Utilizing the sublingual form of squalene in COVID-19 patients: a randomized clinical trial

In this study, the efficacy of sublingual squalene in decreasing the mortality rate among patients with COVID-19 was investigated. Squalene was extracted from pumpkin seed oil with a novel method. Then, the microemulsion form of squalene was prepared for sublingual usage. In the clinical study, among 850 admitted patients, 602 eligible COVID-19 patients were divided in two groups of control (N = 301) and cases (N = 301) between Nov 2021 and Jan 2022. Groups were statistically the same in terms of age, sex, BMI, lymphocyte count on 1st admission day, hypertension, chronic kidney disease, chronic respiratory disease, immunosuppressive disease, and required standard treatments. The treatment group received five drops of sublingual squalene every 4 h for 5 days plus standard treatment, while the control group received only standard treatment. Patients were followed up for 30 days after discharge from the hospital. The sublingual form of squalene in the microemulsion form was associated with a significant decrease in the mortality rate (p < 0.001), in which 285 (94.7%) cases were alive after one month while 245 (81.4%) controls were alive after 1 month of discharge from the hospital. In addition, squalene appears to be effective in preventing re-hospitalization due to COVID-19 (p < 0.001), with 141 of controls (46.8%) versus 58 cases (19.3%). This study suggests sublingual squalene in the microemulsion as an effective drug for reducing mortality and re-hospitalization rates in COVID-19 patients.Trial Registration Number: IRCT20200927048848N3.

Investigation of Cerebral Hemodynamics During Endovascular Aspiration: Development of an Experimental and Numerical Setup

PURPOSE

Acute ischemic stroke is a life-threatening emergency caused by an occlusion of a cerebral artery through a blood clot. Aspiration thrombectomy is an endovascular therapy for the removal of vessel occlusions. However, open questions regarding the hemodynamics during the intervention remain, motivating investigations of blood flow within cerebral arteries. In this study, we present a combined experimental and numerical approach to analyze hemodynamics during endovascular aspiration.

METHODS

We have developed an in vitro setup for investigations of hemodynamic changes during endovascular aspiration within a compliant model of patient-specific cerebral arteries. Pressures, flows, and locally resolved velocities were obtained. In addition, we established a computational fluid dynamics (CFD) model and compared the simulations during physiological conditions and in two aspiration scenarios with different occlusions.

RESULTS

Flow redistribution within cerebral arteries after ischemic stroke is strongly dependent on the severity of the occlusion and on the volume flow extracted by endovascular aspiration. Numerical simulations exhibit an excellent correlation of R = 0.92 for flow rates and a good correlation of R = 0.73 for pressures. Further on, the local velocity field inside the basilar artery had a good agreement between CFD model and particle image velocimetry (PIV) data.

CONCLUSION

The presented setup allows for in vitro investigations of artery occlusions and endovascular aspiration techniques on arbitrary patient-specific cerebrovascular anatomies. The in silico model provides consistent predictions of flows and pressures in several aspiration scenarios.

Association between leisure activities and sleep disturbances among children with and without cerebral palsy

Background/Aims

Sleep disturbances are common among children with cerebral palsy, resulting in adverse consequences. Investigating the association between leisure activities and sleep disturbances could help to develop ways to promote their sleep quality. This study primarily aimed to investigate the association between leisure activities and sleep disturbances among children with and without cerebral palsy. The secondary aim was to study the prevalence of sleep disturbances and some of its associated factors.

Methods

A total of 75 children with cerebral palsy (study group) (mean age 10.0 ± 2.5 years) and 75 typically developing children (control group) (mean age 10.5 ± 2.9 years) were randomly selected to completed the Children's Assessment of Participation and Enjoyment. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children. Factors associated with sleep disturbances (age, gender, school attendance, bedroom sharing, type of cerebral palsy, motor functions, eating and drinking ability and communication functions) were statistically analysed and the prevalence of sleep disturbances was calculated.

Results

Overall frequency of leisure participation was strongly correlated with overall sleep disturbances (P<0.001) among both groups. The prevalence of overall sleep disturbances was 17.1% and 10.6% among the study and the control groups respectively. Eating and drinking ability and spastic quadriplegia emerged as the strongest predictors of overall negative scores on the Sleep Disturbance Scale for Children.

Conclusions

Greater participation in leisure activities is associated with better sleep. Occupational therapists are encouraged to consider this association when planning for occupation-based interventions aimed at enhancing occupational performance.

Effects of adding oral clonidine to standard treatments on pain intensity of patients with acute renal colic: A randomized clinical trial

Background:

The aim of this study was to compare the effect of adding oral clonidine to standard treatments on pain intensity in patients with acute renal colic.

Materials and Methods:

This is a randomized clinical trial that was performed in 2020 in Isfahan. The study population consisted of 200 patients with renal colic. Pain of the patients was assessed using Visual Analog Scale. Patients were then randomized into 4 groups of 50 patients. Group A received 0.1 mg/kg morphine and clonidine tablets (0.2 mg). Group B received morphine and placebo. Group C received 30 mg ketorolac and clonidine tablets. Group D received 30 mg ketorolac and placebo tablets. Pain of patients was assessed. 0.05 mg/kg morphine was administered and repeated every 40 min if the pain was not reduced.

Results:

Our data showed that there was a significant difference between pains of patient by the time of admission in groups (P = 0.04). However, no significant differences were observed between pains of patients in different measuring times (P > 0.05). Using general linear model, we showed that the decreases in pain scores of each group were significant (P < 0.05) but there were no significant differences in pains of patients in different measuring times (P > 0.05). Our data showed that Group A and Group C had lowest frequencies of morphine administrations while Groups B and D had the highest frequencies (P < 0.001).

Conclusion:

We showed that administration of clonidine in patients with renal colic resulted in better pain control and lower morphine injections.

New perspectives of quercetin and vitamin C effects on fibronectin-binding integrins and chemokine receptors in prostate cancer cell lines

OBJECTIVES

The aim of this study is to investigate the effect of two abundant dietary supplements, quercetin and vitamin C on some factors involved in metastasis and proliferation of prostate cancer, which are resistant to conventional chemotherapies in late stages.

BACKGROUND

Bone and brain are two common sites of metastases in prostate cancer, nevertheless the factors involved in their metastatic pathways are not well understood.

METHODS

The effect of quercetin (75µM) and vitamin C (100 µM) on CXCR4, CXCR7 chemokine receptors, α4, α5 and β1 integrins, ki-67 proliferation marker and Vascular endothelial growth factor, VEGF was evaluated using Quantitative Reverse Transcription PCR (RT-qPCR).

RESULTS

The effect of quercetin and vitamin C alone was different on PC3 and DU145 prostate cancer cell lines, but sequential combination reduced significantly the expression of CXCR and CXCR7 chemokine receptors, α4, α5 and β1 integrin subunits, VEGF and Ki-67 proliferation markers in PC3 and DU145 cell lines.

CONCLUSION

Our results indicated the beneficial effect of quercetin and vitamin C on prostate cancer cells with different metastatic sites and their differential response to the treatment which in turn may lead us to reach suitable therapeutic outcomes to combat cancer (Fig. 3, Ref. 36).

Investigation on Heavy Metal Removal from a Crude Oil Contaminated Soil using Rhamnolipid Biosurfactant as a New Eco-Friendly Method

Many studies have been conducted on the removal of heavy metals from industrial wastewater using biosurfactants, but few papers have been published on the removal of heavy metals from soil contaminated with crude oil using this method. The aim of this study is to evaluate the performance of rhamnolipid biosurfactants in removing nickel, chromium, and cadmium from soil contaminated with crude oil. In this study, first rhamnolipid was produced from Pseudomonas aeruginosa PTCC1340 and then confirmed by Thin-Layer-Chromatography (TLC) and Fourier-Transformation-Infrared-Spectroscopy (FTIR). In the next step, a sandy soil (2 mm diameter) was mixed with the crude oil (API = 32.83, viscosity = 6.21cp) at 258C for 2 weeks. The washing parameters included temperature, pH and rhamnolipid dosage. Based on our results, the heavy metal removal of nickel, chromium and cadmium from soil contaminated with crude oil at the optimum condition (258C, 0.8 g/L and pH 11) was 43.05%, 34.73% and 52.81%, respectively. Based on the results, rhamnolipids are found to have considerable potential for removing heavy metals especially cadmium, and the soil washing by the produced biosurfactant leads to the removal of heavy metals without the destructive effects of chemical surfactants and subsequently reduces environmental pollution. Therefore, this biosurfactant rhamnolipid may have a good potential for application in bioremediation of crude oil contamination.

Pathogenicity and Control of Phacidium lacerum, an Emerging Pome Fruit Pathogen in Washington State

Phacidium lacerum (anamorph Ceuthospora pinastri) is a recently reported quarantine fungal pathogen responsible for postharvest rot in apples and pears. Very little is known about its pathogenicity, epidemiology, and best management practices. We screened pathogenicity of P. lacerum on twigs from seven and fruit from nine major commercial apple cultivars. Among the nine cultivars tested, detached fruit of Honeycrisp and Gala cultivars were the most susceptible, whereas WA38 (Cosmic Crisp) was the least susceptible (P < 0.05). Effective concentrations to inhibit 50% growth (EC₅₀) were determined in 41 baseline P. lacerum isolates. The mean EC₅₀ values for four postharvest fungicides, i.e., fludioxonil (FDL), difenoconazole (DIF), thiabendazole (TBZ), and pyrimethanil (PYRI) were 0.16, 0.38, 0.54, and 0.72 µg/ml, respectively. The mean EC₅₀ values for four preharvest fungicides, i.e., pyraclostrobin (PYRA), fluxapyroxad (FLUX), boscalid (BOSC), and fluopyram (FLUP) were 0.96, 12.64, 16.54, and 44.46 µg/ml, respectively. In situ efficacy trials were conducted on detached Gala apples treated preventively and curatively with the aforementioned fungicides. After 6 months of storage at 1°C, FDL and DIF provided full control followed by TBZ and PYRI, whereas the other preharvest fungicides provided fair or low efficacies. Findings of this study shed light on pathogenicity of this emerging pathogen and provide necessary knowledge for effective management of Phacidium rot.

Predictive role of individual factors in the leisure preferences of children and adolescents with cerebral palsy: a cross-sectional study in Iran

Background/Aims

The participation of children and adolescents with cerebral palsy in leisure activities is associated with their preferences. A better understanding of their leisure preferences and the factors that influence them can help therapists to promote young patients' participation in leisure activities. The aim of this study was to describe the role of individual factors in the prediction of leisure preferences of children and adolescents with cerebral palsy in Iran.

Methods

A cross-sectional study design was used. A total of 152 children and adolescents with cerebral palsy were selected to complete the Preferences for Activities of Children questionnaire. Simple and multiple linear regression analyses were performed to assess the role of individual factors in the prediction of preferences for leisure activities.

Results

Individual factors played a significant role in the prediction of leisure preferences. Their influence on the preferences for recreational, physical and self-improvement domains (r2=0.215; 0.154; 0.127, respectively) were greater than for social and skill-based domains (r2=0.045; 0.052, respectively).

Conclusions

Preferences for physical activities need to be augmented while a high preference for social and recreational activities could be used to promote participation in leisure activities. Therapists and other healthcare professionals should consider individual factors relating to leisure preferences when devising therapeutic plans that aim to promote participation in leisure activities.

Molecular Detection and Antimicrobial Resistance Patterns of Shiga Toxigenic Escherichia coli Isolated from Bovine Subclinical Mastitis Milk Samples in Kurdistan, Iran

Bovine subclinical mastitis is regarded as a devastating disease due to the economic costs imposed on dairy husbandry. Moreover, it is a hazard in the public sector in the cases of zoonotic bacteria because of the potential role of unpasteurized milk and dairy products to propagate the infectious agent to the human food chain. The present study aimed to evaluate the frequency, virulence content, and antimicrobial resistance profile of Shiga toxin-producing Escherichia coli (STEC) strains isolated from bovine subclinical mastitis in Kurdistan Province, West of Iran. A total of 400 bovine subclinical mastitis milk samples recognized in the California Mastitis Test were collected aseptically and analyzed for the presence of E. coli phenotypically and molecularly. The isolates were genotypically screened for stx1, stx2, and eae genes. Furthermore, O157:H7 STEC strain was searched among the isolates in a duplex polymerase chain reaction. The antimicrobial resistance scheme of the isolates was determined using the agar disk diffusion method. In general, 173 (43.25%) E. coli isolates were detected among which 39 (22.54%) isolates were STEC. The frequency of STEC virulence genotypes was stx2 (25 isolates, 64.10%), stx2+eae (6 isolates, 15.38%), stx1+stx2 (6 isolates, 15.38%), and stx1+stx2+eae (2 isolates, 5.12%). In addition, three O157: H7 strains were identified with the genetic content of stx1+stx2+eae (2 isolates) and stx1+stx2 (1 isolate). The most prevalent antimicrobial resistance was observed against streptomycin, tetracycline, and ampicillin. Gentamycin, amoxicillin-clavulanic acid, and trimethoprim-sulfadiazine were the most effective antibiotics against O157 strains, whereas gentamycin, ciprofloxacin, and nitrofurantoin were effective against non-O157 strains. The results revealed the significant role of STEC in bovine subclinical mastitis in the studied region. In addition, the distribution of O157:H7 strain and high prevalence of multidrug resistance among the isolates is a matter of concern. Therefore, there is a potential threat of human infection following the consumption of contaminated milk with STEC in Kurdistan Province, Iran.

Effect of Electron Beam Irradiation on Survival of Escherichia coli O157:H7 and Salmonella enterica serovar Thyphimurium in Minced Camel Meat during Refrigerated Storage

Background: Electron beam irradiation is one of the effective ways to control foodborne pathogens. We evaluated the effect of electron beam irradiation on survival of Escherichia coli O157:H7 and Salmonella enterica serovar Thyphimurium in minced camel meat during refrigerated storage. Methods: The meat samples were inoculated with E. coli O157:H7 and S. enterica serovar Thyphimurium and then irradiated with doses of 0, 1, 2, 3, and 5 kGy. The samples were stored at 4±1 °C and evaluated microbiologically up to 10 days. Data were analyzed using SPSS software version 18. Results: The microbial loads of minced camel meat samples were significantly reduced (p<0.0001) with increasing the dose of irradiation. The most effective dose was 5 kGy that highly reduced S. enterica serovar Typhimurium, and completely destroyed E. coli O157:H7. However, E. coli O157:H7 was more sensitive to electron beam irradiation than S. enterica serovar Typhimurium. Conclusion: Electron beam irradiation effectively reduced the population of both E. coli O157:H7 and S. enterica serovar Typhimurium in minced camel meat in a dose dependent manner.

Participation in leisure-time activities and the role of individual factors in children and adolescents with cerebral palsy

Background/Aims

This study evaluated the role of individual factors of children and adolescents with cerebral palsy in the prediction of leisure participation.

Methods

A cross-sectional study design was used. A group of children and adolescents with cerebral palsy were selected to complete the Children's Assessment of Participation and Enjoyment. Participants' cognitive levels were assessed based on the Study of Participation of Children with Cerebral Palsy Living in Europe estimated cognitive levels.

Findings

The models could best predict up to 31.8% of the variance in the participation rates, 28.4% of the variance in the frequency scores and 33.5% of the variance in the enjoyment scores of leisure domains. The type of cerebral palsy was one of the most significant predictive factors of leisure participation (β ranged from −0.177 to −0.525 for quadriplegia).

Conclusions

Therapists and rehabilitation specialists may consider individual factors to predict a proportion of leisure participation subscales before planning for interventions aimed at promoting the leisure participation of children and adolescents with cerebral palsy.

Potential Impact of Populations Drift on Botrytis Occurrence and Resistance to Multi- and Single-Site Fungicides in Florida Southern Highbush Blueberry Fields

Incidence of blossom blight and Botrytis fruit rot (BFR), caused by Botrytis cinerea, on two southern highbush blueberry cultivars was evaluated in several blueberry fields grown in the vicinity (BB-Str⁽⁺⁾) or not (BB-Str^(-)) of strawberry fields in central Florida. Blossom blight and BFR incidence were higher in BB-Str⁽⁺⁾ fields in 2014 and significantly higher in 2015 compared to BB-Str^(-) fields. In total, 613 B. cinerea isolates (i.e., 181 and 432 isolates from BB-Str^(-) and BB-Str⁽⁺⁾ fields, respectively) were collected. The isolates were evaluated for sensitivity to eight single-site and one multisite fungicides using a spore germination and a germ tube elongation assay. Overall, 5, 15, 24, 28, 54, and 93% of isolates collected from BB-Str^(-) were resistant to penthiopyrad, cyprodinil, boscalid, fenhexamid, pyraclostrobin, and thiophanate-methyl, respectively. Respective resistance frequencies in BB-Str⁽⁺⁾ isolates were 10, 30, 65, 66, 89, and 99%. Resistance frequencies for all fungicides were always higher in BB-Str⁽⁺⁾ fields compared to BB-Str^(-) fields. Isolates exhibiting resistance to six or five fungicides simultaneously were predominant (50 to 70%) in blueberry fields regardless if they were grown in the vicinity of strawberry fields or not. Among 308 and 305 B. cinerea isolates tested in 2014 and 2015, 41.8 and 47.1%, respectively, showed reduced sensitivity to the multisite fungicide captan. The lower label rate of captan applied preventively did not control isolates with reduced sensitivity on detached blueberry fruit. These findings suggest a potential population flow between strawberry and blueberry fields that may impact blossom blight and gray mold development in blueberry fields. The relatively lower fungicide input applied to blueberry fields compared with strawberry fields seems to be sufficient to select for resistance and multiple-resistant phenotypes in B. cinerea populations in blueberry.

Clinical Evaluation of Desferrioxamine (DFO) for Removal of Thallium Ions in Rat

An investigation was conducted to evaluate the ability of DFO following the administration of thallium salt in male Wistar rats. Thallium was introduced to several groups of weanling male Wistar rats via different means, through drink, food and intraperitoneal injection. A control group was fed on a diet containing a normal level of iron. After a period of 30 days, all the rats administered thallium were severely anemic and showed toxicity symptoms through loss of hair, an increase in thallium and a decrease in iron levels in the blood. Chelation therapy was carried out to remove the toxic element from the body. The ability of desferrioxamine (DFO) in removing thallium was investigated by injection of this chelator for one week to the remaining rats of similar groups. The results showed that the thallium level present in the blood was significantly reduced and, at the same time, the iron concentration returned to the normal level. It was concluded that DFO chelator is able to remove thallium from the body and could be used for the treatment of complications and eradication of symptoms of thallium intoxication.

Attenuation of heat stress-induced spermatogenesis complications by betaine in mice

High temperatures can induce oxidative stress, impairment of spermatogenesis, and reduction of sperm quality and quantity concomitant with transient periods of partial or complete infertility in male mammals. Promising beneficial effects of betaine supplementation on the epididymal spermatozoa have been reported in experimental studies; however, its effects on testicular heat stress (HS)-induced impairment have yet to be determined. In the present study, betaine (Bet) was orally administrated (250 mg/kg day) during a 14-day period, before (Bet + HS group) or after (HS + Bet group) induction of testicular HS in 7-9 week-old male mice. HS was induced by testicular immersion in water at 42 °C in stress groups. Epididymal spermatozoa and testes were collected at days 14 and 28 after HS induction in order to analyze sperm characteristics, testicular oxidative status, and histological changes. Our studies showed that HS reduced testicular weight, the quality and quantity of epididymal spermatozoa, and impaired maturation of germinal cells. The levels of MDA, catalase, SOD, and GPX were increased in the testes of HS-induced mice (P < 0.01). Although betaine treatment before and after exposure to HS enhanced antioxidant defense (P < 0.05) and accelerated germinal epithelium regeneration, its effects on the characteristics of epididymal spermatozoa were scarce. On the other hand, in the absence of heat stress, quality and quantity of epididymal spermatozoa were improved following 14 days of betaine consumption. Our study revealed the beneficial effect of betaine on HS-induced complications of spermatogenesis, as well as its potency to improve epididymal spermatozoa in intact mice.

Glucose-6-phosphate dehydrogenase deficiency (G6PD) as a risk factor of male neonatal sepsis

Introduction.Neonatal sepsis is a disease process, which represents the systemic response of bacteria entering the bloodstream during the first 28 days of life. The prevalence of sepsis is higher in male infants than in females, but the exact cause is unknown. Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme in the pentose phosphate pathway, which leads to the production of NADPH. NADPH is required for the respiratory burst reaction in white blood cells (WBCs) to destroy microorganisms. The purpose of this study was to evaluate the prevalence of G6PD deficiency in neonates with sepsis. Materials and methods.This study was performed on 76 neonates with sepsis and 1214 normal neonates from February 2012 to November 2014 in the west of Iran. The G6PD deficiency status was determined by fluorescent spot test. WBCs number and neutrophils percentages were measured and compared in patients with and without G6PD deficiency. Results.The prevalence of the G6PD deficiency in neonates with sepsis was significantly higher compared to the control group (p=0.03). WBCs number and neutrophils percentages in G6PD deficient patients compared with patients without G6PD deficiency were decreased, but were not statistically significant (p=0.77 and p=0.86 respectively). Conclusions.G6PD deficiency is a risk factor of neonatal sepsis and also a justification for more male involvement in this disease. Therefore, newborn screening for this disorder is recommended.

Optimized fabrication and characterization of TiO2–Nb2O5–Al2O3 mixed oxide nanotube arrays on Ti–6Al–7Nb

The TiO₂–Nb₂O₅–Al₂O₃ mixed oxide nanotube arrays on Ti67 are the promising nanostructured materials for metallic orthopaedic implants.

Nanotechnology and Pediatric Cancer: Prevention, Diagnosis and Treatment

Despite development of new approaches for the treatment of cancer disease, it is the second cause of mortality in world. Annually, 30000 persons die in Iran due to cancer diseases. Eighty percent of cancer patients are children which about 50% children lead to death. Given the high rate of cancer-related death, the new approaches for prevention, control, early diagnosis, and treatment of this disease seem necessary. Investigation of new strategies is the major challenge for scientists at recent century. Nanotechnology as a new scientific field with novel and small compounds utilized different fields over the past ten years especially in medicine. This science has come to the forefront in the areas of medical diagnostics, imaging, and therapeutic scheduls. Therefore, it has the potential applications for cancer detection and therapy. This review will discuss the therapeutic applications of different nano-materials in diagnosis, imaging, and delivery of therapeutic agents for the treatment of cancer with a major focus on their applications for the treatment of cancer and cancer- related diseases in children. The advancements in established nanoparticle technologies such as liposomes, polymer micelles, and functionalization regarding tumor targeting and controlled release strategies as well as drug delivery were discussed. It will also review the blood toxicity of used nanostructures.

First Report on Resistance to Pyraclostrobin, Thiophanate-methyl, Fenhexamid and Boscalid in Botrytis cinerea from Eucalyptus Seedlings in Florida Greenhouses

Botryotinia fuckeliana de Bary (anamorph Botrytis cinerea Pers.) is an ubiquitous plant pathogen causing gray mold disease on more than 200 crops grown in the field or in greenhouses. Eucalyptus seedlings originating from three different greenhouses showing stem lesions were submitted to the Gulf Coast Research and Education Center Disease Clinic in June 2012. Ten single spore isolates of B. cinerea were obtained and tested for sensitivity using spore germination and germ tube elongation assays described previously (4). Fungicides tested were pyraclostrobin at 100 μg/ml (Cabrio, BASF, Research Triangle Park, NC), thiophanate-methyl at 100 μg/ml (Topsin-M, UPI, King of Prussia, PA), fenhexamid at 1 and 50 μg/ml (Elevate, Arysta Life Sciences, Cary, NC), fludioxonil at 0.1 and 10 μg/ml (Medallion, Syngenta Crop Protection, Research Triangle Park, NC), and iprodione at 5 and 50 μg/ml (Rovral, Bayer CropScience, Greensboro, NC) on 1% malt extract agar (MEA, 10 g malt extract and 15 g agar), and to cyprodinil at 1 and 25 μg/ml (Vanguard, Syngenta Crop Protection) on 0.5% sucrose agar (4). Sensitivity to the succinate dehydrogenase inhibitors (SDHIs) boscalid at 5 μg/ml (Endura, BASF), penthiopyrad at 1 and 3 μg/ml (Fontelis, DuPont Crop Protection, Willington, DE), and fluopyram at 3 μg/ml (Luna Privilege, Bayer CropScience) was evaluated on yeast bacto acetate agar (YBA) (3). The discriminatory dose for boscalid was adapted from (2) whereas those used for penthiopyrad and fluopyram were developed in this study. Isolates were grown on malt yeast extract agar for 7 to 10 days and spore suspensions were prepared in sterile distilled water and diluted to 10⁶ conidia/ml. Respective media in 9-cm petri dishes were seeded with 7-μl droplets from each isolate allowing testing for all isolates on one plate. Two plates were used for each fungicide and sensitivity tests were repeated twice. Germination and germ tube growth were assessed microscopically after 16 to 24 h incubation at 22°C. The frequency of isolates resistant to two, three, and four fungicides was 90, 60, and 10%, respectively. Nine isolates (90%) were resistant to thiophanate-methyl and pyraclostrobin, simultaneously, whereas six (60%) and two isolates (20%) were resistant to boscalid and fenhexamid, respectively. All boscalid-resistant isolates were also resistant to pyraclostrobin and thiophanate-methyl, but one fenhexamid-resistant isolate was sensitive to the other three fungicides. Eight isolates that germinated at 5 μg/ml iprodione but not at 50 μg/ml were considered sensitive. All isolates were sensitive to the SDHIs penthiopyrad and fluopyram as well as to cyprodinil and fludioxonil. To our knowledge, this is the first report of resistance to pyraclostrobin, thiophanate-methyl, fenhexamid, and boscalid in B. cinerea from eucalyptus seedlings in Florida. The absence of resistance to fludioxonil and iprodione is likely because these fungicides are not registered in nurseries as well as fluopyram and penthiopyrad which were developed only recently. Management practices should be developed to limit the selection and spread of additional resistant populations in eucalyptus nurseries as has occurred in Florida strawberries where multi-fungicide resistance is widespread (1). References: (1) A. Amiri et al. Plant Dis. 97:393, 2013. (2) M. Leroch et al. Appl. Environ. Microbiol. 79:159, 2013. (3) G. Stammler and J. Speakman. J. Phytopathol. 154:508, 2006. (4) R. W. S. Weber and M. Hahn. J. Plant Dis. Prot. 118:17, 2011.

A simplified minimally invasive approach to mitral valve surgery - optimal access under direct vision

With increasing enthusiasm in minimally invasive surgery, several approaches and access are being performed with great precision. In this report, we illustrate and describe a minimal invasive approach to mitral valve surgery with optimal access under direct vision, the indications and patient selection, the surgical techniques, its advantages over the other approaches, and its simplicity and reproducibility.

Phenotypic Characterization of Multifungicide Resistance in Botrytis cinerea Isolates from Strawberry Fields in Florida

Chemical control has always been essential for the management of gray mold, caused by Botrytis cinerea, to ensure sustainable strawberry production. However, lack of knowledge about actual resistance development may have disastrous consequences and lead to severe epidemics such as the one that affected several strawberry fields in 2012 in Florida. In this study, we tested 392 isolates collected from Florida strawberry fields between 2010 and 2012 for their sensitivity to boscalid (Bosc), a succinate dehydrogenase inhibitor (SdhI); pyraclostrobin, a quinone outside inhibitor (QoI); boscalid + pyraclostrobin (Pristine); fenhexamid, a hydroxyanilide (Hyd); pyrimethanil and cyprodinil, anilinopyrimidines; fludioxonil, a phenylpyrrole; and fludioxonil + cyprodinil (Switch). The respective resistance frequencies for boscalid, pyraclostrobin, Pristine, fenhexamid, cyprodinil, and pyrimethanil were 85.4, 86.5, 86.0, 44.4, 52.7, and 59.5%. Overall, 17.8 and 19.8% of isolates showed reduced sensitivity to fludioxonil and Switch, respectively. All fungicides sprayed preventively on detached strawberry fruit failed to control isolates with high levels of resistance to each fungicide except for fludioxonil and Switch. Four phenotypes with multifungicide resistance (MFR) were detected in B. cinerea populations from Florida. Isolates resistant to one fungicide (FR1), two (MFR2), three (MFR3), and four (MFR4) fungicides from different chemical groups represented 5.9, 28.6, 41.8, and 23.7% of the total resistant population, respectively. The MFR3 isolates were predominant and contained two subpopulations, the Bosc-QoI-AP^R isolates (56.5%) and the Bosc-QoI-Hyd^R isolates (40.6%). In addition to reporting on very highly resistant populations to boscalid and QoI fungicides, we show evidence for a widespread multifungicide resistance to B. cinerea that warrants immediate implementation of novel management strategies to impede the development of more resistant populations.

First Report of the β-tubulin E198A Allele for Fungicide Resistance in Monilinia fructicola from South Carolina

Resistance to methyl benzimidazole carbamates (MBCs) in Monilinia fructicola, the causal agent of brown rot of stone fruits, is known to be present in South Carolina peach orchards, but the molecular mechanism of resistance has not been investigated. Nine isolates were collected from peach in five counties in South Carolina and examined in petri dish assays on potato dextrose agar (PDA) for resistance to the MBC fungicide thiophanate-methyl (Topsin-M 70WP; Ceraxagri, King of Prussia, PA) at the discriminatory dose of 50 μg/ml. Isolates that grew on the fungicide-amended medium were considered highly resistant (HR). The β-tubulin gene from four sensitive (S) and five HR M. fructicola isolates was PCR-amplified with primer pair TubA and TubR1 as described previously (1). Sequence analysis revealed several silent mutations in introns and exons in S and HR isolates and the presence of the previously described E198A allele in HR but not S isolates (1). Nucleotide sequences of the β-tubulin gene from three S (BS, S2, MfEgpc1) and two HR isolates (MfPdt6 and BR2) were submitted to GenBank under accession numbers HM051379, HM051380, HM051381, HM051382, and HM051383, respectively. To our knowledge, this is the first report of the E198A in M. fructicola isolates from South Carolina and the East Coast. This allele is responsible for high levels of MBC resistance in M. fructicola (1). A previously reported PCR-based method using primers HRF+HRR designed to detect the E198A mutation in M. fructicola HR isolates (1) was improved by adding primer TR739 (5'-TCA CGA CGA ACA ACA TCA AGA-3') to the PCR cocktail. This additional internal primer amplified a 222-bp fragment from all S and HR isolates and therefore provided a useful, additional control. The confirmation of the E198A allele in M. fructicola isolates provides another useful tool to detect MBC resistance in commercial peach orchards in South Carolina. Reference: (1) Z. H. Ma et al. Appl. Environ. Microbiol. 69:7145, 2003.

Reduced Sensitivity in Monilinia fructicola Field Isolates from South Carolina and Georgia to Respiration Inhibitor Fungicides

Quinone outside inhibitor (QoI) and succinate dehydrogenase inhibitor (SdhI) fungicides are respiration inhibitors (RIs) used for preharvest control of brown rot of stone fruit. Both chemical classes are site-specific and, thus, prone to resistance development. Between 2006 and 2008, 157 isolates of Monilinia fructicola collected from multiple peach and nectarine orchards with or without RI spray history in South Carolina and Georgia were characterized based upon conidial germination and mycelial growth inhibition for their sensitivity to QoI fungicides azoxystrobin and pyraclostrobin, SdhI fungicide boscalid, and a mixture of pyraclostrobin + boscalid. There was no significant difference (P = 0.05) between EC₅₀ values for inhibition of conidial germination versus mycelial growth. The mean EC₅₀ values based upon mycelial growth tests for 25 isolates from an orchard without RI-spray history were 0.15, 0.06, 2.23, and 0.09 μg/ml for azoxystrobin, pyraclostrobin, boscalid, and pyraclostrobin + boscalid, respectively. The respective mean EC₅₀ values for 76 isolates from RI-sprayed orchards in South Carolina were 0.9, 0.1, 10.7, and 0.13 μg/ml and for 56 isolates from RI-sprayed orchards in Georgia were 1.2, 0.1, 8.91, and 0.17 μg/ml. Overall, mean EC₅₀ values of populations from RI-sprayed orchards increased three-, two-, five-, and twofold between 2006 and 2008 for azoxystrobin, pyraclostrobin, boscalid, and pyraclostrobin + boscalid, respectively. A subset of 10 M. fructicola isolates representing low and high EC₅₀ values for azoxystrobin, boscalid, and boscalid + pyraclostrobin was selected for a detached fruit assay to determine disease incidence and severity following protective treatments of formulated RI fungicides at label rates. Brown rot incidence was greater than 50% when fruit were inoculated with isolates having EC₅₀ values of 2, 4, and 0.6 μg/ml for azoxystrobin, boscalid, and pyraclostrobin + boscalid, respectively. Pyraclostrobin failed to control any of the isolates tested in detached fruit assays. Based on minimum inhibitory concentration and brown rot incidence data, we recommend using 3 and 0.75 μg/ml as discriminatory doses to distinguish between sensitive isolates and those with reduced sensitivity to azoxystrobin and pyraclostrobin + boscalid, respectively. Results from our in vitro and in vivo assays indicate a shift toward reduced sensitivity in M. fructicola from the southeastern United States. No cross-resistance was observed between the QoI and the SdhI fungicides, which implies that rotation or tank mixtures of these two chemical classes can be used as a resistance management strategy.

Propiconazole Inhibits Armillaria tabescens In Vitro and Translocates into Peach Roots Following Trunk Infusion

Intravascular trunk infusion of propiconazole has been associated with beneficial effects on Armillaria root rot control in Prunus sp. but its basipetal movement has not been verified. Propiconazole, a sterol demethylation inhibitor fungicide, was more effective in inhibiting mycelial growth of Armillaria tabescens isolates in vitro (average effective concentration to inhibit mycelial growth by 50% [EC₅₀ value] of 0.6 μg/ml) compared with fungicides from five other chemical classes (EC₅₀ values ranging from 4.6 to >1,000 μg/ml). The fungicide was infused into the vascular system of peach trees in the spring, summer, and fall of 2005 and 2006. Propiconazole concentration was determined using gas chromatography mass spectrometry in trunk sections above and below the infusion site and in primary roots. Over two experimental years, spring and fall infusions resulted in consistent propiconazole accumulations in primary peach roots. Spring infusions yielded propiconazole concentrations of 1.7 μg/g in 2005 and 5.6 μg/g in 2006, whereas the highest accumulations were detected following fall infusions with 9.2 μg/g in 2005 and 6.7 μg/g in 2006. Propiconazole was also consistently detected in trunk sections collected from above and below the infusion site. The basipetal movement of propiconazole in peach trees and its inhibitory activity against A. tabescens in vitro suggest that propiconazole infusion could be useful for targeted Armillaria root rot management.

Systemic lupus erythematosus in the Fars Province of Iran

Abstract

Clinical features of systemic lupus erythematosus (SLE) have been described from different geographical regions in the world. However, data from many Middle East countries, including Iran, are scarce. This study aims to demonstrate the demographic, clinical, and laboratory characteristics in Iranian patients with SLE. In this prospective study, all the patients referring to Shiraz educational hospitals (Nemazi–Hafez) with SLE (American College of Rheumatology criteria) during a 5-year period (2001 to 2006) were included. A complete history was taken; physical examination and routine hematological, serological, and immunological tests were done for each patient. There were 356 women and 54 men with an average age of 30.27 years at the onset of disease. Of the patients, 78% had hematological abnormalities, 65.5% had articular involvement, 54.5% had photosensitivity, and 60.5% had malar rash. Serositis occurred in 38% of patients of whom 12% had pericarditis and 26% had pleuritis. Nephritis was diagnosed in 48% of the cases and consisted always of glomerular nephritis. Biopsy-proven lupus nephritis was in most cases class IV(49.7% of all the biopsies). Oral ulcers were observed in 28% of patients. Neuropsychiatric manifestations, gastrointestinal involvement, and lymphadenopathy were observed in 31.5%, 8.3%, and 14.2% of patients, respectively. In all, 93% of patients were positive for antinuclear antibodies, whereas antidouble-stranded DNA was positive in 83% of patients. Coomb’s positive hemolytic anemia appeared in 12.4% of the cases. Rheumatoid factor was detected in 9.7% of patients, and lupus erythematosus cell was seen in 32.5% of them. In all, 196 (47.8%) patients represented hypocomplementemia. Regarding hematological manifestations, 74.5% had microcytic hypochromic anemia, 64.6% had leukopenia, and 44.6% had thrombocytopenia; 18 (4.4%) patients died during the study period of which eight (2%) died because of cardiopulmonary involvement. Generally, there was more cutaneous, serositis, and neuropsychiatric involvement in our population than other Middle East countries. Serositis was associated with poorer prognosis, and the pattern of disease in these patients was much more sever than patients without serositis ( P = 0.001). This is the first study of its kind in Iran. More multicenter studies should be undertaken in Iran to describe the pattern of SLE.

Laboratory Evaluation of Three Rapid, Agar-Based Assays to Assess Fungicide Sensitivity in Monilinia fructicola

Three rapid, agar-based assays were compared with a traditional petri dish method for assessing the sensitivity of Monilinia fructicola to propiconazole (0.3 and 2.0 μg/ml), thiophanate-methyl (1.0 and 50 μg/ml), and azoxystrobin (1.0 and 35 μg/ml) in the laboratory. The three assays were based on mycelial growth inhibition on agar disks sliced from lipbalm tubes filled with fungicide-amended potato dextrose agar (PDA), on PDA-coated cotton swabs, or in PDA-filled microcentrifuge tubes. Mycelial growth inhibition of eight previously characterized isolates (two resistant to propiconazole, two highly resistant to thiophanate-methyl, two with low levels of resistance to thiophanate-methyl, and two sensitive to all three fungicides) was determined visually 24, 48, and 72 h after inoculation. The 48-h time point was the earliest suitable time to collect data for all methods because insufficient growth was recorded in the petri dish and tube assays after 24 h. With the exception of the swab assay, all methods classified the isolates previously determined to be fungicide sensitive correctly (i.e., no fungal growth was observed for these isolates). For propiconazole-resistant isolates, the lipbalm assay resulted in levels of growth inhibition very similar to the petri dish method, whereas the swab assay and the tube assay overestimated and underestimated, respectively, the level of resistance. Both the lipbalm and the swab assays classified isolates correctly as being thiophanate-methyl resistant, and both were able to discriminate the isolates previously classified as having low versus high levels of resistance when treated with this fungicide at 50 μg/ml, as was the petri dish method. None of the eight isolates which previously were determined to be azoxystrobin sensitive grew on azoxystrobin-amended media, regardless of the assay type. Overall, the average percentage of correct isolate classifications (relative to their previously determined resistance status) on propiconazole- and thiophanate-methyl-amended media after 48 h ranged from 87.5 to 100, 85.3 to 100, 63.2 to 94.5, and 50.5 to 81.0% for the petri dish, lipbalm, swab, and tube assays, respectively. The lipbalm assay provided the most accurate assessments (85.3 to 100%) after only 24 h of incubation, supporting its use as a rapid and simple tool to monitor resistance levels in M. fructicola field populations.

eEF1A2 activates Akt and stimulates Akt-dependent actin remodeling, invasion and migration

eEF1A2 (eukaryotic protein elongation factor 1 alpha 2) is a protein translation factor that is likely a human oncogene by virtue of its capacity to transform mammalian cells and its high expression in tumors of the ovary, breast and lung. Here, we show that expression of eEF1A2 is sufficient to stimulate the formation of filopodia in BT549 human breast cancer cells and non-transformed Rat2 cells. Filopodia formation in eEF1A2-expressing cells is dependent on the activity of phosphatidylinositol-3 kinase (PI3K), and the ROCK and Akt kinases. Furthermore, eEF1A2 expression is sufficient to activate Akt in a PI3K-dependent fashion and inactivation of eEF1A2 by short interfering RNA reduces Akt activity. Using breast cancer cell line BT 549, we show that eEF1A2 expression stimulates cell migration and invasion in a largely PI3K- and Akt-dependent manner. These results suggest that eEF1A2 regulates oncogenesis through Akt and PI3K-dependent cytoskeletal remodeling.