulate recommendations, following GRADE methodology. The writing group found that despite the commonality and relevance of these questions in emergency care, the quantity and quality of evidence were very limited, and even fundamental definitions of the population and outcomes of interest are lacking. Future research opportunities include developing precise and clinically relevant definitions of low-risk, recurrent, undifferentiated abdominal pain and determining the scope of the existing populations in terms of annual national ED visits for this complaint, costs of care, and patient and provider preferences.

BACKGROUND AND PURPOSE: CT is considered the standard reference both for quantification and characterization of carotid artery calcifications. Our aim was to investigate the relationship among different types of calcium configurations detected with CT within the plaque with a novel classification and to investigate the prevalence of cerebrovascular events. MATERIALS AND METHODS: Seven hundred ninety patients (men = 332; mean age, 69.7 [SD, 13] years; 508 symptomatic for cerebrovascular symptoms and 282 asymptomatic) who underwent computed tomography of the carotid arteries were retrospectively included in this institutional review board–approved study. The plaque was classified into 6 types according to the different types of calcium configurations as the following: type 1, complete absence of calcification within the plaque; type 2, intimal or superficial calcifications; type 3, deep or bulky calcifications; type 4, adventitial calcifications with internal soft plaque of

Interspecies hybrids can express phenotypic traits far outside the range of parental species. The atypical traits of hybrids provide insight into differences in the factors that regulate the expression of these traits in the parental species. In some cases, the unusual phenotypic traits of hybrids can lead to phenotypic dysfunction with hybrids experiencing reduced survival or reproduction. Cuticular hydrocarbons (CHCs) in insects are important phenotypic traits that serve several functions, including desiccation resistance and pheromones for mating. We used gas chromatography mass spectrometry to investigate the differences in CHC production between two closely related sympatric Hawaiian picture-wing Drosophila species, Drosophila heteroneura and D. silvestris, and their F1 and backcross hybrid offspring. CHC profiles differed between males of the two species, with substantial sexual dimorphism in D. silvestris but limited sexual dimorphism in D. heteroneura. Surprisingly, F1 hybrids did not produce three CHCs, and the abundances of several other CHCs occurred outside the ranges present in the two parental species. Backcross hybrids produced all CHCs with greater variation than observed in F1 or parental species. Overall, these results suggest that the production of CHCs was disrupted in F1 and backcross hybrids, which may have important consequences for their survival or reproduction.

Olfactory semiochemicals are volatile chemicals that modify the behavior of tephritids and can be classified as attractants, repellents, stimulants, deterrents and arrestants. Plant kairomones and allomones that influence tephritid behaviors can be both host-plant and non-host-plant in origin. The most dramatic, efficacious, and useful attractant developed from a host plant is that for the apple maggot, Rhagoletis pomonella. Though host-fruit extracts are routinely used to induce higher rates of oviposition in mass-rearing applications, chemically-defined ovipositional stimulants have been poorly researched, few have been identified, and none are in applied use. Trap type has a profound influence on attraction of fruit flies to food-based semiochemicals. Semiochemicals are an important part of our knowledge base for understanding the fundamental ecology of tephritids and for development of semiochemical-based control strategies for economically important tephritid fruit flies. Complexity is real in nature and should be one of the primary considerations in looking for improved attractants.

The Korea Institute of Civil Engineering and Building Technology (KICT) made one of the first radar observations of a rare tornadic storm that occurred on 10 June 2014 in the Seoul metropolitan region, South Korea, using X-band dual-polarization radar. The tornado lasted for about 18 min, during which it destroyed about 20 greenhouses and injured several people. This tornado was rated at F0 on the Fujita scale. The KICT X-band dual-polarization radar was installed in the area northwest of Seoul to monitor storm development, measure rainfall, improve hazard mitigation, and disaster management. This paper presents the high-resolution (both spatial and temporal) polarimetric radar observations of the tornado, along with the radar parameters of reflectivity, differential reflectivity, Doppler velocity, and copolar correlation coefficient. The characteristic signatures of polarimetric variables, including the descending reflectivity core, weak echo hole, Doppler velocity couplet, and hook echo, are used to describe the tornado vortex and its development. In addition, the close range (about 5-km distance) observations of the hook echo show the high-resolution radar signatures of a weak echo region surrounded by high-reflectivity annular rings inside the tornado vortex. From development to dissipation, various finescale features are observed, including lofted tornadic debris and potential hail signatures. The high-resolution (close range) observations were also compared against low-resolution (long range) radar observations. The comparison shows that high-spatiotemporal, low-altitude, and close-range observations can be significantly advantageous for tornado detection and early warning.

Diachasmimorpha longicaudata (Ashmead) and Fopius arisanus (Sonan), are two of the most abundant and widely used parasitoids for biological control of Bactrocera dorsalis (Hendel) worldwide. However, interspecific competition between them frequently occurs within a single host once they coexit in same orchard, resulting in reduction of their combined impact. However, thus far, it is difficult to characterize these complex interactions. This paper demonstrates qPCR-methods for detection of parasitism for single D. longicaudata, and methods to determine interspecific interaction with F. arisanus. Utilizing qPCR-based methodologies, a species-specific probe was designed for D. longicaudata, which was coupled with a previously published probe for F. arisanus. An assay was developed that is sensitive enough to detect parasitism of solitary D. longicaudata across all developmental stages including one egg per host larva (0.01 ng/40 ng parasitoid/host DNA). The detected parasitism of D. longicaudata was higher than that of using traditional rearing-methods. For the lab-reared and wild strain of multiple species parasitization, qPCR-methods also detected higher parasitism by the above two species from one assay respectively when compared to conventional rearing-based methods. In the later experiment, the majority of D. longicaudata larvae were dying or dead within hollow-like host pupae probably due to interspecific competition. This method is a reliable and robust technique to determine parasitism by a single species or both species of parasitoid across all life stages within one host. It will be useful to evaluate parasitoid combined suppression, and to characterize complex interspecific competition between these two species of parasitoids.

SummaryBackground YH4808, a K+-competitive acid blocker, is under clinical development for the treatment of acid-related disorders, such as gastroesophageal reflux disease. Aims We aimed to determine the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of YH4808, compared to placebo and esomeprazole. Methods This double-blind, randomised, placebo- and active comparator (esomeprazole)-controlled study was conducted with 123 healthy male volunteers. We evaluated YH4808 (30-800 mg) properties, administered in single (N=55) and multiple (N=24) oral doses, and recorded the effects on 24-hour intragastric acidity. Results were compared to placebo (N=20) and esomeprazole 40 mg (N=24). Results Plasma YH4808 exposure increased dose-proportionally and declined in a multi-phasic manner. YH4808 ≥200 mg/d maintained intragastric acidity at pH >4 for longer times than esomeprazole during both day and night (%Time at pH >4: >70% vs 58% of a 24-hour period, respectively; and >50% vs 33% of a 9-hour night respectively). A twice-daily regimen of YH4808 more effectively controlled intragastric pH at night than a once-daily regimen. In evaluating the mean areas under the intragastric pH-time curves in 15-minute intervals for 2 hours after dosing, we found that YH4808 had a faster onset than esomeprazole. Moreover, unlike esomeprazole, YH4808 PK and PD were not significantly affected by the CYP2C19 genotype of the subjects. YH4808 was well-tolerated at all doses administered. Conclusion This study showed that YH4808 produced a rapid, sustained suppression of gastric secretion with good tolerability. The results at YH4808 ≥200 mg/d provide a rationale for further clinical investigations in populations with acid-related diseases.

Male annihilation technique (MAT) is a key component of management of the Oriental fruit fly, Bactrocera dorsalis Hendel (Diptera: Tephritidae), because of the ‘strong’ attraction of males to the lure methyl eugenol. The optimal application density for MAT has not been investigated for this economically important pest species. We tested the effect of two levels of MAT application density compared to a no‐MAT control on the daily survivorship of male and female B. dorsalis estimated by mark‐release‐recapture (MRR) using a 1‐km² passive sampling network. Estimated daily survivorship from two separate MRR trials under control (no MAT) conditions was 0.751 for males and 0.948 for females. Male survivorship was similar under control (no MAT) and high application density (256 spots km⁻²; daily survivorship 0.704). However, estimated male survivorship was significantly lower under the low application density (100 spots km⁻²; daily survivorship 0.211). A similar pattern was observed in estimated female survivorship, with a significant reduction in survivorship under the low rate compared with control and high application density (low‐density estimated survivorship 0.652, high density 0.881). The results suggest that a lower application density may be more effective against B. dorsalis than the high application density. A lower application density for effective MAT would benefit growers and the public with respect to management of B. dorsalis through reduced labor and material costs, limiting potential environmental impacts, and increased logistical simplicity finding application sites in urban environments.

The development of quarantine treatments for use against pests that infest food plants arose from the need to protect agricultural interests without prohibiting commerce. The majority of the quarantine treatments used to ensure that commodities are free from exotic pests have been direct treatments that assume a high level of pest infestation in the commodity. Systems approaches differ from other methods such as direct treatments in that they integrate biological and operational factors to meet quarantine requirements. The preharvest component of systems uses information on the pest’s interactions with the host commodity at or about the time of harvest to further reduce the risk that a commodity entering the postharvest chain will be infested. Historically, most quarantine treatments have focused on the postharvest component of systems as the starting point in the development of direct treatments.

This study evaluated the attraction of insects previously shown to be attracted to methyl eugenol to a monofluorinated analog of methyl eugenol. Orchesia Latreille, 1807 (Coleoptera: Melandryidae), an Empis Linneaus, 1758 (Diptera: Empididae) and six Syrphidae (Diptera) (Allograpta obliqua (Say,1823), Blera scitula Williston, 1881, Hadromyia pulchra Williston, 1882, Ferdinandea Rondani, 1884, Melanosoma mellinum (Linnaeus, 1758) and Platycheirus LePeleteier & Serville, 1828) previously shown to be attracted to methyl eugenol were found to be attracted to the monofluorinated methyl eugenol analog. Three additional Diptera: Syrphidae. Dasysyrphus Enderlien ,1938, Pseudoscaeva diversifasciatus Knab, 1914 and Blera humeralis Williston, 1882) were deemed to be attracted to the monofluorinated methyl eugenol. A number of insects attracted to methyl eugenol were not attracted to monofluorinated methyl eugenol including Diptera in Lauxaniidae, Scatopsidae, Mycetophilidae, and Drosphilidae, Lepidoptera i...

Three different torque control algorithms are compared and evaluated for rear wheel drive electric vehicle (EV COMS) with in-wheel motors on split-mu road. The performance of direct yaw moment control, slip ratio control and integral control of both direct yaw moment and slip ratio control are studied by applying these control algorithms to electric vehicle for a straight motion on a split-mu road. The split-mu road disturbs the straight motion and vehicle will deviate from straight path with some error. In simulation, driver model is applied and driver effort of steering wheel angle eliminates this error in all the three cases. The simulation results show that the integral torque control schemes exhibit better performance as compared to direct yaw moment control and slip ratio control as it needs very little driver effort for vehicle straight motion. The three torque control schemes are also compared experimentally on a split-mu road using EV COMS. The desired yaw rate is set to zero in the software and the vehicle trajectory with reference to the desired straight path is recorded and compared. The integral control showed little deviation of test vehicle yaw rate from the desired zero yaw rate as compared to the other two control algorithms.

BACKGROUND Parasitism detection and species identification are necessary in fruit fly biological control. Currently, release of mass-reared Fopius arisanus is practiced worldwide, as it is effective in controlling Bactrocera dorsalis and Ceratitis capitata. To detect and assess parasitism in parasitoid mass-rearing colonies and parasitism levels in field populations across all life stages of hosts, the development of a rapid, specific and sensitive method is important. RESULTS A species-specific probe was designed for F. arisanus, as well as a universal tephritid probe. Utilizing rapid DNA extraction techniques coupled with quantitative-PCR, a simple and fast assay has been developed to detect parasitism of F. arisanus that is sensitive enough to detect the parasitoid across all developmental stages, including a single egg per host egg or 0.25 ng of parasitoid DNA in 40 ng of host DNA. The qPCR methods also detect a higher parasitism rate when compared with rearing-based methods where parasitism rate is based on wasp emergence and where unemerged wasps are not included. CONCLUSION This method is a rapid, sensitive and specific technique to determine the parasitism rate of F. arisanus across all life stages of B. dorsalis, which will be useful to predict parasitoid output from mass rearing and evaluate the outcome of pest suppression after mass release in the field. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

Currently, to observe entire Korean peninsula, two operational S-band radar networks have been operated by the KMA and the MOLIT. In this paper these two radar networks will be described in aspects of their goals and collaboration. In addition, two research X-band radar networks which will be deployed in Seoul and western sea side of Korean peninsula will be introduced.

BACKGROUND The oriental fruit fly, Bactrocera dorsalis (Hendel), is one of the most globally important insect pests. Studies were conducted with the novel anthranilic diamide insecticide cyantraniliprole to determine its lethal and sublethal effects on B. dorsalis. RESULTS An ingestion toxicity bioassay showed that cyantraniliprole was active against B. dorsalis, and the 72 h feeding LC50 was 3.22 µg g−1 in adult diet for a susceptible strain. Sublethal doses of cyantraniliprole (1.30 µg g−1 adult diet) induced a hormesis effect on B. dorsalis. The mating competitiveness of B. dorsalis treated with cyantraniliprole at 3.27 µg g−1 adult diet was significantly lower when compared with the controls. The lower dose (1.30 µg g−1 adult diet) of cyantraniliprole improved the total mating times of both mating pairs in treated groups and also the mating competitiveness of the treated males when compared with the higher dose and controls. Cyantraniliprole-treated females of the mated pairs with the lower dose laid more eggs. On the fifth day, female receptivity in the treated group was significantly reduced when compared with the controls. CONCLUSION These results indicate that cyantraniliprole is effective against B. dorsalis. The inhibition and stimulation effect of cyantraniliprole on the adult's mating performance at different concentrations was proved. © 2014 Society of Chemical Industry

The constant life diagram (CLD) can predict stress-life curves for various stress ratios under variable amplitude loading by using limited fatigue experimental data. The predictive accuracy of the constant life formulation is very important because fatigue analysis results are significantly affected by the accuracy of the estimated S–N curve. In this study, a nonlinear constant life formulation is developed to estimate more accurate S–N curves for previously developed CLDs. Four CLDs are presented and their predictive accuracies are compared with the proposed model on composite materials fatigue data. The accuracy is compared between actual fatigue data and the predicted S–N curve for the arbitrary load condition, for which no experimental data exists. Finally, the results reveal that the proposed model can predict the most accurate S–N curves with simple calculation processes compared to the results of previous constant life models.

Background A tumour suppressive role for EPHB receptors in various malignancies has been described, however their expression profile and prognostic significance in human colorectal cancers (CRCs) remain unclear. In this study, we aimed to investigate the expression profile of EPHB3 during CRC progression and determined its prognostic impact in a large cohort of CRC samples. Methods We examined the EPHB3 mRNA levels by real time PCR with fresh frozen CRC samples and evaluated protein expression by immunohistochemistry with tissue microarrays containing various benign tumours and 610 CRC samples. AOM-DSS induced colitis model was used to investigate the EPHB3 expression profile during the colitis-associated carcinogenesis. Results EPHB3 expression was upregulated in CRCs than in normal colonic mucosa, and showed positive correlations with intestinal stem cell (ISC) markers (EPHB2, OLFM4, LRIG1) and CD44, a candidate cancer stem cell marker. EPHB3 positivity was observed in 24% of 610 CRCs and showed negative correlations with differentiation, lympho-vascular invasions and TNM stages. EPHB3 expression significantly declined during adenoma-carcinoma transition and invasion into deeper layers. In particular, a substantial reduction of EPHB3 was observed in the budding cancer cells at the invasive fronts. In AOM-DSS induced colitis-associated colon cancer model, EPHB3 expression increased along with tumor development. Notably, EPHB3 was positively associated with microsatellite instability (MSI) phenotype but was not associated with CpG island methylator phenotype, KRAS and BRAF mutations. Furthermore, EPHB3 positivity was a prognostic marker for better clinical outcomes in CRC patients. Conclusions EPHB3 was upregulated in CRCs and showed positive correlations with candidate cancer stem cell marker CD44. EPHB3 expression decreased during adenoma-carcinoma transition and particularly in the budding cancer cells at the invasive fronts. EPHB3 positivity was associated with MSI phenotype and demonstrated to be a good prognostic marker in CRCs. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Coffee berry borer, Hypothenemus hampei (Ferrari) is the most serious insect pest of coffee around the world. Although it is already present in most of the world's major coffee growing regions, it is important to delay further spread and to prevent reintroductions that might include hyperparasites or improve the genetic base of existing populations. Green coffee is shipped around the world for custom blending and roasting and such shipments carry the risk of spreading H. hampei. We used heavily infested coffee berries as a surrogate for green coffee to test the freezing tolerance of H. hampei. After freezing, all life stages of H. hampei were dissected from coffee berries and mortality was assessed. Counting all life stages, >15,000 insects were measured in this study. A temperature of approximately -15°C (range, -13.9 to -15.5) for 48 h provided 100% control of all life stages. A logit regression model predicted ≤1 survivor in a million for treatments of -20°C for 5 d or -15°C for 6 d. A freezin...

The oriental fruit fly, Bactrocera dorsalis (Hendel) is a major pest of many fruit crops worldwide. Current detection programs by federal and state agencies in the United States use a grid of traps consisting of liquid methyl eugenol (lure) and naled (toxicant) applied to cotton wicks and hung inside the trap. In recent years efforts have been made to incorporate these chemicals into various solid-type matrices that could be individually packaged to reduce human exposure to the chemicals and improve handling. New solid formulations containing methyl eugenol and either naled or dichlorovinyl dimethyl phosphate toxicants were compared with the standard formulations on cotton wicks in large scale field evaluation in Hawaii. Two reduced risk toxicants (spinosad and Rynaxypyr) were also evaluated. In one test the solid lure-toxicant-matrix combinations were sent to California to be weathered under California climate conditions and then sent back to Hawaii for evaluation. The polymer matrices with lure and toxicant were found to be as attractive as baited wicks and have the same longevity of attraction regardless of being weathered in Hawaii or in California. The new ingestible toxicants were also effective, although further testing of these ingestible lure + toxicant + matrix products is necessary.

Diachasmimorpha kraussii (Fullaway) (Hymenoptera: Braconidae) was first released against Bactrocera latifrons (Hendel) (Diptera: Tephritidae) in Hawaii in March 2003. Over a three month period, eight releases, totaling 7,696 females and 3,968 males, were made in a turkeyberry, Solanum torvum Swartz (Solanales: Solanaceae) patch known to have a well established B. latifrons population. The establishment of D. kraussii was assessed through fruit collections conducted over a three-year period beyond the last release. D. kraussii was recovered 2 weeks, 31 months, and 39 months after the last parasitoid release, with collections not only from the release site, but also from a control site about 5.0 km distance from the release site. Recovery from fruit collections three years after the last parasitoid release confirmed that D. kraussii had become established in Hawaii. Parasitism rates were low, only 1.0–1.4%, compared to rates of 2.8–8.7% for the earlier established egg-larval parasitoid, Fopius arisanus (Sonan).

ABSTBACT We introduce a novel method for quantifying the response of tephritid fruit flies to chemical attractants (lures) under seminatural conditions by using automated detection and quantification via computer vision and an interruptible lure apparatus. We use this method to obtain a high-resolution (0.1 Hz) dataset representing the response of colony-reared melon flies, Bactrocera cucurbitae Coquillett, to cuelure [1-(p-acetoxyphenyl)-butan-3-one] at three different times of the day: morning (0900–1000 hours), mid (1200–1300 hours), and afternoon (1500–1600 hours), or all three times combined. Results consistently show a high and sustained response to cuelure in the morning period, a high but quickly decreasing response during the middle of the day and a low response in the afternoon. We propose possible reasons for the difference in response between the morning and middle of the day periods that could be investigated in future studies. The approach used here also can be used to study other important questions on the biology of tephritid fruit flies and other insects of similar size, particularly those involving their response to chemical lures.

The melon fly, Zeugodacus cucurbitae (Coquillett), is a serious pest of tropical horticulture, causing damage to cucurbits, tree fruits, and fruiting vegetables. Melon flies are especially attractive to freshly sliced cucumber, and this has led to the identification of a nine-compound kairomone lure that can be used to trap both female and male flies. In this study, a seven-compound lure, containing (Z)-6-nonenal, (Z)-6-nonen-1-ol, 1-octen-3-ol, (E,Z)-2,6-nonadienal, (E)-2-nonenal, hexanal, and 1-hexanol, was formulated into PVC plugs (100 or 300 mg/plug) for field testing in wet traps. In Hawaii, 100 mg of the seven-compound cucumber lure, loaded in either plugs or glass capillaries, attracted more flies than traps containing Solulys protein over a 9-wk period. However, both cucumber lure formulations showed marked declines in the number of flies trapped after 3 wk. Similar results were obtained during a 6-wk field trial using 100 mg cucumber lure plugs in Taiwan. Increasing the cucumber lure loading rate to 300 mg/lure increased the effective trapping life of the attractant during a second 9-wk field trial conducted in Hawaii. The synthetic cucumber lure showed female-biased sex ratios in trap captures in the Taiwanese and second Hawaiian field trials. Protein lures captures were female-biased in all three field trials. Wet traps in Hawaii containing the cucumber lure were found to capture 25-30 nontarget insects/trap/week, less than half that captured with Solulys. Captured nontarget insects represented 37 families in 10 orders. The most common families caught were Ceratopogonidae (∼9 flies/trap) and Gryllidae (∼7 crickets/trap).