Epidemiology and cost of Lyme disease‐related hospitalizations among patients with employer‐sponsored health insurance—United States, 2005–2014

An estimated 300,000 cases of Lyme disease occur in the United States annually. Disseminated Lyme disease may result in carditis, arthritis, facial palsy or meningitis, sometimes requiring hospitalization. We describe the epidemiology and cost of Lyme disease‐related hospitalizations. We analysed 2005–2014 data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Databases to identify inpatient records associated with Lyme disease based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) codes. We estimated the annual number and median cost of Lyme disease‐related hospitalizations in the United States in persons under 65 years of age. Costs were adjusted to reflect 2016 dollars. Of 20,983,165 admission records contained in the inpatient databases during the study period, 2,823 (0.01%) met inclusion criteria for Lyme disease‐related hospitalizations. Over half of the identified records contained an ICD‐9‐CM code for meningitis (n = 614), carditis (n = 429), facial palsy (n = 400) or arthritis (n = 377). Nearly 60% of hospitalized patients were male. The median cost per Lyme disease‐related hospitalization was $11,688 (range: $140–$323,613). The manifestation with the highest median cost per stay was carditis ($17,461), followed by meningitis ($15,177), arthritis ($13,012) and facial palsy ($10,491). Median cost was highest among the 15‐ to 19‐year‐old age group ($12,991). Admissions occurring in January had the highest median cost ($13,777) for all study years. Based on extrapolation to the U.S. population, we estimate that 2,196 Lyme disease‐related hospitalizations in persons under 65 years of age occur annually with an estimated annual cost of $25,826,237. Lyme disease is usually treated in an outpatient setting; however, some patients with Lyme disease require hospitalization, underscoring the need for effective prevention methods to mitigate these serious cases. Information from this analysis can aid economic evaluations of interventions that prevent infection and advances in disease detection.     

(Methyl)Mercury,Arsenic, and Lead Contamination of the World’s Largest Wastewater Irrigation System: the Mezquital Valley (Hidalgo State—Mexico)

We investigate the potential of near-infrared (NIR) spectroscopy to predict some heavy metals content (Zn, Cu, Pb, Cr and Ni) in several soil types in Stara Zagora Region, South Bulgaria, as affected by the size of calibration set using partial least squares (PLS) regression models. A total of 124 soil samples from the 0–20 and 20–40 cm layers were collected from fields with different cropping systems. Total Zn, Cu, Pb, Cr and Ni concentrations were determined by Atomic Absorption Spectrometry. Spectra of air dried soil samples were obtained using an FT-NIR Spectrometer (spectral range 700–2,500 nm). PLS calibration models were developed with full-cross-validation using calibration sets of 90 %, 80 %, 70 % and 60 % of the 124 samples. These models were validated with the same prediction set of 12 samples. The validation of the NIR models showed Cu to be best predicted with NIR spectroscopy. Less accurate prediction was observed for Zn, Pb and Ni, which was classified as possible to distinguish between high and low concentrations and as approximate quantitative. The worst model performance in cross-validation and prediction was for Cr. Results also showed that values of root mean square error in cross-validation (RMSE_cv) increased with decreasing number of samples in calibration sets, which was particularly clear for Cu, Pb, Ni and Cr content. A similar tendency was observed in the prediction sets, where RMSEP values increased with a decrease in the number of samples, particularly for Pb, Ni and Cr content. This tendency was not clear for Zn, while even an increase in RMSEP for Cu with the sample size was observed. It can be concluded that NIR spectroscopy can be used to measure heavy metals in a sample set with different soil type, when sufficient number of soil samples (depending on variability) is used in the calibration set.     

Frequency of Phaeosphaeria nodorum, the Sexual Stage of Stagonospora nodorum, on Winter Wheat in North Carolina

ABSTRACT Ascocarps of Phaeosphaeria nodorum, which causes Stagonospora nodorum blotch (SNB) of wheat, have not been found by others in the eastern United States despite extensive searches. We sampled tissues from living wheat plants or wheat debris in Kinston, NC, each month except June from May to October 2003. Additional wheat samples were gathered in Kinston, Salisbury, and Plymouth, NC, in 2004 and 2005. For the 3 years, in all, 2,781 fruiting bodies were dissected from the wheat tissues and examined microscopically. Fruiting bodies were tallied as P. nodorum pycnidia or ascocarps, "unknown" (not containing spores, potentially P. nodorum or other fungi), or "other fungi." In the 2003 sample, asco-carps of P. nodorum were present each month after May at a frequency of 0.8 to 5.4%, and comprised a significantly higher percentage of fruiting bodies from wheat spikes than of those from lower stems and leaves. Ascocarps also were found at frequencies <10% in some wheat debris samples from 2004 and 2005. Analysis of the nucleotide sequences of internally transcribed spacer regions of 18 genetically distinct North Carolina isolates from 2003 suggested that all were P. nodorum, not the morphologically similar P. avenaria f. sp. triticea. Neither the 18 isolates from 2003 nor a set of 77 isolates derived from 2004 Kinston leaf samples gave reason to suspect a mating-type imbalance in the larger P. nodorum population (P >/= 0.4). We conclude that, in North Carolina, sexual reproduction plays a role in initiation of SNB epidemics and the creation of adaptively useful genetic variability, although its relative importance in structuring this population is uncertain.     

Effects of Agrobacterium tumefaciens-mediated transformation and tissue culture on storage lipids in Brassica napus

The variation obtained in storage fatty acids induced by the procedures of tissue culture and transformation with Agrobacterium tumefaciens was investigated and compared in rapeseed, Brassica napus, cv. Hanna. An increased variation in the fatty acid profiles was noted after tissue culture and transformation compared with plants derived directly from seeds. In the second generation of rapeseed transformants, T₂, the content of oleic acid ranged from 39–72%, 12–31% for linoleic acid and 7–16% for linolenic acid. This could be compared with the oleic acid content in the T₂ generation of tissue culture-derived plants which ranged between 47–76% and in seed-derived material where oleic acid ranged between 55–69%.In the T₃ generation the ranges in transgenic seeds were decreased but still larger than in the seed derived plants. The range in transgenic plants was 49–64% for oleic acid, 20–28% for linoleic acid and 9–18% for linolenic acid. The most extreme individuals, both highest and lowest in the common fatty acids, were found in the group of transformed plants independent of generation. The total lipid content was also affected by the two treatments and seeds with the lowest and highest lipid content were both found among the transformed plants. In conclusion, care should be taken to use proper controls when performing transformation experiments in order to distinguish variation in the fatty acid profiles induced by the transformation procedure and tissue culture treatments from the changes due to transgenic expression. This revised version was published online in July 2006 with corrections to the Cover Date.     

An Aqueous Extract of the Dry Mycelium of Penicillium chrysogenum Induces Resistance in Several Crops under Controlled and Field Conditions

We have examined the effect of Pen, an aqueous extract of the dry mycelium of Penicillium chrysogenum, on plant–pathogen interactions. Pen controlled a broad range of pathogens on several crop plants under greenhouse and field conditions. Pen protected grapevine from downy and powdery mildew (caused by Plasmopara viticola and Uncinula necator), tomato from early blight (caused by Phytophthora infestans), onion from downy mildew (Peronospora destructor) and apple trees from apple scab (caused by Venturia inaequalis) to a similar extent as fungicides such as copper and sulphur or well-known inducers such as benzothiadiazole or β-aminobutyric acid. Pen had no major direct fungicidal effect and is thus supposed to protect plants by activating their defense mechanisms. The raw material for extraction of Pen was available in constant quality, a prerequisite for commercial application. Under certain conditions, Pen caused phytotoxic side effects. The symptoms mostly consisted of small necrotic spots or, more rarely, of larger necrotic areas. The development of the symptoms was dependent on several parameters, including concentration of Pen, the number of applications, the persistence on the plant tissue, the plant species and variety and environmental conditions. In grapevine, a partially purified fraction of Pen was much less toxic than the crude Pen extract, but protected the plants to a similar extent against P. viticola. Our data show that Pen has interesting and unique properties as a plant protection agent, but more research is needed to further reduce its phytotoxic side effects.     

Schiff-Sherrington syndrome in a 7-year-old zebra mare (Equus quagga)

A 7-year-old plains zebra (Equus quagga) mare was presented to the Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Germany as an emergency. The owner reported that the mare was unable to stand after a suspected traumatic episode at the home yard. The mare was transported in lateral recumbency in a trailer. Clinical examination revealed tachycardia (up to 102 beats/min), tachypnoea (28 breaths/min), mild fever (38.7°C) and clinical dehydration with elastic skin and dry and red mucous membranes. Neurological examination showed paraplegia with complete loss of nociception of the mid-thoracic region and caudal to it. In contrast, examination of the thoracic limbs revealed marked extensor rigidity and hyperaesthesia resulting in an enhanced acute response to minimal touch of the neck and shoulder region. Lateral radiographs of the thoracic vertebral column led to the diagnosis of a complete fracture of the vertebral body of the 7th thoracic (T) vertebra with suspected traumatic compression of the spinal cord. Post-mortem examination confirmed the diagnosis. Gross pathology revealed a complete comminuted fracture of T7 with marked compression of the spinal cord. This is the first report describing the clinical, radiological and pathological findings of a fracture of a thoracic vertebra leading to a Schiff-Sherrington syndrome in a zebra (Equus quagga).     

Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours

Adrenalectomies for canine adrenal tumours are associated with peri-operative morbidity and mortality. Objectives of this study included assessing the prognostic value of tumour- or surgery-related variables in predicting peri-operative mortality and overall survival in dogs undergoing adrenalectomies for primary adrenal tumours as well as pre-treatment with phenoxybenzamine on survival to discharge with pheochromocytomas specifically. A multi-institutional retrospective cohort study was performed across nine institutions. Electronic medical record searches identified 302 dogs which met the inclusion criteria. Data collected included dog-related, tumour-related, treatment-related, surgery-related, and outcome variables. Univariate and multivariable logistic regression and cox proportional hazards models were used to identify variables associated with death prior to discharge and tumour-related survival. Overall, 87% of dogs survived to discharge with a tumour-related survival time of 3.96 years. Post-operative complications were reported in 25%. Increased surgical time (p = 0.002) and pre-surgical medical treatment other than phenoxybenzamine (p = 0.024) were significantly associated with increased peri-operative mortality while ureteronephrectomy (p = 0.021), post-operative pancreatitis (p = 0.025), and post-operative aspiration pneumonia (p < 0.001) were significantly associated with decreased overall survival. Phenoxybenzamine pretreatment had no effect on peri-operative mortality. Thirty-seven of 45 (82%) dogs with pheochromocytomas not pretreated survived to discharge, and 50 of 59 (85%) dogs with pheochromocytomas pretreated with phenoxybenzamine survived to discharge (p = 0.730). This study provides information on risk factors for death prior to discharge and tumour-related survival that may help guide clinical management and owner expectations. In addition, the study findings challenge the previously reported benefit of phenoxybenzamine for pretreatment of dogs undergoing adrenalectomies for pheochromocytomas.     

Estimation of Genetic Variation Among Verticillium Isolates using AFLP Analysis

Amplified fragment length polymorphism (AFLP) analysis was used to study genetic variation among 76 isolates of Verticillium. A dendrogram based on the AFLP data revealed three main groups. One group consisted of 35 European isolates derived from Brassica napus together with five Californian isolates taken from B. oleracea. This group displayed a high degree of genetic similarity and included three isolates earlier classified as Verticillium longisporum, indicating that all isolates in this group probably should be regarded as members of V. longisporum. V. dahliae isolates constituted the second group while the third group contained four V. albo-atrum isolates. In addition to these three groups, a cluster of six V. nigrescens isolates was observed. However, the genetic distances between the isolates of V. nigrescens were much higher than those between members in the other groups and the bootstrap value for the V. nigrescens cluster was subsequently low. Four isolates classified as V. tricorpus were highly diverse and did not cluster together. Analysis of molecular variance revealed that the isolates of V. longisporum were separated into four subgroups, based on geographic origin. The study furthermore shows that AFLP is a suitable method for studying population structure in Verticillium.     

Inheritance of a pectate lyase mediated soft rot resistance in crosses between transgenic potato lines of cv. désirée andS. tuberosum cultivars

Summary Expression of the pectate lyase (PL) isoenzyme 3 in transgenic potato lines of cv. Désirée mediates an enhanced resistance of tuber tissue toErwinia carotovora (Ec) soft rot due to a pre-activation of plant defence mechanisms. Therefore, theSolanum tuberosum cvs Agave and Adretta with a moderate level of soft rot resistance were crossed with such PL-expressing potato lines. The resulting progenies were assessed with respect to plant/tuber characteristics over a period of four years and then tested for PL3-expression as well as for soft rot resistance. 71% of the selected progeny lines exhibited a stable production of the PL3 enzyme. Statistical analysis revealed differences between the transgenic and the non-transgenic progeny concerning the soft rot resistance of tuber tissue. Compared with the PL-inactive progeny, extension of Ec-rotting on the wound surface of PL-transgenic potatoes was diminished on average by 51.8%. Similarly, the degree of cell lysis caused by bacterial maceration was significantly (P<0.05) reduced in tuber tissue of PL-expressing progeny lines. The latter also revealed an enhanced PPO and PAL activity in their tuber tissue indicating an active plant defence. It is concluded therefore that the PL-mediated soft rot resistance introduced into potatoes by means of molecular techniques is heritable.