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Introduction: We aimed to describe a case of bilateral keratoconjunctivitis after exposure to the toxic sap of Euphorbia lathyris ., Case Report: A 76-year-old gentleman presented after exposure to E. lathyris whilst he was gardening. He had 6/12 visual acuity in his right eye, and 6/4 in his left. Examination revealed marked periocular dermatitis, conjunctival injection and corneal oedema in the right eye with diffuse punctate epithelial staining. He was treated with ocular irrigation, topical steroids, antibiotics, cycloplegics and lubricants. Over 48 h, his left eye started to become symptomatic. He developed bilateral corneal epithelial defects and anterior chamber inflammation. His visual acuity worsened to 6/36 right and 6/24 left. At his 3-week follow-up, there was marked improvement in the resolution of the toxic keratoconjunctivitis in both eyes., Conclusion: Toxic sap from E. lathyris can cause severe keratoconjunctivitis. Irrigation of both eyes despite unilateral symptoms and early follow-up should be considered signs of toxicity may only become evident after 24-48 h., Competing Interests: The authors declare that there are no conflicts of interest., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Background: Idiopathic intracranial hypertension (IIH) is a condition of raised intracranial pressure (ICP). Obstructive sleep apnoea (OSA) has been shown to cause episodic rises in ICP and is frequently reported in patients with IIH. The aim of this study is to identify the prevalence of OSA in a cohort of IIH patients., Methods: We conducted a retrospective case notes review as part of a service evaluation of newly diagnosed IIH patients who were all referred for OSA screening with overnight pulse oximetry. The 3% oxygen desaturation index (3% ODI) was used to evaluate the presence and severity of OSA. The clinical outcomes of patients who received continuous positive airway pressure (CPAP) therapy as treatment for OSA were reviewed., Results: In our cohort of newly diagnosed IIH patients, the yield of overnight pulse oximetry as a screening tool was 48.6% for OSA and 15.3% for moderate to severe OSA. We found that age (p = 0.0008), BMI (p < 0.0001), vitamin B 12 (p = 0.0183), and a higher Epworth Sleep Score (p = 0.0269) correlated with more severe OSA. Eleven (10%) patients had CPAP therapy and those with good adherence alongside weight loss or medical therapy found improvements in symptoms of raised ICP., Conclusion: We report the largest series of consecutive IIH patients screened for OSA using overnight pulse oximetry. The high rate of OSA highlights a potential role for the recognition and management of OSA in the IIH patient cohort. Further studies on the potential contribution of OSA as a cause of raised ICP in the IIH cohort is warranted., (© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Objectives: This article evaluates if ethnicity is an independent poor prognostic factor in COVID-19 disease., Methods: MEDLINE, EMBASE, Cochrane, WHO COVID-19 databases from inception to 15/06/2020 and medRxiv. No language restriction. Newcastle-Ottawa Scale (NOS) and GRADE framework were utilised to assess the risk of bias and certainty of evidence. PROSPERO CRD42020188421., Results: Seventy-two articles (59 cohort studies with 17,950,989 participants, 13 ecological studies; 54 US-based, 15 UK-based; 41 peer-reviewed) were included for systematic review and 45 for meta-analyses. Risk of bias was low: median NOS 7 of 9 (interquartile range 6-8). Compared to White ethnicity, unadjusted all-cause mortality was similar in Black (RR: 0.96 [95% CI: 0.83-1.08]) and Asian (RR: 0.99 [0.85-1.16]) but reduced in Hispanic ethnicity (RR: 0.69 [0.57-0.84]). Age- and sex-adjusted risks were significantly elevated for Black (HR: 1.38 [1.09-1.75]) and Asian (HR: 1.42 [1.15-1.75]), but not for Hispanic (RR: 1.14 [0.93-1.40]). Further adjusting for comorbidities attenuated these associations to non-significance: Black (HR: 0.95 [0.72-1.25]); Asian (HR: 1.17 [0.84-1.63]); Hispanic (HR: 0.94 [0.63-1.44]). Subgroup analyses showed a trend towards greater disparity in outcomes for UK ethnic minorities, especially hospitalisation risk., Conclusions: This review could not confirm a certain ethnicity as an independent poor prognostic factor for COVID-19. Racial disparities in COVID-19 outcomes may be partially attributed to higher comorbidity rates in certain ethnicity., (© 2020. W. Montague Cobb-NMA Health Institute.)

To determine if key attributes for a successful biological control agent are possessed by the predator, Laricobius nigrinus Fender, field studies were conducted in its native range of Seattle, WA. The relationship between adult and immature L. nigrinus abundance to different densities of its prey, Adelges tsugae Annand, were determined. In a second study, predator and prey densities, and survivorship of each sistens A. tsugae stage were determined to gauge the impact of predation. The predator strongly aggregated and increased its reproduction when prey density increased, the two mechanisms of a numerical response. Immature predator-prey ratios were high and average prey density was low in comparison with invaded areas of the eastern United States. Survivorship of aestivating first-instar sistens A. tsugae was low and survivorship of each instar (second, third, and fourth) and adults was high and increased with each stage. When pooled, however, the survivorship of sistens second instar-ovisac stages was low primarily owing to L. nigrinus larval consumption of ovisacs. In its native range, L. nigrinus has key attributes of a successful biological control agent, such as a strong numerical response, high predator-prey ratios, and an important larval impact on A. tsugae populations. Demographic data could serve as important benchmarks for future studies to determine if L. nigrinus and other predators can regulate densities of A. tsugae below eastern hemlock's physiological damage threshold in the eastern United States., (© The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Daily distributions of eclosion and mating activities of Pseudopidorus fasciata Walker (Lepidoptera: Zygaenidae) were recorded under natural and various laboratory conditions. Eclosion of this insect exhibited circadian gating in constant darkness (DD) but not in constant light (LL) at 28°C. Under natural conditions, the majority of adults emerged in midmorning with an eclosion peak around 1000 hours. The eclosion distribution was significantly affected by ambient temperature but not by photoperiod under laboratory conditions. Eclosion was more spread out at 22°C than at higher temperatures, and peak eclosion times were advanced at higher temperatures up to 30°C. Under natural and laboratory diurnal cycles, adults of P. fasciata preferred to mate at dusk, within a few hours before the start of the scotophase. Photoperiod and ambient temperature interacted in regulating the mating distribution in P. fasciata. Mating rhythmicity disappeared under DD and LL, under which the insect either mated arrhythmically (DD) or barely mated (LL). Overall, eclosion rhythm in this insect was predominantly regulated by temperature rather than photoperiod, whereas photoperiod appeared to be more influential than temperature in rhythmic gate of mating patterns.

Eastern hemlocks (Tsuga canadensis Carrière) at two sites in southwestern Virginia were treated by trunk and soil injections of imidacloprid to determine the insecticide's impact on hemlock woolly adelgid, Adelges tsugae Annand. Treatments were 25, 50, and 100% of the highest labeled dosage rates for both stem and soil injection. Three and 4 yr after treatment, the half and full rates had significantly reduced A. tsugae populations, which were accompanied by increased new hemlock shoot growth and higher hemlock health scores on a visual rating of tree appearance. Imidacloprid and metabolite concentrations in tissue of treated trees were determined by liquid chromatography-tandem mass spectrometry, and A. tsugae density decreased as imidacloprid concentrations increased in wood tissue. There were no observed A. tsugae populations in all trees with imidacloprid tissue concentrations >413 ppb. Olefin, di-hydroxy, and 6-chloro-nicotinic-acid metabolites were the imidacloprid metabolites recovered in the highest concentrations. This suggests that hemlock metabolism of imidacloprid may increase efficacy of the parent compound. Stem and soil treatments of low rates of systemic imidacloprid reduce adelgid populations and promote hemlock health, but still may provide a remnant food source for beneficial predators.

Ailanthus altissima (Mill.) Swingle, commonly known as tree-of-heaven, is an invasive tree species that has spread throughout the United States since its introduction in 1784 (2). During a survey in July 2009, approximately 1,100 A. altissima trees were observed at two locations in western Virginia (a roadside in Montgomery Co. and a wooded area adjacent to a railroad in Bedford Co.) exhibiting foliar wilt symptoms, defoliation, yellowish vascular discoloration, or death at an incidence of ~77%. Similar symptoms on A. altissima were reported in Roanoke, VA in the early 1930s and after 2005 in Pennsylvania, attributed to a Verticillium sp. (1,2). To identify the causal agent, discolored xylem tissue samples were excised from 10 symptomatic A. altissima trees at both locations, soaked in 1% NaOCl for 2 min, rinsed with sterilized distilled water for 5 min, and placed onto plum extract agar. Cultures were incubated in the dark at 22°C for 7 to 14 days. The resultant colonies (three to four per location) were subcultured and identified putatively as a Verticillium sp. closely related to Verticillium albo-atrum Reinke and Berthold (3), based on melanized, thick-walled, resting mycelia and phialides arranged in verticillate whorls that amassed round, oval-shaped conidia (5.1 ± 1.2 μm × 2.8 ± 0.4 μm, n = 100). Molecular identification of two fungal isolates (one per location) was determined by amplification of the protein coding genes elongation factor 1-alpha (EF), glyceraldehyde-3-phosphate dehydrogenase (GPD), and tryptophan synthase (TS), using PCR primers developed recently for Verticillium (3). A BLAST search on the edited contigs revealed 100% sequence similarity for all three protein coding genes among the two isolates and reference sequences of isolates PD592 (GenBank Accessions JN188227, JN188163, and JN188035 for EF, GPD, and TS, respectively) and VnAaPA140 (KC307764, KC307766, and KC307768 for EF, GPD, and TS, respectively) of the newly-proposed species, V. nonalfalfae (formerly V. albo-atrum). Aligned sequences from one representative isolate, VnAaVA2 (Bedford Co.), were deposited into GenBank as KC307758 (EF), KC307759 (GPD), and KC307760 (TS). To confirm pathogenicity to A. altissima, the two molecularly characterized isolates (one per location) were inoculated into 18 10-week old A. altissima stems that were grown in an environmental chamber at 24°C, 60% RH, and a 12-h photoperiod from seeds collected in Blacksburg, VA. A conidial suspension of each isolate was injected into each stem (0.1 ml of 1 × 10 8 CFU/ml/stem). All 36 seedlings inoculated with the proposed V. nonalfalfae isolates developed wilting of leaflets within 2 weeks post-inoculation (WPI), defoliation of leaflets by 6 WPI, and were dead by 9 WPI. Eighteen control seedlings were inoculated similarly with distilled water, and remained asymptomatic. Fungi resembling the proposed species V. nonalfalfae were reisolated from all inoculated stems except the control plants, and the species confirmed morphologically as described above. V. nonalfalfae is a recently proposed species that can infect a variety of plant species (3). To our knowledge, this is the first report of this proposed species on A. altissima in Virginia. New state reports of this pathogen on A. altissima are important for regulatory issues associated with using this pathogen as a potential biological control agent. References: (1) G. F. Gravatt and R. B. Clapper. Plant Dis. Rep. 16:96, 1932. (2) M. J. Schall and D. D. Davis. Plant Dis. 93:747, 2009. (3) P. Inderbitzin et al. PLoS ONE, 6, e28341, 2011.

Ailanthus altissima (Mill.) Swingle, tree-of-heaven, is an invasive species native to Asia. It first was introduced into the United States in the 1700 s and now is distributed throughout much of North America. Mechanical and chemical controls are current suppression tactics, however, implementation is costly. A weevil, Eucryptorrhynchus brandti (Harold), was identified in China and imported for quarantine testing in 2004 as a potential biological control agent. Host specificity tests on adult feeding, larval development, and oviposition of this weevil were conducted from 2007 to 2011 on A. altissima and 29 nontarget species. Eucryptorrhynchus brandti adults fed significantly more on A. altissima foliage when compared with all test species. Range of means for feeding on A. altissima was 32.5-106.5 mm(2)/adult/d. In no-choice tests, Simarouba glauca DC, Leitneria floridana Chapm., and Citrus limon (L.) Burm. F., had feeding rates of only 10, 49, and 10%, respectively, compared with the level of feeding on A. altissima. The mean range of adult feeding by E. brandti on all other test species was <7% of feeding on A. altissima (0.0-3.3 ± 5.0 mm(2)/adult/d). In the no-choice larval inoculation tests, larval development only occurred in two of 10 L. floridana seedlings compared with seven of 10 A. altissima seedlings. In the no-choice oviposition tests, oviposition and subsequent larval development did not occur in L. floridiana, whereas all seven A. altissima seedlings supported oviposition and subsequent larval development. The weevil did not appear to be a threat to L. floridana or any other nontarget species tested. Therefore, we conclude that Eucryptorrhynchus brandti is highly host specific to A. altissima.

Very little is known about the searching behavior and sensory cues that Laricobius spp. (Coleoptera: Derodontidae) predators use to locate suitable habitats and prey, which limits our ability to collect and monitor them for classical biological control of adelgids (Hemiptera: Adelgidae). The aim of this study was to examine the visual ability and the searching behavior of newly emerged L. nigrinus Fender, a host-specific predator of the hemlock woolly adelgid, Adelges tsugae Annand (Hemiptera: Phylloxeroidea: Adelgidae). In a laboratory bioassay, individual adults attempting to locate an uninfested eastern hemlock seedling under either light or dark conditions were observed in an arena. In another bioassay, individual adults searching for prey on hemlock seedlings (infested or uninfested) were continuously video-recorded. Beetles located and began climbing the seedling stem in light significantly more than in dark, indicating that vision is an important sensory modality. Our primary finding was that searching behavior of L. nigrinus, as in most species, was related to food abundance. Beetles did not fly in the presence of high A. tsugae densities and flew when A. tsugae was absent, which agrees with observed aggregations of beetles on heavily infested trees in the field. At close range of prey, slow crawling and frequent turning suggest the use of non-visual cues such as olfaction and contact chemoreception. Based on the beetles' visual ability to locate tree stems and their climbing behavior, a bole trap may be an effective collection and monitoring tool.

Eastern hemlock, Tsuga canadensis (L.) Carrière, branchlets were systemically treated with imidacloprid and bioassayed with hemlock woolly adelgid, Adelges tsugae (Annand) (Hemiptera: Adelgidae), and predators. After 10 d, two hemlock woolly adelgid predators, Laricobius nigrinus Fender (Coleoptera: Derodontidae) and Sasajiscymnus tsugae Sasaji & McClure (Coleoptera: Coccinellidae), were allowed to feed on remaining hemlock woolly adelgid for 20 d on branches systemically treated with 1, 10, or 100 ppm imidacloprid. Every 5 d, mortality, mobility (measured as flip time), number of hemlock woolly adelgid consumed, and degree of intoxication of each individual beetle were recorded. Liquid chromatography-mass spectrometry was used to quantify imidacloprid and some of its major metabolites in hemlock wood tissues and in the predator beetles postmortem. Probit analysis of hemlock woolly adelgid mortality and imidacloprid concentrations recovered from branch wood tissues determined the 30 d LC50 to be 242 ppb. A topical application of imidacloprid to the ventral abdomen of individual beetles resulted in a 6 d LD50 value of 1.8 and 0.71 ng imidacloprid per beetle for L. nigrinus and S. tsugae, respectively. In no-choice tests, L. nigrinus mortality was significantly higher on hemlock branchlets treated with 100 ppm imidacloprid than on controls, but S. tsugae mortality was not. S. tsugae consumed the same number of adelgids on treated branchlets as on controls, but L. nigrinus consumed fewer adelgids from the 100 ppm branchlets than on controls. In choice tests, beetle mortality and flip times were generally not significantly different from controls. At times, both beetle species displayed intoxication symptoms after feeding on adelgids from treated branchlets and imidacloprid was recovered from both beetle species postmortem. These results suggest that systemic imidacloprid displayed both lethal and sublethal effects on these two nontarget predators of the hemlock woolly adelgid.

The hemlock woolly adelgid, Adelges tsugae Annand (Hemiptera: Adelgidae), native to western North America and Asia, was accidentally introduced from Japan to the eastern United States. To potentially establish biological control of A. tsugae, we released a predator endemic to western North America, Laricobius nigrinus Fender (Coleoptera: Derodontidae), from 2003 to 2005, in 22 localities from Georgia to Massachusetts. Release sites spanned the invasive range of the adelgid across five United States Department of Agriculture plant hardiness zones (5a to 7a). Release sizes were 75, 150, 300, 600, or 1,200 adult L. nigrinus per site in the fall, winter, early spring, or sequentially (i.e., fall or winter and early spring). We monitored establishment by annual sampling for L. nigrinus adults with beat sheets and for L. nigrinus larvae by branch clipping. At the end of 3 yr, L. nigrinus was established in 13 of the 22 sites. The following variables were evaluated for their correlation with the numbers of L. nigrinus larvae and adults recovered and for their effect on establishment (scored as F(3) presence/absence): (1) Minimum winter temperature at the release site, (2) A. tsugae density at the time of release, (3) release size, and (4) release season. Only minimum winter temperature was correlated with larval recoveries and no variables were correlated with adult recoveries. Logistic regression modeling found that establishment was positively related to minimum winter temperature and release size. We recommend smaller release sizes in warm areas where establishment probability was high (i.e., zones 7a, 6b, and 6a) and larger release sizes in cold areas where establishment probability was low (i.e., zones 5b and 5a). Releases during fall-early spring and across the range of A. tsugae densities tested were successful.

Background: Imidacloprid is the primary insecticide used against the exotic invasive insect hemlock woolly adelgid, Adelges tsugae Annand, a pest of eastern hemlock [Tsuga canadensis (L.) Carrière] trees in the eastern United States. A competitive enzyme-linked immunosorbent assay (ELISA) was evaluated for quantification of imidacloprid in eastern hemlock wood and needle tissues., Results: Matrix effects in the form of false positives and overestimated imidacloprid concentrations were observed in both wood and needle extracts. Tissues required a 100-1000-fold dilution with water in order to reduce matrix effects. Standard curves in 1% wood or needle extract were not significantly different from standard curves prepared in water. Matrix effects were more pronounced at concentrations in the lower working range of the kit, with recovery of 5 microg L(-1) imidacloprid more accurate than recovery of 0.2 microg L(-1)., Conclusion: ELISA remains a valuable tool for semi-quantitative imidacloprid detection within the hemlock system because of its sensitivity, cost and ease of use. However, a 1000-fold dilution of hemlock tissue extract is recommended to ensure accurate imidacloprid determinations.

Synchrony and impact of the predators Laricobius nigrinus Fender and Laricobius rubidus LeConte, on hemlock woolly adelgid, Adelges tsugae Annand, were studied in an eastern hemlock field insectary in Virginia. First, a field insectary for propagation of the introduced L. nigrinus was established by planting hemlocks in 2001, infesting them with hemlock woolly adelgid in 2002 and 2003, followed by releasing 258 L. nigrinus in 2003. Initial sampling showed that the native L. rubidus was present in the area. Hemlock woolly adelgid and both Laricobius species populations increased annually, from which 305 F3 L. nigrinus adults were collected and redistributed to forests in 2007. Second, the phenology of hemlock woolly adelgid and Laricobius spp. life cycles were monitored in 2005 and 2006. Adult L. nigrinus (F2) and L. rubidus were active on hemlock from fall through mid-spring and overlapped with second-instar sistentes nymphs through progredientes eggs. The predators' eggs were oviposited and larvae developed (i.e., F3 L. nigrinus) from late winter to mid-spring on progredientes eggs, indicating synchrony with suitable prey life stages. Third, a predator exclusion experiment was used to examine the relationships between the predators and prey in 2005 and 2006. When exposed to L. nigrinus (F2 adults and F3 larvae) and L. rubidus, hemlock woolly adelgid survival and ovisac density were lower and ovisac disturbance was higher than hemlock woolly adelgid protected in cages. The establishment and production of L. nigrinus at a field insectary, synchronization with, and impacts on hemlock woolly adelgid after a small release 2 yr earlier makes it an important potential biological control agent of hemlock woolly adelgid.

The behavior and daily activity patterns of two specialist predators, Laricobius nigrinus Fender (Coleoptera: Derodontidae) and Sasajiscymnus tsugae, Sasaji and McClure (Coleoptera: Coccinellidae), and a generalist predator, Harmonia axyridis Pallas (Coleoptera: Coccinellidae), of hemlock woolly adelgid, Adelges tsugae (Hemiptera: Adelgidae), were examined using digital video recording in the laboratory. The two specialists are part of a biological control program for A. tsugae, and it is not known if competitive interactions with previously established generalist predators will negatively impact their effectiveness. The behavior and daily activity patterns of adult females of each species were documented in single- and paired-predator assays under simulated spring and summer conditions. Behavior varied qualitatively and quantitatively by species, and did not appear to be highly coordinated temporally or spatially. All species exhibited continuous activity patterns that were punctuated by longer periods of rest. Extensive and intensive searching behavior occurred in all species, with intensive searching being highly variable. Specialist predators appeared to be more selective of feeding and oviposition sites, and rested at more concealed locations than the generalist species. In spring conditions, L. nigrinus had greater activity and a more even behavior distribution than S. tsugae or H. axyridis, which were skewed towards resting. In summer, the latter two species showed increased activity at higher temperatures. Conspecifics significantly altered the time allocated to specific behaviors for L. nigrinus and H. axyridis, resulting in reduced predator effectiveness by reducing time and energy expenditure on activities that directly impact the adelgids. In contrast, S. tsugae conspecifics and all heterospecific combinations showed non-interference. The activity of each species varied with time of day; L. nigrinus was more active at night, while S. tsugae and H. axyridis were more active during the day. All predator groupings maintained a high degree of spatial separation relative to assay size. The use of multiple-predator species combinations that include the specialist predators, is recommended over single-species for biological control of A. tsugae, as temporal and spatial patterns were not highly coordinated. Low-density releases may reduce the potential negative effects of intraspecific competition.