Rhizoctonia solani AG2-1 causing root rot of wasabi (Eutrema japonica) in the UK.

In 2014, glasshouse-grown wasabi (Eutrema japonica) grown in a compost based media displayed symptoms of poor growth and wilting. Visual assessment of the roots showed that 25% of the symptomatic plants sampled had raised black lesions on the roots affecting between 5 and 20% of the total root area. To isolate the causal agent, affected material (approximately 5 mm3) was surface disinfested in sodium hypochlorite (2%) for 30 s, rinsed twice in sterile water and plated on to water agar medium amended with penicillin G (0.2 g/liter) and streptomycin sulfate (0.8 g/liter). Plates were incubated at 20ºC until fungal colonies were visible. After three days, colonies of Rhizoctonia solani were identified based on the presence of septate hyphae with right-angle branching, a pure culture was obtained through hyphal tip transfer onto a new plate of PDA. DNA was extracted from a 7-day old plate of the isolate (WAS1) as described previously (Woodhall et al., 2013). The AG of WAS1 was determined as AG2-1 using a subgroup specific real-time PCR assay (Budge et al., 2009b) and confirmed by DNA sequencing as described previously (Lekuona Gomez et al., 2015). The sequence was 100% identical (587/587bp) to a previously identified AG2-1 isolate 1971 (GenBank accession FJ435126) (Budge et al., (2009a). Pathogenicity of the isolate was confirmed by inoculating three healthy one-year-old wasabi plants grown in loam based compost (John Innes No.3) each with four 5 mm fully colonised PDA plugs of isolate WAS1 placed at approx. 40 mm depth in the soil. Four sterile PDA plugs were place in each of three control plants. All six plants were placed in a greenhouse at 21°C, 18h:6h light: dark and watered as required. After 21 days, multiple black root lesions typically 3-5mm in length were observed on the roots of all inoculated plants. No lesions were observed on the control plants. From three lesions per plant, isolations were attempted as described above. Rhizoctonia solani was recovered from all isolations and the resulting cultures all tested positive for AG2-1 using the real-time PCR assay. Isolations were attempted from the roots of healthy control plants but Rhizoctonia was not recovered. Here we demonstrate that R. solani AG2-1 is associated with root necrosis of Eutrema japonica. Rhizoctonia solani AG2-1 has been reported previously in various Brassica crops in the UK (Budge et al., 2009a) and on Matthiola incana (Lekuona Gómez et al., 2015). It has also been reported causing disease in potatoes and as widely present in UK field soils (Woodhall et al., 2013). Although R. solani AG1 and AG4 of R. solani have been reported to infect Eutrema japonica in Japan (Takeuchi et al., 2003; 2008), this is the first finding that identifies AG2-1 as the causal agent. The potential presence of AG2-1 in soil and/or as plant debris should be considered prior to planting susceptible hosts.

Pediatric Program Leadership's Contribution Toward Resident Wellness.

BACKGROUND: Residency program leaders are required to support resident well-being, but often they do not receive training in how to do so. OBJECTIVE: To determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. METHODS: National cross-sectional web-based survey in June 2015 of pediatric program directors, associate program directors, and coordinators about their experiences supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. RESULTS: The response rate was 39.3% (322/820). Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10%of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (P < .02). CONCLUSIONS: Program leaders spend a significant amount of time supporting resident well-being. Although they think that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being.

Dose escalation using contact X-ray brachytherapy (Papillon) for rectal cancer: does it improve the chance of organ preservation?

OBJECTIVE: A watch and wait policy for patients with a clinical complete response (cCR) after external beam chemoradiotherapy (EBCRT) for rectal cancer is an attractive option. However, approximately one-third of tumours will regrow, which requires surgical salvage for cure. We assessed whether contact X-ray brachytherapy (CXB) can improve organ preservation by avoiding surgery for local regrowth. METHODS: From our institutional database, we identified 200 of 573 patients treated by CXB from 2003 to 2012. Median age was 74 years (range 32-94), and 134 (67%) patients were males. Histology was confirmed in all patients and was staged using CT scan, MRI or endorectal ultrasound. All patients received combined CXB and EBCRT, except 17 (8.5%) who had CXB alone. RESULTS: Initial cCR was achieved in 144/200 (72%) patients. 38/56 (68%) patients who had residual tumour received immediate salvage surgery. 16/144 (11%) patients developed local relapse after cCR, and 124/144 (86%) maintained cCR. At median follow up of 2.7 years, 161 (80.5%) patients were free of cancer. The main late toxicity was bleeding (28%). Organ preservation was achieved in 124/200 (62%) patients. CONCLUSION: Our data suggest that CXB can reduce local regrowth to 11% compared with around 30% after EBCRT alone. Organ preservation of 62% achieved was higher than reported in most published watch and wait studies. Advances in knowledge: CXB is a promising treatment option to avoid salvage surgery for local regrowth, which can improve the chance of organ preservation in patients who are not suitable for or refuse surgery.

The development of monoclonal antibodies to the secA protein of Cape St. Paul wilt disease phytoplasma and their evaluation as a diagnostic tool.

Partial recombinant secA proteins were produced from six different phytoplasma isolates representing five 16Sr groups and the expressed, purified recombinant (partial secA) protein from Cape St. Paul wilt disease phytoplasma (CSPWD, 16SrXXII) was used to immunise mice. Monoclonal antibodies (mAbs) were selected by screening hybridoma supernatants for binding to the recombinant proteins. To characterise the binding to proteins from different phytoplasmas, the antibodies were screened by ELISA and western blotting, and epitope mapping was undertaken. Eight different mAbs with varying degrees of specificity against recombinant proteins from different phytoplasma groups were selected. Western blotting revealed that the mAbs bind to proteins in infected plant material, two of which were specific for phytoplasmas. ELISA testing of infected material, however, gave negative results suggesting that either secA was not expressed at sufficiently high levels, or conformational changes of the reagents adversely affected detection. This work has shown that the phytoplasma secA gene is not a suitable antibody target for routine detection, but has illustrated proof of principle for the methodology.

Systematic review of incidence studies of Parkinson's disease.

Incidence studies of Parkinson's disease (PD) are important for both health-care planning and epidemiological research. This report reviews the methods and results of previous incidence studies of PD and makes recommendations for future studies. Original articles that described the incidence of PD were located using several strategies. The methods were summarised, and the results of studies with similar methodologies were compared on a standardised population. Twenty-five incidence studies were included. Each used different methods to identify incident patients, although most screened both primary care and hospital records. Only eight studies were prospective, and only two of these had any follow-up. The diagnostic criteria for PD varied (11 studies used two or more cardinal motor features, four used the UK Brain Bank criteria), as did the exclusion criteria and the definition of an incident case. In 16 studies, attempts were made to confirm the diagnosis by examination of patients by a specialist as part of the study. None of the studies used identical methods, but five were sufficiently similar to merit comparison. Four of these gave a similar incidence (16-19/100000/year), but one from Italy had a much lower incidence (8.4/100000), the reason for which was unclear. Five studies found significantly greater incidence in men. This review highlights the difficulties in performing good quality incidence studies of PD. Further incidence studies using standardised methods are required. A set of minimal scientific criteria has been devised to improve the quality and consistency of future studies.