Selection Of Management Strategies Research Articles

A novel high-risk model identified by epithelial-mesenchymal transition predicts prognosis and radioresistance in rectal cancer.

Many studies have shown that tumor cells that survive radiotherapy are more likely to metastasize, but the underlying mechanism remains unclear. Here we aimed to identify epithelial-mesenchymal transition (EMT)-related key genes, which associated with prognosis and radiosensitivity in rectal cancer. First, we obtained differentially expressed genes by analyzing the RNA expression profiles of rectal cancer retrieved from The Cancer Genome Atlas database, EMT-related genes, and radiotherapy-related databases, respectively. Then, Lasso and Cox regression analyses were used to establish an EMT-related prognosis model (EMTPM) based on the identified independent protective factor Fibulin5 (FBLN5) and independent risk gene EHMT2. The high-EMTPM group exhibited significantly poorer prognosis. Then, we evaluated the signature in an external clinical validation cohort. Through in vivo experiments, we further demonstrated that EMTPM effectively distinguishes radioresistant from radiosensitive patients with rectal cancer. Moreover, individuals in the high-EMTPM group showed increased expression of immune checkpoints compared to their counterparts. Finally, pan-cancer analysis of the EMTPM model also indicated its potential for predicting the prognosis of lung squamous cell carcinoma and breast cancer patients undergoing radiotherapy. In summary, we established a novel predictive model for rectal cancer prognosis and radioresistance based on FBLN5 and EHMT2 expressions, and suggested that immune microenvironment may be involved in the process of radioresistance. This predictive model could be used to select management strategies for rectal cancer.

T1 colorectal cancer patients' perspective on information provision and therapeutic decision-making after local resection.

Decision-making after local resection of T1 colorectal cancer (T1CRC) is often complex and calls for optimal information provision as well as active patient involvement. The aim was to evaluate the perceptions of patients with T1CRC on information provision and therapeutic decision-making. This multicenter cross-sectional study included patients who underwent endoscopic or local surgical resection as initial treatment. Information provision was assessed using the EORTC QLQ-INFO25 questionnaire. In patients with high-risk T1CRC, we evaluated decisional involvement and satisfaction regarding the choice as to whether to undergo additional treatment after local resection, and the level of decisional conflict using the Decisional Conflict Scale. Ninety-eight patients with T1CRC were included (72% response rate; 79/98 endoscopic and 19/98 local surgical resection; 45/98 high-risk T1CRC). Median time since local resection was 28months (IQR 18); none had developed recurrence. Unmet information needs were reported by 29 patients (30%; 18 low-risk, 11 high-risk), mostly on post-treatment related topics (follow-up visits, recovery time, recurrence prevention). After local resection, 24 of the 45 high-risk patients (53%) underwent additional treatment, while others were subjected to surveillance. Higher-educated patients were more often actively involved in decision-making (93% vs. 43%, p=0.002) and more frequently underwent additional treatment (79% vs. 40%, p=0.02). Decisional conflict (p=0.19) and satisfaction (p=0.78) were comparable between higher- and lower-educated high-risk patients. Greater attention should be given to the post-treatment course during consultations following local T1CRC resection. The differences in decisional involvement and selected management strategies between higher- and lower-educated high-risk patients warrant further investigation.

Water-energy-food-greenhouse gases nexus management in urban environments: A robust multi-agent decision-support system

Conceptual urban water metabolism (CUWM) models provide a holistic view of the efficiency of urban water systems. These models can be linked with multi-agent reinforcement learning (MARL) models to mimic stakeholders' reactions to various strategies. However, the outcomes derived from CUWM-MARL models come with uncertainty. As a result, this paper introduces a decision support system (DSS) that is aware of these uncertainties and uses this information to select robust management strategies based on the output of CUWM-MARL models. First, future scenarios are generated by exploring all combinations of critical values of deeply uncertain variables and values of uncertain variables sampled from an appropriate multivariate copula distribution. Then, a computationally efficient surrogate model is developed to alleviate the computational load of the MARL sub-model. The surrogate model is run through all future scenarios to calculate the system's key performance indicators (KPIs) for each management strategy. Urban water managers can use these KPIs and social choice methods to find consensus management strategies. The proposed methodology has been implemented in the western part of the Tehran metropolitan area, Iran. This study evaluates 26 management strategies consisting of various projects, including reducing water distribution network leakage, implementing urban demand control projects, and utilizing semi-centralized or decentralized wastewater treatment plants. The strategy chosen by the uncertainty-aware DSS enhances the total utility and fairness indices by 125% and 4%, respectively. Moreover, it effectively improves groundwater quality, reduces energy consumption and greenhouse gas emissions, and enhances water supply reliability, ultimately contributing to farmers' job security.

Residual stress and distortion control in wire-arc additive manufacturing process through novel modular substrate

Wire arc additive manufacturing (WAAM) is a proven technology in metal additive manufacturing (AM), which can produce large-scale components at a faster production rate. Since WAAM adopts a welding heat source for metal deposition over the substrate, severe thermal gradients develop around the deposition resulting in residual stresses in the substrate, thereby distorting the substrate. In the case of area filling in metal AM processes, heat accumulation is progressive and a large amount of heat is accumulated at the end of the deposition. This leads to thermal imbalance over the substrate and an increase in the shrinkage forces during cooling, thereby causing higher distortion. This paper mainly deals with the mitigation of distortion in the substrate for area filling caused by the thermal imbalance over the substrate. This thermal imbalance is addressed in two ways; a) by selectively insulating and b) by selectively conducting the heat from the substrate. Simulations are conducted to study the thermal evolution during area filling and counterbalance the heat by insulating and conducting the substrate selectively during experimental deposition. A comparative assessment of distortions of the full conduction, full insulation, selective conduction and selective insulation cases is detailed. The selective thermal management strategy showed lower thermal imbalance over the substrate resulting in lower distortion.

Mpact of Chickpea Varieties and Sowing Dates on Pod Borer Helicoverpa armigera (Hubner)

Background: Global warming and climate change will have a major bearing on population and incidence of insect-pests and their associated yield and quality losses in different crops. In chickpea, a number of insect-pests are observed which mainly limit its production and productivity. Among these, gram pod borer, Helicoverpa armigera (Hubner) (Lepidoptera: Noctuidae) is a major and prominent pest in different chickpea growing areas of the country. The increased demand of residue free crop produce will definitely motivate farmers to select alternative management strategies instead of insecticides for management of insect-pests. Therefore, the current study aimed to determine the effect of different chickpea varieties at different dates of sowing on the population and incidence of gram pod borer. Methods: The present study was conducted at Regional Research Station, PAU-Gurdaspur during Rabi seasons of 2019-20 and 2020-21 to determine the effect of chickpea varieties (PBG 7 and PBG 8) and different sowing dates viz. 25thOctober, 05, 15 and 25thNovember on the larval population and per cent pod borer infestation of Helicoverpa armigera. Result: It was concluded that both the tested chickpea varieties had non-significant effect on population of pod borer, pod damage and gram yield. However, the pod borer’s larval population and pod infestation decreased across sowing dates from last week of October to last week of November. The mean larval population and incidence of H. armigera decreased with a delay in time of sowing i.e. 7.88 and 5.29 larvae/3 rows and 62.96 and 42.27% pod damage in the 25thOctober and 25thNovember sown crop, respectively. The maximum grain yield (17.45 q/ha) was obtained from 15th November sown crop.

Mathematical modeling of production process using cluster analysis methods

Manufacturing process management is a complex problem characterized by decision-making throughout the entire production process and is reduced to finding the best set of possible (alternative) in terms of some criterion or criteria for the use of available resources. The goal of the production process optimization is to analyze a set of alternative production options in complex systems and to determine the most rational possible state depending on the selected management strategies. The system contains many connections between elements and is influenced by random factors. It is not possible to create a real model for the system that is described analytically, but it can be investigated by using simulation modeling. In the mathematical modeling of the production process cluster analysis methods are used which allow to process a large amount of data from all possible states of the system and divide them into similar aggregates according to several characteristics. The analysis of the formed groups is carried out and the regularities that have the most significant impact on the occurrence of states into clusters are revealed.

Consequences of Dryland Maize Planting Decisions Under Increased Seasonal Rainfall Variability

AbstractShifts in rainfall frequency and intensity can lead to heavy crop loss in rainfed agricultural systems. Small‐scale farmers who plant with limited resources need to carefully select management strategies that are well suited for their environment. Farmers must choose between planting higher‐yielding varieties that take longer to mature and lower‐yielding varieties that can be harvested sooner. To better understand the interactions between rainfall variability, cultivar choice, and cropping success, we implement an ecohydrological model that accounts for variation in daily soil moisture and converts water stress to crop yield. We apply the model to growing conditions of dryland farmers in central Kenya, which is a drought‐prone and semiarid region with spatially heterogeneous rainfall. To simulate stochastic daily rainfall, we derive parameters in 10‐day increments from a 30+ year daily rainfall data set. We use these properties to model the stochastic seasonal water availability for cultivars with different maturation lengths. In agreement with past studies, our analysis shows that storms are becoming more intense and less frequent. We show that maize crops are prone to water deficit in the part of the growing season when crop water requirements are highest. Despite the potential for higher‐yielding, late maturing varieties to improve total harvest, we find that early maturing varieties that are drought‐avoidant have the lowest likelihood of failure. In light of reduced rainfall totals, we show that the historical probability of crop failure was lowest in the past and is now increasing.

Implications of cover crop planting and termination timing on rainfed maize production in semi-arid cropping systems

• Introducing cover crops in a rainfed wheat-maize-fallow rotation of semi-arid regions. • Cover crops induced nitrogen immobilization when terminated late in the spring. • Late terminated cover crops suppressed weeds early in the maize growing season. • Late terminated cover crops did not affect soil carbon and respiration. • Cover crops reduced maize grain yield regardless of the termination timing. Despite the potential to increase soil organic matter, cycle soil nutrients, and suppress weeds, there is a concern that cover crops (CCs) soil water use negatively impacts subsequent crops in water-limited environments. Cover crop management practices such as planting and termination timing may mitigate the detrimental impacts of CCs in semi-arid cropping systems. To determine the effects of CCs under water-limited environments, we evaluated the total CC biomass produced in the fall and spring, soil water content during the subsequent maize growing season, weed density and biomass, crop residue, and soil nutrients at the maize V6 development stage, and maize productivity. The experiment was conducted under a wheat-maize-fallow rotation at two sites (Grant and North Platte, NE) during 2016−2017 and 2017−2018. Treatments consisted of three planting timings after winter wheat harvest and three CC termination timings and fallow (no CCs) before maize establishment. Planting CCs shortly after winter wheat harvest increased CC biomass in the fall and early spring compared to late planting. Cover crops terminated early in the spring reduced weed biomass (−70 %), while CCs terminated late in the spring reduced both weed density (−56 %) and biomass (−82 %) compared to fallow. Due to above-normal precipitation during the experiment, soil water measured at 0−20 cm soil depth was impacted by CCs only at Grant 2016−2017. Cover crops terminated late in the spring increased crop residue biomass but decreased total nitrogen at 0−10 cm soil depth by 17 %, and decreased soil nitrate at the 10−20 cm soil depth up to 26 % compared to fallow. Cover crops planted late in the summer (August) and terminated late in the spring (May) had the most detrimental impact on maize grain yield. Late termination of CCs in the spring reduced corn grain yield by up to 20 % compared to fallow. Despite enhanced weed suppression and crop residue, CCs decreased soil nitrogen and maize grain yield, especially when terminated late in the spring. Producers in semi-arid regions of the Great Plains willing to incorporate CCs should use caution when selecting management strategies for their CCs to minimize maize grain yield and economic losses.

The Head and Neck Survivorship Tool (HN-STAR) Trial (WF-1805CD): A protocol for a cluster-randomized, hybrid effectiveness-implementation, pragmatic trial to improve the follow-up care of head and neck cancer survivors

Survivors of head and neck cancer (HNC) can have multiple health concerns. To facilitate their care, we developed and pilot-tested a clinical informatics intervention, HN-STAR. HN-STAR elicits concerns online from HNC survivors prior to a routine oncology clinic visit. HN-STAR then presents tailored evidence-based clinical recommendations as a clinical decision support tool to be used during the visit where the oncology clinician and survivor select symptom management strategies and other actions. This generates a survivorship care plan (SCP). Online elicitation of health concerns occurs 3, 6, and 9 months after the clinic visit, generating an updated SCP each time. HN-STAR encompasses important methods of improving survivorship care (e.g., needs assessment, tailored interventions, dissemination of guidelines) and will be evaluated in a pragmatic trial to maximize external validity. This hybrid type 1 implementation-effectiveness trial tests HN-STAR effectiveness while studying barriers and facilitators to implementation in community oncology practices within the National Cancer Institute Community Oncology Research Program. Effectiveness will be measured as differences in key survivorship outcomes between HNC participants who do and do not use HN-STAR over one year after the clinic visit. The primary endpoint is HNC-specific quality of life; other outcomes include patient-centered measures and receipt of guideline-concordant care. Implementation outcomes will be assessed of survivors, providers, and clinic stakeholders. The hybrid design will provide insight into a dose-response relationship between the extent of implementation fidelity and effectiveness outcomes, as well as how to incorporate HN-STAR into standard practice outside the research setting.

Regional traffic operation and vehicle emission impact assessment of lane management policies

Managed lanes are expected to reduce congestion and, potentially, vehicle emissions. Usually, planning agencies select lane management strategies first and foremost to improve regional mobility. Furthermore, transportation projects are regulated by the Clean Air Act towards the overall regional emission levels and project-level (or corridor-level) pollutant concentrations. The present study aimed to develop and implement an optimal integrated transportation and emissions modeling platform to evaluate regional vehicle emission and pollutant dispersion impacts and their significance for adding a managed lane facility to the roadway network. The case study examined the Loop 375–Border Highway West toll project in El Paso, Texas, under five proposed lane management strategies. Results confirmed the addition of a priced facility can provide congestion relief at the corridor level and cause some rerouting in other parts of the region. However, they do not appear to substantially reduce regional greenhouse gases and criteria pollutant emissions. The findings of the current study provide further insight within a regional context into selecting a transportation project and its true emission savings and air quality benefits.

Wood hydrosystem of three cultivars of Vitis vinifera L. is modified in response to contrasting soils

In Vitis vinifera L., the same genotype can express different phenotypic characteristics depending on the environmental conditions, e.g. soil deepness. Wood anatomy, specifically xylem vessel traits, provide information about the plant’s eco-physiological responses to the environment. Slight changes in vessel diameter and density may impact plant hydrosystem functionality, since large vessels are more efficient in the volume of transported water compared to narrower ones, although the latter are more effective in avoiding stress-induced embolism. The aim of this study was to analyze variations in the wood hydraulic structure of three grapevine cultivars, induced by soils with strong contrast in depth, texture and rock volume, providing evidence of their adaptative capacities. Anatomical and growth traits of each annual growth ring were measured in 8-year-old plants of Bonarda, Malbec and Tempranillo cultivars growing in contrasting depths of soils. Bonarda exhibited no differences in wood productivity between soils with different depths, showing the ability to modulate the earlywood vessel lumen area. Malbec and Tempranillo did show differences in wood productivity between the two types of soils, with major changes in the trade-off between vessel density and lumen area in Tempranillo, while in Malbec there were few changes in the vessel traits. Xylem hydraulic characteristics of the grapevine stems varied in response to soil environment and cultivar. This knowledge may help to select management strategies in areas of soil heterogeneity.

Lethal and sublethal effects of chlorantraniliprole on Helicoverpa armigera adults enhance the potential for use in ‘attract-and-kill’ control strategies

Background: The integrated use of plant-derived volatile attractants and synthetic insecticides in attract-and-kill programs could provide a basis for selective and environmentally-acceptable pest management strategies with applicability for use against multiple pests. Ryanoid insecticide, chlorantraniliprole, has been found to present a potential for use in attract-and-kill strategies against the cotton bollworm Helicoverpa armigera , however lethal and sublethal effects on the adults have not been investigated yet. Results: Laboratory trials showed how chlorantraniliprole was active against H. armigera adults, with respective lethal concentration LC 20 and LC 50 values of 0.010 and 0.036 mg L -1 . Following exposure to a low lethal concentration (LC 20 ) and LC 50 , mating rate, fecundity and longevity of both H. armigera sexes were substantially reduced. Egg hatching was lowered 2- and 5-fold in LC 20 - and LC 50 -treated H. armigera pairs, respectively. When exposed to LC 50 of chlorantraniliprole, the net reproduction rate (R 0 ), intrinsic rate of increase (r) and finite rate of increase (λ) were reduced when compared to control treatments. Significantly lower effects were observed on the subsequent development and growth of H. armigera in subsequent generations. Following adult exposure to the two concentrations tested, no effects were observed on detoxification enzymes i.e., carboxyl esterase (CarE), glutathione S-transferase (GST) or mixed function oxidase (MFOs). Conclusions: Chlorantraniliprole concentrations could lower H. armigera adult survival and reproduction, and the LC 50 showed high potential for being used to control H. armigera through attract-and-kill schemes.

Современные возможности мультимодальной диагностики диабетического макулярного отека для определения выбора тактики лечения

Diabetes is a severe chronic disease that significantly affects the quality of life of individuals, their families, and society worldwide. Diabetic retinopathy, particularly diabetic macular edema (DME), is the leading cause of blindness and low vision among adults of working age in developed countries and Russia. A recent multimodal approach to diagnose DME resulted in new classifications of this disorder and slightly modified earlier views. The analysis of DME biomarkers allows for selecting management strategies for each patient, prescribing adequate medical treatment, and predicting potential treatment response. This paper aimed to analyze published data and up-to-date diagnostic approaches to DME. These tools provide a correct therapeutic strategy based on the DME pattern. Keywords: diabetic macular edema, optical coherence tomography, anti-VEGF treatment. For citation: Pshenichnov M.V. Current multimodal diagnostic tools for diabetic macular edema to select a management strategy. Russian Journal of Clinical Ophthalmology. 2021;21(4):210–214 (in Russ.). DOI: 10.32364/2311-7729-2021-21-4-210-214.

Management of Nonhealable and Maintenance Wounds: A Systematic Integrative Review and Referral Pathway.

To synthesize the evidence regarding nonhealable and maintenance wound management and propose an interprofessional referral pathway for wound management. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this continuing professional development activity, the participant will apply knowledge gained to:1. Identify the ideas from the authors' systematic review that could prove useful in understanding nonhealable and maintenance wound management.2. Select evidence-based management strategies for nonhealable and maintenance wound management. OBJECTIVEThis systematic integrative review aims to identify, appraise, analyze, and synthesize evidence regarding nonhealable and maintenance wound management to guide clinical practice. An interprofessional referral pathway for wound management is proposed. An electronic search of Scopus, Web of Science, PubMed, Academic Search Ultimate, Africa-Wide Information, Cumulative Index of Nursing and Allied Health Literature database with Full Text, Health Source: ConsumerEdition, Health Source: Nursing/Academic Edition, and MEDLINE was conducted for publications from 2011 to 2019. Search terms included (nonhealable/nonhealing, chronic, stalled, recurring, delayed healing, hard-to-heal) and wound types most associated with nonhealable or maintenance wounds. Published studies were hand searched by the authors. Studies were appraised using two quality appraisal tools. Thirteen reviews, six best-practice guidelines, three consensus studies, and six original nonexperimental studies were selected. Data were extracted using a coding framework including treatment of underlying causes, patient-centered concerns, local wound care, alternative outcomes, health dialogue needs, challenges within resource restricted contexts, and prevention. Data were clustered by five wound types and local wound bed factors; further, commonalities were identified and reported as themes and subthemes. Strong evidence on the clinical management of nonhealable wounds is limited. Few studies describe outcomes specific to maintenance care. Patient-centered care, timely intervention by skilled healthcare providers, and involvement of the interprofessional team emerged as the central themes of effective management of maintenance and nonhealable wounds.

Factors influencing management of agitation in aged care facilities: A qualitative study of staff perceptions.

Agitation in older people is commonly associated with cognitive decline, complex medical diagnoses and polypharmacy. Impaired communication and comprehension within a dementia trajectory adds complexity to assessment and management. Despite high prevalence, agitated behaviours remain challenging to manage in residential aged care settings. To explore staff perceptions of agitation in residents of aged care facilities, including the influence of dementia, when selecting management strategies to reduce agitated behaviour. Qualitative descriptive. Semi-structured interviews with 11 aged care staff were conducted at two aged care sites. Transcripts were examined using content analysis to identify common issues and categories. The study complied with COREQ guidelines (see. Appendix S1). Participants reported managing resident agitation at least once per shift; most frequently manifesting as wandering, restlessness or aggression. Management strategies included distraction, providing space, knowing the resident, identifying causative factors, spending individual time and if necessary medication administration. Agitation management was more challenging for residents with dementia due to impaired communication or comprehension of instruction. While participants strived to deliver individualized person-centred care, this was difficult given time and resource constraints. Contemporary management of agitation therefore remains variable in everyday practice, with resident preference used when causative factors were known. Conversely, for residents with impaired communication and/or comprehension, distraction and chemical restraint were commonly used. Nuanced education for assessment and management is recommended to better address this unmet need for some residents. For optimal care, appropriate allocation of time and resources is necessary to identify causative and contextual factors for individual residents. Recommendations are for additional staff training in communication and attitude, and collaborating with frontline staff to develop a practical guide for management of agitation in aged care. These simple initiatives may help to improve consistency of care delivery and resident outcomes.

The dawn of the Middle Paleolithic in Atapuerca: the lithic assemblage of TD10.1 from Gran Dolina

The Atapuerca localities present evidence of a long series of hominin occupations from the Early Pleistocene onward and are a key site for understanding the continuity and discontinuity of Western European technological and settlement dynamics. The TD10 unit from Gran Dolina is located in the upper part of the sequence and divided into four lithostratigraphic subunits (TD10.4 to TD10.1, from bottom to top) dated between ca. 450 ka and ca. 250 ka (Marine Isotope Stage 11 to Marine Isotope Stage 8). The technological analysis of the lithic assemblages belonging to the TD10.1 sequence aims to determine the trends among its archeological levels and check its relation to late Middle Pleistocene technological evolution and site functionality. Archeostratigraphic studies have identified several occupation events within its approximately 1.5 m of thickness, whose artifact densities and occupational models differ. However, no remarkable technical differences have been observed among them. Lithic assemblages from those events show more evolved features than other Atapuerca Mode 2 assemblages. These changes are reflected in the selective raw material management strategies; more hierarchized and predetermined reduction methods; and the progressive decrease of large cutting tools in the lithic assemblages with respect to flake tools, the latter defined by a greater typological diversification. These technological changes did not lead to a clear break with respect to previous technological models and were accompanied by other sporadic but significant changes in subsistence and behavioral strategies (bone tools and retouchers; lithic recycling, and so on), which were consolidated during the Middle Paleolithic. Hence, the archeological record from the TD10.1 subunit of Gran Dolina reflects a local stratigraphic transition from Mode 2 to Mode 3 technocomplexes, paralleling that observed in other sites in southwestern Europe.

Management of odontogenic sinusitis: multidisciplinary consensus statement.

Odontogenic sinusitis (ODS) can present a therapeutic dilemma because multiple treatment strategies have been reported. ODS review articles have been published, but they have lacked multidisciplinary collaboration and an evidence-based methodology. The purpose of this article was to perform an evidence-based review of ODS management options, and develop a multidisciplinary consensus statement on ODS management options. An evidence-based review of dental and medical literature on ODS management was performed using PubMed, EMBASE, and Cochrane Review Databases up to December 2019. Exclusion criteria included non-English-language articles, case series with fewer than 10 patients, fungal sinusitis, and studies that did not report treatment success rates. Because aggregate levels of evidence for recommendations were no higher than level C, a clinical consensus statement was conducted using a modified Delphi method. Sixteen articles met inclusion criteria for the evidence-based review on the following ODS management options: dental treatment alone or combined with ESS for various dental pathologies, and endoscopic sinus surgery (ESS) alone for dental implant-related ODS. Strong consensus was achieved for 9 of the 10 clinical statements, the strongest being the use of shared decision-making for selecting management strategies. No consensus was reached for determining the extent of ESS necessary for uncomplicated ODS. Strong consensus was reached that ODS management should involve shared decision-making between the otolaryngologist, dental provider, and patient, where the benefits and risks of dental treatment and ESS are discussed. Higher-quality studies are necessary to develop evidence-based treatment recommendations for ODS.

Assessing the Impact of Drought Stress and Soil Cultivation in Chardonnay and Xynisteri Grape Cultivars

Cyprus has a long tradition in grape cultivation and wine making and grapevine is important for the sustainability of the agricultural sector, like in other Mediterranean areas. Water scarcity, which is projected to increase due to climate change, could negatively affect the sector. In this research, the effects of irrigation and tillage treatments on various aspects of vine growth and product quality (e.g., yield, physiology and quality attributes), were studied in Chardonnay and Xynisteri cultivars grown in clay soils in Cyprus. Regarding soil properties and water content, N and K were more abundant in the soil than P and through the growing period irrigation tended to increase electrical conductivity (EC) in the soil. Soil water content (volumetric) was 22%–27.5% and 13%–16%, when irrigation was applied or not, respectively. Vegetative soil cover occupied 50%–55% of the surface and contained species typically present in Mediterranean farms (e.g., Poaceae, Fabaceae and Brassicaceae). Tillage increased yield in Xynisteri (4–5 kg plant−1) but negatively affected other parameters such as chlorophyll levels (in Xynisteri). In combination with irrigation, tillage increased antioxidant activity in Chardonnay (assessed by FRAP and DPPH), at harvest. Total phenolics at harvest were higher in the grape juice of Xynisteri, compared to Chardonnay (30–40 and 20–25 mg GA g−1 fresh weight, respectively). Irrigation influenced phytohormone levels in the two cultivars. ABA increased in non-irrigated Xynisteri, reflecting an increased capacity to react towards water stress. Water stress is considered to increase polyphenols in grapes, but in the case of Xynisteri it seems that irrigation water is required to obtain better quality grapes as without irrigation volumetric water content (VWC) is close to the permanent wilting point. Titratable acidity and total tannins decreased in Chardonnay, when tillage and irrigation were applied. In addition, tillage and irrigation tended to elevate the pH of the grape juice. Tillage and irrigation on the other hand, had no effect on the levels of ascorbic acid and total anthocyanin content. The results of this research may help to select management strategies that support the adaptation of viticulture to climate change in Cyprus and other Mediterranean areas.

Functional Luminal Imaging Probe Panometry Identifies Achalasia-Type Esophagogastric Junction Outflow Obstruction

The etiologies of esophagogastric junction outflow obstruction (EGJOO) vary, as do their therapeutic implications. We aimed to identify patients with EGJOO most likely to benefit from achalasia-type treatment, based on findings from functional luminal imaging probe (FLIP) panometry. We performed a retrospective study of 34 patients who received a diagnosis of EGJOO from January 2015 through July 2017. Our analysis included patients who had been evaluated with timed barium esophagram, FLIP, or upper endoscopy. Among the 34 patients with idiopathic EGJOO, 7 (21%) had a normal esophagogastric junction distensibility index (EGJ-DI), based on FLIP panometry, and all had repetitive antegrade contractions. None of the patients had radiographic evidence of EGJOO (RAD-EGJOO), defined as liquid barium retention and/or barium tablet impaction. On the other hand, all 18 patients with RAD-EGJOO had an EGJ-DI less than 2 mm2/mm Hg. Nine of the 18 patients with RAD-EGJOO and EGJ-DI less than 2 mm2/mm Hg underwent achalasia-type treatment, and 77.8% of these (7 of 9) had improvements in Eckardt score. Of the 6 patients with a normal EGJ-DI (>3 mm2/mm Hg) who were treated conservatively and followed up, 100% had improvements in subsequent Eckardt scores. We found that FLIP is useful in identifying patients with EGJOO who are most likely to benefit from achalasia-type therapy. Patients with a low EGJ-DI responded well to achalasia-type treatment, whereas patients with normal results from FLIP panometry had good outcomes from conservative management. FLIP panometry might help select management strategies for this difficult population of patients.

Chemical ecology of Cyclocephala forsteri (Melolonthidae), a threat to macauba oil palm cultivars (Acrocomia aculeata, Arecaceae)

AbstractThe environmental unsustainability of African oil palm crops is a growing worldwide concern, and the macauba palm in tropical Southern America surges as the most viable substitute for the production of first‐generation biodiesel as a renewable fuel. Large‐scale cultivation of the macauba palm, however, is bound to suffer a major setback due to the fast emergence of a florivorous pest threat, Cyclocephala forsteri, a scarab beetle species that can severely reduce fruit yield. Like other congenerics, female and male C. forsteri are night‐foraging and driven in large numbers to macauba palm inflorescences by specific volatile organic compounds. In the present study, we assessed the kairomonal cues involved in this plant–florivore interaction and their potential application in selective pest management strategies. Headspace samples of the floral fragrance of macauba palms at our study site in Central Brazil were largely dominated by 4‐methylanisole (>97% relative amount), which along with the minor constituents 2‐isopropyl‐3‐methoxypyrazine and 2‐sec‐butyl‐3‐methoxypyrazine triggered electroantennographic responses from both female and male C. forsteri. Field behavioural assays evidenced that beetles of this species were exclusively attracted to scented traps baited with 4‐methylanisole. Increased total scent discharge attained with an ultrasonic piezoelectric diffuser has positively influenced attractiveness efficiency of the trapping setup. 4‐Methylanisole is hereby identified as yet another volatile kairomone involved in highly selective attraction of potential pest florivorous cyclocephaline scarabs associated with economically exploitable palms and should be viewed as a key element in short‐term integrated management plans for the cultivation of the macauba palm in South America.