Clinical outcomes of laser hemorrhoidoplasty with feeding vessels suture ligation: a retrospective study in a single center.

BACKGROUND: Laser hemorrhoidoplasty has demonstrated significant therapeutic effectiveness. To diminish postoperative bleeding and enhance overall outcomes, we have additionally adopted suture ligating the feeding vessels. This study aimed to understand the treatment outcomes and any associated complications. METHODS: This study comprised patients with symptomatic grade II-III hemorrhoids who underwent laser hemorrhoidoplasty with feeding vessel suture ligation and Milligan-Morgan hemorrhoidectomy between 1 September 2020, and 31 August 2022. Surgical-related details, postoperative pain, discomfort after discharge, hemorrhoid recurrence, and any complications were collected from inpatient records, outpatient follow-ups, and telephone interviews. Initially, we will analyze the distinctions between the laser group and the traditional group, followed by an investigation into complications and satisfaction within the laser surgery subgroup. RESULTS: The study included 323 patients, with 173 undergoing laser hemorrhoidoplasty (LHP) and 150 undergoing Milligan-Morgan hemorrhoidectomy. Regarding pain assessment, the LHP group exhibited superior performance compared to traditional surgery at postoperative 4 h, before discharge, and during the first and second outpatient visits, with statistically significant differences. Additionally, the LHP group had a lower rate of urinary retention and experienced significantly less pain, with statistically significant differences. CONCLUSIONS: Laser hemorrhoidoplasty with feeding vessels suture ligation has been shown to reduce postoperative pain and appears to be a promising minimally invasive treatment option for symptomatic grade II and III hemorrhoids.

Impact of chemotherapy on surgical outcomes in ileostomy reversal: a propensity score matching study from a single centre.

PURPOSE: In patients with chemotherapy, there is no consensus on the timing of ileostomy closure. Ileostomy reversal could improve the quality of life and minimise the long-term adverse events of delayed closure. In this study, we evaluated the impact of chemotherapy on ileostomy closure and searched for the predictive factors for complications. METHODS: We retrospectively analysed 212 patients with rectal cancer who underwent ileostomy closure surgery during and without chemotherapy and were consecutively enrolled between 2010 and 2016. As a result of the heterogeneity of the two groups, propensity score matching (PSM) was performed with a 1:1 PSM cohort. RESULTS: A total of 162 patients were included in the analysis. The overall stoma closure-related complications (12.4% vs. 11.1%, p = 1.00) and major complications (2.5% vs. 6.2%, p = 0.44) were not significantly different between the two groups. Multivariate analysis demonstrated that chronic kidney disease and bevacizumab use are risk factors for major complications. CONCLUSION: Patients with oral or intravenous chemotherapy can safely have ileostomy closure with an adequate time delay from chemotherapy. When patients use bevacizumab, major complications related to ileostomy closure should still be cautioned.

Quantum Interference between Light Sources Separated by 150 Million Kilometers.

We report an experiment to test quantum interference, entanglement, and nonlocality using two dissimilar photon sources, the Sun and a semiconductor quantum dot on the Earth, which are separated by ∼150 million kilometers. By making the otherwise vastly distinct photons indistinguishable in all degrees of freedom, we observe time-resolved two-photon quantum interference with a raw visibility of 0.796(17), well above the 0.5 classical limit, providing unambiguous evidence of the quantum nature of thermal light. Further, using the photons with no common history, we demonstrate postselected two-photon entanglement with a state fidelity of 0.826(24) and a violation of Bell inequality by 2.20(6). The experiment can be further extended to a larger scale using photons from distant stars and open a new route to quantum optics experiments at an astronomical scale.

Antibacterial activity against Ralstonia solanacearum of the lipopeptides secreted from the Bacillus amyloliquefaciens strain FJAT-2349.

AIMS: The aims of this study were to identify the structure of antibacterial lipopeptide (LP) produced by Bacillus amyloliquefaciens strain FJAT-2349, to analyse the effects of the culture medium and temperature on LP production and to assess the biocontrol efficiency of the LPs against tomato bacterial wilt. METHODS AND RESULTS: Lipopeptides were extracted by acid precipitation and resolved in methanol and their structure was identified through LC-QTOF-MS/MS method. The antibacterial activities of the LPs were evaluated through inhibition zone experiments. The biocontrol efficiency of the LPs against tomato bacterial wilt was examined by a pot test. The LPs were composed of iturin (C14 -C17 iturin A), fengycin (C14 /C16 fengycin A, C14 fengycin B2 , C16 fengycin A2 /B2 , C16 -C17 fengycin B, C15 fengycin A derivatives and C15 fengycin B derivatives) and surfactin (C12 -C16 surfactin A). Moreover, the composition of the LPs was significantly influenced by the culture medium and temperature; the contents of iturin, fengycin and surfactin varied within the range from 0·41-5·89, 4·54-181·67 and 2·05-19·65 mg l-1 in the different culture media and from 0·39-11·04, 1·45-215·14 and 7·79-24·43 mg l-1 under different culture temperatures respectively. The results indicated that the contents of the LP mixture, fengycin and surfactin secreted from FJAT-2349 all decreased along with an increasing culture temperature. The fermentation supernatants and LP extracts had the strongest inhibition activities of Ralstonia solanacearum when strain FJAT-2349 was incubated at 25°C using potato dextrose broth as the culture medium among all the assayed culture conditions. The purified fengycin was found to be the active antibacterial compound against R. solanacearum, but the purified surfactin was not. The pot experiments demonstrated that the LPs secreted from the strain FJAT-2349 could effectively control the tomato bacterial wilt with a biocontrol efficiency of 97·6%. CONCLUSIONS: The LPs secreted from strain FJAT-2349 could serve as potential biocontrol agents against tomato bacterial wilt. SIGNIFICANCE AND IMPACT OF THE STUDY: The LPs exhibited good potential applications in the biocontrol of tomato bacterial wilt.

[A mini-incision on the anterior hip for pediatric femur neck fractures of type Delbet â ¡].

Objective: To investigate the early clinical outcomes of hip anterior short incision and open reduction and internal fixation for the treatment of children with Delbet Ⅱ femoral neck fracture. Methods: A retrospective analysis of 12 children with DelbetⅡ femoral neck fractures was performed with the anterior short incision approach at Department of Pediatric Orthopaedic, Children's Hospital, Nanjing Medical University from January 2014 to August 2016. There were 7 males and 5 females including 8 cases at left side and 4 cases at right side,aged (11.5±0.8) years (range: 8-14 years).Patients underwent surgery in (12.0±0.9) hours (range: 6-20 hours) after the injury. Displaced fractures were treated by open reduction if closed reduction failed.The surgical incision was performed with the anterior inferior iliac spine centered on, extending along the groin crease, and the length was 3 to 4 cm. The interval between the sartorius and the tensor fascia latae was applied, and the direct and indirect head of rectus femoris were resected to visualize the hip joint capsule. T-shaped incision was made in the capsule. After the reduction was obtained, two or three compression canulated screws were used to fix the fracture site. The healing time, complications and corresponding record outcome by X-ray and clinical examination were recorded. At the latest follow-up,the results were analyzed using the Ratliff criteria and clinical outcomes were assessed by pain, restrictive hip movement, normal activity or the avoidance of games, and the femoral neck in the radiograph. Results: Twelve patients had been followed-up for (30.0±4.1)months(range: 24-36 months). X-ray showed the fractures' healing time was (8.0±0.4) weeks(range: 7-9 weeks). Ten of the 12 fractures healed after one operation and were associated with no evidence of osteonecrosis of the femoral head. One case occurred premature physeal closure. There were no cases with fracture relocation, coaxvara, delayed union and nonunion or any significant postoperative complications. There was no infection, flexible internal fixation or ruptures. According to Ratliff grade, 9 cases of 12 patients were fine and 3 cases was acceptable. Conclusions: Satisfactory short-term effects can be achieved by a mini-incision on the anterior hip for Delbet Ⅱ pediatric femur neck fractures. The anterior incision has the advantage of less trauma, smaller incision scar, better fracture reduction and fixation, and less wound complications.

Toward Scalable Boson Sampling with Photon Loss.

Boson sampling is a well-defined task that is strongly believed to be intractable for classical computers, but can be efficiently solved by a specific quantum simulator. However, an outstanding problem for large-scale experimental boson sampling is the scalability. Here we report an experiment on boson sampling with photon loss, and demonstrate that boson sampling with a few photons lost can increase the sampling rate. Our experiment uses a quantum-dot-micropillar single-photon source demultiplexed into up to seven input ports of a 16×16 mode ultralow-loss photonic circuit, and we detect three-, four- and fivefold coincidence counts. We implement and validate lossy boson sampling with one and two photons lost, and obtain sampling rates of 187, 13.6, and 0.78 kHz for five-, six-, and seven-photon boson sampling with two photons lost, which is 9.4, 13.9, and 18.0 times faster than the standard boson sampling, respectively. Our experiment shows an approach to significantly enhance the sampling rate of multiphoton boson sampling.

The prevalence and influencing factors for child neglect in a rural area of Anhui province: a 2-year follow-up study.

OBJECTIVES: The purpose of the current study was to identify the change of prevalence and influencing factors for child neglect in a rural area of Anhui province through the 2-year follow-up study. STUDY DESIGN: Longitudinal study with 2-year follow-up. METHODS: Analyses were based on data from a longitudinal study, performed in five elementary schools and three secondary schools in Changfeng County. A total of 816 children aged between 7 and 16 years completed the three assessments during the period of 2009-2011. Generalized estimating equations (GEEs) were applied to identify the influencing factors of child neglect. RESULTS: The prevalence of child neglect was 67.8%, 56.6%, and 57.7% at the three assessments, respectively. There were 272 children (33.3%) having consistently experiencing neglect during three assessments and 106 (13.0%) children had not suffered from neglect during three assessments. Among 553 participants who experienced neglect at the first assessment, 105 (19.0%) children no longer met the diagnosis at the next two assessments. Fifty-two children who did not suffer from neglect at the first assessment experienced neglect at the final assessment. The results of GEEs showed that child neglect was clearly associated with age (odds ratio [OR] = 0.95, 95% confidence interval [CI] = 0.92-0.99, P = 0.016), male gender (OR = 1.20, 95% CI = 1.00-1.43, P = 0.047), siblings (OR = 1.26, 95% CI = 1.03-1.55, P = 0.028), parental marital disruption (OR = 2.02, 95% CI = 1.09-3.78, P = 0.027), left-behind status (OR = 1.26, 95% CI = 1.06-1.49, P = 0.008), severe family dysfunction (OR = 1.46, 95% CI = 1.03-2.07, P = 0.035), quality of life (OR = 0.98, 95% CI = 0.98-0.99, P < 0.001), positive coping styles (OR = 0.97, 95% CI = 0.94-0.99, P = 0.001), and negative coping styles (OR = 1.03, 95% CI = 1.02-1.05, P < 0.001). CONCLUSION: Our studies detected the decreased prevalence of child neglect across the three assessments. Additionally, some sociodemographic, psychosocial and family risk factors of child neglect were identified, which will be helpful for child neglect prevention strategies development and implementation in China.

[Effects and mechanism of allogeneic platelet rich plasma on collagen synthesis in wound healing].

Objective: To investigate the effects and mechanism of allogeneic platelet rich plasma (PRP) on collagen in wound surface at different time. Methods: A total of 50 clean 7-week rats were selected for this study, including 10 rats for platelet-rich blood plasma preparation, 20 rats for PRP group and 20 rats for control group, 0.1 ml allogenic PRP and 0.1 ml saline were smeared respectively on wound surfaces of PRP and control group, wound regeneration and healing were examined. Cellular and histological morphology alteration was observed via Masson staining, type Ⅰ and type Ⅲ collagen protein and mRNA expression level were detected by Western blot and real-time PCR. T test was applied for comparison between two samples and one-way ANOVA was utilized for comparison between two groups. Results: The wound healing rate of PRP group was higher than that of control group on 3(rd,) 6(th,) 10(th) and 15(th) day (30.33±3.35 vs.18.35±2.04, 55.51±2.74 vs.36.83±2.34, 79.64±1.40 vs.56.92±1.44, 86.88±2.12 vs.65.80±1.76) after wound surface formation, there were statistic differences (t=13.66-50.48, all P<0.05). The wound collagen of PRP group form faster and coarser, and the fibers arrayed more densely in Masson staining. The protein expression of type Ⅰ collagen(1.92±0.09 vs.1.18±0.11) and type Ⅲ collagen(1.16±0.05 vs.0.74±0.11) of PRP group were higher than that of control group (t=22.99, P<0.01; t=17.62, P<0.05); the mRNA expression of type Ⅰ collagen(5.17±0.11 vs.1.79±0.18, 6.97±0.09 vs.1.96±0.08, 6.00±0.26 vs.2.10±0.05, 4.95±0.11 vs.3.58±0.09)and type Ⅲ collagen(2.35±0.08 vs.1.44±0.05, 3.08±0.05 vs.1.84±0.06, 3.48±0.07 vs.2.36±0.09, 4.42±0.07 vs.2.77±0.10) were higher than that of control group on 3(rd,) 6(th,) 10(th) and 15(th) day after wound surface formation, there were significant differences (t=43.37-188.37, all P<0.05). Conclusion: The allogeneic platelet rich plasma may promote fibroblasts secreted collagen by activated and releasing all kinds of growth factors, especially type Ⅰ and type Ⅲ collagen to accelerate the wound healing.

On-Demand Single Photons with High Extraction Efficiency and Near-Unity Indistinguishability from a Resonantly Driven Quantum Dot in a Micropillar.

Scalable photonic quantum technologies require on-demand single-photon sources with simultaneously high levels of purity, indistinguishability, and efficiency. These key features, however, have only been demonstrated separately in previous experiments. Here, by s-shell pulsed resonant excitation of a Purcell-enhanced quantum dot-micropillar system, we deterministically generate resonance fluorescence single photons which, at π pulse excitation, have an extraction efficiency of 66%, single-photon purity of 99.1%, and photon indistinguishability of 98.5%. Such a single-photon source for the first time combines the features of high efficiency and near-perfect levels of purity and indistinguishabilty, and thus opens the way to multiphoton experiments with semiconductor quantum dots.

Near-Transform-Limited Single Photons from an Efficient Solid-State Quantum Emitter.

By pulsed s-shell resonant excitation of a single quantum dot-micropillar system, we generate long streams of 1000 near-transform-limited single photons with high mutual indistinguishability. The Hong-Ou-Mandel interference of two photons is measured as a function of their emission time separation varying from 13 ns to 14.7 µs, where the visibility slightly drops from 95.9(2)% to a plateau of 92.1(5)% through a slow dephasing process occurring at a time scale of 0.7 µs. A temporal and spectral analysis reveals the pulsed resonance fluorescence single photons are close to the transform limit, which are readily useful for multiphoton entanglement and interferometry experiments.

Determination of the thermal, oxidative and photochemical degradation rates of scintillator liquid by fluorescence EEM spectroscopy.

The thermal, oxidative and photochemical stability of the scintillator liquid proposed for the SNO+ experiment has been tested experimentally using accelerated aging methods. The stability of the scintillator constituents was determined through fluorescence excitation emission matrix (EEM) spectroscopy and absorption spectroscopy, using parallel factor analysis (PARAFAC) as an multivariate analysis tool. By exposing the scintillator liquid to a well-known photon flux at 365 nm and by measuring the decay rate of the fluorescence shifters and the formation rate of their photochemical degradation products, we can place an upper limit on the acceptable photon flux as 1.38 ± 0.09 × 10-11 photon mol L-1. Similarly, the oxidative stability of the scintillator liquid was determined by exposure to air at several elevated temperatures. Through measurement of the corresponding activation energy it was determined that the average oxygen concentration would have to be kept below 4.3-7.1 ppbw (headspace partial pressure below 24 ppmv). On the other hand, the thermal stability of the scintillator cocktail in the absence of light and oxygen was remarkable and poses no concern to the SNO+ experiment.

[Analysis of the influence factors of school-age children's refractive status].

Objective: To analyze the influence of the eye biological parameters, height, and weight on the school-age children's refractive status. Methods: Cross-sectional study. A total of 1 656 children (1 656 eyes), aged from 7 to 14 years, were selected from 8 schools in Wenzhou during June 2012 and June 2013. The height and weight of each child were measured, and the body mass index (BMI) was calculated. The eye biological parameters, including axial length (AL), corneal power (C=1/CR), anterior chamber depth (ACD), and white to white (WTW), were measured by IOLMaster (version 5.0, Carl Zeiss, Germany), and the AL/CR was calculated. Refraction was measured by fast cycloplegic retinoscopy, and the spherical equivalent (SE) was calculated. Only right eyes were included in the analysis. SPSS16.0 was used to analyze the data. The correlations of the equivalent spherical power, the eye biological parameters, height, weight, and BMI were evaluated. Linear regression analysis was used for the SE, AL, and AL/CR. Results: The prevalence of myopia in 7- to 14-year-old school-age children was 50.2% on the average, 48.4% in boys, and 51.7% in girls. The average SE was (-1.07±1.74) D. With adjustment of the age, gender, urban and rural areas, there was an association between the SE and AL, AL/CR, ACD, height and weight. The correlation coefficient was -0.663, -0.730, -0.416, -0.365, and -0.281, respectively (P<0.05). There was no significant correlation between the SE and WTW, corneal power and BMI. Regarding the different refractive statuses, there was a stronger correlation between the SE and AL, AL/CR in children with hyperopia, moderate myopia or high myopia than those with emmetropia or mild myopia (P< 0.01). In the older children, the correlation between the SE and AL, AL/CR was stronger. Linear regression analysis showed SE= 26.55-9.11·AL/CR and 23.0-1.02·AL. Conclusions: There was an association between the SE and AL, AL/CR, ACD, height and weight in school-age children. In children with hyperopia, moderate myopia, high myopia or at an older age, the correlation was more significant between the SE and AL, AL/CR. (Chin J Ophthalmol, 2016, 52:831-835).

Entanglement-based machine learning on a quantum computer.

Machine learning, a branch of artificial intelligence, learns from previous experience to optimize performance, which is ubiquitous in various fields such as computer sciences, financial analysis, robotics, and bioinformatics. A challenge is that machine learning with the rapidly growing "big data" could become intractable for classical computers. Recently, quantum machine learning algorithms [Lloyd, Mohseni, and Rebentrost, arXiv.1307.0411] were proposed which could offer an exponential speedup over classical algorithms. Here, we report the first experimental entanglement-based classification of two-, four-, and eight-dimensional vectors to different clusters using a small-scale photonic quantum computer, which are then used to implement supervised and unsupervised machine learning. The results demonstrate the working principle of using quantum computers to manipulate and classify high-dimensional vectors, the core mathematical routine in machine learning. The method can, in principle, be scaled to larger numbers of qubits, and may provide a new route to accelerate machine learning.

Sustainable Participation in Community Health Programs to Promote a Healthy Lifestyle and Prevent and Protect against Dementia among Rural Taiwanese Middle-Aged and Older Adults.

BACKGROUND: Resource and economic constraints limit access to health care in rural populations, and consequently, rates of chronic illnesses are higher in this population. Further, little is known about how rural populations adopt active and healthy lifestyle behavior for dementia prevention. OBJECTIVES: This study aimed to explore the impact of modification in lifestyle behaviors on changes in cognitive function among middle-aged and older adults living in a rural area of Taiwan. DESIGN: In this prospective longitudinal study, changes in lifestyle and cognitive function were compared between the experimental and control groups. SETTING: Six rural community care stations were randomly cluster sampled in southern Taiwan. PARTICIPANTS: A total of 155 participants were enrolled and classified into two groups according to their community activity participation rate (CAPR). The control group (n=68) had a CAPR < 1x/month, and the experimental group (n=87) had a CAPR ≥ 1x/month. MEASUREMENTS: Cognitive function of the participants was measured using the MMSE scale. Lifestyle behaviors were measured using a self-designed questionnaire based on the Transtheoretical Model. RESULTS: From 2018-2020, the experimental group successfully maintained a healthy lifestyle. The MMSE score in the experimental group was significantly higher in the 3rd year than that in the control group (25.37 vs 22.56, p < 0.001). CONCLUSIONS: Sustainable community participation and adopting a healthy lifestyle could effectively maintain the cognitive function of the study participants. However, more needs to be done to support rural older adults to maintain a healthy diet and control their weight.

Experimental quantum computing to solve systems of linear equations.

Solving linear systems of equations is ubiquitous in all areas of science and engineering. With rapidly growing data sets, such a task can be intractable for classical computers, as the best known classical algorithms require a time proportional to the number of variables N. A recently proposed quantum algorithm shows that quantum computers could solve linear systems in a time scale of order log(N), giving an exponential speedup over classical computers. Here we realize the simplest instance of this algorithm, solving 2×2 linear equations for various input vectors on a quantum computer. We use four quantum bits and four controlled logic gates to implement every subroutine required, demonstrating the working principle of this algorithm.

Indistinguishable tunable single photons emitted by spin-flip Raman transitions in InGaAs quantum dots.

This Letter reports all-optically tunable and highly indistinguishable single Raman photons from a driven single quantum dot spin. The frequency, linewidth, and lifetime of the Raman photons are tunable by varying the driving field power and detuning. Under continuous-wave excitation, subnatural linewidth single photons from off-resonant Raman scattering show an indistinguishability of 0.98(3). Under π pulse excitation, spin- and time-tagged Raman fluorescence photons show an almost vanishing multiphoton emission probability of 0.01(2) and a two-photon quantum interference visibility of 0.95(3). Lastly, Hong-Ou-Mandel interference is demonstrated between two single photons emitted from remote, independent quantum dots with an unprecedented visibility of 0.87(4).

Cetuximab plus chemotherapy as first-line treatment for metastatic colorectal cancer: effect of KRAS mutation on treatment efficacy in Taiwanese patients.

Cetuximab, either alone or in combination with chemotherapy, is approved for treatment of patients with metastatic colorectal cancer (mCRC). We reviewed retrospectively records of 50 patients with mCRC from a single center in Taiwan. All patients had ECOG performance status grade 2, histological diagnosis of advanced CRC based on RECIST criteria, and were given at least three cycles of chemotherapy plus cetuximab. We compared the effectiveness of therapy in patients with wild-type and mutant KRAS genes, assessed the overall response (OR) rate of patients with locally advanced or metastatic non-resectable CRC, and assessed the progression-free survival (PFS) time. The ten patients with KRAS mutations had poorer response rates than the 40 patients with the wild-type KRAS gene. Patients with the wild-type and mutant genes had similar progression free survival (PFS) status and median time to PFS. The median overall survival time was significantly greater in patients with the wild-type gene than in those with the mutant gene (28.77 ± 6.43 months vs. 15.13 ± 0.50 months, p=0.014). Taiwanese patients with mCRC respond better to a cetuximab plus chemotherapy regime if their tumors have the wild-type KRAS gene.

First Report of the Root-Knot Nematode Meloidogyne arenaria Infecting Noni in China.

Noni (Morinda citrifolia) is an important medicinal plant and its fruit and root are of high value. In recent years, noni has been cultivated widely on Hainan Island, China. A survey of eight commercial noni fields in four counties found that most fields had plants with symptoms consistent with damage caused by root-knot nematodes. Above-ground symptoms included reduced vigor, plant stunting, and chlorosis. Affected roots were galled, swollen, cracked, and rotten. Fruit loss associated with diseased plants was quantified as 85%. In each field, three samples were taken consisting of 15 cm wide × 20 cm deep soil (containing roots). The nematode population was extracted and quantified according to Barker (1). Nematodes were found in all soil and root samples with population densities ranging from 450 to 835 eggs and second-stage juveniles (J2s) per 200 g subsample of soil, and 685 to 985 eggs and J2s per 10 g sub-sample of fresh roots. Three single egg masses were respectively hand-picked from one sample of diseased noni roots and inoculated onto tomato plants grown with sterilized soil at 20 to 28°C in the greenhouse. After 8 weeks, nematodes were extracted from the roots of tomato plants and identified by morphology, enzyme analysis, and molecular characterization. Morphology of the female perineal patterns showed a low dorsal arch with large lateral lines separating the striae of the dorsal and ventral sectors, leading to the tail terminus; and wavy, coarse striae with forking at lateral lines and short irregular striae near the lateral lines. Enzyme analysis of the esterase phenotype was also typical of the A1 phenotype in M. arenaria. Based on the perineal pattern and esterase phenotype, the Meloidogyne species was identified as M. arenaria (Est A1) (3). Total genomic DNA was extracted from ca. 10 µl of packed second-stage juveniles (J2s) using the method of Cenis (2). The primers C2F3 (5'-GGTCAATGTTCAGAAATTTGTGG-3') and 1108 (5'-TACCTTTGACCAATCACGCT-3') (4) was used to amplify the intergenic region between COII and LrRNA genes of the mtDNA and an amplification product (1,700 bp) was obtained, similar to M. hispanica, M. incognita, and M. javanica. Root-knot nematodes (Meloidogyne spp.) have been reported to be cause disease on noni in Hawaii. However, to our knowledge, this is the first report of M. arenaria (Est A1) infecting noni in China. References: (1) K. R. Barker. Pp. 19 in: An Advanced Treatise on Meloidogyne. Vol. II, Methodology. K. R. Barker et al. eds. North Carolina State University Graphics, Raleigh, 1985. (2) J. L. Cenis. Phytopathology 83:76,1993. (3) P. E. Esbenshade and A. C. Triantaphyllou. J. Nematol. 17:6,1990. (4) T. O. Power and T. S. Harris J. Nematol. 25:1,1993.

Chlamydial infection during trachoma monitoring: are the most difficult-to-reach children more likely to be infected?

OBJECTIVES: During mass antibiotic distributions for trachoma, certain individuals are difficult to locate and go untreated. These untreated individuals may serve as a source of community reinfection. The importance of this difficult-to-locate, untreated population is unclear. We sought to determine whether individuals who are difficult to locate were more likely to be infected with ocular chlamydia than those who were easier to locate. METHODS: We monitored 12 Ethiopian communities 1 year after a third annual mass azithromycin treatment for trachoma. Conjunctival swabbing for chlamydial RNA was performed in a random sample of children from each community. If insufficient numbers of children were enrolled on the first monitoring day, we returned on subsequent days. RESULTS: Of the 12 communities, 10 required more than one monitoring day. On average, 16.1% (95% CI 7.9-30.0) of children were enrolled after the initial day. Evidence of chlamydia was found in 7.1% (95% CI 2.7-17.4) of 0- to 9-year-old children. No ocular swabs collected after the initial day were positive for chlamydial RNA. Children examined after the initial monitoring day were significantly less likely to have ocular chlamydial infection than children seen on the initial day; Mantel-Haenszel common OR = 0 (95% CI 0-0.77). CONCLUSIONS: In a setting of repeated annual mass azithromycin treatments, after approximately 80% of individuals have been located in a community, extra efforts to find absent individuals may not yield significantly more cases of ocular chlamydia.