Effects of COVID-19 on Pediatric Cancer Care: A Multicenter Study of 11 Middle Eastern Countries.

During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients' flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.

Validation of degree-day models for predicting the emergence of two fruit flies (Diptera: Tephritidae) in northeast Egypt.

We estimated thermal developmental thresholds (T0 ) and degree-day (DD) constants for the immature stages of two tephritid pests, Bactrocera zonata (Saunders) and Ceratitis capitata (Weidenmann). Males of both species were trapped in an Egyptian guava orchard during the fruiting seasons of 2016 and 2017 and trap catches were compared with peak flights predicted by the DD model based on local weather data. Ceratitis capitata had faster development than B. zonata at 20 and 25 °C, but their overall developmental rate was similar at 30 and 35 °C. The thermal threshold of development (T0 ) of B. zonata was higher than that of C. capitata, indicating greater sensitivity to cold. Although 35 °C yielded the fastest development of both species, survival was higher at 30 °C, with B. zonata experiencing a slight advantage, suggesting better tropical adaptation. Immature development of B. zonata and C. capitata was estimated to require 338 and 373 d, respectively, and 616 and 424 DD for a complete generation. Trap catches over both seasons showed good correspondence to peaks of fly activity predicted by the DD models; deviations from expectation ranged from 0 to 7 d for both fly species. Both species had four overlapping generations per season, with B. zonata abundance peaking in the first generation in both years, but only in 2016 for C. capitata. The models predict about eight and 12 generations per year in northeast Egypt for B. zonata and C. capitata, respectively. These models should be useful for timing pest control measures to coincide with periods of peak fly activity in fruit orchards.

A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has specific implications for oral and maxillofacial surgeons because of an increased risk of exposure to the virus during surgical procedures involving the aerodigestive tract. The objective of this survey was to evaluate how the COVID-19 pandemic affected oral and maxillofacial surgery (OMFS) training programs during the early phase of the pandemic. STUDY DESIGN: During the period April 3 to May 6, 2020, a cross-sectional survey was sent to the program directors of 95 of the 101 accredited OMFS training programs in the United States. The 35-question survey, designed by using Qualtrics software, aimed to elicit information about the impact of the COVID-19 pandemic on OMFS residency programs and the resulting specific modifications made to clinical care, PPE, and resident training/wellness. RESULTS: The survey response rate from OMFS program directors was 35% (33 of 95), with most responses from the states with a high incidence of COVID-19. All OMFS programs (100%) implemented guidelines to suspend elective and nonurgent surgical procedures and limited ambulatory clinic visits by third week of March, with the average date being March 16, 2020 (date range March 8-23). The programs used telemedicine (40%) and modified in-person visit (51%) protocols for dental and maxillofacial emergency triage to minimize the risk of exposure of HCP to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Shortage of personal protective equipment (PPE) was experienced by 51% of the programs. Almost two-thirds (63%) of the respondents recommended the use of a filtered respirator (i.e., N95 respirator) with full-face shield and stated that it was their preferred PPE, whereas 21% recommended the use of powered air-purifying respirators (PAPRs) during OMFS procedures. Only (73%) of the programs had resources for resident wellness and stress reduction. Virtual didactic training sessions conducted on digital platforms, most commonly Zoom, formed a major part of education for all programs. CONCLUSIONS: All programs promptly responded to the pandemic by making appropriate changes, including suspending elective surgery and limiting patient care to emergent and urgent services. OMFS training programs should give more consideration to providing residents with adequate stress reduction resources to maintain their well-being and training and to minimize exposure risk during an evolving global epidemic.

Measuring the Costs of Limb Regeneration and Their Transgenerational Consequences in Two Nearctic Lady Beetles (Coleoptera: Coccinellidae).

We examined the ability of Coleomegilla maculata DeGeer and Hippodamia convergens Guerin-Meneville to regenerate, during pupation, a foreleg amputated in the fourth instar. Leg regeneration was complete for 80.7% of amputated H. convergens larvae, with 12.5% regenerating partially, and 6.8% showing no regeneration. Regeneration in C. maculata was 72.2% complete, 20.5% partial, and 7.2% none, but mortality following ablation was slightly higher than for H. convergens (7.4 vs. 0.6%). Ablation/regeneration caused a slight delay in pupation, but pupation time, fresh mass at emergence, and reproductive performance remained unaffected in either species. Reciprocal crosses were made between regenerated and unoperated beetles, and 12 progeny reared from the second clutch of each female in all treatments. Mating treatment affected eclosion time in H. convergens, whereas in C. maculata, larval development and pupation time were also affected. Considering all treatments, larval mortality was higher in H. convergens than in C. maculata, but lower when both H. convergens parents regenerated. Parental mating treatment did not affect adult weight in either species, but development of C. maculata progeny was faster when only the sire regenerated, and slower when the only the dame regenerated, whereas progeny of regenerated sires completed pupated faster than those sired by controls. We infer that genes activated during regeneration have pleiotropic effects with subtle, gender-specific, epigenetic consequences. If these pleiotropic effects are genetically linked to important traits, regenerative genetic elements could be conserved in coccinellids via natural selection acting on these traits, rather than on regenerative ability per se.

Improving the Lifetime Efficiency of Trimedlure-Dispensing System in Trapping the Fruit Fly Ceratitis capitata Using Polyethylene Matrix.

Detection of the Mediterranean fruit fly, Ceratitis capitata (Wiedemann), is highly reliant on traps loaded with trimedlure (TML), a male-specific attractant. The successful application of attractants requires that constituents are placed in a suitable dispensing system to reduce volatilization and increase the effective field longevity of the attractant. A series of trials were conducted in different fruit orchards to test 1) the efficiency of a polyethylene-matrix plug in regulating the emission rate of TML 2) and the lifetime attractiveness of the plug compared to the cotton wick dispenser. Cotton dispensers containing the recommended dose of TML (0.75 cm3) and with a double dose (1.5 cm3) remained active for 6 and 8 wk, respectively. The increase in TML dose from 0.75 cm3 to 1.5 cm3 led to an increase in the longevity of the cotton dispenser, but there was no significant difference between the doses in biological activity. In all trials, TML-polyethylene matrix dispensers were more efficient under field conditions as they attracted more males for up to 12 wk and prolonged the release of TML more than the cotton wick dispensers. The TML-loaded polyethylene matrix dispensers might be useful in 1) minimizing the losses of the liquid TML from cotton wicks, 2) avoiding the damage that occurs when using other dispensers, 3) prolonging the TML lifetime in the field through regulating its release rates, 4) potentially minimizing the adverse effect of high temperatures on release rate, and, finally, 5) minimizing the costs of using large amounts of expensive TML solutions.

Fitness costs of reflex bleeding in the ladybird beetle Harmonia axyridis: the role of parental effects.

Reflex bleeding is an important antipredator defense mechanism in Coccinellidae. We examined the costs of reflex bleeding in larval and adult stages of the ladybird beetle Harmonia axyridis on offspring fitness and reproductive performance through the comparisons between bled and control larvae, reciprocal crosses of bled/control beetles, and early and late clutch phenotypes. Beetles bled during their larval stage spent a longer time in development and weighed less than controls. Egg fertility was reduced for crosses where either one or both parents had been bled during the larval or adult stage. Offspring crosses that included a parent bled during the larval stage suffered fitness costs in development and female body mass, while those bled during the adult stage suffered no transgenerational costs. Males that suffered bleeding during their larval stage accelerated progeny development of nonbled females in early clutches, suggesting a positive transgenerational effect of larval bleeding, while males that did not suffer bleeding accelerated progeny development of bled females in later clutches. As the underlying effects of bleeding on females' offspring in the early clutches were diminished in the late ones, suggesting another transgenerational effect. The strengths of maternal and paternal effects on progeny development of parents bled at the larval stage were higher in earlier clutches. This study suggests that H. axyridis adults are less affected than larvae by the frequent use of the defensive secretions in their stressful habitats.

Beneficial effects of antioxidants in improving health conditions of sheep infected with foot-and-mouth disease.

The effect of multinutrient antioxidant treatment on sheep naturally infected with FMD virus was investigated in terms of general health conditions, serum proteins profile, and antioxidant/oxidant parameters. Twenty diseased sheep were divided into 4 equal groups (n = 5) and underwent certain therapeutic protocols for 8 weeks as follows: GI, infected not treated group; GII, infected and treated with the ideal and usual line of treatment against FMD virus infection; GIII, infected animals supplemented orally zinc methionine at a dose of 5 g/head/day and vitamin E with selenium-enriched yeast at the same dose level; GIV, infected animals received both the ideal treatment and antioxidants. The animals under experiment were clinically evaluated. Blood samples were obtained for the comet assay and biochemical examination at zero time and at the 8th week after treatment. Results revealed that DNA damage reduced in both GIII and GIV groups which received antioxidants. In the GI group, the activity of SOD and GPx and the level of total antioxidant capacity (TAC) markedly decreased. However, in both GIII and GIV groups treated with multinutrient antioxidants, GPx and TAC values significantly increased after treatment in comparison with the values of the same groups before treatment. After treatment with multinutrient antioxidants, α1-, ß-, and γ-globulins levels markedly increased in GII and GIII groups while α2-globulin level decreased. The improvement in healing of clinical signs and general health conditions was clear in the GIV group. Finally, FMD infection in sheep was found to be associated with oxidative stress. The use of antioxidants as therapeutic approaches recovers and improves general health conditions and performance of affected animals.

Limb Regeneration and Interference Competition Consequences on Foraging Efficiency of Coccinella undecimpunctata and Hippodamia variegata (Coccinellidae: Coleoptera) to Their Prey, Aphis craccivora (Hemiptera: Aphididae).

Regeneration of limbs lost during development has been recorded in a large number of species of hexapoda including many Coccinellids. Although regeneration has obvious survival and fitness benefits, it has also been demonstrated to impose costs on development, reproduction, and behavior. To investigate consequences of regeneration on foraging behavior, Coccinella undecimpunctata L. and Hippodamia variegata (Goeze) larvae were treated to remove one limb, allowed to pupate and regenerate and then prey searching ability assessed. Different densities of adults were placed in Petri dishes with aphid prey and consumption assessed over a 24-h period. Amputation/regeneration, predator species, and predator density significantly affected the total number of aphids consumed. Aphid consumption rates and predation efficiency of both regenerated and control beetles significantly increased as predator density increased. Although there were significant differences in consumption between ablated/regenerated and control C. undecimpunctata at each predator densities, H. variegata did not. Further, mutual interference was significantly higher for regenerated compared with control C. undecimpunctata but not so for H. variegata. This is the first demonstration of an effect of ablation/regeneration on foraging behavior of C. undecimpunctata and suggests that H. variegata demonstrates an adaptive phenotypic response to limb regeneration. Coccinellids are widely used as biological agents and these findings concerning the impact of variation in predator density have clear implications for the management of predator-prey ratios in order to maximize efficiency of pest consumption.

Identifying Prognostic Factors That Influence Outcome of Childhood Acute Myeloid Leukemia in First Relapse in Saudi Arabia: Results of the Multicenter SAPHOS Study.

BACKGROUND: The outcome of childhood acute myeloid leukemia (AML) in first relapse (rAML) remains poor. Reported overall survival (OS) rates vary between high-income developed countries and those with fewer resources. The OS of rAML in high-income developing countries (HIDCs) has not been reported. PATIENTS AND MATERIALS: A multicenter study was performed in an HIDC. The outcome of patients with relapsed non-M3/non-Down syndrome AML was evaluated. Three-year OS was computed using the Kaplan-Meier method, and predictors of OS were analyzed using a Cox proportional hazards model. RESULTS: A total of 88 patients with non-M3/non-Down syndrome AML diagnosed between January 2005 and December 2012 with a first relapse were identified. Their 3-year OS was 22.6% ± 5.4%. Patients with inv(16) and t(8;21) had an OS of 75.0% ± 21.7% and 36.0% ± 16.1%, respectively. Worse outcomes were associated with "other intermediate" and 11q23 rearrangement AML (OS of 9.4% ± 8.7% and 10.7% ± 9.6%, respectively). Patients experiencing time to relapse (TTR) less than 1 year had shorter OS than those with a longer TTR (14.6% ± 5.4% vs. 41.1% ± 11.5%; P = .006). The outcome of patients after stem cell transplantation (SCT) in second complete remission (CR2) was superior compared with no SCT (50.9% ± 11.2% vs. 7.7% ± 4.6%; P = .001). TTR, risk group, CR2, and SCT in CR2 were the most significant predictors for survival. CONCLUSIONS: rAML remains a clinical challenge. Genetic variability in outcomes was observed. A majority of patients with inv(16) were successfully salvaged post-relapse, whereas patients with 11q23 rearrangement had a poor prognosis. Only one-third of those with t(8;21) rAML survived. Better access to SCT in HIDCs is needed.

A Life Table for Liriomyza trifolii (Diptera: Agromyzidae) in a Temperate Zone of Northeast Egypt With Key Factor Analysis.

The American serpentine leaf miner, Liriomyza trifolii (Burgess) (Diptera: Agromyzidae), is a perennial pest of leguminous crops in the Mediterranean region. A life table was constructed for L. trifolii infesting broad bean, Vicia faba L., in northern Egypt. Key factor analysis was used to rank sources of immature mortality over two seasons. Leaf miners had three successive generations, and a partial fourth, in each year, with peak abundance in March-April. Less than 15 and 22% of L. trifolii survived to adult in seasons one and two, respectively. The largest contributor of immature leaf miner mortality in both seasons was unknown (41.2 and 39.1% of total mortality, respectively), and likely comprised a combination of abiotic factors, parasitoid-inflicted mortality (host-feeding), and predation. Parasitism was second, contributing 36.2 and 35.6% of total mortality in the two seasons, respectively, primarily due to larval parasitism by Diglyphus isaea (Walker) (Hymenoptera: Eulophidae), and low levels of larval-pupal parasitism by Opius pallipes Wesmael (Hymenoptera: Braconidae) and Halticoptera circulus (Walker) (Hymenoptera: Pteromalidae). Residual mortality resulted from malformed pupae or failed adult emergence. Key factor analysis revealed malformation to be the major cause of pupal mortality. Sequential regression confirmed that unknown mortality and D. isaea were the top stage-specific factors, both acting on larvae. Parasitoid abundance tracked host abundance across generations, but density dependence was not observed for any mortality factor, and the magnitudes of regression slopes were small. The results indicate the potential importance of conservation biological control in management of L. trifolii, given that naturally occurring parasitoids and other biotic/abiotic factors exert significant mortality on immature leaf miners.

When Predators Avoid Predation by Their Con- and Heterospecific Competitors: Non-consumptive Effects Mediate Foraging Behavior and Prey Handling Time of Predators.

Aphids show highly aggregated distributions, and thus their predators tend to aggregate as well, creating conditions optimal to consumptive and non-consumptive (N-CEs) effects among competing predators, both conspecific and heterospecific. If predatory larvae are themselves potential prey for other predators, they may be also sensitive to N-CEs imposed by their con- or heterospecifics. A partitioned Petri-dish that permitted the passage of visual and chemical signals was used to examine the N-CEs of predator on foraging behavior of other predators, as prey themselves. Functional responses of second-instar Chrysoperla carnea Stephens (Chrysopidae: Neuroptera) and third-instar Coccinella undecimpunctata L. (Coccinellidae: Coleoptera) to Aphis craccivora Koch. (Aphididae: Hemiptera) in the absence and presence of predation threat were derived. Both predators responded to presence of competitor signals with declined consumption, but lower attack rate and longer handling time were evident for C. undecimpunctata. The functional response type of second-instar C. carnea did not alter, even in the presence of larger heterospecifics, remaining a type 2 functional response in all treatments, but that of third-instar C. undecimpunctata did under the predation risk of third-instar C. carnea. Therefore, the third-instar C. undecimpunctata appeared to have suffered foraging costs (longer handling time and lower attack rate) under predation risk of C. carnea, but second-instar C. carnea did not. If predatory larvae of both species are synchronized in the same aphid patch, C. undecimpunctata might leave the patch to minimize its own risk of being preyed upon, or at least search at reduced rates. Thus, N-CEs may signify be biologically significant.

Clinical characteristics and outcome of childhood acute promyelocitic leukemia (APL) in Saudi Arabia: a multicenter SAPHOS leukemia group study.

BACKGROUND: Acute promyelocytic leukemia (APL) is a rare form of acute myelogenous leukemia (AML). Survival rates exceed 80% in developed countries. Successful treatments rely on all-trans retinoic acid with anthracycline-based chemotherapy. Availability of modern care and public knowledge play important roles in pediatric APL survival. METHOD: A cytogenetic diagnosis of APL was confirmed in 30 (14.5%) out of 207 children consecutively diagnosed with de novo AML between January 2005 and December 2012 at nine cancer care centers in Saudi Arabia. Patients were treated based on the standard protocol used by the center following the PETHEMA or the C9710 treatment protocols. We modeled 5-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) vs. treatment and potential covariates of age at diagnosis, involvement of central nervous system (CNS), and white blood cell (WBC) levels. RESULTS: The median age was 10.4 years with a male:female ratio of 1.9. WBC was 10 × 109/l or greater in 57% and CNS involvement was confirmed in 13%. OS, EFS, and CIR were 74 ± 12%, 55 ± 19%, and, 36 ± 17% respectively. No significant difference was found by treatment protocol. WBC levels were significantly prognostic for all negative events, but treatment with C9710 significantly ameliorated negative WBC effects. Overall outcomes were comparable to those reported in developed countries. CONCLUSIONS: Access to modern care is likely to be a critical factor in successful and comparable outcomes of childhood APL across the globe. In the present study, utilizing a cytarabine-containing protocol improved outcome of high-risk pediatric patients with APL.

Differences in Flight Activity of Coleomegilla maculata and Hippodamia convergens (Coleoptera: Coccinellidae) Following Emergence, Mating, and Reproduction.

The flight activity of Coleomegilla maculata DeGeer and Hippodamia convergens Guerin-Meneville (Coleoptera: Coccinellidae) was examined by observing tethered beetles in the laboratory. C. maculata were fed eggs of Ephestia kuehniella Zeller, as were larval H. convergens, whereas adult H. convergens were fed Melanaphis sacchari (Zehntner) to induce egg maturation; adults of both species received water and diluted honey. A spot of magnetic paint was applied to one elytrum of each beetle, which then adhered to a small neodymium magnet attached to a thread. Beetles were permitted 1 h flight opportunities daily for 3-d periods, first as virgins on their fifth day of adult life, secondly after mating, thirdly after females began oviposition, and fourthly after prey were withheld and egg maturation and oviposition ceased. Both species exhibited low flight activity as virgins, and whereas C. maculata females increased their activity after mating, H. convergens females did not. Flight activity in C. maculata did not change with onset of oviposition, whereas it increased in H. convergens males, but not females. In contrast, H. convergens females increased their flight activity after cessation of oviposition, whereas C. maculata females did not. Female flight activity when either virgin or mated correlated weakly with fecundity in C. maculata, but not in H. convergens. Species differences are discussed in the context of nutritional ecology; H. convergens usually enters diapause immediately following emergence, and is more dependent on aphids for reproduction, whereas C. maculata develops and reproduces on a wider range of foods and is not so constrained.

Comparative Life Histories of Greenbugs and Sugarcane Aphids (Hemiptera: Aphididae) Coinfesting Susceptible and Resistant Sorghums.

Host-plant resistance has been a fundamental component of aphid management in cereal crops. Over decades, various sources of resistance to greenbug, Schizaphis graminum (Rondani), were bred into cultivars of sorghum, Sorghum bicolor (L.) Moench, to counter recurring virulent greenbug biotypes. The recent invasion of sugarcane aphid, Melanaphis sacchari (Zehntner), raised questions about plant-mediated interactions between the two aphids and the possibility of using greenbug antibiosis against sugarcane aphid. The present work was undertaken to characterize the impact of PI 550610 resistance to 'biotype I' greenbug, expressed in seed parental line KS 116B, on aphid life histories and to observe plant-mediated interactions between aphid species in its presence and absence. At 23°C, sugarcane aphid nymphs matured 1.5 d faster than greenbug nymphs on susceptible hybrid P8500, but at similar rates on the resistant line, which delayed maturity by 1-1.5 d in both species and increased juvenile mortality by three- to fourfold. Sugarcane aphid reproductive rate was double that of greenbug on susceptible sorghum (4.45 vs. 2.30 nymphs per female per day), but not significantly different on the resistant one (3.09 vs. 2.27). Thus, PI 550610 expresses antibiosis, not tolerance, to these aphids. Coinfestation of P8500 had a positive effect on greenbug intrinsic rate of increase (rm), which changed to negative on KS 116B, whereas the rm of sugarcane aphid was unaffected by coinfestation with greenbug on either cultivar. The results indicate that KS 116B will be useful for producing sugarcane aphid-resistant hybrids, and that PI 550610 antibiosis changes the sugarcane aphid-greenbug interspecific relationship from commensalism to amensalism.

Egg Cannibalism and its Life History Consequences Vary with Life Stage, Sex, and Reproductive Status in Hippodamia convergens (Coleoptera: Coccinellidae).

Egg cannibalism is common in Coccinellidae, but its biological consequences have not been fully explored. We examined egg cannibalism by neonates, fourth instars, and adults of Hippodamia convergens Guerin-Meneville for effects on development, reproduction, and progeny fitness. We also tested female adults for ability to avoid cannibalizing their own eggs and first-instar larvae, and both sexes for changes in cannibalism propensity following mating, all in the presence of ad libitum food [larvae: eggs of Ephestia kuehniella Zeller (Lepidoptera: Pyralidae), adults: Schizaphis graminum (Rondani)]. Cannibalism by neonates reduced developmental time and increased male body size. Cannibalism in the fourth instar accelerated pupation and led to the production of eggs that hatched faster, regardless of which parent cannibalized. However, egg fertility was improved only by maternal cannibalism in the fourth instar. Females recognized their own egg clusters, sometimes added eggs to them, and preferentially cannibalized nonfilial clusters. Most gravid females cannibalized a first-instar larva within 30 min, whether filial or not. Adult egg cannibalism was similar for virgin males and females, but declined after mating in males, and increased in females, although it had no effect on fecundity or fertility. Daughters of cannibal pairs were heavier than those of other mating combinations, but offspring of noncannibal parents had the fastest development. Reproductive females appeared to use egg cannibalism to reduce risk for their own eggs, increasing the number cannibalized with the number laid. Thus, egg cannibalism in coccinellids varies with life stage, sex, and reproductive condition, independent of food availability, and benefits are life stage specific.

Hematopoietic stem cell transplantation in the Eastern Mediterranean Region (EMRO) 2011-2012: A comprehensive report on behalf of the Eastern Mediterranean Blood and Marrow Transplantation group (EMBMT).

OBJECTIVE/BACKGROUND: The Eastern Mediterranean Blood and Marrow Transplantation (EMBMT) group has accumulated over 31 years of data and experience in hematopoietic stem cell transplantation (HSCT), particularly in hemoglobinopathies, severe aplastic anemia, inherited metabolic and immune disorders, in addition to a wide array of hematologic malignancies unique to this region. A regional update in current HSCT trends is highly warranted. We studied the trends of HSCT activities in World Health Organization-Eastern Mediterranean (EMRO) region, surveyed by the EMBMT, between 2011 and 2012. METHODS: Retrospective analysis of the survey data mainly of cumulative number of transplants, types of transplants (autologous vs. allogeneic), types of conditioning such as myeloablative versus reduced intensity was conducted. Also, trends in leukemias, hemoglobinopathies, severe aplastic anemia, inherited bone marrow failure syndromes, amongst others were analyzed. RESULTS: Twenty-one teams from nine EMRO countries reported their data (100% return rate) to the EMBMT for the years 2011-2012, with a total of 3,546 first HSCT (1,670 in 2011; 1,876 in 2012). Allogeneic HSCT (allo-HSCT) represented the majority (62%) in both years. The main indications for allo-HSCT were acute leukemias (988; 46%), bone marrow failure syndromes (421, 20%), hemoglobinopathies (242; 11%), and immune deficiencies (157; 7%). There was a progressive increase in the proportions of chronic myeloid leukemia cases transplanted beyond first chronic phase (37 [7%] of all chronic myeloid leukemia cases in 2011 vs. 39 [29%] in 2012). The main indications for autologous transplants were multiple myeloma/plasma cell disorders (510; 39%), Hodgkin lymphoma (311; 24%), non-Hodgkin lymphoma (259; 20%), and solid tumors (163; 12%). Reduced intensity conditioning continued to show a progressive decrease over years (9.5% in 2011 vs. 7.9% in 2012), yet remained relatively low compared with contemporary practices in Europe published by EBMT. The vast majority (91%) of allo-HSCT source was from sibling donors with continued dominance of peripheral blood (64%) followed by bone marrow (33%).While umbilical cord blood transplants increased to 4% of allo-HSCT, matched unrelated donor remained underutilized and there was no haplo-identical transplant reported. Large centers with >50 HSCT/year, showed a continued increase in the total number of allo-HSCT over the past 2years that may be related to capacity building issues and require further studies. CONCLUSION: There is a discernable increase of HSCT rate in the EMRO region with a significant expansion in utilization of cord blood transplants and allogeneic peripheral blood-HSCT as a valuable source. However, further research of outcome data and the development of regional donor banks (cord blood and matched unrelated donors) may help to facilitate future planning to satisfy the escalating regional needs and augment collaboration within the EMBMT and globally.

Host plant mediates foraging behavior and mutual interference among adult Stethorus gilvifrons (Coleoptera: Coccinellidae) preying on Tetranychus urticae (Acari: Tetranychidae).

Physical plant characteristics can influence predator foraging and their behavioral responses to each other. This study examined the searching efficiency and functional response of adult female Stethorus gilvifrons Mulsant foraging for Tetranychus urticae Koch (Acari: Tetranychidae) on castor bean, common bean, and cucumber leaves. Experiments conducted on leaf discs in arenas for 12 h revealed a type II functional response for S. gilvifrons on all host plants. Per capita searching efficiency and killing power decreased with increasing predator density on all plants, but most notably on common bean, the plant with the highest prey consumption rates, due to greater mutual interference. Attack rates were highest on common bean and lowest on castor bean, whereas handling times were shortest on common bean and longest on cucumber, such that the daily predation rate was maximal on common bean. Host plant interacted with predator and prey densities to affect searching efficiency and functional response, the differences in mite consumption among host plants increasing with predator and prey densities. The waxy layers of castor bean leaves and high trichome counts of cucumber leaves appeared to reduce predator foraging efficiency. Thus, the efficacy of S. gilvifrons against T. urticae is likely to be greatest on plants such as Phaeseolus vulgaris L. that have relatively smooth leaves.

Does decline of lung function in wheezy infants justify the early start of controller medications?

OBJECTIVE: To compare lung function in wheezy infants, with risk factors of asthma and with some immunological parameters which may be useful as predictors of subsequent asthma. METHODS: The data of 241 infants aged 5­36 mo, with recurrent wheeze (≥3 episodes of physician confirmed wheeze) prior to receiving inhaled corticosteroids or anti-leukotrine agents was retrospectively analyzed. They were subdivided into 2 subgroups; those with asthma risk factors (132 patients) and those without (109 patients) Also, 67 healthy, age and sex matched children without recurrent wheezes were taken as control group. Total serum IgE, eosinophilic percentage, tPTEF/tE (time to peak expiratory flow to total expiratory time), total respiratory system compliance (Crs) and resistance of the respiratory system (Rrs) was done for patients and control groups. RESULTS: Wheezy infants had a significantly higher eosinophilic percentage and total serum IgE as well as a significantly lower pulmonary function parameters when compared to healthy controls. Wheezy infants with positive family history of asthma and those who had not been breast fed showed significant reduction in the mean values of tPTEF/tE and increased both eosinophilic percentage and total serum IgE. Crs was significantly decreased in wheezy infants with positive seasonal variations and those who had increased both eosinophilic percentage and total serum IgE. Rrs showed significant increase in wheezy infants with positive family history of atopy and those who had increased eosinophilic percentage and increased total serum IgE. CONCLUSIONS: Lung function, eosinophilic percentage, total serum IgE and asthma risk factors could be used as predictors for ongoing wheeze in this subset of children.

Foraging behavior of the coccinellid Nephus includens (Coleoptera: Coccinellidae) in response to Aphis gossypii (Hemiptera: Aphididae) with particular emphasis on larval parasitism.

This study assessed the effect of parasitism of Nephus includens (Col.: Coccinellidae) larvae by Homalotylus flaminius (Hym.: Encyrtidae) on the predation rates of the predator on the cotton aphid, Aphis gossypii Glover (Hem.: Aphididae) by deriving functional responses for second- and fourth-instar predators at prey densities ranging from 10 to 80 aphids per arena. The relationship between the functional and numerical responses of adult females of N. includens also was determined for prey densities ranging from 10 to 140 aphids per arena. Predation rates of unparasitized and parasitized second-instar N. includens were both fit by a type II functional response model with parameters as follows: unparasitized (a = 0.0768 hours(-1) and T(h) = 0.975 h) and parasitized (a = 0.0787 hours(-1) and T(h) = 0.8823 hours). Predation rates of unparasitized and parasitized fourth-instar N. includens were fit by type III and II models, respectively, with the following parameters: unparasitized (b = 0.1702 hours(-1) and T(h) = 0.2369 hours) and parasitized (a = 0.038 h(-1) and T(h) = 0.539 h). The unparasitized fourth-instar was the most voracious stage, having the highest attack rate and lowest handling time. Considering these attributes, it would seem to be the most effective stage of this predator against A. gossypii. Adult female lady beetles (N. includens) showed a type III functional response and their numerical response increase to prey density was curvilinearly related to prey density, with the highest number of eggs being produced at highest prey densities. The maximum saturation level for both predation and egg production for adult females occurred at a prey density of 120 aphids. Thus, a ratio 1:120 (predator:prey) should be used when releasing this species for augmentative biological control. Release of either fourth-instar or adult stage N. includens should be minimized the potentially negative effect of parasitism by H. flaminius on early developmental stages, and hence increase its efficiency in biocontrol programs.

Hemolytic anemia: an unusual presentation of cor triatriatum sinistrum.

Cor triatriatum is a congenital malformation of the heart which is usually presented with heart failure. We have dealt with an unusual presentation of a two-month-old child with cor triatriatum presented with hemolytic anemia.