Optic Canal Size is an Indicator for the Accessory Optic Canal: Applications for Anterior Clinoidectomy.

BACKGROUND: The ophthalmic artery normally travels with the optic nerve through the optic canal. However, sometimes, the ophthalmic artery travels through a foramen within the optic strut named an accessory optic canal, double optic canal, or ophthalmic canal. This variant puts individuals at an increased risk for blindness or death during anterior clinoidectomy due to unforeseen hemorrhage of the ophthalmic artery or internal carotid artery when the optic strut is separated from the body of the sphenoid bone. Several features make the accessory optic canal difficult to recognize on imaging: its variant nature, small size, and ability to masquerade as a caroticoclinoid foramen or a pneumatized sphenoidal structure. Hence, improved methods of presurgical identification are warranted. The aim of this study was to assess the size and shape of the optic canal, with and without a concomitant accessory optic canal, to determine whether measurement of the optic canal may provide useful information regarding the presence of an accessory optic canal. METHODS: In 191 dry crania, optic canals with and without concomitant accessory optic canals were assessed for the following parameters: canal area, canal perimeter, circularity, solidity, the axes and aspect ratio of a best-fit ellipse, and roundness. RESULTS: Normal optic canals were found to have a larger area (P = 0.036), perimeter (P = 0.043), and minor axis of a best-fit ellipse (P = 0.031) than the optic canals that occurred alongside accessory optic canals. CONCLUSIONS: Asymmetry in optic canal size can help indicate the presence of a unilateral accessory optic canal before surgery.

Prevalence, drivers and surveillance of antibiotic resistance and antibiotic use in rural China: Interdisciplinary study.

This study aimed to characterise antibiotic prescribing and dispensing patterns in rural health facilities in China and determine the community prevalence of antibiotic resistance. We investigated patterns and drivers of antibiotic use for common respiratory and urinary tract infections (RTI/UTI) in community settings, examined relationships between presenting symptoms, clinical diagnosis and microbiological results in rural outpatient clinics, and assessed potential for using patient records to monitor antibiotic use. This interdisciplinary mixed methods study included: (i) Observations and exit interviews in eight village clinics and township health centres and 15 retail pharmacies; (ii) Urine, throat swab and sputum samples from patients to identify potential pathogens and test susceptibility; (iii) 103 semi-structured interviews with doctors, patients, pharmacy workers and antibiotic-purchasing customers; (iv) Assessment of completeness and accuracy of electronic patient records through comparison with observational data. 87.9% of 1123 recruited clinic patients were prescribed antibiotics (of which 35.5% contained antibiotic combinations and >40% were for intravenous administration), most of whom had RTIs. Antibiotic prescribing for RTIs was not associated with presence of bacterial pathogens but was correlated with longer duration of infection (OR = 3.33) and presence of sore throat (OR = 1.64). Fever strongly predicted prescription of intravenous antibiotics (OR = 2.87). Resistance rates in bacterial pathogens isolated were low compared with national data. 25.8% of patients reported antibiotics use prior to their clinic visit, but only 56.2% of clinic patients and 53% of pharmacy customers could confirm their prescription or purchase included antibiotics. Diagnostic uncertainty, financial incentives, understanding of antibiotics as anti-inflammatory and limited doctor-patient communication were identified as key drivers of antibiotic use. Completion and accuracy of electronic patient records were highly variable. Prevalence of antibiotic resistance in this rural population is relatively low despite high levels of antibiotic prescribing and self-medication. More systematic use of e-records and in-service training could improve antibiotic surveillance and stewardship in rural facilities. Combining qualitative and observational anthropological methods and concepts with microbiological and epidemiological investigation of antibiotic resistance at both research design and analytic synthesis stages substantially increases the validity of research findings and their utility in informing future intervention development.

Attenuative Effect of Diallyl Trisulfide on Caspase Activity in TNF-α-induced Triple Negative Breast Cancer Cells.

BACKGROUND/AIM: Diallyl trisulfide (DATS) has been shown to prevent and inhibit carcinogenesis in cancer cells. We have previously shown DATS's ability to decrease the percentage of viable cells, inhibit cell migration and modulate genes involved in the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-B) and mitogen-activated protein kinase (MAPK) signaling. MATERIALS AND METHODS: This study aimed to compare the efficacy of DATS in tumor necrosis factor alpha (TNF-α) induced MDA-MB-231 and MDA-MB-468 cells and investigate its role in cell-death signaling via cell cycle, flow cytometry, and caspase assay. RESULTS: DATS exhibit a time-dependent accumulation of G2/M phase cells in both cell lines, with higher effects in the MDA-MB-468 for all time points. DATS's ability to decrease the percentage of viable cells in both MDA-MB-231 and MDA-MB-468 cells was shown by a significant but slight increase of early and late apoptosis in the presence of DATS compared to control. Moreover, MDA-MB-468 cells showed more sensitivity to the DATS effect, evidenced by the higher percentage of apoptosis than MDA-MB-231 cells. The caspase studies showed a significant increase in caspase 3 and 8 activity in the presence of DATS, compared to control, in both cell lines. DATS showed no significant increase in caspase 9 activity in both cell lines compared to the control. CONCLUSION: DATS-induced apoptosis in human breast cancer cells is mediated, at least in part, by cell cycle arrest and caspase activity. These findings provide information for future studies into the role of DATS in TNBC therapy and prevention.

Online interactive medical neuroimaging exercise to identify human brain structures.

A persisting need remains for developing methods for inspiring and teaching undergraduate medical students to quickly learn to identify the hundreds of human brain structures, tracts and spaces that are clinically relevant (viewed as three-dimensional volumes or two-dimensional neuroimages), and to accomplish this with the option of virtual on-line methods. This notably includes teaching the essentials of recommended diagnostic radiology to allow students to be familiar with patient neuroimages routinely acquired using magnetic resonance imaging (MRI) and computed tomography (CT). The present article includes a brief example video plus details a clinically oriented interactive neuroimaging exercise for first year medical students (MS1s) in small groups, conducted with instructors either in-person or as an entirely online virtual event. This "find-the-brain-structure" (FBS) event included teaching students to identify brain structures and other regions of interest in the central nervous system (and potentially in head and neck gross anatomy), which are traditionally taught using brain anatomy atlases and anatomical specimens. The interactive, small group exercise can be conducted in person or virtually on-line in as little as 30 min depending on the scope of objectives being covered. The learning exercise involves coordinated interaction between MS1s with one or several non-clinical faculty and may include one or several physicians (clinical faculty and/or qualified residents). It further allows for varying degrees of instructor interaction online and is easy to convey to instructors who do not have expertise in neuroimaging. Anonymous pre-event survey (n = 113, 100% response rate) versus post-event surveys (n = 92, 81% response rate) were attained from a cohort of MS1s in a neurobiology course. Results showed multiple statistically significant group-level shifts in response to several of the questions, showing an increase in MS1 confidence with reading MRI images (12% increase shift in mean, p < 0.001), confidence in their approaching physicians for medical training (9%, p < 0.01), and comfort levels in working online with virtual team-based peers and with team-based faculty (6%, p < 0.05). Qualitative student feedback revealed highly positive comments regarding the experience overall, encouraging this virtual medium as a desirable educational approach.

Estimating the Cost of Production of Two Pentatomids and One Braconid for the Biocontrol of Spodoptera frugiperda (Lepidoptera: Noctuidae) in Maize Fields in Florida.

The fall armyworm is a polyphagous lepidopteran pest that primarily feeds on valuable global crops like maize. Insecticides and transgenic crops have long been a primary option for fall armyworm control, despite growing concerns about transgenic crop resistance inheritance and the rate of insecticide resistance development. Global dissemination of the pest species has highlighted the need for more sustainable approaches to managing overwhelming populations both in their native range and newly introduced regions. As such, integrated pest management programs require more information on natural enemies of the species to make informed planning choices. In this study, we present a cost analysis of the production of three biocontrol agents of the fall armyworm over a year. This model is malleable and aimed towards small-scale growers who might benefit more from an augmentative release of natural enemies than a repetitive use of insecticides, especially since, though the benefits of using either are similar, the biological control option has a lower development cost and is more environmentally sustainable.

Ceramic Bonding Interface under Shear-Compression Stress: Ultra-High-Speed Imaging Contribution.

The aim of this study is to visualize and characterize by ultra-high-speed imaging (UHSI) the failure phenomena at the resin-ceramic bonding interface of lithium disilicate (LiSi2) samples bonded with gold-standard protocol (Monobond Plus [MB]) and the nontoxic one (Monobond Etch & Prime [MEP]) subjected to mechanical loading. Unprecedented frame rate, image resolution, and recording time were reached by using the most advanced UHSI camera. The finite element analysis (FEA) of the proposed mechanical test confirmed that the specific design of our samples enables a combined shear and compression stress state, prone to test the bonding interface while being close to physiological stresses. Ten LiSi2 samples were pretreated by gold standard (MB, n = 5) and self-etching primer (MEP, n = 5). Axial compression loading gradually increased until catastrophic failure was performed. As shown by the FEA, the angle between the bonding interface and load direction leads to shear-compression stresses at the resin-ceramic bonding interface. Failure was recorded by UHSI at 300,000 fps. All recorded images were analyzed to segregate events and isolate the origin of fracture. For the first time, thanks to the image recording setup, it was observed that debonding is the first event before breakage, highlighting that sample fracture occurs by interfacial rupture followed by slippage and cohesive failure of materials. Failure mode could be described as mixed. MEP and MB showed similar results and behavior.

Effects of Three Cultural Practices on Drosophila suzukii (Diptera: Drosophilidae) in Open Blueberry Fields in Florida.

The spotted-wing Drosophila (SWD), Drosophila suzukii, is native species in Southeast Asia. For over a decade, this invasive pest has been globally expanding. The economic losses to soft fruits and stoned fruits in the United States are increasing every year. Presently, the only viable tool to reduce the SWD population is the continued use of broad-spectrum insecticides. Pesticide resistance is appearing in the populations for the SWD. Organic farmers have limited options to control this pest in open fields. The major goal of this study was to develop cost-effective pest management strategies to manage the SWD using three types of mulches (two plant-based and one fabric-based) to reduce fly population and damage in open blueberry fields in north Florida. The study was conducted in two fruiting seasons (2017 and 2018). The study results demonstrated that the fly trap catches in 2017 shortleaf pine needle mulch had much higher populations (about 2.5-fold) of the SWD than all other treatments. In 2018, the numbers were about 1.7-fold more on shortleaf pine needle mulch than on other treatments. The fine texture of the mulch (pine needles) can easily facilitate the emergence of the SWD if the mulch is not thick enough. Although the pine needles covered the soil surface, it may have been too thin and thus allowed the SWD adults to emerge from the soil without much hindrance. In 2018, a higher population of the SWD was recorded from all the mulching practices. However, there were no significant differences in trap catches between all treatments. In general, the fly population is reduced with the use of pine bark and black weed fabric mulches. This is the first study that reports the effects of three mulches in controlling the SWD populations, which could benefit conventional and organic blueberry growers.

Intraguild Interactions of Three Biological Control Agents of the Fall Armyworm Spodoptera frugiperda (JE Smith) in Florida.

The fall armyworm, Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae), is a maize pest worldwide. Its host range comprises more than 350 reported plant species, and it is the primary insect pest attacking maize in Florida. Global trade has not only assisted but accelerated its invasion into the Eastern Hemisphere. Regular pesticide use promotes resistance in the species; therefore, there is an urgent need for alternative pest management strategies. This study evaluated the interactions of biological control agents within a similar guild. Some of the reported interactions could potentially lead to the integration of these agents within the same niche to increase biological control efficiency against the fall armyworm. We evaluated three biocontrol agents that are natural enemies of Lepidopteran pests, the true bugs Podisus maculiventris and Euthyrhynchus floridanus (Hemiptera: Pentatomidae) and a parasitoid, Cotesia marginiventris (Hymenoptera: Braconidae). Depending on their intraguild interactions, these agents could potentially be useful for biological control of the fall armyworm. The study investigated these three biocontrol agents and concluded that integrating these agents to control the fall armyworm is a possibility; however, only under certain conditions. Investigations were focused on evaluating the predator-parasitoid and devised pairing interactions. Predator response to prey in a choice or no-choice scenario and choices based on olfaction or other bodily cues were studied under experimental laboratory conditions.

Learning about COVID-19 across borders: public health information and adherence among international travellers to the UK.

OBJECTIVE: Public health control measures at borders have long been central to national strategies for the prevention and containment of infectious diseases. Travel was inevitably associated with the rapid global transmission of COVID-19. In the UK, public health authorities tried to reduce the risks of travel-associated spread by providing public health information at ports of entry. This study investigates risk assessment processes, decision-making and adherence to official advice among international travellers, to provide evidence for future policy on the provision of public health information to facilitate safer international travel. STUDY DESIGN: This study is a qualitative study evaluation. METHOD: International air passengers arriving at the London Heathrow Airport on scheduled flights from China and Singapore were approached for interview after consenting to contact in completed surveys. Semi-structured interviews were conducted by telephone, using two topic guides to explore views of official public health information and self-isolation. Interview transcripts were coded and analysed thematically. RESULTS: Participants regarded official advice from Public Health England as adequate at the time, despite observing differences with intervention measures implemented in their countries of departure. Most participants also described adopting precautionary measures, including self-isolation and the use of face coverings that went beyond official advice, but reported adherence to guidance on contacting health authorities was more variable. Adherence to the official guidance was informed by the perceived salience of specific transmission possibilities and containment measures assessed in relation to participants' local social and institutional environments. CONCLUSION: Analysis of study findings demonstrates that international air travellers' responses to public health advice constitute a proactive process of risk assessment and rationalised decision-making to guide preventive action. This process incorporates consideration of the current living situation, trust in information sources, correspondence with cultural logics and willingness to accept potential risk to self and significant others. Our findings concerning international passengers' understanding of, and compliance with, official advice and mitigation measures provide valuable evidence to inform future policy and generate recommendations on the presentation of public health information to facilitate safer international travel. Access to a central source of regularly updated official information would help minimise confusion between different national guidelines. Greater attention to the differentiated information needs of diverse groups in creating future public-facing guidance would help to minimise the uncertainties generated by the receipt of generic information.

Cribra orbitalia is correlated with the meningo-orbital foramen and is vascular and developmental in nature.

Cribra orbitalia is a phenomenon with interdisciplinary interest. However, the etiology of cribra orbitalia remains unclear. Recently, the appearance of cribra orbitalia was identified as vascular in nature. This study assessed the relationship between anatomical variation of vasculature, as determined by the presence of meningo-orbital foramina, and the presence of cribra orbitalia in 178 orbits. Cribra orbitalia was identified in 27.5% (49:178) of orbits (22.7%, 35:154 adult orbits and 58.3%, 14:24 subadult orbits) and meningo-orbital foramina were identified in 65.8% (100:152) of orbits. Among the 150 total intact adult orbits (i.e., orbital roof and posterior orbits both intact), cribra orbitalia was found in 35 (23.3%). Of these 35 occurrences of cribra orbitalia, 32 (91.4%) had the concurrent finding of a meningo-orbital foramen. However, in the absence of the meningo-orbital foramen, cribra orbitalia was only found in three sides out of the total sample of intact orbits (3:150; 2.0%). Fisher's exact test revealed that the presence of cribra orbitalia and the meningo-orbital foramen were statistically dependent variables (p = .0002). Visual evidence corroborated statistical findings-vascular impressions joined cribra orbitalia to meningo-orbital foramina. This study identifies that individuals who possess a meningo-orbital foramen are anatomically predisposed to developing cribra orbitalia. Conversely, cribra orbitalia is unlikely to occur in an individual who does not possess a meningo-orbital foramen. Thus, the antecedent of cribra orbitalia is both vascular and developmental in nature. This report represents an important advancement in the understanding of cribra orbitalia-there is an anatomical predisposition to the development of cribra orbitalia.

Public health information on COVID-19 for international travellers: lessons learned from a mixed-method evaluation.

OBJECTIVES: In the containment phase of the response to the COVID-19 outbreak, Public Health England (PHE) delivered advice to travellers arriving at major UK ports. We aimed to rapidly evaluate the impact and effectiveness of these communication materials for passengers in the early stages of the pandemic. STUDY DESIGN: The study design used is the mixed-methods evaluation. METHODS: A questionnaire survey and follow-up interviews with passengers arriving at London Heathrow Airport on scheduled flights from China and Singapore. The survey assessed passengers' knowledge of symptoms, actions to take, and attitudes towards PHE COVID-19 public health information; interviews explored their views of official public health information and self-isolation. RESULTS: One hundred and twenty-one passengers participated in the survey and 15 in follow-up interviews. Eighty three percentage of surveyed passengers correctly identified all three COVID-19 associated symptoms listed in PHE information at that time. Most could identify the recommended actions and found the advice understandable and trustworthy. Interviews revealed that passengers shared concerns about the lack of wider official action, and that passengers' knowledge had been acquired elsewhere as much from PHE. Respondents also noted their own agency in choosing to self-isolate, partially as a self-protective measure. CONCLUSION: PHE COVID-19 public health information was perceived as clear and acceptable, but we found that passengers acquired knowledge from various sources and they saw the provision of information alone on arrival as an insufficient official response. Our study provides fresh insights into the importance of taking greater account of diverse information sources and of the need for public assurance in creating public health information materials to address global health threats.

First Report of Insecticide Resistance to Organophosphates and Pyrethroids in the Small Hive Beetle (Coleoptera: Nitidulidae) and Development of a Resistance Monitoring Technique.

The small hive beetle, Aethina tumida Murray (Coleoptera: Nitidulidae), is a serious threat to the honey bee industry, which relies on chemicals for the control of major honey bee pests. We developed a glass vial bioassay for resistance monitoring of adult A. tumida populations in honey bee colonies. We also determined concentrations that could be used to discriminate between susceptible and resistant strains. These include the pyrethroids cypermethrin (25.0 µg per vial) and fluvalinate (25.0 µg per vial) and the organophosphates malathion (10.0 µg per vial), chlorpyrifos (2.5 µg per vial), and coumaphos (25.0 µg per vial). Here, we report that resistance to fluvalinate and coumaphos was widespread in A. tumida populations in Florida in 2019. Aethina tumida populations were still susceptible to cypermethrin, malathion, and chlorpyrifos. The levels of resistance differed between pyrethroid and organophosphate insecticides. Over the last 10 yr, A. tumida populations have developed 43.7-fold resistance to coumaphos and 5.4-fold to fluvalinate. The levels of insecticide resistance were not similar within insecticides in the same class, which suggest that this type of resistance is manageable. Our results demonstrate the usefulness of glass vial bioassays to detect resistance in adult A. tumida and provide the foundation for a resistance management strategy. To the best of our knowledge, this is the first report of insecticide resistance in small hive beetle populations and suggests an urgent need for alternative control strategies for these serious pests of honey bee colonies.

Distinguishing between congenital phenomena and traumatic experiences: Osteochondrosis versus osteochondritis.

The current study is to distinguish between osteochondrosis and osteochondritis, utilizing surface microscopy of individuals with documented pathology. Osteochondrosis is associated with smooth borders and gradient from edge to defect base, while osteochondritis and subchondral impaction fractures are associated with subsidence of the affected area of articular surface with irregular edges. The base of osteochondrosis is penetrated by multiple channels, smoothly perforate its surface, indistinguishable from unfused epiphyses, confirming their vascular nature. This study provides a technique for distinguishing osteochondrosis and osteochondritis and further documents of the value of epi-illumination microscopy in expanding our understanding of bone and joint disease.

Clinical Implications of the Submental and Sublingual Arteries in Relation to the Mylohyoid Boutonnière.

OBJECTIVE: Mylohyoid musculature may be included in the submental artery flap to protect perforators. However, blood vessels may pass through the mylohyoid muscle and therefore cause bleeding and risk to pedicle or perforator injury when a mylohyoid-containing flap is lifted. The objectives of this study were to identify the prevalence of the submental and sublingual arteries that traverse the mylohyoid and to assess relationships between vasculature transmitted through mylohyoid muscles and mylohyoid boutonnières. STUDY DESIGN: Cross-sectional human cadaveric study. SETTING: The West Virginia University School of Medicine human gross anatomic laboratories. SUBJECTS AND METHODS: A total of 43 intact mylohyoid muscles from 22 cadavers were dissected. The prevalence of submental vasculature perforating the mylohyoid was recorded in addition to the prevalence and contents of mylohyoid boutonnières. RESULTS: Of 43 mylohyoid muscles, 21 (48.8%) transmitted the submental or sublingual arteries, and 30 (69.1%) possessed boutonnières. One muscle had 2 boutonnières. Of 31 mylohyoid boutonnières, 21 transmitted blood vessels (67.7%). Specifically, 9 transmitted an artery and a vein (29.0%), and 12 transmitted an artery (38.7%). Ten boutonnières (32.3%) were exclusively occupied by fascia. CONCLUSION: This report identifies the importance of identifying and carefully ligating branches of the submental artery that pierce the mylohyoid during elevation of the submental island flap. This report also identifies that a boutonnière is often present where a submental or sublingual artery is traversing the mylohyoid to supply sublingual glands, tongue, and anterior mandible.

Cribra orbitalia is a vascular phenomenon unrelated to marrow hyperplasia or anemia: Paradigm shift for cribra orbitalia.

The orbital phenomenon, cribra orbitalia, has long been a source of controversy, especially with regard to its nature, derivation, and relationship to anemia. Therefore, the external surfaces of orbital roofs were systematically examined microscopically in human skulls from historical collections. Superior orbital surfaces of 278 individual crania within the Hamann-Todd collection were assessed at various magnifications using epi-illumination microscopy to identify the presence of cribra orbitalia and characterize its nature. Also, 12 additional individuals with diagnosed anemia in the Hamann-Todd collection were evaluated. Orbital roof alterations, present in one-third of examined crania, had two discrete appearances: Vascular grooves (45%) and application of new bone in a vascular branching pattern on the orbit surface (55%). Porosity of the orbit was not observed. Evaluation of the orbits of 12 individuals with diagnosed anemia revealed one with a single deep defect, suggesting a space-occupying phenomenon, but no evidence of bone accretion, vascular grooves, or porosity. Cribra orbitalia has often been lumped indiscriminately as an indicator of organismal stress, rather than identified as a indicating a specific etiology. Neither that perspective nor porosity are supported by high resolution examination of orbital roof changes. Recognition of the blood vessel imprint pattern falsifies previous speculations and provides a new paradigm. The actual character of cribra orbitalia is documented and new hypotheses generated. While population prevalence of cribra orbitalia seems excessive for explanation on the basis of these hypotheses, the imprints are clearly vascular in origin.

Molecular Assessment of Genes Linked to Immune Response Traits of Honey Bees in Conventional and Organically Managed Apiaries.

Honey bees are of great economic importance, not only for honey production but also for crop pollination. However, honey bee populations continue to decline mainly due to exposure to pesticides, pathogens and beekeeping practices. In this study, total soluble protein was measured, total RNA was extracted and first-strand cDNAs were generated. Quantitative PCR was used to assess the relative expression (transcript abundances) of immune function-related genes in honey bees collected from organically and conventionally managed hives. Honey bees collected from conventionally managed hives with 0% Varroa mite infestation levels displayed an upregulated expression of the prophenoloxidase gene (cellular defense). Similarly, honey bees collected from organically managed hives had increased levels of the vitellogenin gene (immune function and longevity). The gene expression for malvolio (sucrose responsiveness) was highest in organically managed hives with 0% Varroa mite infestations. Young adult bees collected from organically managed hives with 5% Varroa mite infestation levels had upregulated expressions of the gene spaetzle, whereas bees from similarly infested, conventionally managed hives did not, suggesting that honey bees from organically managed hives could mount an immune response. In young adult bees collected from organically managed hives only, the expression of the immune deficiency gene (antimicrobial defense) was upregulated. The relative gene expression for superoxide dismutase 1 increased in young adult bees collected from hives with 5% Varroa mite infestation levels as expected. However, for superoxide dismutase 2, there was a high level of gene expression in adult bees from both conventionally managed hives with 0% Varroa mite infestation levels and organically managed hives with 5% Varroa mite infestations. The gene CYP9Q3 (pesticide detoxification) that metabolizes coumaphos and fluvalinate was upregulated in adult bees collected from organically managed bees. Overall, these findings provide useful insights into the genetic response of honey bees to some environmental stressors and could be an important component of best beekeeping practices that intend to enhance honey bee health.

Factors associated with adherence to self-isolation and lockdown measures in the UK: a cross-sectional survey.

OBJECTIVES: To investigate factors associated with adherence to self-isolation and lockdown measures due to COVID-19 in the UK. STUDY DESIGN: Online cross-sectional survey. METHODS: Data were collected between 6th and 7th May 2020. A total of 2240 participants living in the UK aged 18 years or older were recruited from YouGov's online research panel. RESULTS: A total of 217 people (9.7%) reported that they or someone in their household had symptoms of COVID-19 (cough or high temperature/fever) in the last 7 days. Of these people, 75.1% had left the home in the last 24 h (defined as non-adherent). Men were more likely to be non-adherent, as were people who were less worried about COVID-19, and who perceived a smaller risk of catching COVID-19. Adherence was associated with having received help from someone outside your household. Results should be taken with caution as there was no evidence for associations when controlling for multiple analyses. Of people reporting no symptoms in the household, 24.5% had gone out shopping for non-essentials in the last week (defined as non-adherent). Factors associated with non-adherence and with a higher total number of outings in the last week included decreased perceived effectiveness of government 'lockdown' measures, decreased perceived severity of COVID-19 and decreased estimates of how many other people were following lockdown rules. Having received help was associated with better adherence. CONCLUSIONS: Adherence to self-isolation is poor. As we move into a new phase of contact tracing and self-isolation, it is essential that adherence is improved. Communications should aim to increase knowledge about actions to take when symptomatic or if you have been in contact with a possible COVID-19 case. They should also emphasise the risk of catching and spreading COVID-19 when out and about and the effectiveness of preventative measures. Using volunteer networks effectively to support people in isolation may promote adherence.

Transoral Chondrolaryngoplasty: Scarless Reduction of the Adam's Apple.

The purpose of our study is to test the feasibility of transoral thyroid chondrolaryngoplasty using a similar approach to transoral thyroidectomy. This approach would allow for gender-affirming surgery while avoiding an external neck scar. We carried out our cadaveric feasibility study in an anatomy laboratory at an academic center. Five fresh cadavers were used for this study. We used a lower oral vestibular incision, along with retractors and an endoscope to dissect and gain access to the laryngeal prominence of the thyroid cartilage. Portions of the laryngeal prominence were then removed using scissors to achieve a satisfactory neck contour. Endoscopic as well as extracorporeal photographs were taken to demonstrate the approach. We were able to remove the laryngeal prominence successfully in all of our cadaveric specimens with this transoral approach.

Improving exposure for transoral oropharyngeal surgery with the floor of mouth window: a cadaveric feasibility study.

BACKGROUND: Transoral robotic and laser surgery is rising in popularity due to the increasing incidence of Human Papilloma Virus (HPV) related oropharyngeal cancer. However, adequate exposure of the tongue base remains a major hurdle in many cases. This study introduces a novel surgical technique called the Floor of Mouth Window, which can be used to improve tongue base exposure at the time of transoral surgery. METHODS: This is a preclinical anatomic cadaver study. Seven fresh cadavers were used for this study. Exposure of the tongue base was compared between conventional mouth gags - the Feyh-Kastenbauer and McIvor - and our novel procedure, the Floor of Mouth Window. Exposure was compared subjectively using endoscopic and extracorporeal photographs, as well as objective measurements of inter-incisor distance, and oral cavity volume. RESULTS: The exposure achieved by the Floor of Mouth Window technique was superior to the mouth gags. Inter-incisor distance and oral cavity volume measurements were all more favorable with the Floor of Mouth Window. This technique allowed for successful transoral laser tongue base and tonsil resection without the use of gags or scopes. CONCLUSION: The Floor of Mouth Window is an adjunctive procedure that simply and reliably improved exposure for transoral oropharyngeal surgery in this cadaveric feasibility study. This improved exposure may help increase the adoption of transoral surgery and reduce the number of aborted cases due to anatomic limitations.

Evaluation of Monitoring Traps and Lures for Drosophila suzukii (Diptera: Drosophilidae) in Berry Plantings in Florida.

Drosophila suzukii (Diptera: Drosophilidae) is an invasive insect pest that was detected in Florida in August 2009 in Hillsborough County. Very limited information is available for berry growers to properly detect and monitor this serious pest in southern highbush blueberry (hybrids of Vaccinium corymbosum L. × V. darrowi Camp), rabbiteye blueberry (Vaccinium virgatum L.), and blackberry (Rubus fruticosus L.) production systems. We compared several D. suzukii traps and lures/baits at two sites in Florida. The traps evaluated included Trécé, Scentry, and a standard homemade cup trap. These traps were compared with various baits and lures, including Trécé lure, Scentry lure, yeast bait, and Suzukii trap, under Florida production systems. Early detection is important to develop an effective monitoring system so management action can be taken before economic damage occurs. Data were recorded as overall trends, as well as in 4-5 trapping periods from early to late season. Overall, the Scentry trap baited with Scentry lure, the Trécé trap baited with Trécé lure + yeast, and the Trécé trap baited with Scentry lure were the best performing traps. Yeast-based traps were also attractive to D. suzukii early in the season, but they did not provide consistent captures as the season progressed. The Scentry trap with yeast bait, the Scentry trap with Scentry lure, the Trécé trap with Trécé lure + yeast bait, and a cup trap with yeast bait caught most of the flies during the first trapping period in 2015 and 2016 in the rabbiteye blueberry. In the southern highbush blueberry, the population of D. suzukii was much lower than in the rabbiteye blueberry planting, and the Scentry trap with Scentry lure captured the highest number of flies during the first trapping period in 2016. In the blackberry, the Scentry trap with Scentry lure numerically had the highest captures during the first trapping period, but this was not significantly different from the cup trap with yeast bait, the Trécé trap baited with Suzukii trap, and the Trécé trap with Trécé lure. Overall, the Scentry trap with Scentry lure was the most consistent trap that captured D. suzukii flies throughout the season in the three production systems-rabbiteye blueberry, southern highbush blueberry, and blackberry. Growers in low pressure systems that are similar to Florida can use the Scentry trap with Scentry lure to monitor D. suzukii populations.