Requeening queenright honey bee colonies with queen cells in honey supers.

Many Canadian beekeepers replace a subset of their honey bee queens annually. However, introducing a new queen to a honey bee colony is a management practice with a high degree of uncertainty. Despite the consensus that it is most effective to introduce queens to queenless colonies, some commercial beekeepers claim success with introducing queen cells into the honey super of queenright colonies. We tested the success rate of this practice by introducing queen cells to 100 queenright colonies in southern Alberta during a honey flow. The genotypes of the resultant offspring drones were determined using the microsatellite marker A76 to identify their laying queen mothers. Our results show that new queens successfully supersede original queens in 6% of queenright colonies, suggesting that the practice does not result in the new queen taking over leadership in most colonies. Additionally, supersedure by daughter queens is more common (13%) than new queen supersedure when introducing queen cells to queenright colonies during a honey flow. However, there could be a benefit to the practice of requeening queenright colonies with queen cells in honey supers if the colonies that accepted a new queen (whether a daughter of or unrelated to the old queen) were colonies with a failing queen.

Strong effects of food quality on host life history do not scale to impact parasitoid efficacy or life history.

Parasitoids are small insects, (e.g., small wasps or flies) that reproduce by laying eggs on or within host arthropods. Parasitoids make up a large proportion of the world's biodiversity and are popular agents of biological control. Idiobiont parasitoids paralyze their hosts upon attack and thus are expected to only target hosts large enough to support offspring development. Host resources generally impact host attributes and life histories including size, development, and life span. Some argue slow host development in response to resource quality increases parasitoid efficacy (i.e., a parasitoid's ability to successfully reproduce on or within a host) due to longer host exposure to parasitoids. However, this hypothesis is not always supported and does not consider variation in other host traits in response to resources that may be important for parasitoids (e.g., variation in host size is known to impact parasitoid efficacy). In this study we test whether trait variation within host developmental stages in response to host resources is more important for parasitoid efficacy and life histories than trait variation across host developmental stages. We exposed seed beetle hosts raised on a food quality gradient to mated female parasitoids and measured the number of hosts parasitized and parasitoid life history traits at the scale of host stage- and age-structure. Our results suggest host food quality does not cascade to impact idiobiont parasitoid life histories despite large food quality effects on host life history. Instead, variation in host life histories across host developmental stages better predicts parasitoid efficacy and life histories, suggesting finding a host in a specific instar is more important for idiobiont parasitoids than finding hosts on or within higher quality resources.

Use of an emergency preparedness disaster simulation with undergraduate nursing students.

This is a report of an educational strategy to prepare nursing students to respond to disasters. The strategy includes an emergency preparedness disaster simulation (EPDS) implemented in a school of nursing simulation lab using patient simulators, task trainer mannequins, and live actors. The EPDS immerses student groups into a "tornado ravaged assisted-living facility" where the principles of emergency preparedness can be employed. A total of 90 B.S.N. students participated in the EPDS in the final semester of their senior year. Student post-simulation survey responses were overwhelmingly positive, with mean scores of 4.65 (on a 5-point Likert scale) reported for the EPDS "increasing understanding of emergency preparedness" and "well organized." Mean scores were over 4.40 for "scenario believability, increasing knowledge base, increasing confidence in working in teams, ability to handle emergency preparedness situations and to work more effectively in hospital or clinic." The lowest mean score of 4.04 was for "prompting realistic expectations." Owing to the effectiveness of this educational strategy, the EPDS has been incorporated into the undergraduate curriculum.

The negative effect of triple-negative breast cancer on outcome after breast-conserving therapy.

PURPOSE: To evaluate disease failure patterns and overall survival (OS) of women with triple-negative (TN) breast cancer who underwent breast-conserving therapy (BCT) and to understand the relationship of TN tumors with other prognostic factors. PATIENTS AND METHODS: The Surveillance, Epidemiology, and End Results (SEER) registry identified 562 women diagnosed and/or treated with unilateral invasive breast cancer during 2003-2004 at three Emory hospitals. After medical record review, 193 eligible women, with all tumor types, received BCT. Primary endpoints (local, regional, and distant recurrences) and secondary endpoint (OS) were evaluated using chi-square tests and Cox proportional hazards models. RESULTS: Of the 193 women, 33 (17.1%) had TN tumors and 160 (82.9%) had non-TN tumors. Patient characteristics were similar between the two tumor types; however, tumor grade and use of chemotherapy and hormones differed between the two groups. Median follow-up was 3.4 years; 22 patients had recurrence (12.2%), and 12 died (6.2%). Patients with TN tumors had higher local (12% versus 4% for non-TN) and distant recurrences (15% versus 4% for non-TN) rates (p = 0.01). On multivariate survival analyses, TN status [hazard ratio (HR) 1.8, 95% confidence interval (CI) 1.13-2.93] and African American (AA) race (HR 1.9, 95%CI 1.2-3.07) were independent predictors of inferior OS. CONCLUSIONS: Patients with TN breast cancer showed significant increases in local and distant metastatic recurrence rates after BCT, and TN status and AA race were independent negative predictors of survival. For the future, identification of these high risk features may bring personalized medicine closer to reality.

Design and implementation of an interdisciplinary pediatric mock code for undergraduate and graduate nursing students.

Higher patient acuity and shortage of healthcare professionals have led to an expansion in the role and responsibilities for nurses, and ultimately, nursing students. Nursing faculty are challenged to develop strategies based on core competencies to obtain optimal practice within this complex system. Use of patient simulators is an effective strategy as it allows for deliberate practice of skills and standardized exposure to limited scenarios. The rarity of pediatric codes and opportunities for students to interact in teams led faculty to develop an interdisciplinary pediatric mock code simulation. Senior baccalaureate students function as members of a pediatric code team with emergency nurse practitioner students as code team leaders. Student preparation included Web-based information and an interactive class on code skills and team communication during a sentinel event. The scenario incorporated team roles and family-centered care. The debriefing session reinforced the evidence and reviewed quality improvement and safety through error identification and patient consequences. A total of 43 BSN students and 12 emergency nurse practitioner students participated. The simulation was rated very highly for realism, enjoyment, concept clarification in debriefing, increasing knowledge base, ability to function in the clinical setting, and increasing confidence in caring for a critically ill infant.

Telehealth Adaptation for Multidisciplinary Colorectal Cancer Clinic During the COVID-19 Pandemic.

Background The study objectives were to transition in-person colorectal cancer multidisciplinary clinic (MDC) to a telehealth MDC (tele-MDC) format and to assess early outcomes.  Methods A colorectal tele-MDC was devised, in which patients used remote-access technology while supervised by a clinician. The team consisted of surgeons, medical oncologists, radiation oncologists, radiologists, and pathologists. Outcomes were assessed with patient and provider surveys, using a 5-point Likert scale (higher = more favorable). Results A total of 18 patients participated in the tele-MDC. Surveyed patients (n=18) and physicians (n=19) were satisfied with the quality of care (mean Likert = 4.93, 4.53, respectively), and low standard deviations (range 0-1.03) across all questions reflected homogeneity in satisfaction with the metrics surveyed. Conclusions This pilot study demonstrates that a functional colorectal cancer tele-MDC is a feasible alternative to in-person MDC during the coronavirus disease 2019 (COVID-19) pandemic, with the potential for a high degree of patient and physician satisfaction.

Using National Quality Forum breast cancer indicators to measure quality of care for patients in an AVON comprehensive breast center.

In April 2007, the National Quality Forum (NQF) endorsed the first nationally recognized hospital-based performance measures for quality of care for breast cancer. The aim of this study was to measure quality of care at our AVON Center for Breast Care (AVONCBC) using these indicators. We retrospectively reviewed tumor registry and medical records of females under age 70 diagnosed with breast cancer in years 2005-2006. For patients diagnosed with hormone receptor negative breast cancer, 22 of 29 (75.9%) and 28 of 32 (87.5%) were considered for or received chemotherapy in 2005 and 2006, respectively. Of those patients, 21 of 29 (72.4%) and 24 of 32 (75.0%) were considered for or received chemotherapy within the NQF 4-month period. For patients undergoing breast conserving surgery (BCS), 20 of 23 (86.9%) in 2005 and 37 of 39 (94.9%) in 2006 were referred for adjuvant radiation therapy. The proportion of patients who received radiation therapy within 1 year of diagnosis was 18 of 23 (78.2%) and 29 of 39 (74.4%) for diagnosis years 2005 and 2006, respectively. The vast majority of patients in our AVONCBC are referred to medical and/or radiation oncology for adjunctive therapy and about three-fourths receive treatment compliant with the NQF QI. To increase our compliance rate, we are developing methods to improve access to the multiple disciplines in our AVONCBC. Using the NQF indicators serves to assess hospital performance at a systems-level and as a useful method for tracking cancer quality of care.

Food quality effects on instar-specific life histories of a holometabolous insect.

It is a long-standing challenge to understand how changes in food resources impact consumer life history traits and, in turn, impact how organisms interact with their environment. To characterize food quality effects on life history, most studies follow organisms throughout their life cycle and quantify major life events, such as age at maturity or fecundity. From these studies, we know that food quality generally impacts body size, juvenile development, and life span. Importantly, throughout juvenile development, many organisms develop through several stages of growth that can have different interactions with their environment. For example, some parasitoids typically attack larger instars, whereas larval insect predators typically attack smaller instars. Interestingly, most studies lump all juvenile stages together, which ignores these ecological changes over juvenile development.We combine a cross-sectional experimental approach with a stage-structured population model to estimate instar-specific vital rates in the bean weevil, Callosobruchus maculatus across a food quality gradient. We characterize food quality effects on the bean weevil's life history traits throughout its juvenile ontogeny to test how food quality impacts instar-specific vital rates.Vital rates differed across food quality treatments within each instar; however, their effect differed with instar. Weevils consuming low-quality food spent 38%, 37%, and 18% more time, and were 34%, 53%, and 63% smaller than weevils consuming high-quality food in the second, third, and fourth instars, respectively. Overall, our results show that consuming poor food quality means slower growth, but that food quality effects on vital rates, growth and development are not equal across instars. Differences in life history traits over juvenile ontogeny in response to food quality may impact how organisms interact with their environment, including how susceptible they are to predation, parasitism, and their competitive ability.

Photophase Duration Affects Immature Black Soldier Fly (Diptera: Stratiomyidae) Development.

This study tested the effect of photophase duration on black soldier fly, Hermetia illucens (L.; Diptera: Stratiomyidae), development. Successful larval eclosion, development time and adult emergence were measured for individuals exposed to 0 h, 8 h, and 12 h of light, at approximately 27°C and 70% relative humidity. Accumulated degree hours (ADH) were calculated to correct for differences in temperature across treatments. Larvae successfully eclosed in all treatments, with larvae in 12 h light requiring 5.77% and 4.5% fewer ADH to eclose than larvae in 0 h and 8 h, respectively. Overall, larvae in 0 h required 39.34% and 37.78% more ADH to complete their development from egg to adult than larvae in 8 h and 12 h, respectively. The effect of photophase duration on juvenile development was largest in the post-feeding stage, and smallest in the pupal stage. Specifically, post-feeding larvae in 0 h required 80.02% and 90.08% more ADH to pupate than larvae in 8 h and 12 h, respectively, but pupae in 8 h required 9.63% and 7.52% fewer ADH to eclose than pupae in 0 h and 12 h, respectively. Lastly, larval mortality was significantly higher in 0 h, with 72% survivorship, and 96% and 97% in 8 h and 12 h, respectively. However, 17.8% of mortality in the absence of light is hypothesized to be a result of predation by Arachnidae and Blattidae. These data could prove valuable for optimizing industrial processes for mass-production of this species for use as alternative protein in feed for livestock, poultry, and aquaculture.

Bacteria mediate oviposition by the black soldier fly, Hermetia illucens (L.), (Diptera: Stratiomyidae).

There can be substantial negative consequences for insects colonizing a resource in the presence of competitors. We hypothesized that bacteria, associated with an oviposition resource and the insect eggs deposited on that resource, serve as a mechanism regulating subsequent insect attraction, colonization, and potentially succession of insect species. We isolated and identified bacterial species associated with insects associated with vertebrate carrion and used these bacteria to measure their influence on the oviposition preference of adult black soldier flies which utilizes animal carcasses and is an important species in waste management and forensics. We also ascertained that utilizing a mixture of bacteria, rather than a single species, differentially influenced behavioral responses of the flies, as did bacterial concentration and the species of fly from which the bacteria originated. These studies provide insight into interkingdom interactions commonly occurring during decomposition, but not commonly studied.

Characteristics and treatment modalities for African American women diagnosed with stage III breast cancer.

BACKGROUND: Stage III breast cancers account for about 6% to 7% of all invasive breast cancers diagnosed annually in the United States. In African American (AA) women, the incidence of stage III breast cancers is almost double that in Caucasian women. The aim of this study was to correlate age, receptor status, nuclear grade, and differences in treatment modalities for stage III breast cancer in an inner-city hospital serving a large AA population. METHODS: A retrospective review was performed for all stage III primary breast cancers diagnosed and or treated from 2000 to 2006. RESULTS: : Of 840 primary invasive breast cancers, the authors identified 107 as stage III, 40.2% IIIA, 32.7% IIIB, 16.8% T4D, and 10.3% IIIC. The majority of the patients were AA (n = 93, 86.9%). Stage IIIC patients were younger (P < .05). Triple negative tumors (TNT) accounted for 29.0%. TNT were more likely among the inflammatory breast cancers (50.0%) compared with the other 3 groups (P < .05). Twenty-two patients (20.5%) refused chemotherapy, and 24 of the 91 patients (26.3%) who should have received chest wall radiation refused. There was no difference in race, marital status, religion, or age in the patients that refused chemotherapy or radiation therapy versus the majority of patients in this series who received standard care. CONCLUSIONS: Stage III breast cancers in AA women have distinct clinical characteristics. A high number of these patients refused chemotherapy and radiation therapy. Reasons for refusal need to be better defined so strategies can be implemented to improve compliance for these advanced stage patients.