Selection and characterization of spinetoram resistance in field collected Drosophila melanogaster.

Insecticides are commonly employed in vineyards to control vinegar flies and limit sour rot disease. Widespread resistance to available insecticides is having a negative impact on managing Drosophila melanogaster populations, rendering control of sour rot more difficult. An insecticide registered for use in vineyards to which resistance is not yet widespread (at least in New York and Missouri) is spinetoram. Spinetoram targets the nicotinic acetylcholine receptor α6, and mutations in α6 have been associated with resistance in some insects. Our goals were to select for a spinetoram resistant strain of D. melanogaster (starting with field collected populations), characterize the resistance, and identify the mutation responsible. After five selections a strain (SpinR) with >190-fold resistance was obtained. Resistance could not be overcome by insecticide synergists, suggesting an altered target site was involved. We cloned and sequenced the α6 allele from the spinetoram resistant strain and identified a mutation causing a glycine to alanine change at amino acid 301 (equivalent position to the G275E mutation found in some spinosad/spinetoram resistant insects). This mutation was found at low levels in field populations, but increased with each selection until it became homozygous in SpinR. We discuss how the identification of the spinetoram resistance mutation can be used for resistance management.

Selection for, and characterization of, fluralaner resistance in the house fly, Musca domestica.

House flies, Musca domestica (L), are the mechanical vector of >100 human and animal pathogens, including those that are antibiotic-resistant. Given that house flies are associated closely with human and livestock activity, they present medical and veterinary health concerns. Although there are numerous strategies for control of house fly populations, chemical control has been favored in many facilities. Products with pyrethroid active ingredients have been used predominantly for >35 years in space sprays. As a result, strong selection for pyrethroid resistance has led to reduced control of many populations. Reliance on a limited number of insecticides for decades has created fly control problems necessitating the discovery and formulation of new control chemistries. Fluralaner is a relatively new insecticide and acaricide (first reported in 2010), belonging to the isoxazoline class. These insecticides target the glutamate- and gamma-aminobutyric acid-gated (GABA) chloride channels, which is a different mode of action from other insecticides used against house flies. Although is it not currently registered for house fly control in the United States, previous work has shown that fluralaner is highly toxic to house flies and that there was limited cross-resistance found in laboratory strains having high levels of resistance to other insecticides. Herein, we characterized the time and age dependency of fluralaner toxicity, detected cross-resistance in populations from across the United States, and selected a highly resistant (>11,000-fold) house fly strain. We found that the fluralaner LD50 of 18-24 h old flies was 2-fold higher than for 5-6 d old flies. This appears to be due to more rapid penetration of fluralaner into the 5-6 d old flies. Fluralaner resistance was inherited as an intermediate to incompletely dominant trait and was mapped to chromosomes 5 and 3. Resistance could be suppressed to 7-fold with piperonyl butoxide, suggesting that cytochrome P450 (CYP)-mediated detoxification was a major mechanism of resistance. Decreased penetration was also demonstrated as a mechanism of resistance. The utility of fluralaner for house fly control is discussed.

A single centre evaluation of the 2019 UK SABR consortium guidelines for primary lung cancer: correlation between Prescription Dose Spillage and inverse Paddick Conformity Index.

Background: The aim of the study was to determine level of agreement between RTOG Conformity Index (RTOG-CI), Paddick Conformity Index (PCI) and Prescription Dose Spillage (PDS) in describing lung stereotactic ablative radiotherapy (SABR) plan conformity; to elucidate any limitations, in practice, of PCI and PDS. International Commission on Radiation Units and Measurements report 91 (ICRU 91) aimed to reduce inconsistencies in dose prescription and normalisation between centres by specifying SABR reporting rules, and suggested using PCI. UK SABR Consortium 2019 guidelines adopted PDS to measure plan quality, but not the PCI. Materials and methods: 51 consecutive lung SABR plans received 54 Gy in 3 fractions (54 Gy/3 Fr), 55 Gy/5 Fr or 60 Gy/8 Fr. Plans were developed according to 2016 UK SABR consortium guidelines, which did not specify PCI or PDS; these values were retrospectively calculated. As PCI varies from 0 to an optimum of 1, inverse PCI (invPCI) was used for calculations. Results: PTV-adjusted PDS tolerances were met in 80.4% of studied plans. A near-perfect positive correlation between invPCI and PDS (R2 = 0.978) was found - stronger than between invPCI and the previously-used RTOG-CI (R2 = 0.915). Conclusions: The strong invPCI-PDS correlation is likely dependent on adequate PTV coverage, present in our cohort. This supports the UK SABR Consortium's adoption of PDS provided PTV coverage is ensured. Plan conformity should be confirmed by visual slice-by-slice review.

Maternally induced intraclutch cannibalism: an adaptive response to predation risk?

Theory on condition-dependent risk-taking indicates that when prey are in poor condition, their anti-predator responses should be weak. However, variation in responses resulting from differences in condition is generally considered an incidental by-product of organisms living in a heterogeneous environment. Using Leptinotarsa decemlineata beetles and stinkbug (Podisus maculiventris) predators, we hypothesised that in response to predation risk, parents improve larval nutritional condition and expression of anti-predator responses by promoting intraclutch cannibalism. We showed that mothers experiencing predation risk increase production of unviable trophic eggs, which assures provisioning of an egg meal to the newly hatched offspring. Next, we experimentally demonstrated that egg cannibalism reduces L. decemlineata vulnerability to predation by improving larval nutritional condition and expression of anti-predator responses. Intraclutch cannibalism in herbivorous insects might be a ubiquitous strategy, aimed to overcome the dual challenge of feeding on protein-limited diets while living under constant predation threat.

Small- to medium-sized mammals show greater morphological disparity in cervical than lumbar vertebrae across different terrestrial modes of locomotion.

During mammalian terrestrial locomotion, body flexibility facilitated by the vertebral column is expected to be correlated with observed modes of locomotion, known as gait (e.g., sprawl, trot, hop, bound, gallop). In small- to medium-sized mammals (average weight up to 5 kg), the relationship between locomotive mode and vertebral morphology is largely unexplored. Here we studied the vertebral column from 46 small- to medium-sized mammals. Nine vertebrae across cervical, thoracic, and lumbar regions were chosen to represent the whole vertebral column. Vertebra shape was analysed using three-dimensional geometric morphometrics with the phylogenetic comparative method. We also applied the multi-block method, which can consider all vertebrae as a single structure for analysis. We calculated morphological disparity, phylogenetic signal, and evaluated the effects of allometry and gait on vertebral shape. We also investigated the pattern of integration in the column. We found the cervical vertebrae show the highest degree of morphological disparity, and the first thoracic vertebra shows the highest phylogenetic signal. A significant effect of gait type on vertebrae shape was found, with the lumbar vertebrae having the strongest correlation; but this effect was not significant after taking phylogeny into account. On the other hand, allometry has a significant effect on all vertebrae regardless of the contribution from phylogeny. The regions showed differing degrees of integration, with cervical vertebrae most strongly correlated. With these results, we have revealed novel information that cannot be captured from study of a single vertebra alone: although the lumbar vertebrae are the most correlated with gait, the cervical vertebrae are more morphologically diverse and drive the diversity among species when considering whole column shape.

Are America's Caregivers on the Brink of Extinction? The Pandemic Straw that Broke the Nurses' Back.

The coronavirus disease 2019 pandemic has drawn attention to many of the inadequacies of the US health-care system. Perhaps, no profession has felt these shortcomings more than nurses. This female-dominated profession has the potential to suffer a high attrition rate for several reasons, including declining mental health and increasing workplace violence. Nurses have already begun to leave the bedside. Unless significant changes can be made quickly to prevent more of these caregivers from leaving the profession, the health and safety of the US population are at risk.

Insecticide resistance in Drosophila melanogaster in vineyards and evaluation of alternative insecticides.

BACKGROUND: Cultivation of grapes is a major crop globally, particularly in support of the wine production industry which has significant economic impact in numerous countries. Sour rot is an economically important disease of grapes. It is caused by an interaction of yeast + acetic acid bacteria, and vectored by Drosophila spp. Substantial control of sour rot in wine grape vineyards has been achieved by control of Drosophila using insecticides such as zeta-cypermethrin. An outbreak of sour rot and high populations of Drosophila melanogaster were observed in 2018 in a vineyard in New York (Finger Lakes region), USA. Flies from this population were found to be resistant to zeta-cypermethrin (the active ingredient in Mustang Maxx®), but whether or not this was a widespread problem was not known. To determine if resistance was geographically limited, we surveyed populations of D. melanogaster collected from 11 vineyards across New York State and one in Missouri (USA). We also evaluated 19 alternative insecticides for their potential use for control of D. melanogaster, by determining their toxicity to a susceptible strain and by examining cross-resistance using a field-collected population. RESULTS: There were high levels of resistance to zeta-cypermethrin, malathion, and acetamiprid found in all populations sampled. Resistance to zeta-cypermethrin and malathion was stable over 33 months. Results from two vineyards also suggested that resistance to spinetoram was starting to evolve. The alternative insecticides we evaluated had LC50 values to the susceptible strain ranging from 0.65 to 15 000 ng·cm-2 . CONCLUSION: Resistance to zeta-cypermethrin, malathion, and acetamiprid is geographically widespread and the levels of resistance are similar between early season and late season collections. Cross-resistance was detected against all the insecticides tested, with the lowest levels seen for broflanilide, fipronil, and flumethrin. These patterns of resistance/cross-resistance/multiple resistance are discussed in terms of selection within and outside of vineyards. The implications of these results to insecticide resistance monitoring and management are discussed.

Defence Clinical Psychology Service: an overview of clinical psychology in the UK Ministry of Defence.

The Defence Clinical Psychology Service (DCPS) is the professional clinical psychology service and community of clinical psychology practice within UK Ministry of Defence (MoD). The DCPS provides professional clinical care, consultation and research in support of the UK Armed Forces. Regulated by the Health and Care Professions Council, DCPS psychologists are employed as Crown (Civil) Servants within the MoD. Serving as assets of Joint Forces Command within the Defence Primary Healthcare organisation, the professional leadership for such personnel is provided by the office of the Defence Consultant Advisor (DCA) for clinical psychology. The following paper offers an overview of the history, service context, training and mission of the DCPS. Areas for future development are also considered.

Leadership in 21st century military healthcare: what did clinical psychologists ever do for us?

Psychology is integral to the concepts and practice of leadership. Leadership models often have their roots in psychological paradigms, making it intrinsically easy for psychologists to grasp and apply them alongside clinical models. Psychologists' 'second-order' skills have been used to good effect in the changing landscape of military mental healthcare: modelling adaptive responses to change, understanding the non-conscious aspects of relationships in hierarchical organisations, working with systems, the ability to diagnose situational requirements and act accordingly, drawing on a range of psychological theories and leadership styles. The clinical psychologist as a professional who can help others 'reframe' a situation or experience is key to their leadership role within healthcare settings, 'enabling others to achieve shared purpose in the face of uncertainty'. The contribution that clinical psychology has made to leadership in Defence over the past 20 years will be illustrated by personal accounts from 'experts by experience'.

Individual Attributes, Values, and Goals of an All-Military Women Antarctic Expedition.

BACKGROUND: While participation of women in the military has increased, research on performance of female teams engaged in arduous physical activity in isolated, confined, and extreme (ICE) environments remains sparse.METHODS: A team of six British military women completed the Multidimensional Personality Questionnaire-Brief Form, Triarchic Psychopathy Measure, and Personal Values Questionnaire (PVQ) prior to embarking on an expedition that traversed the Antarctic continent. Questionnaires were completed weekly on the ice; repeat of the PVQ and individual semistructured debriefing interviews were carried out within 9 d post-expedition.RESULTS: Personality findings indicated a generally well-adjusted group with notable individual differences in personality and personal values. Positive affect and camaraderie among teammates was evident throughout, although pace vs. distance in the strategy of the daily trek was a continuing point of tension. Honesty in communication was viewed as key to team effectiveness. A significant post-expedition decline in the tradition value (Pre M = -0.55, SD = 0.99; Post M = -0.82, SD = 1.12) and an increase in the conformity value (Pre M = -0.26, SD = 0.46; Post M = 0.18, SD = 0.27) was found.DISCUSSION: Congruence in personal and team goals among group members engaged in highly challenging activities is crucial for optimal team performance. Presence of two highly dominant individuals has a negative effect on team dynamics. Application of study findings to space exploration is considered.Blackadder-Weinstein J, Leon GR, Norris RC, Venables NC, Smith M. Individual attributes, values, and goals of an all-military women Antarctic expedition. Aerosp Med Hum Perform. 2019; 90(1):18-25.

Resolving plasmid structures in Enterobacteriaceae using the MinION nanopore sequencer: assessment of MinION and MinION/Illumina hybrid data assembly approaches.

This study aimed to assess the feasibility of using the Oxford Nanopore Technologies (ONT) MinION long-read sequencer in reconstructing fully closed plasmid sequences from eight Enterobacteriaceae isolates of six different species with plasmid populations of varying complexity. Species represented were Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter cloacae, Serratia marcescens and Klebsiella oxytoca, with plasmid populations ranging from 1-11 plasmids with sizes of 2-330 kb. Isolates were sequenced using Illumina (short-read) and ONT's MinION (long-read) platforms, and compared with fully resolved PacBio (long-read) sequence assemblies for the same isolates. We compared the performance of different assembly approaches including SPAdes, plasmidSPAdes, hybridSPAdes, Canu, Canu+Pilon (canuPilon) and npScarf in recovering the plasmid structures of these isolates by comparing with the gold-standard PacBio reference sequences. Overall, canuPilon provided consistently good quality assemblies both in terms of assembly statistics (N50, number of contigs) and assembly accuracy [presence of single nucleotide polymorphisms (SNPs)/indels with respect to the reference sequence]. For plasmid reconstruction, Canu recovered 70 % of the plasmids in complete contigs, and combining three assembly approaches (Canu or canuPilon, hybridSPAdes and plasmidSPAdes) resulted in a total 78 % recovery rate for all the plasmids. The analysis demonstrated the potential of using MinION sequencing technology to resolve important plasmid structures in Enterobacteriaceae species independent of and in conjunction with Illumina sequencing data. A consensus assembly derived from several assembly approaches could present significant benefit in accurately resolving the greatest number of plasmid structures.

Does sexual dimorphism in facial soft tissue depths justify sex distinction in craniofacial identification?

Separation of male and female soft tissue depths into discrete groups for craniofacial identification implies that males and females differ enough from each other, with respect to this application, for this distinction to be useful. In this study, previously published soft tissue depth data were analyzed for sex separation. It was found that the variation within each sex was large while the variation between the sexes was small. Often the value of two standard deviations of the measurement for either sex was larger than the difference displayed between the means of each sex. Furthermore, opposite sex overlap in regions defined to be close to the male or female mean were found to be large and the amount of variance explained by sex was small (less than 6% on average). These results indicate that while male and female means at single craniofacial landmarks may differ slightly, and even at statistically significant levels, individual male and female soft tissue depths are often the same or very similar. On average, soft tissue depths of the face do display some sexual dimorphism but it is not marked and of little practical meaning for craniofacial identification where a single individual must be independently considered. Thus, there is little use in separate reporting of data for males and females and data should be combined to increase sample sizes.

Dementia caregiver intervention research: in search of clinical significance.

PURPOSE: We reviewed intervention studies that reported dementia caregiver outcomes published since 1996, including psychosocial interventions for caregivers and environmental and pharmacological interventions for care recipients. Our goal was to focus on issues of clinical significance in caregiver intervention research in order to move the field toward a greater emphasis on achieving reliable and clinically meaningful outcomes. DESIGN AND METHODS: MEDLINE, PsycINFO, and Cumulative Index to Nursing & Allied Health databases from 1996 through 2001 were searched to identify articles and book chapters mapping to two medical subject headings: caregivers and either dementia or Alzheimer's disease. Articles were evaluated on two dimensions, outcomes in four domains thought to be important to the individual or society and the magnitude of reported effects for these outcomes in order to determine if they were large enough to be clinically meaningful. RESULTS: Although many studies have reported small to moderate statistically significant effects on a broad range of outcomes, only a small proportion of these studies achieved clinically meaningful outcomes. Nevertheless, caregiving intervention studies have increasingly shown promise of affecting important public health outcomes in areas such as service utilization, including delayed institutionalization; psychiatric symptomatology, including the successful treatment of major and minor depression; and providing services that are highly valued by caregivers. IMPLICATIONS: Assessment of clinical significance in addition to statistical significance is needed in this research area. Specific recommendations on design, measurement, and conceptual issues are made to enhance the clinical significance of future research.

Adaptation of EPEC-EM Curriculum in a Residency with Asynchronous Learning.

OBJECTIVE: The Education in Palliative and End-of-life Care for Emergency Medicine Project (EPEC™-EM) is a comprehensive curriculum in palliative and end-of-life care for emergency providers. We assessed the adaptation of this course to an EM residency program using synchronous and asynchronous learning. METHODS: Curriculum adaptation followed Kern's standardized six-step curriculum design process. Post-graduate year (PGY) 1-4 residents were taught all EPEC™-EM cognitive domains, divided as seven synchronous and seven asynchronous modules. All synchronous modules featured large group didactic lectures and review of EPEC™-EM course materials. Asynchronous modules use only EPEC™-EM electronic course media for resident self-study. Targeted evaluation for EPEC™-EM knowledge objectives was conducted by a prospective case-control crossover study, with synchronous learning serving as the quasi-control, using validated exam tools. We compared de-identified test scores for effectiveness of learning method, using aggregate group performance means for each learning strategy. RESULTS: Of 45 eligible residents 55% participated in a pre-test for local needs analysis, and 78% completed a post-test to measure teaching method effect. Post-test scores improved across all EPEC™-EM domains, with a mean improvement for synchronous modules of +28% (SD=9) and a mean improvement for asynchronous modules of +30% (SD=18). The aggregate mean difference between learning methods was 1.9% (95% CI -15.3, +19.0). Mean test scores of the residents who completed the post-test were: synchronous modules 77% (SD=12); asynchronous modules 83% (SD=13); all modules 80% (SD=12). CONCLUSION: EPEC™-EM adapted materials can improve resident knowledge of palliative medicine domains, as assessed through validated testing of course objectives. Synchronous and asynchronous learning methods appear to result in similar knowledge transfer, feasibly allowing some course content to be effectively delivered outside of large group lectures.