Biology, Thermal Requirements, and Fertility Life Table of Strains of Trichogramma foersteri (Hymenoptera: Trichogrammatidae) in Palpita forficifera (Lepidoptera: Crambidae).

Trichogramma foersteri Takahashi is a parasitoid recently identified in eggs of Palpita forficifera Munroe, considered the main pest of the olive tree in Brazil. The efficiency of a parasitoid is conditioned to several factors such as the temperature. The objective was to study the biology of the immature and adult phases at different constant temperatures (10, 15, 20, 25, and 30 °C), determine thermal requirements, and to elaborate a fertility life table for five strains (R1, R2, R3, R4, and R5) to T. foersteri. At 10 °C, there was no development of T. foersteri. The duration of the egg-adult period (days) was inversely related to temperature, ranging from 32 to 34 days (at 15 °C) to 6.5 to 7.5 days (at 30 °C). The thermal range evaluated did not influence parasitism (parasitism > 57%) and the sex ratio (sr > 0.74). The base temperature (Tt) was similar for all strains (approximately 12 °C), corresponding to a thermal constant (K) of 120.48 to 145.13 degree days. For the adult stage, T. foersteri had the highest rate of parasitism (> 48%) to 15 °C. The emergence rate ranged from 75 to 100%. The thermal range did not influence the sex ratio of the lines (sr > 0.70), but reduced the longevity from 50 days (at 15 °C) to 6 days (at 30 °C). Regarding the fertility life table, all strains of T. foersteri showed biological potential of development and growth in eggs of P. forficifera in the thermal range of 15 to 30 °C, important information for the establishment of biological control programs.

Irrational Performance Beliefs and Mental Well-Being Upon Returning to Sport During the COVID-19 Pandemic: A Test of Mediation by Intolerance of Uncertainty.

Purpose: This study examined the extent to which irrational performance beliefs and intolerance of uncertainty co-occur in relation to mental well-being among a sample of athletes and coaches (N = 94, M age = 31.99, SD = 12.81) upon their return to sport following COVID-19 disruptions. Methods and Results: Despite the parity in views, independent samples t-test results identified three significant differences in the tested variables between athletes and coaches, which suggested that athletes are more likely to entertain depreciative thoughts about performances and react more aversively to uncertainty, whereas coaches reported a better mental well-being state. Pearson correlation coefficient analysis confirmed a significant positive relationship between composite irrational performance beliefs and intolerance of uncertainty scores, with both these variables being inversely related to mental well-being. Results from a simple atemporal mediation analysis using the PROCESS macro verified that intolerance of uncertainty fully mediated the adverse effect irrational beliefs exert on mental well-being. Conclusion: Sports psychology practitioners within the framework of REBT are advised to explore their orientation of modifying irrational beliefs aligned to clients' perceptions and tolerance of uncertainty in sport through the inclusion of IU-specific awareness and behavioral experiments.

The effect of different dietary flavourants and salt levels on feed intake of juvenile ostriches.

Yearly the ostrich industry loses up to 40% of newly-hatched chicks, partly due to insufficient feed intake. This study was conducted to determine whether the inclusion of various feed flavourants would improve feed intake in ostrich chicks (Trial 1). Ninety-six dayold ostrich chicks were raised in groups of 12 at a Western Cape research farm until 28 days of age. These chicks were provided with free-choice access to a variety of flavoured diets, namely sweet, sour, bitter, salt or an unflavoured control diet. Chicks were found to prefer salty feed, as the salt-flavoured diet had the highest daily feed intake (34% of total) throughout the trial. Subsequently Trial 2 was conducted to determine the preferred level of dietary salt (Experiment 1) as well as the influence dietary salt had on various production parameters (Experiment 2). In Experiment 1, three groups of seven chicks each were offered ad libitum access to diets containing 4 g/kg, 14 g/kg, 24 g/kg, and 34 g/kg of salt respectively. Experiment 1 found that chicks preferred the diet containing 14 g salt/kg (36.4% of total daily feed consumed). For Experiment 2, 56 birds were divided into eight groups of seven. Conversely to the current conventional inclusion of 4 g salt/kg, Experiment 2 showed that chicks reared on a diet containing 14 g salt/kg had a 41.7% higher average daily gain than the group consuming 4 g salt/kg. It can therefore be concluded that ostriches prefer diets with a higher dietary salt level than current conventional diets provide (14 g/kg vs 4 g/kg).

Damage control laparotomy outcomes in a major urban trauma centre.

BACKGROUND: Damage control laparotomy (DCL) is associated with high mortality. The purpose of this study was to review the outcomes of DCL. METHODS: All patients undergoing DCL for penetrating trauma from May 2015 to July 2017 were reviewed. Data retrieved were demographics, mechanism of injury, vitals, and biochemical parameters. Injury severity was described by the revised trauma score (RTS), penetrating abdominal trauma index (PATI), injury severity score (ISS) and trauma and injury severity score (TRISS). Indications for DCL, length of ICU stay, number of procedures and primary abdominal closure rates, complications and mortality were recorded. RESULTS: Fifty-one patients underwent DCL and 47 patients sustained gunshot injuries. Indications for laparotomy were haemodynamic instability (n = 27) and peritonism in stable patients (n = 22). The medians for the different severity scores were RTS 7.36, ISS 20, and PATI 30. The organs most commonly injured, in decreasing frequency, were small bowel (33), large bowel (25), abdominal vasculature (22), liver (18), stomach (14), kidney (10), diaphragm (10), spleen (9) and pancreas (8). DCL procedures performed were abdominal packing (36), temporary bowel ligation (30), vascular (5) and ureteric (1) shunting. The median number of laparotomies performed per patient was three, with a primary fascial closure rate of 69%. The mortality rate was 29%. CONCLUSION: DCL in our centre is associated with a 29% mortality rate. Severe acidosis, massive blood transfusion in first 24 hours and median PATI score more than 47 are independent risk factors associated with increased mortality.

Creencias limitantes a la hora de la cesación tabáquica / Limiting beliefs when quitting smoking

Objetivo: Evaluar las creencias de los fumadores yexfumadores sobre la preocupación por contagiarse deCOVID-19, las ganas de dejar de fumar y percepciónde éxito de los tratamientos efectivos en pandemia. Pacientes y métodos: Se aplicó un cuestionario, voluntario y auto-administrado, sobre las conductas encuarentena COVID-19 a mayores de 18 años, mediantedifusión por redes sociales durante abril y mayo del2020. De 1.948 encuestas, se analizaron 1.071 entreexfumadores (n= 565) y fumadores actuales (n= 506). Se consideraron las siguientes variables: comorbilidades, preocupación por ser tabaquista en época deCOVID-19, tipo de cigarrillo consumido, ganas dedejar de fumar, tratamientos elegidos para la cesacióny la decisión de dejar de fumar. Resultados: El grado de preocupación se asocia con lasganas de dejar de fumar (p <0,001). La declaración de“me preocupa bastante” se correlaciona con las ganasde dejar de fumar (p <0,001), y “no me preocupa” conla ausencia de ganas (p <0,001). La opción para dejar de fumar que presenta el mayor acuerdo generalizadoentre los fumadores con ganas de dejar de fumar ypreocupados por su condición de fumador en pandemiaes la creencia de que “La decisión de querer dejar defumar es fundamental” es “Muy efectiva”, con un 79 %de los encuestados eligiendo esta opción. Conclusión: La preocupación por contagiarse deCOVID-19 incrementa las ganas de dejar de fumar.La mayoría de los fumadores y exfumadores creen quepara dejar de fumar es suficiente con su decisión y sinprecisar tratamiento.(AU)

Objective: Evaluate the beliefs of the smokers andex-smokers on the concern about catching COVID-19,desires to stop smoking and perception of success ofthe effective treatments in the pandemic. Patients and methods: A voluntary and self-administered questionnaire was applied to those over 18years of age on the behaviors during the COVID-19quarantine, by means of dissemination through thesocial networks during April and May of 2020. Of the1,948 surveys, 1,071 were analyzed among ex-smokers(n= 565) and current smokers (n= 506). The followingvariables were considered: comorbidities, concern aboutbeing a smoker during the times of COVID-19, type of cigarette used, desire to quit smoking, treatments chosen to quit smoking and the decision to sop smoking. Results: The degree of concern is associated with thedesire to quit smoking (p <0.001). The statement that“I am quite concerned” correlates with the desire toquit smoking (p <0.001), and that of “I am not concerned” with that of no desire (p <0.001). The optionto quit smoking that showed the greatest generalizedagreement among the smokers who desired to quitsmoking and concerned about their condition of being a smoker in the pandemic is the belief that “Thedecision to want to quit smoking is fundamental” is“Very effective,” with 79 % of those surveyed choosingthis option. Conclusion: Concern about catching COVID-19increases the desire to quit smoking. Most of thesmokers and ex-smokers believe that their decisionto stop smoking is sufficient and that treatment isnot necessary.(AU)

Fatty acids reveal aquaculture and drought effects on a large tropical reservoir.

Fatty acids (FAs) and their metrics have been used to detect and assess the impacts of urbanization and agriculture on aquatic ecosystems. Here, we investigated whether seston FAs are also useful to characterize and understand early-stage aquaculture impacts in a large tropical reservoir (Furnas Reservoir, SE Brazil). We tested the hypothesis that single FAs, as well as selected FA metrics in the seston fraction, are efficient markers of net-cage fish farming effects. In general, fish farming had only minor effects on standard water chemical variables, mainly small increases in ammonium, nitrate, and dissolved organic nitrogen concentrations. By increasing concentrations of several polyunsaturated FAs, early-stage fish farming improved sestonic food quality in the more oligotrophic branch of the reservoir under drought conditions. However, in general, increases in concentrations of bacterial FAs, due to fish farming, suggested organic matter (OM) subsidies from non-ingested and non-assimilated fish feed. In the more eutrophic reservoir branch, seston FA profiles suggested that fish farming caused an increase of low-quality food resources, such as cyanobacteria. Thus, background impact levels may determine the biochemical responses of tropical reservoirs to fish farming. Higher contributions of potentially sewage-derived and bacterial FAs during drought conditions, especially at reference sites of the more oligotrophic branch, suggested that drought shifted OM inputs towards anthropogenic sources, thereby overwriting land-use related differences between reservoir branches and homogenizing their environmental conditions. In conclusion, FA variables were useful to evaluate and understand environmental conditions, as well as the effects of early-stage fish farming and drought, and should be considered in impact assessments in tropical lentic ecosystems.

Oil gland and oil pores in billfishes: in search of a function.

Billfishes are well known for their distinctive elongated rostra, i.e. bills. The functional significance of billfish rostra has been frequently discussed and the recent discovery of an oil gland (glandula oleofera) at the base of the rostrum in swordfish, Xiphias gladius, has added an interesting facet to this discussion regarding the potential co-evolution of gland and rostra. Here, we investigated the oil gland and oil pores (through which the oil is brought to the skin surface) of four billfish species - swordfish, Atlantic blue marlin (Makaira nigricans), Indo-Pacific sailfish (Istiophorus platypterus) and striped marlin (Kajikia audax) - and provide detailed evidence for the presence of an oil gland in the last three. All four species had a high density of oil pores on the forehead which is consistent with the hypothesis of hydrodynamic benefits of the oil. The extension of the pores onto the front half of the rostrum in sailfish and striped marlin, but not in swordfish or blue marlin, suggests that the oil may have additional functions. One such function could be linked to the antibacterial and anti-inflammatory properties of the oil. However, the available evidence on predatory rostrum use (and hence the likelihood of tissue damage) is only partly consistent with the extension of pores on rostra across species. We conclude that the oil gland probably serves multiple, non-mutually exclusive functions. More detailed information on rostrum use in blue marlin and swordfish is needed to better link behavioural and morphological data with the aim of accomplishing a full comparative analysis.

Genetic diversity and population structure of Culex modestus across Europe: does recent appearance in the United Kingdom reveal a tendency for geographical spread?

In mainland Europe, the mosquito species Culex modestus Ficalbi (1890) is a bridge vector for West Nile virus (WNV) from its natural bird-mosquito cycle to mammals. The present study assessed the genetic diversity of Cx. modestus, as well as related Culex species, using the mitochondrial COI DNA barcoding region and compared this with the population structure across Europe. A haplotype network was mapped to determine genealogical relationships among specimens. The intraspecific genetic diversity within individual Culex species was below 2%, whereas the interspecific genetic divergence varied from 2.99% to 13.74%. In total, 76 haplotypes were identified among 198 sequences. A median-joining network determined from 198 COI sequences identified two major lineages that were separated by at least four mutation steps. A high level of intraspecific genetic diversity was not detected in Cx. modestus in samples submitted from different European populations, which indicates that morphologically identified specimens represent a single species and not a species complex. Therefore, it is deduced that different populations of Cx. modestus will show a similar potential to transmit WNV, lending support to concerns that the population present in southeast England represents a risk of transmission to humans.

Effects of Extrinsic, Intraspecific Competition and Host Deprivation on the Biology of Trichopria anastrephae (Hymenoptera: Diapriidae) Reared on Drosophila suzukii (Diptera: Drosophilidae).

The pupal parasitoid Trichopria anastrephae Lima (Hymenoptera: Diapriidae) shows potential to control Drosophila suzukii (Matsumura) (Diptera: Drosophilidae), and understanding the behavior of this parasitoid in challenging environments is important to obtain a higher efficiency in mass rearing and in biological control programs. This study aimed to verify the effects of extrinsic intraspecific competition and the absence of host on the parasitism of T. anastrephae in D. suzukii pupae. Therefore, to evaluate the parasitism of T. anastrephae under intraspecific competition, groups of 20 pupae (24 h old) of D. suzukii were offered for different densities of parasitoids (1, 3, 5, or 10 couples) during a 7-day period. Whereas to evaluate the effects of host deprivation on parasitism of T. anastrephae, we tested different treatments: T1-no deprivation, T2-complete deprivation, T3-deprivation every other day, T4-deprivation for 3 days, and T5-deprivation for 7 days. The increase of density of parasitoids resulted in an increase of oviposition scars on pupae and a longer biological cycle, suggesting the occurrence of superparasitism. Increased density also resulted in a higher percentage of attacked pupae, but did not affect parasitoids emergence nor sex ratio. Host deprivation affected number of parasitized pupae, number and sex ratio of offspring, and the longevity of females. Based on our findings, competition among females do not impair offspring viability, and host deprivation for a period up to 7 days do not influence parasitism capacity, indicating that it can be used as a pre-release strategy.

Population Dynamics of Drosophila suzukii (Diptera: Drosophilidae) in Berry Crops in Southern Brazil.

Drosophila suzukii (Matsumura) is an invasive species originating in Southeast Asia and considered a severe pest in berry crops in several countries of the Northern Hemisphere and Europe. In South America, the species was first detected in 2013. The objective of the study was to monitor the seasonal activity of D. suzukii in commercial crops of blackberry, strawberry guava, surinam cherry, blueberry, and strawberry during two consecutive harvests and in three properties in the Southern region of Brazil during the 2015/2016 and 2016/2017 harvests, with the aid of traps baited with apple cider vinegar. The highest population peaks were observed during late spring to mid-fall in all areas and plant species studied. It was verified that temperature is the factor that most influenced the seasonal activity of D. suzukii in the field, promoting low catches of the species during winter. However, even during periods of low temperatures (winter period), the presence of D. suzukii in the crops was verified, demonstrating the species' ability to stay in place from year to year, surviving in alternative hosts such as Eriobotrya japonica, a common species in the region. The information on the time of the highest occurrence of the pest in different hosts presented in this study provides the basis for decision-making in relation to the management of D. suzukii, to avoid further economic damage.

Extracorporeal shock wave lithotripsy under intravenous sedation for treatment of urolithiasis.

BACKGROUND: In contrast to treatment with oral or intramuscular analgesics, extracorporeal shock wave lithotripsy (E.S.W.L.) can be performed with patients under sedation too. Besides the advantage of increased shock energy, patients tend to have more constant breathing excursions and are more idle during treatment, potentially increasing the stone-free ratio (S.F.R.) after treatment. METHODS: This study presents the results of 310 patients who underwent 400 E.S.W.L. procedures under sedation, with a stationary lithotripter. RESULTS: After one procedure, the S.F.R. was 54.8% (170/310). A second treatment was successful in 42.1% (32/76), a third treatment in 21.4% (3/14). Therefore, 66.1% (205/310) of patients eventually became stone-free. Kidney stones were successfully treated in 65.4% (161/246), ureteral stones in 68.8% (44/64) of cases. Patients with stones ≤15 mm were successfully treated in 67.4% (194/288), patients with stones >15 mm in 50% (11/22) of cases. Considering each procedure individually, 45.3% (181/400) of procedures were successful after 3 weeks. Extending follow-up to 3 months is important, since 26.7% of stones (24/90) eventually still disappeared, increasing S.F.R. to 51.3% after one procedure. Complications occurred after 5.5% E.S.W.L.-procedures. CONCLUSIONS: E.S.W.L. is a well-tolerated, non-invasive procedure that produces reasonable stone clearance of both upper and lower urinary tract calculi. Performing the procedure whilst patients are intravenously sedated results in an acceptable S.F.R. Strong selection based on unfavourable factors could increase the chance on successful treatment and spare patients a pointless procedure. However, considering E.S.W.L.'s elegant nature, sometimes a more tolerant approach seems justifiable.

[Sandfly fever-a "neglected" disease]. / Sandmückenfieber ­ eine "vernachlässigte" Krankheit.

A 45-year-old woman presented at the outpatient department of a center for tropical diseases with fever, diarrhea, headache, myalgia, malaise, and an itchy papular rash. She had been on holiday with her family for 11 days in a mountain village in northern Cyprus. The place was infested with a lot of small, stinging flies or mosquitoes. She and her family became sick after they returned home. The physical examination was normal apart from the rash on the inside of the extremities. Significantly elevated transaminases and a slightly increased C­reactive protein level were found in the blood examination. Considering the country of travel, the report of the "stinging flies" and the clinical presentation, sandfly fever was also taken into account as a differential diagnosis for the hepatitis. Antibodies to the sandfly fever Sicilian virus (SFSV) were detected. They showed the typical dynamics during the course of the illness and thus "pappataci fever" was diagnosed. The case report and a short review of up-to-date literature is meant encourage consideration of phlebovirus infection as a possible differential diagnosis in travelers or refugees suffering from severe febrile hepatitis and rash or aseptic viral meningitis after their stay in the Mediterranean area.

Cement-augmented sacroiliac screw fixation with cannulated versus perforated screws - A biomechanical study in an osteoporotic hemipelvis model.

INTRODUCTION: Cement-augmentation is a well-established way to improve the stability of sacroiliac screw fixation in osteoporosis-associated fragility fractures of the posterior pelvic ring. However, to date little is known about the influence of different techniques of cement augmentation on construct stability. The aim of this study was to evaluate the primary stability of cement-augmented sacroiliac screw fixation with cannulated versus perforated screws under cyclic loading. MATERIALS AND METHODS: A total of eight fresh-frozen human cadaveric hemipelvis specimens with osteoporosis were used. After generating ventral osteotomies on both sides of the sacrum, each specimen was treated using a cement-augmented cannulated screw on one side and a cement-augmented perforated screw on the other side. Afterwards, axial cyclic loading was performed. RESULTS: No statistically significant difference was found between cannulated and perforated screws concerning maximum load (356.25 N versus 368.75 N, p = 0.749), plastic deformation (1.95 mm versus 1.43 mm, p = 0.798) and stiffness (27.04 N/mm versus 40.40 N/mm, p = 0.645). CONCLUSIONS: Considering the at least equivalent results for perforated screws, cement augmentation via perforated screws might be an interesting option in clinical practice because of potential advantages, e.g. radiological control before cement application, reduced risk of cement displacement and time saving.

Standardised data reporting from pre-hospital advanced airway management - a nominal group technique update of the Utstein-style airway template.

BACKGROUND: Pre-hospital advanced airway management with oxygenation and ventilation may be vital for managing critically ill or injured patients. To improve pre-hospital critical care and develop evidence-based guidelines, research on standardised high-quality data is important. We aimed to identify which airway data were most important to report today and to revise and update a previously reported Utstein-style airway management dataset. METHODS: We recruited sixteen international experts in pre-hospital airway management from Australia, United States of America, and Europe. We used a five-step modified nominal group technique to revise the dataset, and clinical study results from the original template were used to guide the process. RESULTS: The experts agreed on a key dataset of thirty-two operational variables with six additional system variables, organised in time, patient, airway management and system sections. Of the original variables, one remained unchanged, while nineteen were modified in name, category, definition or value. Sixteen new variables were added. The updated dataset covers risk factors for difficult intubation, checklist and standard operating procedure use, pre-oxygenation strategies, the use of drugs in airway management, airway currency training, developments in airway devices, airway management strategies, and patient safety issues not previously described. CONCLUSIONS: Using a modified nominal group technique with international airway management experts, we have updated the Utstein-style dataset to report standardised data from pre-hospital advanced airway management. The dataset enables future airway management research to produce comparable high-quality data across emergency medical systems. We believe this approach will promote research and improve treatment strategies and outcomes for patients receiving pre-hospital advanced airway management. TRIAL REGISTRATION: The Regional Committee for Medical and Health Research Ethics in Western Norway exempted this study from ethical review (Reference: REK-Vest/2017/260).

Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations.

BACKGROUND: Pre-hospital tracheal intubation success and complication rates vary considerably among provider categories. The purpose of this study was to estimate the success and complication rates of pre-hospital tracheal intubation performed by physician anaesthetist or nurse anaesthetist pre-hospital critical care teams. METHODS: Data were prospectively collected from critical care teams staffed with a physician anaesthetist or a nurse anaesthetist according to the Utstein template for pre-hospital advanced airway management. The patients served by six ambulance helicopters and six rapid response vehicles in Denmark, Finland, Norway, and Sweden from May 2015 to November 2016 were included. RESULTS: The critical care teams attended to 32 007 patients; 2028 (6.3%) required pre-hospital tracheal intubation. The overall success rate of pre-hospital tracheal intubation was 98.7% with a median intubation time of 25 s and an on-scene time of 25 min. The majority (67.0%) of the patients' tracheas were intubated by providers who had performed >2500 tracheal intubations. The success rate of tracheal intubation on the first attempt was 84.5%, and 95.9% of intubations were completed after two attempts. Complications related to pre-hospital tracheal intubation were recorded in 10.9% of the patients. Intubations after rapid sequence induction had a higher success rate compared with intubations without rapid sequence induction (99.4% vs 98.1%; P=0.02). Physicians had a higher tracheal intubation success rate than nurses (99.0% vs 97.6%; P=0.03). CONCLUSIONS: When performed by experienced physician anaesthetists and nurse anaesthetists, pre-hospital tracheal intubation was completed rapidly with high success rates and a low incidence of complications. CLINICAL TRIAL NUMBER: NCT 02450071.

Molecular epidemiology of Shiga toxin-producing O113:H21 isolates from cattle and meat.

The serotype O113:H21 is considered one of the relevant non-O157 STEC serotypes associated with severe human infections. Due to the increased detection of O113 strains and their relationship with clinical cases, which emphasizes the importance of this serogroup as an emerging pathogen, our aim was to determine the characteristics of STEC O113:H21 strains circulating in bovine cattle and retail meat from Argentina. For this purpose, we determined the presence and combinations of various virulence genes (and their variants) related to adhesion and toxicity in a collection of 34 isolates. Their genetic relatedness using multiple-locus variable-number tandem repeat analysis (MLVA) was also studied. Subtyping of stx genes indicated that O113:H21 strains circulating in Argentina mainly present stx2a alone or together with stx2c or, less frequent, with stx2d , all of which are subtypes associated with human disease. We found plasmid markers, such as saa, ehxA and subA, in a higher proportion than previous studies, and five variants of saa, two of which were novel ones. In relation to MLVA subtyping, we detected a limited diversity among the isolates considering that several loci were not discriminative and, that in some farms, the same clone seemed to remain circulating throughout the year. The O113:H21 strains studied harbour several toxin and adhesion genes (saa, espP, fimCD, ehaA, iha, hcpA, elfA, lpfO113, ecpA, subA, cdt-V) and Stx subtypes associated with human disease. Results also highlighted that subtyping of stx and saa is useful to discriminate O113:H21 strains that share virulence genes. In conclusion, this study shows that a number of O113:H21 strains that occur in foods and bovines could be pathogenic for humans. This situation calls for further attention in the prevention and control of foodborne disease caused by these strains.

Inter-disciplinary cooperation in a physician-staffed emergency medical system.

BACKGROUND: On-scene management of pre-hospital emergencies is often inter-disciplinary, involving ground-emergency medical services (EMS), police- and fire services, and in Norway general practitioners on-call. This can also be supplemented by physician-staffed EMS (P-EMS), utilizing helicopters or rapid response vehicles. We hypothesized that P-EMS cooperates extensively with other emergency services, and therefore the primary aim of this study was to investigate the fraction of inter-disciplinary cooperation between P-EMS and other emergency services. METHODS: Retrospective, observational study of primary pre-hospital missions with patient contact performed at a Norwegian P-EMS base from 01.01.06 to 31.12.15. Descriptive statistics, comparisons using Student`s t-test, and chi-squared test for trend were applied. RESULTS: Inter-disciplinary cooperation occurred in 94.3% of the 8580 missions, of which physician-staffed EMS cooperated with ground EMS in 92.4%, general practitioner 32.9%, police service 11.6% and fire service 11.8%. Trauma constituted 34.4 and cardiac arrest 14.1% of missions. The mean National Advisory Committee for Aeronautics score was 4.21 (95% Confidence Interval 4.18-4.24). There was an overall decrease in cooperation with general practitioners and the police service (P < 0.001). During helicopter missions, we reported a decrease in general practitioner cooperation compared to an increase during rapid response car missions (P < 0.001). In cardiac arrest cases, cooperation with both general practitioners and the fire service increased (P < 0.001). CONCLUSION: Physician-staffed EMS cooperates extensively with other professional emergency services, especially ground-EMS. On-scene cooperation with general practitioners decreased, whereas there was an increased cooperation with the fire service in a "first-responder" role during cardiac arrest missions.

ArgO145, a Stx2a prophage of a bovine O145:H- STEC strain, is closely related to phages of virulent human strains.

Shiga toxins (Stx) are the main virulence factor of a pathogroup of Escherichia coli strains that cause severe human diseases. These toxins are encoded in prophages (Stx prophages), and generally their expression depends on prophage induction. Several studies have reported high diversity among both Stx prophages and Stx. In particular, the toxin subtype Stx2a is associated with high virulence and HUS. Here, we report the genome of ArgO145, an inducible Stx2a prophage identified in a bovine O145:H- strain which produced high levels of Shiga toxin and Stx phage particles. The ArgO145 genome shared lambda phage organization, with recombination, regulation, replication, lysis, and head and tail structural gene regions, although some lambda genes encoding regulatory proteins could not be identified. Remarkably, some Stx2a phages of strains isolated from patients in other countries showed high similarity to ArgO145.