Longitudinal Assessment of Prevalence and Incidence of Salmonella and Escherichia coli O157 Resistance to Antimicrobials in Feedlot Cattle Sourced and Finished in Two Different Regions of the United States.

The objective was to investigate the influence of cattle origin and region of finishing on the prevalence of Salmonella, Escherichia coli O157:H7, and select antimicrobial resistance in E. coli populations. Yearling heifers (n = 190) were utilized in a 2 × 2 factorial arrangement. After determining fecal Salmonella prevalence, heifers were sorted into one of four treatments: heifers originating from South Dakota (SD) and finished in SD (SD-SD); heifers originating from SD and finished in Texas (SD-TX); heifers originating from TX and finished in SD (TX-SD); and heifers originating from TX and finished in TX (TX-TX). Fecal, pen, and water scum line samples were collected longitudinally throughout the study; hide swab and subiliac lymph node (SLN) samples were collected at study end. A treatment × time interaction was observed (p ≤ 0.01) for fecal Salmonella prevalence, with prevalence being greatest for TX-TX and TX-SD heifers before transport. From day (d) 14 through study end, prevalence was greatest for TX-TX and SD-TX heifers compared with SD-SD and TX-SD heifers. Salmonella prevalence on hides were greater (p ≤ 0.01) for heifers finished in TX compared with SD. Salmonella prevalence in SLN tended (p = 0.06) to be greater in TX-TX and SD-TX heifers compared with TX-SD and SD-SD. Fecal E. coli O157:H7 prevalence had a treatment × time interaction (p = 0.04), with SD-TX prevalence being greater than TX-SD on d 56 and SD-SD and TX-TX being intermediate. A treatment × time interaction was observed for fecal trimethoprim-sulfamethoxazole-resistant and cefotaxime-resistant E. coli O157:H7 prevalence (p ≤ 0.01). Overall, these data suggest that the region of finishing influences pathogenic bacterial shedding patterns, with the initial 14 d after feedlot arrival being critical for pathogen carriage.

European guideline (EuroGuiDerm) on atopic eczema: part I - systemic therapy.

The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This first part of the guideline includes general information on its scope and purpose, the health questions covered, target users and a methods section. It also provides guidance on which patients should be treated with systemic therapies, as well as recommendations and detailed information on each systemic drug. The systemic treatment options discussed in the guideline comprise conventional immunosuppressive drugs (azathioprine, ciclosporin, glucocorticosteroids, methotrexate and mycophenolate mofetil), biologics (dupilumab, lebrikizumab, nemolizumab, omalizumab and tralokinumab) and janus kinase inhibitors (abrocitinib, baricitinib and upadacitinib). Part two of the guideline will address avoidance of provocation factors, dietary interventions, immunotherapy, complementary medicine, educational interventions, occupational and psychodermatological aspects, patient perspective and considerations for paediatric, adolescent, pregnant and breastfeeding patients.

European guideline (EuroGuiDerm) on atopic eczema - part II: non-systemic treatments and treatment recommendations for special AE patient populations.

The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clinicians and patient representatives) from 12 European countries participated. This second part of the guideline includes recommendations and detailed information on basic therapy with emollients and moisturizers, topical anti-inflammatory treatment, antimicrobial and antipruritic treatment and UV phototherapy. Furthermore, this part of the guideline covers techniques for avoiding provocation factors, as well as dietary interventions, immunotherapy, complementary medicine and educational interventions for patients with atopic eczema and deals with occupational and psychodermatological aspects of the disease. It also contains guidance on treatment for paediatric and adolescent patients and pregnant or breastfeeding women, as well as considerations for patients who want to have a child. A chapter on the patient perspective is also provided. The first part of the guideline, published separately, contains recommendations and guidance on systemic treatment with conventional immunosuppressive drugs, biologics and janus kinase (JAK) inhibitors, as well as information on the scope and purpose of the guideline, and a section on guideline methodology.

Wayfinding and spatial perception among adolescents with mild intellectual disability.

BACKGROUND: The study's aim was to examine whether spatial orientation can be improved in students with cognitive disabilities. METHOD: Participants were 55 boys and girls with attention deficit and mild cognitive impairment from a special education school. The procedure included an intervention for two experimental groups that studied wayfinding and orientation in the environment: group #1 learned to use a map while navigating, and group #2 learned to use a Google navigation app with voice instructions. Two pre-post tests were applied: (1) Mental folding test for children (MFTC) and (2) field test with map. RESULTS: Both groups improved their ability in navigation and wayfinding. No advantage for one learning method over the other was demonstrated, except for shortened navigation time in the group navigating with a map, and a slight though not significant tendency of improvement in the MFTC task in the group learning navigation using a voice app. CONCLUSION: It is worth noting that the study did not examine the students' own preferences for the way of learning, which may have implications for the degree of possible improvement. Also, a longer period of the learning process might yield a clearer understanding concerning the differences between the two teaching methods that were examined.

Life history traits and interactions of Stylops advarians (Strepsiptera) with its bee host, Andrena milwaukeensis.

Specimens of Stylops advarians were sampled by collecting foraging bees of Andrena milwaukeensis along the South Saskatchewan River within Saskatoon, Saskatchewan. As the foraging season progressed from early May till late June over three consecutive years (2016-2018), most stylopized bees possessed endoparasitic adult (neotenic) females of S. advarians protruding from the bee gaster's dorsum. In contrast, very few adult bees stylopized by male puparia, and no free-living males, were encountered. Over the sampling period, prevalence remained around 22% each year; mean intensity was 1.2 (range of 1-3 female parasites per bee); and parasite abundance was 0.27. Also newly reported for Stylops is the occurrence of one bee bearing four Stylops (two neotenic females and two males with puparia), plus another bee with a male puparium extruded from its gaster's sternites. Around 2 May each year, a high proportion of the earliest captured female bees were stylopized. However, non-stylopized female bees typically were not encountered until about 10 days later, suggesting the parasites manipulate female bee hosts to emerge earlier, in close synchrony to male bee emergence. First-instar larvae of S. advarians appeared from 22-25 May, indicating that adults of S. advarians matured and mated at similar times each season.

ETFAD/EADV Eczema task force 2020 position paper on diagnosis and treatment of atopic dermatitis in adults and children.

Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and pathogenic variabilities, the patient's age and also target flare prevention. Basic therapy includes hydrating and barrier-stabilizing topical treatment universally applied, as well as avoiding specific and unspecific provocation factors. Visible skin lesions are treated with anti-inflammatory topical agents such as corticosteroids and calcineurin inhibitors (tacrolimus and pimecrolimus), which are preferred in sensitive locations. Topical tacrolimus and some mid-potency corticosteroids are proven agents for proactive therapy, which is defined as the long-term intermittent anti-inflammatory therapy of frequently relapsing skin areas. Systemic anti-inflammatory or immunosuppressive treatment is a rapidly changing field requiring monitoring. Oral corticosteroids have a largely unfavourable benefit-risk ratio. The IL-4R-blocker dupilumab is a safe, effective and licensed, but expensive, treatment option with potential ocular side-effects. Other biologicals targeting key pathways in the atopic immune response, as well as different Janus kinase inhibitors, are among emerging treatment options. Dysbalanced microbial colonization and infection may induce disease exacerbation and can justify additional antimicrobial treatment. Systemic antihistamines (H1R-blockers) only have limited effects on AD-related itch and eczema lesions. Adjuvant therapy includes UV irradiation, preferably narrowband UVB or UVA1. Coal tar may be useful for atopic hand and foot eczema. Dietary recommendations should be patient-specific, and elimination diets should only be advised in case of proven food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Psychosomatic counselling is recommended to address stress-induced exacerbations. Efficacy-proven 'Eczema school' educational programmes and therapeutic patient education are recommended for both children and adults.

Silicon Photonic Microring Resonator Arrays for Mass Concentration Detection of Polymers in Isocratic Separations.

Molecular weight distribution (MWD) is often the most informative analytical parameter in polymer analysis, with gel permeation chromatography (GPC) being the most common approach for determining the MWD for polymer samples. Many industrially relevant polymers lack chromogenic or fluorogenic signatures, precluding use of spectroscopy-based detection. Universal detectors, such as evaporative light scattering and charged aerosol detectors, are nonlinear, limiting quantitative polymer analysis. Differential refractive index (dRI) detectors show linear mass concentration sensitivity but are limited for some analyses given that they are incompatible with gradient-based separations, have a limited dynamic range, and require extended thermal equilibration times. In this study, we investigated the utility of silicon photonic microring resonator arrays as a quantitative mass concentration detector for industrial polymer analysis. Microring resonators have optical properties that are sensitive to changes in refractive index, offer an extended dynamic range, have a broad solvent compatibility, and have a linear mass concentration detection for a range of molecular weights. Linear mass concentration detection for microrings was demonstrated through a series of isocratic GPC separations using narrow MWD polystyrene (PS) standards. This detection technology was then utilized in conjunction with conventional GPC detectors to analyze a series of broad MWD PS standards, with results in good agreement with dRI and UV/visible. These results demonstrate the potential of the microring resonator platform as a detector for industrial polymer analysis.

Correction: DNA Sequence Evolution and Rare Homoeologous Conversion in Tetraploid Cotton.

[This corrects the article DOI: 10.1371/journal.pgen.1006012.].

DNA Sequence Evolution and Rare Homoeologous Conversion in Tetraploid Cotton.

Allotetraploid cotton species are a vital source of spinnable fiber for textiles. The polyploid nature of the cotton genome raises many evolutionary questions as to the relationships between duplicated genomes. We describe the evolution of the cotton genome (SNPs and structural variants) with the greatly improved resolution of 34 deeply re-sequenced genomes. We also explore the evolution of homoeologous regions in the AT- and DT-genomes and especially the phenomenon of conversion between genomes. We did not find any compelling evidence for homoeologous conversion between genomes. These findings are very different from other recent reports of frequent conversion events between genomes. We also identified several distinct regions of the genome that have been introgressed between G. hirsutum and G. barbadense, which presumably resulted from breeding efforts targeting associated beneficial alleles. Finally, the genotypic data resulting from this study provides access to a wealth of diversity sorely needed in the narrow germplasm of cotton cultivars.

The Distress and Risk Assessment Method predicts postoperative narcotic use in patients undergoing rotator cuff repair.

BACKGROUND: The Distress and Risk Assessment Method (DRAM) predicts poor outcomes in spine, hip, and knee surgery. Unlike other areas of orthopedic surgery, DRAM scores are not predictive of lower postoperative patient-reported outcomes after arthroscopic rotator cuff repair (RCR). PURPOSE: As concerns for opioid dependence and abuse grow, the purpose of this study was to analyze the correlation between preoperative DRAM scores, modified Zung scores, and postoperative narcotic use in patients who underwent arthroscopic RCR. MATERIALS AND METHODS: This prospective cohort study identified and enrolled patients >18 years of age with full-thickness rotator cuff tears at a single institution. Patients with prior shoulder surgery, greater than 1-tendon RCR, and preoperative narcotic use were excluded. One-hundred and fifty patients were enrolled, with 114 (76%) completing all preoperative and postoperative questionnaires. Preoperative DRAM scores were collected from every patient. Postoperative narcotic use was evaluated via survey and converted to total morphine equivalents. RESULTS: Increased preoperative DRAM scores predicted higher postoperative morphine equivalent units (P = .002, r = 0.29). When dividing patients into those <17 or ≥17 on the modified Zung score, 44 of 114 (39%) met criteria for "at risk or depressed." This group showed a statistically significant trend toward higher postoperative morphine equivalent unit intake (P = .004). CONCLUSION: Baseline psychological distress (DRAM) can predict narcotic requirements after RCR and serve as a powerful tool to identify patients at risk for increased narcotics requirements postoperatively. In our cohort, 39% of patients showed evidence of baseline depression, which highlights a potential role of the modified Zung score to identify patients in need of preoperative psychological counseling.

The Role of Blood Flow Restriction Therapy Following Knee Surgery: Expert Opinion.

Blood flow restriction (BFR) therapy is becoming increasingly popular in musculoskeletal injury rehabilitation. In particular, this form of therapy is being utilized more often in the postoperative setting following knee surgery, including anterior cruciate ligament reconstruction. BFR therapy provides patients and clinicians an alternative treatment option to standard muscle strengthening and hypertrophy guidelines in the setting of postoperative pain, weakness, and postoperative activity restrictions that contribute to muscle atrophy. The ability to complete exercise in a low load environment and achieve similar physiological adaptations as high-intensity strength training makes this modality appealing. With poor patient-related outcomes associated with continued muscle atrophy, pain, and muscle weakness, some researchers have investigated BFR training postoperatively following arthroscopic knee surgery with promising results. However, owing to the current paucity of research studies, inconsistency among reported protocols, and mixed results, it may be some time before a mass adoption of BFR therapy is made into the world of orthopaedic rehabilitation. Although the current data is inconclusive, we choose to utilize BFR in postoperative knee patients, regardless of weight-bearing status, for whom maintenance of existing muscle mass or improvement of decreased postoperative strength levels is important. Therefore, the purpose of this expert opinion is to review the background of BFR, describe the clinical evidence of BFR following knee surgery, and report the authors' current recommendations for application of BFR postoperatively.

The effects of "grunting" on serve and forehand velocities in collegiate tennis players.

The aim of this study was to examine the effects of grunting on velocity and force production during dynamic and static tennis strokes in collegiate tennis players. Thirty-two (16 male and 16 female) division II and III collegiate tennis athletes with a mean age of 20.2 ± 1.89 years participated as subjects. Demographic and survey data were obtained before subjects completed a 10- to 15-minute warm-up of serves and ground strokes while grunting and not grunting. The subjects performed randomized sets (3 grunting and 3 nongrunting trials) of serves and forehand strokes both dynamically and isometrically. Stroke velocities and isometric forces were measured with a calibrated radar gun and calibrated dynamometer, respectively. Electromyographic (EMG) data from subjects' dominant pectoralis major and contralateral external oblique muscles were recorded and averaged for data analysis. A repeated measures multivariate analysis of variance (RM-MANOVA) compared dynamic stroke velocity, isometric muscle force, and peak EMG activity during each breathing condition at the 0.05 alpha level. The RM-MANOVA indicated that dynamic velocity and isometric force of both serves and forehand strokes were significantly greater when the subjects grunted (F = 46.572, p < 0.001, power = 1.00). Peak muscle activity in the external oblique and pectoralis major muscles was also greater when grunting during both types of strokes (F = 3.867, p = 0.05, power = 0.950). Grunt history, gender, perceived advantages, and disadvantages of grunting, years of experience, highest level of competition, and order of testing did not significantly alter any of these results. The velocity, force, and peak muscle activity during tennis serves and forehand strokes are significantly enhanced when athletes are allowed to grunt.

Development of an experimental model for liver abscess induction in Holstein steers using an acidotic diet challenge and bacterial inoculation.

Holstein steers (n = 40; initial BW = 84.9 ±â€…7.1 kg) were used to study the genesis of liver abscesses (LA) using an acidotic diet challenge with or without intraruminal bacterial inoculation. Steers were housed in individual pens inside a barn and randomly assigned to one of three treatments: (1) low-starch control diet comprised primarily of dry-rolled corn and wet corn gluten feed (CON); (2) high-starch acidotic diet with steam-flaked corn (AD); or (3) acidotic diet plus intraruminal inoculation with Fusobacterium necrophorum subsp. necrophorum (9.8 × 108 colony forming units [CFU]/mL), Trueperella pyogenes (3.91 × 109 CFU/mL), and Salmonella enterica serovar Lubbock (3.07 × 108 CFU/mL), previously isolated from LA (ADB). Steers in AD and ADB were fed the acidotic diet for 3 d followed by 2 d of the CON diet, and this cycle was repeated four times. On day 23, ADB steers were intraruminally inoculated with the bacteria. At necropsy, gross pathology of livers, lungs, rumens, and colons was noted. Continuous data were analyzed via mixed models as repeated measures over time with individual steer as the experimental unit. Mixed models were also used to determine the difference in prevalence of necropsy scores among treatments. Ruminal pH decreased in AD and ADB steers during each acidotic diet cycle (P ≤ 0.05). LA prevalence was 42.9% (6 of 14) in ADB vs. 0% in AD or CON treatments (P < 0.01). Ruminal damage was 51.1% greater in ADB than in AD (P ≤ 0.04). Culture of LA determined that 100% of the abscesses contained F. necrophorum subsp. necrophorum, 0% contained T. pyogenes, 50% contained Salmonella, and 50% contained a combination of F. necrophorum subsp. necrophorum and Salmonella. The F. necrophorum subsp. necrophorum was clonally identical to the strain used for the bacterial inoculation based on phylogenetic analysis of the whole genome. This experimental model successfully induced rumenitis and LA in Holstein steers and confirms the central dogma of LA pathogenesis that acidosis and rumenitis lead to the entry of F. necrophorum into the liver to cause abscesses. Our findings suggest that an acidotic diet, in conjunction with intraruminal bacterial inoculation, is a viable model to induce LA. Further research is needed to determine the repeatability of this model, and a major application of the model will be in evaluations of novel interventions to prevent LA.

Liver abscesses (LA) in feedlots are costly to the beef industry. At harvest, LA cause an increase in liver condemnations, carcass trimming, and a decrease in quality grade. The objective of this research was to develop an experimental LA model in Holstein steers using an acidotic diet with and without intraruminal inoculation of bacteria involved in LA formation. These data suggest acidotic diet challenges in conjunction with bacterial inoculation were able to induce LA in Holstein steers. The acidotic diet alone caused reduced rumen content pH and caused rumen wall inflammation and damage, observed at harvest. Nonetheless, the addition of bacteria had a compounding effect on rumen damage. Both bacteria inoculated were isolated from 57% of LA suggesting they may work in synergy to form LA.

Adolescents' physical activity habits--results from a national health survey.

BACKGROUND: The MABAT Youth National Health and Nutrition Survey was conducted in Israel by the Ministry of Health and the Center for Disease Control. This article presents results of physical activity (PA) habits in Israel, in relation to recommendations by world health organizations. METHODS: Participants were 6274 adolescents, grades 7-12, enrolled in a cross-sectional, representative, school-based survey. Sufficient level of PA was defined as any moderate and vigorous level of PA that adds up daily to 60 min/day. Light PA was considered to be an insufficient level of PA. RESULTS: Only 10.5% of the participants reported performing sufficient PA. Large gender differences were found, with 17.7% of boys versus only 4.6% of girls meeting the guidelines. CONCLUSIONS: Results highlight the need to develop programmes for school children in Israel to promote PA. Such programmes have been initiated in many countries that have a large percentage of adolescents with a sedentary lifestyle.

Short communication: evaluation of an endotoxin challenge and intraruminal bacterial inoculation model to induce liver abscesses in Holstein steers.

Holstein steers (n = 40; initial body weight [BW] = 96.0 ± 10.5 kg) were individually housed in a climate-controlled barn to evaluate potential models for the genesis of liver abscesses (LA). In this 2 × 2 factorial, steers were balanced by BW and randomly assigned to one of two treatments: 1) intravenous saline injection followed by intraruminal bacterial inoculation with Fusobacterium necrophorum subsp. necrophorum (1 × 109 colony forming unit [CFU]/mL) and Salmonella enterica serovar Lubbock (1 × 106 CFU/mL; CON; n = 20 steers); or 2) intravenous injection with 0.25 µg/kg BW of lipopolysaccharide (LPS; Escherichia coli O111:B4) followed by intraruminal bacterial inoculation of F. necrophorum subsp. necrophorum (1 × 109 CFU/mL) and S. enterica serovar Lubbock (1 × 106 CFU/mL; LBI; n = 20 steers) and 1 of 2 harvest dates (3 or 10 d post LPS infusion). Body weights were recorded on days -4, -1, 3, and 10, and blood was collected for hematology on days -4, 3, and 10, relative to LPS infusion on day 0. Intraruminal bacterial inoculation occurred on day 1. Steers from each treatment group were harvested at two different time points on day 3 or 10 to perform gross pathological examination of the lung, rumen, liver, LA (if present), and colon. Feed disappearance was less for LBI than CON (P < 0.01); however, BW did not differ (P = 0.33) between treatments. Neither treatment nor time differed for hematology (P ≥ 0.13), and no gross pathological differences were noted in the lung, liver, LA, or colon (P ≥ 0.25). A treatment × harvest date interaction was noted for ruminal pathology in which LBI had an increased percentage of abnormal rumen scores on day 3 (P < 0.01). These results suggest that an LPS challenge in combination with intraruminal bacterial inoculation of pathogens commonly isolated from LA was not sufficient to induce LA in steers within 3 or 10 d (P = 0.95) when compared to CON. Further evaluation is needed to produce a viable model to investigate the genesis and prevention of LA in cattle.

Liver abscesses in feedlot cattle can cause a decrease in feed intake, average daily gain, feed efficiency, and hot carcass weight. At harvest, liver abscesses result in liver condemnations, carcass trimming, and a potential decrease in quality grade, with an estimated economic cost to packers of $41.6 million annually. Our objective was to evaluate an intravenous endotoxin challenge followed by intraruminal inoculation of bacteria commonly isolated from liver abscesses over a 10-d period as a potential model to understand the genesis and etiology of liver abscesses in cattle and evaluate possible preventative interventions. Results suggest that an endotoxin challenge in combination with intraruminal bacterial inoculation is not a viable model to induce liver abscesses in steers, and bacterial inoculation alone was insufficient to induce liver abscesses. The length of time necessary to induce liver abscesses is also unknown. Based on our results, more research is needed to develop a noninvasive model to induce liver abscesses in cattle.

Predicting metabolizable energy from digestible energy for growing and finishing beef cattle and relationships to the prediction of methane.

Reliable predictions of metabolizable energy (ME) from digestible energy (DE) are necessary to prescribe nutrient requirements of beef cattle accurately. A previously developed database that included 87 treatment means from 23 respiration calorimetry studies has been updated to evaluate the efficiency of converting DE to ME by adding 47 treatment means from 11 additional studies. Diets were fed to growing-finishing cattle under individual feeding conditions. A citation-adjusted linear regression equation was developed where dietary ME concentration (Mcal/kg of dry matter [DM]) was the dependent variable and dietary DE concentration (Mcal/kg) was the independent variable: ME = 1.0001 × DE - 0.3926; r2 = 0.99, root mean square prediction error [RMSPE] = 0.04, and P < 0.01 for the intercept and slope. The slope did not differ from unity (95% CI = 0.936 to 1.065); therefore, the intercept (95% CI = -0.567 to -0.218) defines the value of ME predicted from DE. For practical use, we recommend ME = DE - 0.39. Based on the relationship between DE and ME, we calculated the citation-adjusted loss of methane, which yielded a value of 0.2433 Mcal/kg of dry matter intake (DMI; SE = 0.0134). This value was also adjusted for the effects of DMI above maintenance, yielding a citation-adjusted relationship: CH4, Mcal/kg = 0.3344 - 0.05639 × multiple of maintenance; r2 = 0.536, RMSPE = 0.0245, and P < 0.01 for the intercept and slope. Both the 0.2433 value and the result of the intake-adjusted equation can be multiplied by DMI to yield an estimate of methane production. These two approaches were evaluated using a second, independent database comprising 129 data points from 29 published studies. Four equations in the literature that used DMI or intake energy to predict methane production also were evaluated with the second database. The mean bias was substantially greater for the two new equations, but slope bias was substantially less than noted for the other DMI-based equations. Our results suggest that ME for growing and finishing cattle can be predicted from DE across a wide range of diets, cattle types, and intake levels by simply subtracting a constant from DE. Mean bias associated with our two new methane emission equations suggests that further research is needed to determine whether coefficients to predict methane from DMI could be developed for specific diet types, levels of DMI relative to body weight, or other variables that affect the emission of methane.

Blueprint for Implementing and Improving Eligible Inferior Vena Cava Filter Retrieval Across Institutions.

Introduction: Placement of removable inferior vena cava filters (rIVCFs) has increased, but this has not been accompanied by timely removal, with retrieval rates as low as 8.5% at some institutions. Failure to remove rIVCFs that were not medically necessary resulted in increased complications. This study discussed the development of an inferior vena cava (IVC) filter follow-up protocol. Methods: A method to monitor IVC filter placement and retrieval was developed. A weekly report was generated detailing placement and removal of rIVCFs. A standardized retrieval calculator was utilized to determine efficacy of removal. An IVC filter Retrieval Assessment Form was developed. Managing physicians and patients with medically unnecessary filters were sent letters with a retrieval checklist and order form. If not removed within one year, additional letters were sent. Standardized IVC filter reporting templates were created and utilized after insertion of all filters with retrieval status. Letters eventually were built into the electronic medical record for direct routing. Results: From 2015 to 2020, IVC filters were placed in 719 patients. Of those, 58% were eligible for retrieval. Initial rates of rIVCF removal in eligible patients were as low as 30-33% in 2015. The retrieval rate of eligible filters rose to 44% in September 2018. The rate of retrieval rose to 61% in January 2021. Conclusions: Employing a systemic protocol to aid in follow-up of patients following rIVCF placement may improve rates of retrieval. Regular evaluation and revision of the process demonstrated a significant role in achieving an increase in retrieval rates.

Detecting marine pests using environmental DNA and biophysical models.

The spread of marine pests is occurring at record rates due to globalisation and increasing trade. Environmental DNA (eDNA) is an emerging tool for pest surveillance, allowing for the detection of genetic material shed by organisms into the environment. However, factors influencing the spatial and temporal detection limits of eDNA in marine environments are poorly understood. In this study we use eDNA assays to assess the invasive ranges of two marine pests in south-eastern Australia, the kelp Undaria pinnatifida and the seastar Asterias amurensis. We explored the temporal and spatial detection limits of eDNA under different oceanographic conditions by combining estimates of eDNA decay with biophysical modelling. Positive eDNA detections at several new locations indicate the invasive range of both pest species is likely to be wider than currently assumed. Environmental DNA decay rates were similar for both species, with a decay rate constant of 0.035 h-1 for U. pinnatifida, and a decay rate constant of 0.041 h-1 for A. amurensis, resulting in a 57-73% decrease in eDNA concentrations in the first 24 h and decaying beyond the limits of detection after 3-4 days. Biophysical models informed by eDNA decay profiles indicate passive transport of eDNA up to a maximum of 10 to 20 km from its source, with a ~90-95% reduction in eDNA concentration within 1-3 km from the source, depending on local oceanography. These models suggest eDNA signals are likely to be highly localised, even in complex marine environments. This was confirmed with spatially replicated eDNA sampling around an established U. pinnatifida population indicating detection limits of ~750 m from the source. This study highlights the value of eDNA methods for marine pest surveillance and provides a much-needed description of the spatio-temporal detection limits of eDNA under different oceanographic conditions.

Anatomical robotic prostatectomy: technical factors to achieve superb continence and erectile function.

Debate continues as to the superiority of robotic versus open radical prostatectomy for the surgical treatment of localized prostate cancer. Despite this controversy, retrospective data from high volume centres has demonstrated RARP is associated with improved pentafecta outcomes with lower transfusion rates, less incontinence, lower positive surgical margins and improved potency. Advocates of robotic assisted radical prostatectomy (RARP) believe an enhanced visual field, the precision afforded by robotic technology as well as lack of bleeding, sharp dissection and delicate tissue handling lead to improved outcomes. Prostate Cancer is the second most common cancer diagnosed in men, and as the number of post-surgical patients increases, the complications of urinary incontinence and erectile dysfunction not only have a significant negative impact on patients' quality of life, but have become an expanding part of clinical practice. This article outlines what are believed to be the most important strategies based on anatomical knowledge and technical expertise, that allow robotic prostatectomists to achieve superb outcomes in urinary and erectile function.