Rounded Ends Research Articles

Essential Competencies for Oncology in Physical Therapist Professional Education Programs: Results of a Mixed Methods Modified Delphi Study.

The objective was to establish consensus-based competencies for oncology within physical therapist professional education programs in the United States. A mixed-methods approach implementing a sequential exploratory design that included 3 phases was used to establish oncology competencies for physical therapist professional education programs. Participants in each phase were physical therapists representing diverse practice settings, experience levels, and geographical regions. Student physical therapists were included in phases 2 and 3. Three online focus groups were followed by an in-person group discussion to establish cancer-related themes, domains of practice, and competencies. Participants evaluated the competencies in a 3-round modified Delphi study for relevance and clarity. Each competency required 80% consensus using a Likert scale (1 = not at all relevant/clear, 5 = extremely relevant/clear). It was not accepted if a competency did not meet the 80% threshold by the end of round 3. Six domains of practice and 28 competencies were developed and evaluated. Within the 6 domains, 21 competencies were accepted: general cancer concepts (n = 4), musculoskeletal system (n = 3), neurologic system (n = 5), integumentary system (n = 2), cardiovascular and pulmonary system (n = 5), and involvement of multiple systems across the lifespan (n = 2). Along with the 21 competencies, participants also recommended 11 overarching oncology themes to incorporate into physical therapist professional education programs. Delivering cancer content using a body systems approach was recommended. As the number of survivors of cancer continues to grow, integration of these essential competencies within physical therapist professional education programs will improve the profession's capacity to provide quality care to meet the societal need of persons living with and beyond cancer. Academic and clinical educators should integrate these competencies to ensure that physical therapist professional education programs appropriately prepare physical therapists for providing care for persons living with and beyond cancer across the lifespan.

Intra-orbital Foreign Body

Abstract Background: This case report describes a young man with an intra-orbital foreign body (FB) in both eyes. Case Report: Intra-orbital FBs are rare, with few cases reported in the literature. This is because the orbit protects the globe from external forces, and the orbit is a closed cavity with one opening. This report details the case of a 28-year-old man who presented to the emergency unit with an 11-hour history of an intra-orbital FB. The patient was lying on a bench when a stationary motorcycle fell on him. He noticed that he was unable to open both eyes and was rushed to a peripheral hospital, then subsequently referred to this tertiary center. On examination, he was ill-looking and anxious but not febrile or pale. Systemic examination did not reveal any abnormality. Unaided visual acuity in the right eye (OD) was nil perception of light, while left eye visual acuity (OS) was counting fingers. The right eyelid was ptotic due to edema. He underwent basic laboratory investigations that were all normal. A plain X-ray revealed a radio-opaque FB penetrating the left orbit, fracturing the medial walls into the right orbit, with the round end positioned behind the right globe. The FB was identified as a broken part of a brake/clutch lever from the motorcycle. A computerized tomography scan showed a metallic object in both orbits, accompanied by pneumocephalus, and suggested transection of the right optic nerve. The patient was prepared for FB removal and repair of the lid penetration under general anesthesia, following review by the ENT surgeon and neurosurgeon. The brake lever was successfully removed, and the patient was administered antibiotics. Post-operatively, visual acuity in the right eye remained at nil perception of light, while that in the left eye improved to 6/9 upon discharge. Conclusion: There is no established protocol for managing intra-orbital FBs, as removal depends on factors such as the size, composition, and potential compression damage to structures around the globe, which could further compromise vision or function. Small inert objects may be left in place if removal would cause damage. However, in this case, removal was deemed necessary for several reasons.

Consensus guidelines on the bedside assistant skills required in robotic surgery.

While bedside assistants play a critical role in many robotic operations, substantial heterogeneity remains in bedside assistant training pathways. As such, this study aimed to develop consensus guidelines for bedside assistant skills required for team members in robotic operations. We designed a study using the Delphi process to develop consensus guidelines around bedside assistant skills. We generated an initial list of bedside assistant skills from the literature, training materials, and expert input. We selected experts for the Delphi process based on prior scholarship in the area of robotic bedside assistant education and experience facilitating robotic bedside assistant training. For each item, respondents specified which robotic team members should have the skill from a list of "basic" bedside assistants, "advanced" bedside assistants, surgeons, surgical technologists, and circulating nurses. We conducted two rounds of the Delphi process and defined 80% agreement as sufficient for consensus. Fourteen experts participated in two rounds of the Delphi process. By the end of the second round, the group had reached consensus on 253 of 305 items (83%). The group determined that "basic" bedside assistants should have 52 skills and that "advanced" bedside assistants should have 60 skills. The group also determined that surgeons should have 54 skills, surgical technologists should have 25 skills, and circulating nurses should have 17 skills. Experts agreed that all participants should have certain communication skills and basic knowledge of aspects of the robotic system. We developed consensus guidelines on the skills required during robotic surgery by bedside assistants and other team members using the Delphi process. These findings can be used to design training around bedside assistant skills and assess team members to ensure that each team member has the appropriate skills. Hospitals can also use these guidelines to standardize expectations for robotic team members.

Reaching consensus amongst international experts on the use of high importance-rated antimicrobials in animals – a Delphi study

In Australia, antimicrobials are given an importance rating by the Australian Strategic and Technical Advisory Group on antimicrobial resistance. High importance antimicrobials are those essential for the treatment or prevention of infections in humans, where there are few or no treatment alternatives. In this study we consulted with experts from across human and animal health using the Delphi consensus-building process to establish the circumstances under which antimicrobials with high importance to human health could be used in animals in Australia. We used three rounds of online surveys. Group responses were provided to participants in each subsequent round to facilitate convergence of opinion. Consensus was defined as 80 % or more of respondents selecting the same option for a question. By the end of the third round, consensus was achieved on eight items. This included the use of high importance antimicrobials being appropriate if culture and sensitivity testing indicated the organism was resistant to low- and medium-rated antimicrobials that could be used to treat the case. If any high-importance antimicrobials are prescribed for animals there was also agreement that a clear indication for this use and justification for antimicrobial choice must be recorded in the medical history, along with the dose rate, route of administration, the duration and the time point for review of the condition and associated antimicrobial therapy.Appropriateness of use of high importance antimicrobials in critically ill animals where culture and sensitivity results are not available is still undefined. Further work is also required to establish which particular organisation should be notified of the use of high importance antimicrobials not registered for use in animals. The Delphi process was valuable in facilitating consensus amongst international experts from a broad range of health backgrounds and experience.

Conceptual Framework of Upper Cross Syndrome: A Delphi Study.

Upper cross syndrome (UCS) is one of the most common postural dysfunctions due to prolonged flexed attitude. Good posture plays an important role in maintaining musculoskeletal balance and protecting it from further injury. Conducting research on the conceptual framework will help clinicians to identify and plan treatment strategies for the correction of this syndrome and prevent secondary complications. Thus, the aim of this study was to develop a conceptual framework for UCS. The Delphi method was used to conduct the study and develop a conceptual framework. A total of 30 multidisciplinary experts participated in the study, and a list of 41 items was finalized after an extensive literature review. A cover letter along with all the items was mailed to the experts to obtain their input. Three rounds of Delphi were conducted until a consensus was reached. The following parameters were used to determine consensus: moderate Kendall's coefficient of concordance (Kendall's W), agreement greater than 51.0%, interquartile range (IQR) below 1.5, and standard deviation (SD) below 1. By the end of the third round, 37 items were finalized. The conceptual framework consisted of four items in postural alignment, eight items in muscular imbalance, 20 items in functional limitation, and five items in the psychosocial domain. We successfully developed a conceptual framework for UCS. Four domains, including postural alignment, muscular imbalance, functional limitation, and psychosocial, were identified. This will lead to a deeper comprehension of UCS, which will facilitate its early detection and treatment. The multidimensional approach of the study will provide a better scope for the clinicians to educate the patient about good posture, which not only will impact physical performance but also improve quality of life. The development of this framework will help to prevent, monitor the progress, and correct UCS.

First report of leaf spot caused by Paramyrothecium roridum on Coffea arabica in Hawai'i, USA.

During the 2022-2023 season, the harvested coffee crop in Hawai'i (Coffea arabica) was valued at $57.1 million (USDA NASS 2023). In September 2022, coffee leaf samples with foliar leaf spots affecting the Kona Typica variety were collected from Hōnaunau, Hawai'i, incidence <10%. The symptoms were circular, necrotic leaf spots with yellow margins, which merged, resulting in complete leaf blade coverage and subsequent leaf drop. Sporodochia were present on the abaxial leaf surface. Symptomatic leaf tissue was disinfected in 10% bleach solution for 60 seconds and chlorotic leaf tissue from the spot margins were excised and placed onto water agar and potato dextrose agar (PDA; Difco, USA). After a 7-day incubation period, pure cultures with white aerial mycelium having sporodochia arranged in concentric rings with olivaceous to black conidial masses were isolated. The conidia were aseptate, hyaline, smooth, cylindrical with rounded ends, measuring 5.1 to 6.8 μm long and 1.7 to 2.3 μm wide (n=50). Based on symptomology and cultural/morphological characteristics (Huaman-Pilco et al. 2023; Lombard et al. 2016; Pelayo-Sanchez et al. 2017), the isolates were initially identified as Paramyrothecium roridum (Tode) L. Lombard & Crous, comb. nov. (syn. Myrothecium roridum Tode). Fungal identification of isolate P22-81-2 was further confirmed using BLAST analysis of bulk sequenced PCR products of the ribosomal DNA internal transcribed spacer (ITS) region (White et al. 1990), β-tubulin (βtub), RNA polymerase II (RPB2), and calmodulin genes (Lombard et al., 2016; Huaman-Pilco et al., 2023). The gene sequences (GenBank accession nos. PP211198, PQ192517-19) were >98.4% identical to the P. roridum type specimen (CBS 357.89). A multilocus maximum likelihood phylogenetic analysis incorporating sequence data from previous relevant studies (Lombard et al., 2016; Pinruan et al. 2022) confirmed species identification. To prove pathogenicity, four, 26-month-old Kona Typica variety seedlings were foliar inoculated with a 1 X 106 conidia/ml suspension using a perfume atomizer. An additional four plants were inoculated in a similar manner with sterile water which served as controls. All plants were sprayed to drip on both the upper and lower leaf surfaces and incubated in a clear plastic bag to keep the humidity levels between 90 to 100% for 48 hours at 24°C. After 48 hours, the plants were removed from the bags, placed on a greenhouse bench, and observed weekly for symptom development. Within seven days light brown sunken spots had developed on all inoculated plants. The spots continued to enlarge having a dark distinct margin, light tan center, chlorotic halo, and formed concentric rings, which were identical to the original diseased samples. Leaf spots were not present on any of the control plants. The test was conducted twice. A fungus was consistently reisolated from the leaf spot margins of inoculated plants and morphologically (PDA) and molecularly (ITS, βtub, RPB2, calmodulin) identified as P. roridum, thus fulfilling Koch's Postulates. To the best of our knowledge, this is the first report of P. roridum causing leafspots on C. arabica plants in Hawai'i. This pathogen has been reported on coffee in other parts of the world including Colombia, Costa Rica, Guatemala, Puerto Rico, and Mexico (USDA Fungus-Host Database). Under the right conditions, P. roridum has the potential to cause leafspots and defoliation resulting in economic losses for coffee growers in Hawai'i.

Use of Integra dermal regeneration template in burn patients: An Italian expert consensus Delphi study

IntroductionBurn injuries pose significant challenges in healthcare, with Integra dermal regeneration template (DRT) emerging as a prominent solution to enhance wound healing and recovery. Although there is no clear consensus on its technical use and application. We convened a panel of 14 burn specialists aiming to provide consensus regarding the application and usage of Integra in managing burn wounds. MethodsPanelists employed a modified Delphi technique to assess agreement and provide feedback on 81 initial statements covering various aspects of Integra DRT application in burn wound care over three subsequent rounds. This study was endorsed by the Italian Society of Burn Surgery (SIUST). ResultsFourteen heads of burn unit departments participated in the Delphi process. At the end of the third round and subsequent discussion on the final statement list, the panel achieved consensus on 24 statements shaping recommendations for Integra application across various aspects, including wound bed preparation, acellular dermal matrix application, definitive coverage, and complication management. ConclusionThe resultant 24 finalized statements from this Italian consensus offer a comprehensive and practical framework for employing Integra DRT in burn patient care. Reflective of specific Italian expertise and practice, these recommendations supplement and refine existing literature, serving as a dynamic guide subject to periodic updates aligned with evolving evidence and experience in the field of burn surgery.

First report of anthracnose caused by Colletotrichum fructicola on winter jasmine (Jasminum nudiflorum) in China.

Winter jasmine (Jasminum nudiflorum Lindl.) is a medium-sized, deciduous shrub native to China that has become a popular choice among gardeners and landscapers. In 2020 to 2021, symptoms of anthracnose including brown necrotic spots, enlarged irregular lesions and leaf blight were observed on leaves of 20 winter jasmine shrubs in a public garden (22°34'58'' N; 113°56'23'' E) in Shenzhen, China, and with an estimated disease incidence of 65%. Tissues samples (6 × 6 mm2) surrounding the necrotic spots were surface sterilized with 75% ethanol for 30 s, followed by 2% NaClO for 1 min, then rinsed with sterile water for three times and dried with sterile filter paper. Tissues were placed on potato dextrose agar (PDA) medium and incubated at 25℃. After 3 to 7 d, pure cultures were obtained by transferring hyphal tips to new plates and 32 isolates producing Colletotrichum-like colonies were obtained from 40 tissues (isolation frequency=32/(4×10)=80%). Three representative isolates YCH09, YCH23 and YCH32 were selected for further study. Three selected isolates were identical in morphological characteristics. Colonies on PDA after 5 d at 25℃ were white to gray with cottony mycelia and grayish-white on the underside of the culture. Conidia (n = 60) measured 15.4 ± 1.1 µm (13.0 to 17.1 µm) in length and 5.4 ± 0.3 µm (4.9 to 6.0 µm) in width and were hyaline, single-celled, cylindrical with rounded ends. Appressoria (n = 15) measured 7.1 ± 0.1 µm (5.3 to 8.9 µm) in length and 5.2 ± 0.2 µm (4.1 to 6.2 µm) in width and were brown to dark brown, ovoid. These morphological features were aligned with those of Colletotrichum spp. (Weir et al. 2012). Sequences of five genetic markers of representative isolates YCH09, YCH23 and YCH32 including the rDNA internal transcribed spacer region, chitin synthase, partial actin, β-tubulin 2 and Apn2-Mat1-2 intergenic spacer and partial mating type (Mat1-2) region were 99.3 to 100% identical to the ex-type isolate of C. fructicola strain ICMP 18581 (Zhang et al., 2020). From the maximum likelihood phylogenetic tree which was constructed based on concatenated sequences, three representative isolates (YCH09, YCH23 and YCH32) were clustered with other isolates of C. fructicola. The above morphological and molecular characteristics suggest that causal agent was C. fructicola. Pathogenicity was tested using a whole-plant assay. Five healthy plants were inoculated by spraying a conidial suspension (1.5×104 conidia/ml; 20 ml per plant) of the isolate YCH23 onto the foliage (Marshall et al., 2023). Three noninoculated control plants were sprayed with sterile water. All plants were placed in a greenhouse at 25±2℃ with approximately 75% relative humidity. Yellow lesions appeared on leaves of inoculated plants as early as 4 days after inoculation (DAI), and irregularly shaped brown spots similar to those observed in the field were formed on 10 DAI. Noninoculated plants remained asymptomatic. Colletotrichum isolates resembling morphological characters of YCH23 were reisolated from all inoculated plants, then identified as C. fructicola by DNA sequence analysis. C. fructicola is a well-known fungus causing anthracnose on more than 63 plant species including agricultural and horticultural plants worldwide (Talhinhas and Baroncelli, 2021). To our knowledge, this is the first report of C. fructicola infecting J. nudiflorum plants in China. Since its potential risk to other horticultural plant species, precautions may be necessary to minimize the spread of this fungi.

In-Vitro Tooth Cleaning Efficacy and Filament End Rounding of Different Manual Children's Toothbrushes.

This in-vitro study aimed to investigate the cleaning efficacy of 18 different manual children's toothbrushes applying horizontal, vertical, and rotational movements, as well as to evaluate the rounding of their filament ends. Models equipped with artificial teeth (coated with titanium dioxide) were brushed using a brushing machine with clamped manual children's toothbrushes. The machine carried out horizontal, vertical, and rotational movements for 1 min with a constant contact pressure of 100 g. The percentage of the area of titanium dioxide removed from the buccal, mesial, distal and total surfaces of the artificial teeth corresponded to the cleaning efficacy. To assess the filament design, a scanning electron microscope was used to check the morphology of the filaments which was scored with Silverstone and Featherstone scale. SPSS 22 was used for data analysis. The rotational and the vertical movements achieved the best cleaning efficacy with all tested toothbrushes. The vast majority of the tested toothbrushes had their poorest cleaning efficacy in the horizontal movement. Only a small part of the children's toothbrushes (3 out of 18) had a correct and acceptable proportion of rounded bristle ends. Based on the present results, it could be concluded that the cleaning efficacy of different manual children's toothbrushes varied considerably. The best cleaning efficacy was almost always observed for rotational and vertical movements.

First report of Colletotrichum orbiculare causing anthracnose of pointed gourd in India.

Pointed gourd (Trichosanthes dioica Roxb.), of the Cucurbitaceae family, is widely cultivated as a vegetable in many countries such as Bangladesh, India, Pakistan, Myanmar, Nepal and Sri Lanka. Over 800,000 metric tons of pointed gourds are produced annually in India, where cultivation is estimated to occupy over 33,000 hectares of land (MoA & FW, Government of India). In summer 2018, significant losses (approximately 15-20%) occurred in the sub-Himalayan region in West Bengal state of India (21.14-21.30° N, 78.82-79.02°E) due to a disease with typical anthracnose-like symptoms on the fruits. Light yellowish, small sized round to irregular spots were also apparent on the leaves. These spots gradually increased in size and turned into light brown and were surrounded by yellow halo. The lesions on the fruits were circular, yellow-brown, necrotic and sunken. A survey of four fields (1.5 ha) was conducted and a disease incidence of 30-40% was observed. Necrotic tissues from fruit as well as leaves were cut into approximately 5 mm2, surface sterilized with 0.1% HgCl2, plated in potato dextrose agar and incubated at 28ºC for 7 days in the dark. A total of 50 morphologically similar colonies were obtained from 20 sampled fruits and 10 sampled leaves. Fungal colonies were initially white, becoming gray as the cultures aged on PDA. The cultures developed black acervuli around the center of the colony. Setae were brown in colour, 1-5 septate, 40-100 µm long. Conidia were also observed through light and scanning electron microscopy and exhibit as (4-6 ×13-19 µm) hyaline, aseptate, cylindrical to oblong, with one end round and other truncate. The morphological characteristics were found similar to Colletotrichum orbiculare Damm, P.F. Cannon & Crous as reported by Damm et al. (2013). Ten isolates were obtained by transferring hyphal tips to new PDA plates and incubating under the same conditions. To confirm the identity of the pathogen, genomic DNA was extracted from five pure isolates (PG-Pha, PG-Pha-2, PG-Pha-3, PG-Pha-4, PG-Pha-5) with the cetyltrimethylammonium bromide (CTAB). Further, the ITS1-5.8S-ITS2 region, D1/D2 region of the 28S rRNA large subunit (LSU), Actin (ACT) gene and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene were amplified using specific primers, ITS1/ITS4 (White et al. 1990), NL1/NL4, ACT1/ACT2 and GDF1/GDR1 respectively and PCR conditions described in Damm et al. (2012). A GenBank BLAST search showed 99-100% identity to the Colletotrichum orbiculare (Acc. Nos. KP898988 for ITS1-5.8S-ITS2, Z18997 for 28S rRNA, AB778553 for ACT gene, and KF178482 for GAPDH). All obtained sequences were submitted to the GenBank (Acc. Nos. MN006616, OP811046-OP811049, [ITS1-5.8-ITS2], MN006684, PP391616-PP391619 [28S rRNA], MN168524, PP400822-PP400825 [ACT gene], OP627091, PP400826-PP400829 [GAPDH]). For phylogenetic analysis, MEGA version 11 (Tamura et al. 2021) was used to construct a maximum likelihood tree with 1000 bootstrap replicates, based on a concatenation alignment of three gene sequences (ITS, Actin and GAPDH) of the all the five C. orbiculare isolates as well as sequences of other Colletotrichum species obtained from GenBank. The cluster analysis revealed that, isolate PG-Pha form a cluster with other C. orbiculare isolates. Pathogenicity tests were conducted to confirm Koch's postulates. Pathogenicity tests were performed in mature fruits by inoculating them (n=8) with 10 µl of a 1×106 conidia/ml suspension at needle puncture wound sites. In control set up sterile distilled water was pipetted on fruits. Fruits were placed on sterile trays covered with glasses and incubated at humid chambers at 28±2ºC with 12 h of light. Healthy one-month old potted pointed gourd plants (n=15) were sprayed with conidial suspension until run-off. A set of 15 plants were sprayed with sterile distilled water and maintained as control. The plants were kept in a greenhouse at 25ºC, >75% relative humidity, and a 16/8 h day/night cycle for 15 days. Sterile distilled water was sprayed on the plants at one day interval to maintain the humidity. Inoculated fruits started showing yellowing symptoms one day post inoculation and gradually yellow-brown sunken spots became visible at the place of puncture, whereas control fruits remain symptomless even after 7 days of inoculation. Inoculated leaves showed disease symptoms similar to those observed in the field whereas leaves of control sets were symptomless even after 15 days. The pathogenicity test was repeated thrice under the same conditions mentioned before. C. orbiculare was successfully re-isolated from all the symptomatic tissues of leaves as well as fruits, completing Koch's postulates. Previously, the pathogen has been reported as an important anthracnose pathogen of Cucurbitaceae, especially of cucumber (Cucumis sativus), melons (Cucumis melo), watermelon (Citrullus lanatus), pumpkin (Cucurbita pepo) and squash (Cucurbita maxima) (Farr and Rossman 2020). To our knowledge, this is the first report of C. orbiculare causing anthracnose of pointed gourd. This disease represents a threat to producers in India and central Asia. Further research may contribute to the development of management strategies for this disease.

Paramedics’ Anxiety and Concerns Towards Attending Traumatic Events

Introduction Trauma is a major problem in Saudi Arabia and a leading cause of mortality and morbidity in young age groups. In 2018, road traffic injuries and trauma were the second-leading cause of death after ischaemic heart disease. There is a lack of research that explores the psychological effects on emergency medical service (EMS) professionals of providing the required pre-hospital care for trauma cases. This study aims to identify which trauma cases cause the most anxiety and concern among a group of EMS professionals. Methods A study using a two-round Delphi method was undertaken online with EMS professionals working for the Saudi Red Crescent Authority (SRCA) across the country. Results The response rate was 70% (n=14) at the end of round two. All participants were male and the majority of professionals who participated were from the capital city, representing 36%. Most of the professionals held a bachelor’s degree as the highest level of education (78%). The initial round generated one item that achieved 70% of the consensus; however, the second round did not achieve any consensus. The overall top item for the trauma cases that caused the most anxiety and concern as identified by respondents was road traffic collision. Conclusion Road traffic collisions are a leading cause of death and based on the respondents’ agreement they cause paramedics the most anxiety and concern of the cases they attend.

Experimental and three-dimensional performance analysis of a bio-inspired fish-ridge vertical axis wind rotor

The savonius vertical axis wind rotor has a simple structure, making it a suitable choice for power generation in small-scale, low wind speed environments. However, its wind energy conversion efficiency is low. To improve the conversion efficiency of the wind rotor using the proposed fish-bridge structure, the wind tunnel tests are conducted to collect actual wind and rotational speeds. In addition, Computational Fluid Dynamics (CFD) simulation is conducted to reveal potential operating mechanisms, with special emphasis on analyzing the effects of aspect ratio and end plate on the performance of the fish-ridge wind rotor. The CFD results show that the wind power coefficient of this wind rotor presents an increasing trend with the increase of the aspect ratio and the area of the end plate, and that with round end plates is improved by 24.26 % compared to that of the wind rotor without end plates, and that with an aspect ratio of 3.5 is improved by 32.58 % compared to that of the wind rotor with an aspect ratio of 1. By increasing the aspect ratio and the end plate area of the wind rotor, the contact airflow is raised and concentrated, which improves the aerodynamic performance of the wind rotor.

Integrated morphological and molecular approaches unveil a new species and a new record of the genus Entoloma (Entolomataceae) from southern Punjab, Pakistan

In southern Punjab, Pakistan, the genus Entoloma remains poorly explored. Four collections of the genus Entoloma were collected during the mycological surveys from 2020 to 2022, in different areas of southern Punjab, Pakistan. Morpho-anatomical and molecular phylogenetic analyses based on ITS and combined ITS-28S sequences revealed that these four collections belong to the genus Entoloma Rusticoides group including a new species named E. khalidii and a new record for Pakistan, named E. phaeocarpum. The new species is characterized by a hemispherical to convex pileus with dark brown depressed center, slightly smaller isodiametric basidiospores, the presence of clavate to utriform cheilocystidia, and pileipellis hyphae with rounded ends. These findings underscore the importance of morphological, microscopical, and molecular approaches in fungal taxonomy and contribute to unveiling the fungal diversity in underexplored regions. The discovery of these species emphasizes the significance of continued exploration and conservation efforts to preserve myco-diversity in southern Punjab, Pakistan. Colored photographs of fresh basidiomata and habitats, illustrations of key anatomical characters, detailed descriptions, phylogenetic trees, and comparisons with closely related species are also provided.

First report of Colletotrichum queenslandicum associated with chilli anthracnose in Mauritius.

Globally, chilli (Capsicum annuum L.) is one of the most economically important and widely cultivated crop which elicits ethnomedicinal and nutritional potential as well as enhancing the taste and aroma of foods (Ayob et al., 2022; Kiran et al., 2020). Anthracnose disease is regarded as a prime constraint in chilli production, leading to enormous losses in tropical and subtropical countries. In September 2022, chilli fruit displaying sunken, shriveled and dark bown to black lesion with abundant acervuli on the surface was obtained from Flacq, Mauritius. From the symptomatic tissue, small pieces of the diseased tissue were excised, surface-disinfected using 1% sodium hypochlorite, twice rinsed using sterilized distilled water, air-dried and plated on PDA. After 7 days of incubation at room temperature, white to greyish white colony with dense white cottony aerial mycelium was recovered. Out of two isolates, CHF and CH10, the latter was considered for morphological and molecular characterization. The observed conidia (n=30) were unicellular, straight, cylindrical with rounded ends and slight constriction near the centre and had average length and width of 20.5 µm and 6 µm, respectively. For growth rate measurement of the isolate, two 5×5 mm of fungal agar plugs were taken from growing edge of colony, inoculated at centre of individual PDA plate and incubated at room temperature with a natural light/dark cycle. The diameter of the cultures were measured perpendicularly for a period of 7 days and the growth rate was calculated as 7-day average of daily growth (mm day-1). The growth rate of the fungal isolate (CH10) was 13.5 mm day-1 on PDA. Based on the morphological characters, the isolate was classified within the C. gloeosporioides species complex. For precise identification of the isolate, DNA was extracted from fungal mycelium using traditional DNA isolation methods (Ranghoo and Hyde, 2000), followed by PCR amplification and DNA sequencing using primer pairs ITS4/ITS5 (White et al., 1990), GDF/GDR and T1/Bt2b (Gan et al., 2016), respectively. ITS gene sequence (600 bp) confirmed that the isolate was Colletotrichum, with 99.83% similarity to KR704204 while GADPH (277 bp), TUB2 (733 bp) and ApMat (801 bp) gene sequences showed 99.64 to 100% similarity to C. queenslandicum with GenBank reference sequences, KT372374, KU221378 and MG674932 respectively. The gene sequences of isolate CH10 were deposited in GenBank database under the following accession numbers OR681557 (ITS), OR233734 (GADPH), OR475575 (TUB2) and PP622748 (ApMat). Koch's postulates were confirmed by spraying disease-free chilli plants with 10µL of conidial suspension (1 × 106 spores/ml) prepared from 7 days old colony of isolate CH10. Healthy chilli plants inoculated with sterile distilled water served as a negative control experiment. The plants were grown in pots in a moist chamber at 25˚C. After 5 days post-inoculation, anthracnose symptoms were developed on test plants while the control plant remained asymptomatic. The original isolate was successfully recovered from the test fruits, thus fulfilling Koch's postulates. The experiment was repeated thrice and revealed the same results. To the best of our knowledge, this is the first record of C. queenslandicum in Mauritius and is the first time to report anthracnose of chilli caused by this fungus. Colletotrichum queenslandicum has previously been reported in Europe, Mexico, US, Puerto Rico, Australia, Fiji, Brazil, Indonesia and China. Furthermore, the latter was associated with papaya, avocado, cashew, coffee, Persian lime, Licania tomentosa, white mangrove, lychee, mango, Nephelium lappaceum, olive, passionfruit, Dracaena cambodiana and Syzygium australe (Câmara and Vieira, 2022; Shidiq et al., 2024; Wang et al., 2022). This study will allow local farmers training and extension facilities to increase awareness among farmers about this disease-causing agent and allow them to take necessary measures for building up chilli crops resilience against this new and emerging pathogen in Mauritius.

Discovery and Characterization of Four Aphelenchid Species from Cultivated Regions of Southern Alberta, Canada.

The nematode family Aphelenchoididiae is considered fungal-feeding, predatory, or root hair feeders. Some members of this family are universally present in agricultural landscapes and are an integral part of soil health and conservation studies. In the present soil nematode biodiversity survey, we detected four species of the genera Aphelenchus, Aphelenchoides, and Robustodorus. Because fungal-feeding nematodes from southern Alberta have not previously been reported, we conducted a detailed morphological and molecular investigation, identifying these species as Aphelenchus avenae, Aphelenchoides limberi, Aphelenchoides prairiensis n. sp. and Robustodorus paramegadorus n. sp. The first two species we document as new records from southern Alberta, whereas A. prairiensis n. sp. and R. paramegadorus n. sp. we describe in detail as new taxa. Briefly, A. prairiensis n. sp. is an amphimictic species having 4 lateral lines; hemispherical anteriorly flattened lip region; delicate stylet and swelling-like stylet knobs; excretory pore at the posterior edge of nerve ring. Female tail conical, gradually tapering towards a truncated end with single mucro. Spicule 23.0 (20.0-25.0) µm long having elongated rounded condylus, small, blunt conical rostrum, and lamina that gradually tapers towards the rounded distal end; three pairs of caudal papillae were present on the male tail. Robustodorus paramegadorus n. sp., is a parthenogenetic species with 3 lines in the lateral fields; lip region rounded, anteriorly flattened; stylet robust, with knobs rounded to bean-shaped; excretory pore located posterior to nerve ring; reproductive components were quite indiscernible with a short 24.0 (18.0-27.0) µm post-vulval uterine sac; tail conical, ending with pointed to wedge-shaped tip. We performed molecular characterizations for each species and constructed phylogenetic trees to study the phylogenetic relationship of these aphelenchid species. The discovery of A. prairiensis n. sp. and R. paramegadorus n. sp. indicates that soil nematode diversity is relatively unexplored in southern Alberta. The findings of this study will significantly enhance the identification processes and may contribute towards future soil health and biodiversity efforts.

First Report of Anthracnose on Euonymus japonicus Thunb. Caused by a Provisionally Novel Species of Colletotrichum in the Magnum Complex in South Korea.

Euonymus japonicus Thunb., also known as the evergreen spindle tree, is an evergreen tree, which is widely planted as a hedge plant along streets in South Korea. In April 2022, severe anthracnose symptoms were observed on the leaves of this tree in Jangsu in the Jeonbuk Province of the country (35°43'49.44″N, 127°34'53.7″E). About 80% of the leaves of each affected tree within a 0.03-ha area showed incidence of the disease on approximately 30 trees were planted along the roadside (~30 m). These symptoms typically included circular or irregularly shaped whitish-gray lesions with a diameter of 2.0 to 3.0 cm. In cases where some leaves were severely affected, larger blotches formed. To isolate the pathogen, about ten leaves showing anthracnose symptoms on each tree were randomly selected and brought to the laboratory. Fungal isolations were made from acervuli filled with conidial masses on infected evergreen tissues, followed by plating onto 2% potato dextrose agar (PDA) as well as incubated at 25℃. On the PDA, colonies were circular, raised, green-grey or dark grey, and had a distinct white margin. The conidia were single-celled, transparent, cylindrical with rounded ends, had smooth walls, with a length ranging from 12 μm to 16.7 μm and a width raging from 4 μm to 6.5 μm (av. = 14.1 X 5.0 μm, n=40). Of those that were successfully recovered with approximately 90% frequency, two monoconidial isolates were deposited to the culture collection at Chungnam National University in South Korea (Accession number: CDH059-060). To ensure the identity of the fungus, genomic DNAs were extracted from the selected isolates, CDH059-060, and were sequenced. This was achieved based on partial sequences of the internal transcribed spacer (ITS), actin and beta-tubulin (TUB2) gene regions which were amplified using ITS1F / ITS4 (Gardes and Bruns 1993; White et al. 1990), ACT-512F / ACT-783R (Carbone and Kohn 1999), and T1 / Bt2b (O'Donnell and Cigelnik 1997; Glass and Donaldson 1995) primer pairs, respectively. The resulting sequences were deposited to GenBank (OR984424-425) for ITS, (OR996289-290) for actin, and (OR996291-292) for TUB2. For a phylogenetic analysis, sequences from different gene regions (ITS, actin and TUB2) retrieved from GenBank were aligned, concatenated, and analyzed as a single dataset based on a maximum likelihood analysis. The phylogenetic result revealed that the fungus isolated in this study was positioned in a clearly distinct lineage, provisionally representing an undetermined species of Colletotrichum, which is most closely related to Colletotrichum liaoningense (Y.Z. Diao, C. Zhang, L. Cai & X.L. Liu, CGMCC3.17616 (KP890104 for ITS, KP890097 for actin, and KP890111 for TUB, Diao et al. 2017). Sequence comparisons revealed that this pathogen differed from C. liaoningense at 20 of 494 characters (∼4.0%) in the ITS and 2 of 251 (∼1.0%) in the actin sequences. For pathogenicity tests, three seedlings of E. japonicus were used. The leaves for each tree were treated with 10 ml of a conidial suspension by spraying (1x10⁶ conidia ml-1 of the isolate, CDH059), while the three seedlings were treated with distilled water as control. After sprayed, the treated areas were sealed with plastic bags for a day to maintain humidity. Anthracnose symptoms identical to those observed in the field appeared seven days after inoculations, while no symptoms were observed in the control. Re-isolations were successfully achieved from the treatments, fulfilling Koch's postulates. Anthracnose associated with the provisionally novel species of Colletotrichum sp. on E. japonicus has not been recorded elsewhere, and in this regard, this is the first report of anthracnose caused by Colletotrichum sp. on E. japonicus in Korea. To effectively control the disease, more attention should be paid to the host range of the pathogen and other regions where the disease caused by the pathogen might occur in the country.

First Report of Anthracnose Caused by Colletotrichum siamense on Machilus thunbergii Siebold & Zucc. in South Korea.

Machilus thunbergii Siebold & Zucc., known as Japanese bay tree, is an evergreen tree distributed widely in East Asia, including South Korea, where the species is of ecological importance. Machilus thunbergii provides habitat for wildlife species and is a common urban tree. In September 2022, anthracnose symptoms on leaves were observed in Jeju (33°26'02.4"N, 126°19'48.8"E) and Tongyeong (34°49'27.1"N, 128°24'01.8"E) in South Korea. Disease incidence on leaves of each affected tree, naturally growing in an urban forest area covering approximately 0.5 ha was approximately ~ 70 % in each study area. Anthracnose symptoms that were observed on 70 to 80% leaves per tree in each study area included orbicular or irregular, whitish-grey spots on leaves that were 1.5 to 3.0 cm in diam. In some cases where leaves were severely affected, larger blotches were formed, leading to bleaching symptoms and eventually defoliation. For pathogen isolation, two or three leaves showing anthracnose symptoms from each of the 15 trees were randomly selected and brought to the laboratory. Fungal isolations were then directly made by transferring spores from acervuli that developed on diseased leaves onto potato dextrose agar (PDA) media. Cushion shaped acervuli filled with salmon to orange-colored conidial masses were produced on media approximately two weeks after the incubation at 25 ± 1°C with a photoperiod of 12 h. Conidia were single celled, hyaline, cylindrical with rounded ends, smooth walls, 13.7 to 18.1 μm long and 3.1 to 4.5 μm wide (n=30). Among 15 cultures that were successfully isolated, 10 isolates were retained based on culture characteristics, and two randomly selected monoconidial cultures were deposited in the culture collection (CDH) of the Chungnam National University, Republic of Korea (Accession No. CDH057-58). Two isolates selected, CDH057 and CDH058, were subjected to identification, and this was achieved based on multiplesequence comparisons using on internal transcribed spacer regions of rDNA (ITS1 and ITS2), partial sequences of actin (ACT) and β-tubulin (TUB2) gene regions amplified using ITS1F / ITS4, ACT-512F / ACT-783R and T1 / Bt2b, respectively (Weir et al. 2012). The representative sequence data were deposited in GenBank under the accession numbers OR473277 and OR473278 for the ITS, OR480772 and OR480773 for ACT, and OR480774 and OR480775 for TUB2. The resulting sequences were further used for a phylogenetic analysis based on the maximum likelihood method using a concatenated dataset of the ITS, ACT and TUB2 gene sequences for Colletotrichum species in the C. gloeosporioides clade. The results showed that the pathogen isolated in this study clustered with Colletotrichum siamense (Vouchered specimens: MFLU 090230, COUFPI291, and COUFPI294) (Prihastuti et al. 2009). Sequence comparisons revealed that the isolates obtained in this study differed from the type species of C. siamense (MFLU 090230; FJ972613 for ITS, FJ 907423 for ACT, FJ907438 for TUB2) at 2 of 258 bp (∼0.8%) and 6 of 387 bp (∼1.6%) in the ACT and TUB2 sequences, respectively, while the ITS was identical to the type species. For pathogenicity tests, a total of ten three-year-old seedlings of M. thunbergii were used. The leaves of each tree were sprayed with 5 ml of conidial suspension (105 conidia/ml, isolate CDH057). Three control plants were sprayed with sterile water. After being sprayed, treated areas were sealed with a plastic bag for 24 hours to preserve humidity. Anthracnose symptoms, identical to those observed in the field, appeared five to seven days after the inoculations, while no symptoms were observed on control plants. The isolates used in the pathogenicity test were reisolated from 90% of lesions, and their identity was confirmed based on sequence comparisons, thus fulfilling Koch's postulates. Species of the C. gloeosporioides species complex include important plant pathogens, particularly C. siamense, which cause significant losses of economic and ecological relevance on a wide range of hosts (~ 100 hosts) (Talhinhas and Baroncelli 2021). Although C. fioriniae in the C. acutatum species complex, was found on M. thunbergii in South Korea (Thao et al. 2023), anthracnose associated with C. siamense on M. thunbergii has not been reported in the country. In this regard, this is the first report of anthracnose caused by C. siamense on M. thunbergii in South Korea. To effectively control the disease, more attention should be paid on the host range of the pathogen and other regions where the disease caused by the pathogen might occur in the country.

First report of anthracnose of Lithocarpus polystachyus caused by Colletotrichum fructicola in China.

Lithocarpus polystachyus (Wall. ex A. DC.), an economically valuable plant species belonging to the Fagaceae family, has been used as herbal tea to prevent diabetes because of the high content of flavonoids and dihydrochalcones in the leaves (Shang et al. 2022). In July 2022, the severe leaf lesion on L. polystachyus was first observed in Yongshun County, Xiangxi autonomous prefecture (28°45'34''N, 109°40'11''E), Hunan province, China. Yongshun County is characterized by hills and mountains, situated in a subtropical region with a mild and humid climate. A second outbreak in July 2023 was observed in the same area. The observed incident rates in the past two years were 87.3% and 90.6%, respectively. Once infected, almost all plant leaves will be infected, leading to a substantial reduction in the yield of L. polystachyus. The disease presented symptoms characterized by round or irregularly shaped lesions that initially manifested as brown spots. These lesions frequently merged into larger, dark-brown areas along the leaf margins before eventually wilting. To ascertain the pathogenic species responsible for this disease, fungal isolation was conducted using a tissue separation method (Xu et al. 2023). The infected leaf tissues were surface-disinfected with 75% ethanol and 0.1% HgCl then small pieces (1×1 cm), were placed onto potato dextrose agar (PDA) medium (Sigma-Aldrich, 70139) and incubated at 28°C for 6-9 days. Colonies were villiform and initially white, becoming gray after 6 days. Sterilized dissecting needles were used to pick single hyphal tips from the edge of the colonies and placed onto PDA for strain purification. After 15 days, the purified colonies grew fluffy white hyphae with abundant conidia. The conidia were cylindrical, had round ends, and ranged from 5.75 to 14.83 μm long and 1.75 to 2.38 μm wide (n=50). According to morphological and cultural characteristics, these isolates were preliminarily identified as Colletotrichum fructicola Prihast., L. Cai & K.D. Hyde (Damm et al. 2012). To further affirm the identity of the pathogen, DNA was extracted from mycelia using a DNA extraction kit (Sigma-Aldrich, G2N70). The internal transcribed spacer (ITS) region, the transcription elongation factor (TEF), and the actin (ACT) gene were then amplified from genomic DNA extracted from three isolates (Cof1, Cof2, and Cof3) using specific primers. The primers utilized were ITS1/ITS4 (White et al. 1990), EF1-728F/EF1-986R and ACT-512F/ACT-783R (Carbone and Kohn 1999) for ITS region, transcription elongation factor gene and actin gene amplification, respectively. Sequence identity indicated that these isolates were highly homologous to C. fructicola. The ITS (Genbank No. PP002156, OR880553 and OR880554), TEF (No. PP061421, PP061422 and PP061423), and ACT (No. PP061418, PP061419 and PP061420) sequences of the isolates Cof1, Cof2, and Cof3 shared 99 to 100% identity with their counterparts (No. OR083309, MF627961, and OQ427895) in C. fructicola, respectively. A neighbor-joining phylogenetic tree constructed using MEGA11 (Tamura et al. 2021) also indicated that these isolates were C. fructicola. Both morphological and molecular characteristics confirmed the identification of this pathogen as C. fructicola. Colletotrichum species are known to cause anthracnose disease in a variety of economically important crops (Sharma and Kulshrestha 2015). To further validate the ability of the isolated C. fructicola to induce the same symptoms as observed in the field, the pathogenicity assay was assessed following Koch's postulates (Gradmann, 2014). Conidial suspensions (1×105 conidia per mL) from three isolates were individually inoculated onto artificially wounded leaves of 3-year-old L. polystachyus. Negative controls were established by inoculating leaf wounds with sterile distilled water. The plants were incubated in a greenhouse at 28°C and 90% humidity with a 12-h photoperiod. The experiment was replicated three times. Necrotic lesions were observed on all pathogen-inoculated wounds within 6 days after inoculation, whereas controls showed no observable symptoms. Morphological and molecular characterization of re-isolated pathogens from infected leaves indicated that the pathogens were identical. To our knowledge, this is the first report of anthracnose of L. polystachyus caused by C. fructicola in China. Farmers in the local mountainous areas are economically reliant on L. polystachyus production, while anthracnose has caused over half of the trees to lose their commercial value, resulting in significant economic losses. Our findings hold great promise for advancing strategies in the prevention and treatment of anthracnose in L. polystachyus.

A Delphi Consensus on Surgical Technique of Roux-en-Y Gastric Bypass: An Obesity and Metabolic Surgery Society of India Initiative

Abstract Introduction: Roux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric surgical procedure. However, its complexity has led to various technical adaptations being practiced globally, including in India. Recognizing the need for uniformity in such a crucial procedure, the Obesity Surgery Society of India (OSSI) took the initiative of doing a Delphi consensus on the technique of RYGB. Methods: A panel of 17 experts, chosen from OSSI members, was formed based on their extensive experience with RYGB, years of practice, the proportion of RYGB in their practice, and their academic contributions and recommendations from the executive committee. A questionnaire comprising 40 statements regarding the key steps of the procedure was shared with the selected experts through email. Consensus was deemed to be reached when the statements received scores exceeding 70%. Results: After three rounds of surveys, consensus was reached on 34 statements. Following the first round, statements without consensus underwent reformulation and were redistributed along with pertinent literature. Despite these efforts, six statements remained unresolved by the end of the third round, indicating areas where expert consensus could not be achieved. Conclusions: This Delphi consensus gives a snapshot in the practices of experts doing RYGB in India. It details the various intricacies and technical aspects of the procedure.

Public Law Developments in Türkiye on Its Centennial

Abstract As the centennial anniversary of the Turkish Republic has been celebrated in 2023, by virtue of a dynamic interplay between law and politics both nationally and internationally, year 2023 has been a legally active one for Türkiye. The general elections and the presidential elections were held in May, and Recep Tayyip Erdoğan extended his twenty years of power by five more at the end of the second round, while AKP (Justice and Development Party, led by Erdoğan) once again became the leading political party in the Parliament. Along with the ongoing economic hardship the State is in for the last few years now, which was deteriorated with the devastating earthquakes of 6 February, and the wars in nearby countries, it may be submitted that the legal outlook has been heavily influenced by internal and external stress factors. This survey presents a selection of public law related legal developments that took place in Türkiye, between January and November of 2023.