Spotted wing drosophila,
Drosophila suzukii
, is an invasive insect that attacks ripe, small fruit such as raspberries, blackberries and blueberries. Little is known about its foraging ecology and ...current trapping methods and monitoring systems are ineffective at commercial scales. In semi-field studies, we evaluated adult alightment and ovipositional preference within and among raspberry plants using sentinel Tangletrap-coated and clean raspberry fruit, respectively, positioned within the exterior and interior plant canopy at four different heights (60, 85, 110 and 135 cm from the base) and conducted in field cages using sexually mature adults. Alightment of adults on Tangle-trap-coated fruit indicated a preference for fruit positioned at lower heights and/or interior locations based on significantly greater numbers being captured on sentinel sticky-coated berries at the two lowest heights. Oviposition in clean raspberry fruit also yielded a similar pattern. In mark-release-recapture studies conducted in the field, spotted wing drosophila prefer sentinel sticky fruit positioned on exterior rows as they alighted on these berries in significantly greater numbers than fruit at in the central portion of the plot. Likewise, in field trials with wild fly populations, infestations were significantly greater in edge rows compared with interior rows. Collectively, our results suggest that monitoring and behaviorally based management strategies may be more effective if they target adults foraging in the lower canopy of small fruit plants located on the crop perimeter.
Recurrent or previously irradiated head and neck cancers (HNC) are therapeutically challenging and may benefit from high-dose, highly accurate radiation techniques, such as stereotactic ablative ...radiation therapy (SABR). Here, we compare set-up and positioning accuracy across HNC subsites to further optimize the treatment process and planning target volume (PTV) margin recommendations for head and neck SABR.
We prospectively collected data on 405 treatment fractions across 79 patients treated with SABR for recurrent/previously irradiated HNC. First, interfractional error was determined by comparing ExacTrac x-ray to the treatment plan. Patients were then shifted and residual error was measured with repeat x-ray. Next, cone beam computed tomography (CBCT) was compared with ExacTrac for positioning agreement, and final shifts were applied. Lastly, intrafractional error was measured with x-ray before each arc. Results were stratified by treatment site into skull base, neck/parotid, and mucosal.
Most patients (66.7%) were treated to 45 Gy in 5 fractions (range, 21-47.5 Gy in 3-5 fractions). The initial mean ± standard deviation interfractional errors were -0.2 ± 1.4 mm (anteroposterior), 0.2 ± 1.8 mm (craniocaudal), and -0.1 ± 1.7 mm (left-right). Interfractional 3-dimensional vector error was 2.48 ± 1.44, with skull base significantly lower than other sites (2.22 vs 2.77; P = .0016). All interfractional errors were corrected to within 1.3 mm and 1.8°. CBCT agreed with ExacTrac to within 3.6 mm and 3.4°. CBCT disagreements and intrafractional errors of >1 mm or >1° occurred at significantly lower rates in skull base sites (CBCT: 16.4% vs 50.0% neck, 52.0% mucosal, P < .0001; intrafractional: 22.0% vs 48.7% all others, P < .0001). Final PTVs were 1.5 mm (skull base), 2.0 mm (neck/parotid), and 1.8 mm (mucosal).
Head and neck SABR PTV margins should be optimized by target site. PTV margins of 1.5 to 2 mm may be sufficient in the skull base, whereas 2 to 2.5 mm may be necessary for neck and mucosal targets. When using ExacTrac, skull base sites show significantly fewer uncertainties throughout the treatment process, but neck/mucosal targets may require the addition of CBCT to account for positioning errors and internal organ motion.
With the increasing complexity of schools and society, there is great need for expanded understanding of the many dimensions of diversity within the field of assistive technology (AT). The question ...that lies before us is how has diversity been examined in AT research and literature? Following a research synthesis method similar to Summers (1985) and Edyburn (2000, 2001, 2002, 2003, 2004) the purpose of this study was threefold: (a) first, to conduct a literature review of scholarly publications in the area of AT that focused on the diversity dimensions of family, rural, culture, race, or gender between the years of 2000 and 2004, (b) second, to identify to what extent literature scatter was present or absent in this literature review, and (c) third, to answer the question ‘What have we learned?’ Using study criteria, 19 articles scattered across 12 peer-reviewed journals were identified and classified under five categories: family, rural, culture, race, and gender. Implications for practitioners and the field of AT are discussed.
To determine the incidence, predisposing factors, and costs of emergency treatment of severe hypoglycemia in people with type 1 and type 2 diabetes.
Over a 12-month period, routinely collected ...datasets were analyzed in a population of 367,051 people, including 8,655 people with diabetes, to measure the incidence of severe hypoglycemia that required emergency assistance from Ninewells Hospital and Medical School (NHS) personnel including those in primary care, ambulance services, hospital accident and emergency departments, and inpatient care. Associated costs with these episodes were calculated.
A total of 244 episodes of severe hypoglycemia were recorded in 160 patients, comprising 69 (7.1%) people with type 1 diabetes, 66 (7.3%) with type 2 diabetes treated with insulin, and 23 (0.8%) with type 2 diabetes treated with sulfonylurea tablets. Incidence rates were 11.5 and 11.8 events per 100 patient-years for type 1 and type 2 patients treated with insulin, respectively. Age, duration, and socioeconomic status were identified as risk factors for severe hypoglycemia. One in three cases were treated solely by the ambulance service with no other contact from health care professionals. The total estimated cost of emergency treatment of severe hypoglycemia was </= pound 92,078 in one year.
Hypoglycemia requiring emergency assistance from health service personnel is as common in people with type 2 diabetes treated with insulin as in people with type 1 diabetes. It is associated with considerable NHS resource use that has a significant economic and personal cost.
Objective
A variety of benign and neoplastic lesions can affect the synovium, including pigmented villonodular synovitis (PVNS) and synovial chondromatosis. Prior to surgical resection, accurate ...characterization of synovial lesions is necessary for appropriate treatment planning. Additionally, recent advances in potential medical therapies for PVNS could decrease or eliminate the need for surgery in some cases. Such treatment options demand accurate characterization of synovial lesions prior to treatment.
Methods and materials
Institutional IRB approval was obtained. We identified 54 synovial biopsies performed at our institution using a comprehensive database search under ultrasound (US) or computed tomography (CT) guidance. Cases were reviewed for pre-procedure imaging, location, biopsy approach, biopsy results, post-procedure complications, and surgical pathology if synovectomy was performed.
Result
A total of 54 image-guided synovial biopsies were performed, 36 using CT guidance and 18 using US guidance. Six different anatomic locations were biopsied (the hip, knee, shoulder, elbow, ankle, and temporomandibular joint). Synovial tissue was obtained in 89% of cases (48/54). CT-guided biopsies had a positive yield of 86% (31/36) and US-guided biopsies had a positive yield of 94% (17/18). Surgical pathology was obtained in 30 of the cases and image-guided biopsy concordance was 90% (27/30). Of the patients taken for synovectomy, biopsy concordance of suspected neoplastic lesions was 100% (23/23). In cases of suspected neoplasm, the concordance between image-guided biopsy and surgical pathology was 96% (22/23). There were no reported complications.
Conclusion
Image-guided biopsy of synovial lesions is safe and effective for establishing a definitive diagnosis prior to surgical or other intervention.
Since the establishment of the brown marmorated stink bug,
Halyomorpha halys
(Stål) (Hemiptera: Pentatomidae) in North America and Europe, there has been a large, multi-group effort to characterize ...the composition and impact of the indigenous community of arthropod natural enemies attacking this invasive pest. In this review, we combine 98 indigenous natural enemy datasets spanning a variety of sampling methods, habitats, and geographic areas. To date, the vast majority of
H. halys
biological control research has focused on the egg stage, using sentinel egg masses to characterize indigenous parasitoid and predator communities and their contribution to
H. halys
egg mortality. Although egg parasitism and predation levels by indigenous natural enemies are low (typically <10% each) in most surveys, total egg mortality attributable to natural enemies can be higher (typically between 5 and 25%; up to 83%)—even though these values were likely underestimated in most cases because some mortality due to biological control was not recognized. In North America, where the most data are available, it appears that the relative prevalence of different indigenous parasitoid species varies among habitat types, particularly between crop and non-crop habitats. Predator species responsible for egg mortality are much less commonly identified, but appear to include a wide variety of generalist chewing and sucking predators. To date, studies of natural enemies attacking
H. halys
nymphs and adults are relatively rare. Based on our review, we identify a number of key research gaps and suggest several directions for future research.
•For MCC patients who received RT, practice patterns varied by primary tumor site.•Patients with head & neck MCC had less surgery and more radiation therapy.•Despite practice variance by tumor site, ...patients had similar locoregional control.•Given similar outcomes, patient-centric approaches for management are warranted.
Clinically localized Merkel cell carcinoma (MCC) has been associated with high rates of disease relapse. This study examines how primary tumor anatomic site drives patterns of care and outcomes in a large cohort treated in the contemporary era.
Patterns of care and associated outcomes were evaluated for clinically Stage I-II MCC patients treated at our institution with adjuvant radiation therapy (RT) to the primary site and/or regional nodal basin as a component of their curative intent therapy between 2014–2021.
Of 80 patients who met inclusion criteria, the primary tumor anatomic site was head and neck (HN) for 42 (53%) and non-head and neck (NHN) for 38 (47%). Primary tumor risk factors were similar between cohorts. Fewer patients with HN tumors had wide local excision (WLE; HN-81% vs. NHN-100% p < 0.01). Of those undergoing WLE, patients with HN tumors received higher dose adjuvant RT (>50 Gy: HN-70% vs. NHN-8%; p < 0.01). Patients with HN tumors were less likely to undergo sentinel lymph node biopsy (HN-62%vs. NHN-100%; p < 0.01) and more likely to have elective nodal RT (HN-48% vs. NHN-0%). Despite varying management strategies, there was no significant difference in local recurrence-free survival (3-yr LRFS HN-94% vs. NHN-94%; p = 0.97), nodal recurrence-free survival (3-yr NRFS HN-89% vs. NHN-85%; p = 0.71) or overall recurrence-free survival (3-yr RFS 73% HN vs. 80% NHN; p = 0.44).
Among patients with primary MCC who had RT as a component of their initial treatment strategy, anatomically-driven heterogeneous treatment approaches were associated with equally excellent locoregional disease control.
To compare MR imaging techniques with differing contrast and spatial resolution for evaluation of complete disruption of the ulnar collateral ligament (UCL) anterior bundle in a cadaveric elbow ...model.
Complete UCL tears were surgically created at the typical location for clinical tears in eight of 28 fresh frozen cadaveric elbow specimens. All specimens underwent 1.5 T MR imaging in the oblique coronal plane, using an extremity coil. The sequences employed were: T1-weighted spin echo (T1 SE), proton density-weighted (PD) fast spin echo (FSE), fat-suppressed T2-weighted FSE (T2 FSE), gradient recalled echo (GRE) with a high matrix, PD FSE with a high matrix (HRPD), and fat suppressed T1-weighted SE with intra-articular gadolinium (MRAr). Two radiologists independently graded the UCL with separate and side-by-side assessments.
Sensitivity/specificity pairs were as follows for reader A and reader B, respectively: T1 SE: 0.25/0.95, 0.50/0.95; PD FSE: 0.38/1.00, 0.25/1.00; T2 FSE: 0.50/0.95, 0.63/0.95; GRE: 0.63/0.85, 0.63/0.60; MRAr: 0.88/1.00, 1.00/0.80; HRPD: 0.50/1.00, 0.88/0.80. Kappa statistics for measuring interobserver reliability for each sequence were poor under T1 SE (-0.13) and GRE (0.19), moderate under HRPD (0.41) and T2 FSE (0.44) and good under MRAr (0.62) and PD FSE (0.78). For both readers, the rating for overall image quality was highest for HRPD, and the rating for UCL lesion conspicuity was the highest for MRAr.
Of the MR imaging pulse sequences tested, MRAr showed the greatest ability to identify complete ligamentous injuries with good agreement between readers and had the highest subjective preference for lesion conspicuity. However, HRPD had the least interobserver variability and the highest subjective preference for overall image quality.
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