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Competing Interests: Declaration of competing interest All authors report no conflicts of interest to disclose.

Background: Screening for blunt cerebrovascular injuries (BCVIs) in asymptomatic high-risk patients has become routine. To date, the length of this asymptomatic period has not been defined. Determining the time to stroke could impact therapy including earlier initiation of antithrombotics in multiply injured patients. The purpose of this study was to determine the time to stroke in patients with a BCVI-related stroke. We hypothesized that the majority of patients suffer stroke between 24 hours and 72 hours after injury., Methods: Patients with a BCVI-related stroke from January 2007 to January 2017 from 37 trauma centers were reviewed., Results: During the 10-year study, 492 patients had a BCVI-related stroke; the majority were men (61%), with a median age of 39 years and ISS of 29. Stroke was present at admission in 182 patients (37%) and occurred during an Interventional Radiology procedure in six patients. In the remaining 304 patients, stroke was identified a median of 48 hours after admission: 53 hours in the 144 patients identified by neurologic symptoms and 42 hours in the 160 patients without a neurologic examination and an incidental stroke identified on imaging. Of those patients with neurologic symptoms, 88 (61%) had a stroke within 72 hours, whereas 56 had a stroke after 72 hours; there was a sequential decline in stroke occurrence over the first week. Of the 304 patients who had a stroke after admission, 64 patients (22%) were being treated with antithrombotics when the stroke occurred., Conclusions: The majority of patients suffer BCVI-related stroke in the first 72 hours after injury. Time to stroke can help inform clinicians about initiation of treatment in the multiply injured patient., Level of Evidence: Prognostic/Epidemiologic, level III.

Background: A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fundamentals of laparoscopic surgery (FLS) than traditional practice volume metrics., Methods: Twenty medical students were recruited to practice three FLS tasks: peg transfer, circle cut, and intracorporeal knot tie. Up to 7hours of self-directed practice was allotted to each participant. Practice attempts were scored by standard FLS criteria and monitored via Cusum. Each participant's terminal Cusum performance was analyzed retrospectively. Posttests were conducted by faculty blinded to practice performance., Results: Eighteen participants completed the study (90%). Median adjusted posttest scores were 102.3, 84.1, and 78.6 for peg transfer, circle cut, and knot tie, respectively. For the knot tie task, participants who exceeded the Cusum decision interval during their final practice attempts performed significantly higher on posttesting (81.2 vs 71.5, p=0.015). Knot tie terminal Cusum score was positively associated with posttest performance after adjusting for practice volume (p=0.031). Total practice volume and practice time were not significantly associated with posttest performance for any FLS task., Conclusion: Cusum score is a more valid representation of FLS proficiency than practice volume or practice time. Incorporating Cusum in a clinical setting may promote more efficient allocation of time resources and operative volume., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Isolates of Stenocarpella maydis from seed companies and plant disease clinics in the United States and the Republic of South Africa were assayed for isozyme polymorphisms and cultural variability. A low level of isozyme polymorphisms was detected in this collection of isolates. Isozyme polymorphisms were detected for α-esterase, hexose kinase, and malate dehydroge-nase of the enzymes assayed. Fungi often have limited variability among isozyme profiles, and this is especially true for fungi that have host specialization such as biotrophs or fungi with formae speciales designations. Optimum growth temperature, colony color, and pycnidiospore production were also measured. All isolates had an optimum temperature of 28 to 31°C for colony growth on acidified potato dextrose agar. Colony color and pycnidiospore production were variable over the course of several experiments, indicating that these phenotypes are poor genetic markers.

A diallel cross of seven inbreds and one synthetic line of maize were analyzed in 1994 and 1995 for their reaction to Diplodia ear rot. An additional inbred line was included in the 1995 analysis. Plants were inoculated by placing a pycnidiospore suspension (5 × 10 3 spores per ml) of Stenocarpella maydis in the whorl at the V14 to V15 growth stage. Crosses were evaluated for disease incidence of Diplodia ear rot at harvest, and the percentage of plants with Diplodia ear rot in a plot was used for analysis. In both years, general combining ability (GCA) effects were significant. In 1995, specific combining ability effects were also significant. There were no reciprocal effects. There was no significant interaction between year and genotypes, indicating that crosses reacted the same in both years. Inbred lines B37, H111, B68, and MS had negative GCA effects that contributed toward resistance in both years. VA26, with intermediate resistance to Diplodia ear rot, contributed toward susceptibility. Only inbred lines with a high degree of resistance should be used as parents.

Translational alterations occur in maize (Zea mays L.) leaves stressed by pathogen infection or herbicide paraquat treatment. These translational changes include: (a) dissociation of large polysomes to small polysomes, monosomes, and subunits; (b) a decreased rate of total protein synthesis; and (c) a reduced synthesis of several proteins by polysomes in vitro. The polysome dissociation was neither due to an extraction artifact nor to degradation of RNA by RNase. The protein patterns of polysomes isolated from leaves inoculated with Bipolaris maydis at 6 to 48 hours showed an increase in the intensity of a 57 kilodalton protein. When inoculated with less virulent pathogens, such as B. zeicola, Exserohilum turcicum, or Colletotrichum graminicola, the protein was accumulated in polysomes of leaves at 24 to 48 hours after inoculation. The 57 kilodalton protein was also accumulated in polysomes of maize leaves responding to heat shock or herbicide paraquat treatments. The purified 57 kilodalton protein reassociated with polysomes isolated from healthy leaves and inhibited polysomal translation in vitro. Since the 57 kilodalton protein is rapidly accumulated in maize polysomes in response to various biological and environmental stresses and may affect protein synthesis, it may be involved in translational regulation of maize leaves during stress response.

Zea mays grown with high levels of N fertilizer transports more sucrose into kernels than with low N. Sucrose translocation was greatest in genotypes with the highest capacity to deposit nitrogenous compounds as zein and glutelin in the kernel. These two proteins combined contain about 80% of the total N in the kernel and about 60% of the total N in the plant at maturity. They appear to serve as a functional N sink for the deposition of nitrogenous compounds. As the N sink capacity increases with additional available N fertilizer, more sucrose is transported into the kernel, resulting in increased kernel weight and grain yield. Zein functions as a more dynamic N sink than glutelin because the synthesis of zein is readily manipulated by N fertilization and genetic means. Increases in N deposition in the normal endosperm induced by N fertilizer are confined primarily to zein. Early termination of zein accumulation in the opaque-2 mutant results in a reduction of sucrose movement into kernels. By using plants heterozygous for normal and opaque-2 in these studies, interplant variability was eliminated and the hypothesis relating the kernel N sink capacity to productivity was strengthened.