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rials.Rust fungi are important plant pathogens and have been extensively studied on crops and other host plants worldwide. This study describes the heterecious life cycle of a rust fungus on Digitaria eriantha (finger grass) and the Solanum species S. lichtensteinii (large yellow bitter apple), S. campylacanthum (bitter apple), and S. melongena (eggplant) in South Africa. Following field observations, inoculation studies involving telial isolates collected from Digitaria plants produced spermogonia and aecia on S. lichtensteinii, S. campylacanthum, and S. melongena. Likewise, inoculation of finger grass with aeciospores collected from the aforementioned Solanum species produced uredinia on D. eriantha. Pennisetum glaucum (pearl millet varieties Milkstar and Okashana, as well as 17 experimental lines) and S. elaeagnifolium (silverleaf nightshade or bitter apple) were resistant to the rust isolates. Morphological descriptions and molecular phylogenetic data confirmed the identity of the rust on Digitaria as P. digitariae, herein reinstated as a species and closely related to P. penicillariae the pearl millet rust, also reinstated. Puccinia digitariae has a macrocyclic, heterecious life cycle in which teliospores overwinter on dormant D. eriantha plants. Aecia sporulate on species of Solanum during spring and early summer to provide inocula that infect new growth of Digitaria.We designed an anonymous survey to identify knowledge gaps regarding correctional medicine and health disparities for justice-affected patients and distributed it to medical students. Fifty-six percent of the 140 students who responded (14% response rate) had some interaction with the criminal justice system and/or a justice-affected person. Most students somewhat agreed to having knowledge of health risks/disparities related to incarceration. Most were unaware of correctional medicine as a subspecialty. A majority felt comfortable providing care to justice-affected patients and on average agree this population should have equal access to health care. There was a statistically significant correlation between students who considered correctional medicine as a career and belief that these patients should have equal health care access, with the importance of including correctional health care in medical education. We agree with the growing body of literature that concludes there is a need for correctional health care curricula in medical education.
This study sought to (a) characterize the demographic, audiological, and intervention variability in a population of Deaf and Hard of Hearing (DHH) children receiving state services for hearing loss; (b) identify predictors of vocabulary delays; and (c) evaluate factors influencing the success and timing of early identification and intervention efforts at a state level.
One hundred DHH infants and toddlers (aged 4-36 months) enrolled in early intervention completed the MacArthur-Bates Communicative Development Inventories, and detailed information about their audiological and clinical history was collected. We examined the influence of demographic, clinical, and audiological factors on vocabulary outcomes and early intervention efforts.
We found that this sample showed spoken language vocabulary delays (production) relative to hearing peers and showed room for improvement in rates of early diagnosis and intervention. These delays in vocabulary and early support services were predicted by an overlapping subset of hearing-, health-, and home-related variables.
In a diverse sample of DHH children receiving early intervention, we identify variables that predict delays in vocabulary and early support services, which reflected
dimensions that are immutable, and those that clinicians and caretakers can potentially alter. We provide a discussion on the implications for clinical practice.
https//doi.org/10.23641/asha.19449839.
https//doi.org/10.23641/asha.19449839.Reactive oxygen species (ROS)-mediated reductions in nitric oxide (NO)-dependent dilation are evident in adults with major depressive disorder (MDD); however, the upstream mechanisms remain unclear. Here, we hypothesized that nuclear factor-κB (NF-κB) activation-induced ROS production contributes to microvascular endothelial dysfunction in MDD. Thirteen treatment-naive adults with MDD (6 women; 19-23 yr) and 10 healthy nondepressed adults (HAs; 5 women; 20-25 yr) were tested before and after (open-label design) systemic NF-κB knockdown (nonacetylated salicylate; 3,000-4,500 mg/day × 4 days). Red cell flux (laser Doppler flowmetry) was measured during graded intradermal microdialysis perfusion of the endothelium-dependent agonist acetylcholine (ACh), alone and in combination with NO synthase inhibition [NG-nitro-l-arginine methyl ester (l-NAME)] or ROS scavenging (apocynin). Serum salicylate concentrations following treatment were not different between groups (22.8 ± 7.4 HAs vs. 20.8 ± 4.3 mg/dL MDD; P = 0.46)epressive disorder (MDD). In adults with MDD, acute localized scavenging of reactive oxygen species (ROS) with apocynin improved NO-dependent dilation before, but not after, salsalate administration. These data suggest that activation of NF-κB, in part via stimulation of vascular ROS production, contributes to blunted NO-mediated endothelium-dependent dilation in young adults with MDD.Background Few studies have focused on the treatment of common bile duct (CBD) stones after cholecystectomy, for which optimal treatment options remain unclear. Aims To compare the safety and efficacy of laparoscopic common bile duct exploration (LCBDE) versus endoscopic retrograde cholangiopancreatography (ERCP) for CBD stone treatment after cholecystectomy. Materials and Methods A total of 201 patients were enrolled in this retrospective cohort study, of whom 134 with ≤3 stones and a maximum stone diameter of 3 stones or maximum stone diameter of ≥15 mm, LCBDE demonstrated certain advantages.Objectives To assess the feasibility, acceptability, and effects of Mindfulness Based Stress Reduction (MBSR) live online during the COVID-19 shutdown. Design Mixed-methods study using a sequential explanatory design. Settings/location Cohorts 1-4 took place in-person and Cohorts 5-6 took place over Zoom following the onset of the COVID-19 pandemic. Subjects Participants were paying members of the general public enrolled in one of six live MBSR courses. Interventions All MBSR courses followed the standard 8-week MBSR curriculum, led by experienced instructors. Outcome measures Feasibility measured via class attendance, acceptability measured via the adapted Treatment Satisfaction Survey, and MBSR course effects measured by a focus group with Cohort 5, and the following assessments completed by all cohorts Perceived Stress Scale-10, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9 and the 36-item Short Form Survey. Results 73 adults participated in six live MBSR courses (48 in the four in-person and access to MBSR and address health inequities.Background Conflict between clinicians is prevalent within intensive care units (ICUs) and may hinder optimal delivery of care. However, little is known about the sources of interpersonal conflict and how it manifests within the context of palliative and end-of-life care delivery in ICUs. Objective To characterize interpersonal conflict in the delivery of palliative care within ICUs. Design Secondary thematic analysis using a deductive-inductive approach. We analyzed existing qualitative data that conducted semistructured interviews to examine factors associated with variable adoption of specialty palliative care in ICUs. Settings/Subjects In the parent study, 36 participants were recruited from two urban academic medical centers in the United States, including ICU attendings (n = 17), ICU nurses (n = 11), ICU social workers (n = 1), and palliative care providers (n = 7). Measurements Coders applied an existing framework of interpersonal conflict to guide initial coding and analysis, combined with a flexible inductive approach allowing new codes to emerge. Results We characterized three properties of interpersonal conflict disagreement, interference, and negative emotion. In the context of delivering palliative and end-of-life care for critically ill patients, "disagreement" centered around whether patients were appropriate for palliative care, which care plans should be prioritized, and how care should be delivered. "Interference" involved preventing palliative care consultation or goals-of-care discussions and hindering patient care. "Negative emotion" included occurrences of silencing or scolding, rudeness, anger, regret, ethical conflict, and grief. Conclusions Our findings provide an in-depth understanding of interpersonal conflict within palliative and end-of-life care for critically ill patients. Further study is needed to understand how to prevent and resolve such conflicts.Background Women worldwide face risks from pregnancy, HIV, and other sexually transmitted infections (STIs). To date, highly effective contraceptive methods provide no HIV/STI protection, and HIV prevention products, excluding condoms, provide no pregnancy protection. Intravaginal rings (IVRs) delivering antiretrovirals and contraceptives are a promising multipurpose prevention technology (MPT). Methods Embedded within a Phase I randomized, placebo-controlled trial, we examined acceptability of continuous versus interrupted use of a 90-day MPT IVR among 47 low-risk women in Norfolk, Virginia and the Dominican Republic. A baseline survey assessed menstruation attitudes, risk perceptions and trial-related motivations. Follow-up surveys (M1/M3) examined user experiences with and preferences for IVR attributes; 18 women also participated in two in-depth interviews. Results Most women rated the IVR's flexibility and smoothness (86%) and ease of insertion/removal (76%) as very acceptable. Fewer women similarly rated the IVR size (57%) and changes in color from menstruation (52%). Most participants experienced no changes or less bleeding. Those reporting more/heavier bleeding (20% M1, 15% M3) disliked the change. Overall, women preferred a 3-month (75%) to a 1-month IVR (7.5%) or a bimonthly injectable (10%). find more In qualitative interviews, women were willing to continuously use an IVR for 6-12 months, providing it did not "degrade" inside the body. Reasons for trial participation and prevention preferences, menstrual attitudes, and perceived IVR benefits and doubts varied by site. Conclusions Findings provide strong evidence of demand for an MPT IVR that protects from pregnancy and HIV/STIs, lasts longer than 1 month, minimally disrupts menstrual bleeding, and is in women's control. numberClinicalTrials.gov #NCT03279120.Introduction The COVID-19 pandemic ushered in a rapid, transformative adoption of telemedicine to maintain patient access to care. As clinicians made the shift from in-person to virtual practice, they faced a paucity of established and reliable clinical examination standards for virtual care settings. In this systematic review, we summarize the accuracy and reliability of virtual assessments compared with traditional in-person examination tools. Methods We searched PubMed, Embase, Web of Science, and CINAHL from inception through September 2019 and included additional studies from handsearching of reference lists. We included studies that compared synchronous video (except allowing for audio-only modality for cardiopulmonary exams) with in-person clinical assessments of patients in various settings. We excluded behavioral health and dermatological assessments. Two investigators abstracted data using a predefined protocol. Results A total of 64 studies were included and categorized into 5 clinical domains neurological (N = 41), HEENT (head, eyes, ears, nose, and throat; N = 5), cardiopulmonary (N = 5), musculoskeletal (N = 8), and assessment of critically ill patients (N = 5).