Cold temperatures drive the latitudinal range limits and inhibit overwintering survival of the redbanded stink bug (Hemiptera: Pentatomidae).

For non-native insects that are economically damaging, understanding the drivers of range expansions and contractions is important for forecasting pest pressure. The invasion of the redbanded stink bug, Piezodorus guildinii (Westwood) (Hemiptera: Pentatomidae), reached Louisiana, United States, in 2000, after which the northern range limits of this species have fluctuated annually. Low winter temperatures have been implicated as a major driver of this pattern, but the importance of cold temperatures-or other abiotic factors-for the persistence of this pest over large geographic scales are incompletely understood. We coupled occurrence data of P. guildinii with climatic data to investigate trends in P. guildinii presence in relation to winter temperatures and develop species distribution models, forecasting habitat suitability based on current and future climatic scenarios. Our results show that (i) some P. guildinii persisted in locations where ambient temperatures reached -12°C, (ii) overwintering temperatures drive P. guildinii range dynamics, and (iii) with intermediate projections of climatic warming, northward expansion by P. guildinii in North America is likely to be minimal. While the northern extent of P. guildinii's range may now be largely realized in North America, our results suggest that increased frequency of mild winters could reduce interannual fluctuations of P. guildinii and enable it to become a more consistent economic concern for soybean growers throughout the Midsouth region of the United States.

Overwintering site selection and associated microclimates for the redbanded stink bug (Hemiptera: Pentatomidae), a non-native pest of soybean.

Cold winter temperatures govern the distribution and abundance of many insect species, but refugia that provide microclimates can moderate temperature-driven mortality. Winter temperatures have been implicated in limiting the survival and range of Piezodorus guildinii (Westwood) (Hemiptera: Pentatomidae; redbanded stink bug), an economically damaging invasive pest in the southeastern United States, but the role of refugia in overwintering survival of this pest is poorly understood. We conducted 2 studies in successive years to evaluate how leaf litter from hardwoods, pines, and soybeans modulate overwintering site selection and survival of P. guildinii. In the second-year study, we also quantified the buffering effect of the 3 leaf litter types compared to ambient conditions and assessed diapause. In the first-year study, we found that stink bugs preferentially dispersed into leaf litter compared with remaining unsheltered on bare soil; no clear preference among leaf litter types was found. In the second year, however, no clear differences were found among leaf litter types and bare soil. Means of daily minimum temperatures under leaf litter were at least 3.0 ±â€…0.9 °C (SE) warmer and generally less variable than ambient conditions. While high mortality in both studies illustrates that more work must be done to fully understand overwintering survival, limited survival through potentially lethal conditions in the first-year study nonetheless emphasizes the possibility of populations persisting and rebounding in the following spring. Furthermore, our study highlights the potential for stink bugs to persist in areas with lethal ambient temperatures by dispersing into widely available substrates.

Geospatial Mapping to Target Injury Prevention for Older Adult Ground-Level Falls: A Feasibility Study.

BACKGROUND: Trauma centers target injury prevention efforts based on trauma registry and local epidemiological data. Identifying geographic patterns of injury through geospatial mapping has emerged as a technology to help identify at-risk individuals. Yet, the feasibility of using spatial analysis to target injury prevention efforts remains unknown. OBJECTIVE: This study aims to demonstrate the use of geospatial mapping of older adult ground-level falls to target injury prevention efforts. METHODS: This retrospective cohort analysis of ground-level falls among older adults was conducted from 2017 to 2020 at a Level I trauma center and safety net hospital. Trauma admissions, U.S. census median income, Hispanic percentage, and population density by zip codes were combined to create choropleth and heat maps to identify injury hot spots to target fall prevention classes. RESULTS: A total of 5,629 patients were reviewed, of which 3,002 (53%) were fall cases. Low-level falls (<10 ft) accounted for 2,224 cases; 1,449 were among older adults centered around the study hospital. Ground-level falls accounted for 1,663 patients, of whom 1,182 were older adults clustering around senior housing, assisted living facilities, nursing homes, and rehabilitation centers. As a result, our fall prevention classes are now targeted at these newly identified locations. CONCLUSION: Geospatial analysis provided powerful visualization of fall injury locations to target our fall prevention efforts. Geospatial analysis is a feasible tool for trauma centers to guide injury prevention strategies that effectively target the populations most in need.

Chlorantraniliprole Residual Control and Concentration Determination in Cotton.

Studies were conducted in 2020 and 2021 at the Delta Research and Extension Center in Stoneville, MS, to determine the residual concentrations of chlorantraniliprole in cotton (Gossypium hirsutum, L.) leaves, as well as the concentrations in petals and anthers that developed after the time of application. Foliar applications of chlorantraniliprole were applied at four rates for leaves and two rates for petals and anthers at the second week of bloom. Additional bioassays were conducted to determine mortality of corn earworm (Helicoverpa zea, Boddie) in anthers. For the leaf study, plants were partitioned into three zones consisting of top, middle, and bottom zones. Leaf samples from each zone were analyzed for chemical concentrations at 1, 7, 14, 21, and 28 days after treatment (DAT). Residual concentrations, although variable, persisted through all sampling dates, rates, and zones tested. In this study, chlorantraniliprole remained detectable up to 28 DAT. Results from the cotton flower petal and anther studies detected concentrations of chlorantraniliprole in petals at 4, 7, 10, and 14 DAT, but no concentrations were detected in anthers. Therefore, no mortality of corn earworm was recorded in the anther bioassays. A series of diet-incorporated bioassays were conducted using concentrations previously found in the petal study to determine baseline susceptibilities of corn earworms and predicted mortality. Results from the diet-incorporated bioassays showed similar susceptibility in field and lab colony corn earworms. Concentrations of chlorantraniliprole could provide up to 64% control of corn earworm when feeding occurs on the petals.

Unraveling quad fever: Severe hyperthermia after traumatic cervical spinal cord injury.

PURPOSE: There are many infectious and inflammatory causes for elevated core-body temperatures, though they rarely pass 40 â„ƒ (104 ℉). The term "quad fever" is used for extreme hyperpyrexia in the setting of acute cervical spinal cord injuries (SCIs). The traditional methods of treating hyperpyrexia are often ineffective and reported morbidity and mortality rates approach 100%. This study aims to identify the incidence of elevated temperatures in SCIs at our institution and assess the effectiveness of using a non-invasive dry water temperature management system as a treatment modality with mortality. METHODS: A retrospective analysis of acute SCI patients requiring surgical intensive care unit admission who experienced fevers ≥ 40 â„ƒ (104 ℉) were compared to patients with maximum temperatures < 40 â„ƒ. Patients ≥18 years old who sustained an acute traumatic SCI were included in this study. Patients who expired in the emergency department; had a SCI without radiologic abnormality; had neuropraxia; were admitted to any location other than the surgical intensive care unit; or had positive blood cultures were excluded. SAS 9.4 was used to conduct statistical analysis. RESULTS: Over the 9-year study period, 35 patients were admitted to the surgical intensive care unit with a verified SCI. Seven patients experienced maximum temperatures of ≥ 40 â„ƒ. Six of those patients were treated with the dry water temperature management system with an overall mortality of 57.1% in this subgroup. The mortality rate for the 28 patients who experienced a maximum temperature of ≤ 40 â„ƒ was 21.4% (p = 0.16). CONCLUSION: The diagnosis of quad fever should be considered in patients with cervical SCI in the presence of hyperthermia. In this study, there was no significant difference in mortality between quad fever patients treated with a dry water temperature management system versus SCI patients without quad fever. The early use of a dry water temperature management system appears to decrease the mortality rate of quad fever.

Practical resistance to Cry toxins and efficacy of Vip3Aa in Bt cotton against Helicoverpa zea.

BACKGROUND: Crops genetically engineered to make insect-killing proteins from Bacillus thuringiensis (Bt) have revolutionized management of some pests. However, the benefits of such transgenic crops are reduced when pests evolve resistance to Bt toxins. We evaluated resistance to Bt toxins and Bt cotton plants using laboratory bioassays and complementary field trials focusing on Helicoverpa zea, one of the most economically important pests of cotton and other crops in the United States. RESULTS: The data from 235 laboratory bioassays demonstrate resistance to Cry1Ac, Cry1Fa, and Cry2Ab occurred in most of the 95 strains of H. zea derived from Arkansas, Louisiana, Mississippi, Tennessee, and Texas during 2016 to 2021. Complementary field data show efficacy decreased for Bt cotton producing Cry1Ac + Cry1Fa or Cry1Ac + Cry2Ab, but not Cry1Ac + Cry1Fa + Vip3Aa. Moreover, analysis of data paired by field site and year shows higher survival in bioassays was generally associated with lower efficacy of Bt cotton. CONCLUSIONS: The results confirm and extend previous evidence showing widespread practical resistance of H. zea in the United States to the Cry toxins produced by Bt cotton and corn, but not to Vip3Aa. Despite deployment in combination with Cry toxins in Bt crops, Vip3Aa effectively acts as a single toxin against H. zea larvae that are highly resistant to Cry toxins. Furthermore, Vip3Aa adoption is increasing and previous work provided an early warning of field-evolved resistance. Thus, rigorous resistance management measures are needed to preserve the efficacy of Vip3Aa against this highly adaptable pest. © 2022 Society of Chemical Industry.

Standardized Field Trials in Cotton and Bioassays to Evaluate Resistance of Tobacco Thrips (Thysanoptera: Thripidae) to Insecticides in the Southern United States.

Foliar-applied insecticide treatments may be necessary to manage thrips in cotton (Gossypium hirsutum L.) under severe infestations or when at-planting insecticide seed treatments do not provide satisfactory protection. The most common foliar-applied insecticide is acephate. Field observations in Tennessee suggest that the performance of acephate has declined. Thus, the first objective was to perform leaf-dip bioassays to assess if tobacco thrips, Frankliniella fusca (Hinds) (Thysanoptera: Thripidae), in cotton production regions have evolved resistance to foliar-applied insecticides. A second objective was to assess the performance of commonly applied foliar insecticides for managing thrips in standardized field trials in Arkansas, Tennessee, Mississippi, and Texas. For both objectives, several insecticides were evaluated including acephate, dicrotophos, dimethoate, lambda-cyhalothrin, imidacloprid, and spinetoram. Field trials and bioassays were completed from 2018 to 2021. Dose-response bioassays with acephate were performed on tobacco thrips field populations and a susceptible laboratory population. Bioassay results suggest that tobacco thrips have developed resistance to acephate and other organophosphate insecticides; however, this resistance seems to be most severe in Arkansas, Tennessee, and the Delta region of Mississippi. Resistance to other classes of insecticides were perhaps even more evident in these bioassays. The performance of these insecticides in field trials was variable, with tobacco thrips only showing consistent signs of resistance to lambda-cyhalothrin. However, it is evident that many populations of tobacco thrips are resistant to multiple classes of insecticides. Further research is needed to determine heritability and resistance mechanism(s).

A Dynamic Threshold Approach for Tarnished Plant Bug (Hemiptera: Miridae) Management in the Midsouthern U.S. Cotton.

One of the most economically important pests of cotton, Gossypium hirsutum L., in the midsouth region of the United States is the tarnished plant bug, Lygus lineolaris (Palisot de Beauvois, Hemiptera: Miridae). Tarnished plant bug populations across the region have exhibited widespread resistance to numerous insecticide classes. To minimize late season resistance development, reducing unwarranted applications during the late flowering period can aid in resistance management and potentially reduce input costs. Trials were conducted during 2019 and 2020 to evaluate the impacts of tarnished plant bug populations in the later flowering period of cotton by modifying or terminating threshold regimes during the later weeks of bloom. Results showed that dynamic thresholds altered at the fourth week of bloom or later can reduce the number of late season applications made with no penalty to yield. Additionally, when utilizing a week of bloom termination approach, no significant yield losses were seen when terminating applications after the fourth week of bloom. These data may offer an alternative method to managing tarnished plant bug populations during the later flowering period of midsouth cotton.

Perioperative Multimodal Pain Management Approach in Older Adults With Polytrauma.

INTRODUCTION: The use of intravenous (IV) acetaminophen (APAP) postoperatively in older adults may be a beneficial strategy. We implemented a multimodal pain management approach in our hospital in 2015, with IV APAP being the first-line therapy. MATERIALS AND METHODS: This was a retrospective, single-center, observational cohort study of polytrauma, orthopedic surgical patients aged ≥50 y. Patients admitted in 2017, postimplementation of pain protocol, were categorized as the exposed patients. Patients in the year 2014 served as the historical cohort. The two primary outcomes evaluated were postoperative opioid consumption in morphine milligram equivalents (MMEs) and patient pain scores. RESULTS: In total, 121 eligible patients were identified for this study; 22 historical control patients and 99 exposed patients. We observed a significant reduction in postoperative opioid use up to 48 h postoperatively (20.9 ± 27 versus 4.3 ± 12.4 MME [P < 0.05] at 24 h and 19.8 ± 31.2 versus 2.1 ± 11.3 MME [P < 0.05] at 48 h, respectively). The mean opioid consumption remained significantly lower in patient subgroup of age ≥74 y with no difference in the mean pain scores (1.5 ± 1.5 versus 1.9 ± 1.6 [P = 0.48] at 24 h and 1.5 ± 1.8 versus 2.0 ± 1.5 [P = 0.21] at 48 h postoperatively in the historical versus exposed cohort, respectively). Exposed patients had a shorter hospital length of stay than control patients (5.0 [3, 7] versus 6.5 [5, 9.5] d; P = 0.01). CONCLUSIONS: The use of multimodal pain management with IV APAP as first-line therapy was associated with reduced opioid use in the perioperative setting for older adults with polytrauma.

Tarnished Plant Bug (Heteroptera: Miridae) Behavioral Responses to Chemical Insecticides.

The tarnished plant bug (Lygus lineolaris Palisot de Beauvois) is the dominant insect pest of cotton (Gossypium hirsutum L.) in the Mid-South Cotton Belt. This is partly due to the fact that this pest has developed resistance to most insecticides used for control. Laboratory experiments were conducted during 2014 and 2015 to study the behavioral response of tarnished plant bug nymphs to several classes of insecticides. Twenty third-instar nymphs were placed in individual dishes divided into four quadrants with five green bean pieces in each quadrant (10 treated and 10 untreated green beans in each dish). Dishes were checked at 1, 4, 8, and 24 h. Tarnished plant bug nymphs appeared to avoid green beans treated with IGR, pyrethroid, organophosphate, or carbamate insecticides, while there appeared to be an attraction to green bean pieces treated with sulfoxamine and pyridine carboxamide insecticides. No relationship was observed with neonicotinoid insecticides within 24 h.

Development of Economic Thresholds Toward Bollworm (Lepidoptera: Noctuidae), Management in Bt Cotton, and Assessment of the Benefits From Treating Bt Cotton With Insecticide.

Widespread field-evolved resistance of bollworm [Helicoverpa zea (Boddie)] to Cry1 and Cry2 Bt proteins has threatened the utility of Bt cotton for managing bollworm. Consequently, foliar insecticide applications have been widely adopted to provide necessary additional control. Field experiments were conducted across the Mid-South and in Texas to devise economic thresholds for foliar insecticide applications targeting bollworm in cotton. Bt cotton technologies including TwinLink (TL; Cry1Ab+Cry2Ae), TwinLink Plus (TLP; Cry1Ab+Cry2Ae+Vip3Aa), Bollgard II (BG2; Cry1Ac+Cry2Ab), Bollgard 3 (BG3; Cry1Ac+Cry2Ab+Vip3Aa), WideStrike (WS; Cry1Ac+Cry1F), WideStrike 3 (WS3; Cry1Ac+Cry1F+Vip3Aa), and a non-Bt (NBT) variety were evaluated. Gain threshold, economic injury level, and economic thresholds were determined. A 6% fruiting form injury threshold was selected and compared with preventive treatments utilizing chlorantraniliprole. Additionally, the differences in yield from spraying bollworms was compared among Bt cotton technologies. The 6% fruiting form injury threshold resulted in a 25 and 75% reduction in insecticide applications relative to preventive sprays for WS and BG2, respectively. All Bt technologies tested in the current study exhibited a positive increase in yield from insecticide application. The frequency of yield increase from spraying WS was comparable to that of NBT. Significant yield increases due to insecticide application occurred less frequently in triple-gene Bt cotton. However, their frequencies were close to the dual-gene Bt cotton, except for WS. The results of our study suggest that 6% fruiting form injury is a viable threshold, and incorporating a vetted economic threshold into an Integrated Pest Management program targeting bollworm should improve the sustainability of cotton production.

Contralateral pneumothorax after central line placement in COVID-19 positive patients.

Contralateral pneumothorax after percutaneous central venous catheter placement has not been previously reported. Three patients who required intubation and mechanical ventilation for acute respiratory failure due to COVID-19 were identified with a new pneumothorax on routine post-placement chest roentgenogram on the side opposite the catheter placement.  Retrospective review of charts, radiographs, and laboratory studies.  No causative relationship was identified between the percutaneous placement of the central venous catheters and the subsequent pneumothoraces identified on the contralateral side, other than the presence of active COVID-19 viral pneumonia. The timing of the contralateral pneumothoraces were coincidental the placement of the central venous catheters.  We believe these pneumothoraces were a consequence of the pulmonary pathology of the COVID-19 virus.

Reducing Catheter-Associated Urinary Tract Infection: The Impact of Routine Screening in the Geriatric Hip Fracture Population.

BACKGROUND: Catheter-associated urinary tract infection (CAUTI) is a noted complication among geriatric hip fracture patients. This complication results in negative outcomes for both the patients and the institution providing care. Screening measures to identify predisposing factors, with early diagnosis and treatment of urinary tract infection (UTI) present on admission, may lead to reduced rates of CAUTI. OBJECTIVE: The goals of this study were to determine the prevalence of UTI on admission among geriatric hip fracture patients and whether routine screening for UTI or predisposing factors at presentation resulted in reduced rates of CAUTI. METHODS: A retrospective observational study of geriatric hip fracture patients from January 2017 to December 2018 at a Level I trauma center was performed. Rates of UTI on admission and CAUTI were calculated using routine admission urinalysis. RESULTS: Of the 183 patients in the sample, 36.1% had UTI on admission and 4.4% of patients developed CAUTI. There were no significant differences in patient demographics, comorbidities, and complications between those with UTI on admission and those without. CONCLUSIONS: Urinary tract infection on admission may be present among a large portion of geriatric hip fracture patients, leading to increased rates of CAUTI. Routine screening for UTI and its predisposing factors at admission can identify these patients earlier and lead to earlier treatments and prevention of CAUTI.

Prospective Evaluation of a Circulating Tumor Cell Sensitivity Profile to Predict Response to Cisplatin Chemotherapy in Metastatic Breast Cancer Patients.

BACKGROUND: Cisplatin (cDDP) has regained interest for metastatic breast cancer (MBC) patients, given the platinum sensitivity in subtypes and better manageable toxicity. Here, the primary aim was to determine whether molecular characteristics of circulating tumor cells (CTCs) could identify patients responding to cDDP and to describe the outcomes to cDDP monotherapy in a large group of MBC patients pretreated with anthracycline- and taxane-based treatments. METHODS: Based on cell line data, a CTC-cDDP-sensitivity profile was generated. Applying an A'Herns single-stage phase II design, further investigation was considered worthwhile if 5/10 patients with a favorable profile responded to cDDP. Patients received 70mg/m2 cDDP every three weeks, CTCs were enumerated and the CTC-cDDP-sensitivity profile was determined. In total, 65 heavily pretreated MBC patients (77% received ≥2 lines of previous chemotherapy for MBC) were eligible for the per-protocol analysis. Primary endpoint was response rate, secondary endpoints included best observed response, progression-free survival (PFS) and overall survival (OS). RESULTS: The best observed response during cDDP therapy was a partial response in 7% and stable disease in 56% of the patients. None of the patients with a favorable CTC-cDDP-sensitivity profile had a response. The median baseline CTC count was 8 (range 0-3254). Patients with <5 CTCs had a better PFS and OS than patients with ≥5 CTCs (median PFS 4.5 months (95%CI 2.38-6.62) vs. 2.1 months [(95%CI 1.34-2.80)(p=0.009)] and median OS 13.1 months (95%CI 9.89-16.33) vs. 5.6 months [(95%CI 3.60-7.64)(p=0.003)]. No other factors than CTC count were associated with outcome to cDDP therapy, including triple-negative breast cancer versus ER-positive tumors. CONCLUSIONS: The CTC-cDDP-sensitivity profile was unable to select patients responding to cDDP monotherapy. In an unselected group of heavily pretreated MBC patients, cDDP yields outcomes comparable to other chemotherapeutic regimens for heavily pretreated MBC patients. CTC count was the only factor associated with outcome in these patients. CLINICAL TRIAL REGISTRATION: (https://www.trialregister.nl/trial/3885, identifier NTR4046).

The Impact of Brown Stink Bug (Hemiptera: Pentatomidae) Damage during the Seedling Stage on Field Corn Growth and Yield.

Brown stink bug, Euschistus servus (Say) (Hemiptera: Pentatomidae), is a common insect that can infest corn fields in the Mid-South and Southeastern U.S. Infestations and damage are sporadic, thus little research has been conducted on the impact of brown stink bug infesting corn seedlings. Two experiments were conducted in eleven commercial corn fields in the Mississippi Delta to evaluate the impact of damage from natural stink bug infestations during the seedling stage (

"It Will Work": The Story of Nina Starr Braunwald and the First Successful Mitral Valve Replacement.

Cardiothoracic surgery is a clinical and scientific discipline that has evolved enormously over the last decades. Cardiac problems that were historically death sentences can now be addressed with approaches that only continue to improve. In the late 1950s, while cardiothoracic surgery was still a nascent field, Nina Starr Braunwald emerged as a pioneer for this exponential improvement. As the first woman cardiac surgeon in an era in which general surgery and surgical specialties were dominated by men, Dr Braunwald not only made revolutionary contributions to cardiothoracic surgery, but also did so while balancing roles as a dedicated mother and supportive partner.

Carl Toldt Centennial, Surgeon and Anatomist.

Carl Florian Toldt was an Austrian anatomist who made meaningful contributions worldwide and defined what is one of the most important surgical landmarks in abdominal surgery. Through his research studies, the embryologic dissection plane known as the "White Line of Toldt" represents an important anatomical landmark that helps to mobilize either the ascending or descending colon. His career spanned over 45 years, beginning in Verona and continuing to Prague and Vienna. He was an author of several innovative books and scientific articles regarding micro- and macroscopic anatomy. In addition, he received numerous recognitions and prizes for his work, making him an essential figure in the medical scientific community. Even a street in Vienna, Karl-Toldt-Weg, is named in his honor. The purpose of this historical article is to celebrate and honor Toldt 100 years following his death, remembering his scientific contributions to the medical and surgical fields and giving thanks for his numerous accomplishments. This article brings light to the man behind the eponym.

Effects of Soybean Plant Population on Yield Loss From Defoliation.

Plant densities in Mid-South U.S. soybean, Glycine max (L.) Merr., fields can vary greatly due to a wide range of factors, although soybean yields are generally insensitive to variations in density. Currently, it is unknown if yield loss from insect-related defoliation varies across different soybean stand densities. Soybean was planted in Starkville and Stoneville, MS, in 2016 and 2017 at five seeding rates ranging from 123,500 to 420,070 seed/ha in 74,130 seed/ha increments. Each seeding rate contained a nondefoliated plot and a plot that was defoliated 67% at the R1 growth stage. Defoliated plants had a greater leaf expansion rate from R1 to R3 than nondefoliated plants. Defoliation reduced yield where plant densities were <192,800 plants/ha, but greater densities were not affected. Reduced yield in defoliated plots when compared with nondefoliated plots at equivalent R3 leaf area index values indicated that some resources were used to replace the removed leaf area instead of seed production. These results suggest that fields with substandard plant densities might benefit from a reduced treatment threshold for defoliating pests.

Effects of Soybean Planting Date on Yield Loss From Defoliation.

Soybean, Glycine max (L.) Merr., is planted during 3.5-4 mo across the Mid-South United States. Currently, no information exists regarding the effects of planting date on soybean yield loss from early season defoliation. In 2015 and 2016, to evaluate the effects of planting date on yield loss from defoliation, soybean were planted in field plots 2 wk apart from early April to mid-June, for a total of six planting dates. Each planting date included a nondefoliated control and a 100% defoliation treatment where leaves were manually excised at the V4 growth stage. Mean yield loss from defoliation varied across planting dates, with mid-April plantings having the least amount yield reduction, 573 kg/ha, and early-June plantings having the greatest yield reduction, 904 kg/ha. Percent yield reduction from defoliation increased as planting was delayed, suggesting that defoliation thresholds might need adjustment based on planting date and yield potential. However, more research is needed at lower levels of defoliation to accurately delineate such thresholds.