Notes

Macular ganglion mobile complex injuries in several periods regarding anterior ischemic optic neuropathy.
Atrial fibrillation (AF) is associated with increased risks of stroke and heart failure. Electronic health record (EHR)-based AF risk prediction may facilitate efficient deployment of interventions to diagnose or prevent AF altogether.

We externally validated an electronic health record AF (EHR-AF) score in IBM Explorys Life Sciences, a multi-institutional dataset containing statistically deidentified EHR data for over 21 million individuals (Explorys Dataset). We included individuals with complete AF risk data, ≥2 office visits within 2 years, and no prevalent AF. We compared EHR-AF to existing scores including CHARGE-AF (Cohorts for Heart and Aging Research in Genomic Epidemiology Atrial Fibrillation), C
HEST (coronary artery disease or chronic obstructive pulmonary disease, hypertension, elderly, systolic heart failure, thyroid disease), and CHA
DS
-VASc. We assessed association between AF risk scores and 5-year incident AF, stroke, and heart failure using Cox proportional hazards modeling, 5-year Aredictive accuracy for incident AF using readily ascertained EHR data. AF risk is associated with incident stroke and heart failure. Use of such risk scores may facilitate decision support and population health management efforts focused on minimizing AF-related morbidity.
EHR-AF demonstrates predictive accuracy for incident AF using readily ascertained EHR data. AF risk is associated with incident stroke and heart failure. Use of such risk scores may facilitate decision support and population health management efforts focused on minimizing AF-related morbidity.
Lactate levels in clinical practice are often used as a quantitative indicator for the severity of hypoperfusion and the responsiveness to therapeutic interventions. In the hospital acute care setting, lactic acidosis combined with the appropriate clinical exam signs warrants surgical evaluation. The purpose of our study was to evaluate all surgical consults for lactic acidosis in a single community hospital to identify what cofactors were most often predictive of the need for surgical management and operative intervention.

A retrospective chart review within a 5-year period was conducted on all consultations to general surgery in which patients additionally had lactic acidosis defined as >2mEq. Within this population, various subjective and objective parameters were evaluated. Final analysis compared these parameters between patients with lactic acidosis who underwent surgical intervention and those who did not require operative intervention.

Within the 5-year period, 432 patients met our criteria of a surgical consult placed for lactic acidosis. Final results from the highest quality statistical model showed significant variables as diffuse tenderness on physical exam (
-value = .0010, Odds Ratio (OR) = 2.77) and focal tenderness on physical exam (
-value = .0440, OR = 1.76). The presence of peritoneal signs (
-value = .0521, OR = 2.02) resulted in operative intervention twice as often in patients with lactic acidosis.

To better appropriate health care costs, measures need to be taken to ensure resources are being utilized properly. In patients with lactic acidosis, one should go "back to the basics" with the physical examination to determine which patients truly need a surgical consultation.
To better appropriate health care costs, measures need to be taken to ensure resources are being utilized properly. In patients with lactic acidosis, one should go "back to the basics" with the physical examination to determine which patients truly need a surgical consultation.Individuals who experience stress can engage in health-risk behaviours that may decrease work performance. The aim of this study was to determine perceived stress levels in Brazilian workers and verify whether perceived stress was associated with health-risk behaviours. Stress levels of 1,270 workers (1,019 men, 251 women) were assessed using the Perceived Stress Scale. The health-risk behaviours investigated were low intake of vegetables and fruits, daily smoking, high-risk alcohol consumption, physical inactivity, and the presence of obesity. The Student's t-test or one-way analysis of variance was used to assess differences in stress levels. Ordinal regression was used to determine the association between the degrees of stress and health-risk behaviours. Women had higher perceived stress levels than men. In addition, perceived stress levels were higher in those who had low socioeconomic status, were unmarried, had a negative perception of their health, were smokers, or had obesity. Smoking and the presence of two or more health-risk behaviours were associated with 1.84 (95% CI 1.24-2.73) times and 1.49 (95% CI 1.18-1.89) times higher odds of experiencing higher degrees of stress, respectively. In women, such an association was observed with the presence of obesity (odds ratio 2.0; 95% CI 1.01-3.98).
Disparities in outcomes among trauma patients have been shown to be associated with race and sex. The purpose of this study was to analyze racial and sex mortality disparities in different regions of the United States, hypothesizing that the risk of mortality among black and Asian trauma patients, compared to white trauma patients, will be similar within all regions in the United States.

The Trauma Quality Improvement Program (2010-2016) was queried for adult trauma patients, separating by U.S. Census regions. Multivariable logistic regression analyses were performed for each region, controlling for known predictors of morbidity and mortality in trauma.

Most trauma patients were treated in the South (n = 522388, 40.7%). After risk adjustment, black trauma patients had a higher associated risk of death in all regions, except the Northeast, compared to white trauma patients. The highest associated risk of death for blacks (vs. whites) was in the Midwest (odds ratio [OR] 1.30,
< .001). Asian trauma presources explain these findings.Ipomoea pes-caprae plays an important role in protecting the tropical and subtropical coastal beach of the world. In 2018, a leaf spot was observed on I. pes-caprae in Xisha islands of China, 13.2-25.8% of leaves were infected. The initial symptoms were small (1-3 mm diameter), single, circular, dark gray spots with a light-yellow center on the leaves. The lesions enlarged and were scattered or confluent, distinct and circular, subcircular or irregular, occasionally vein-limited, pale to dark gray-brown, with a narrow dark brown border surrounded by a diffuse yellow margin. Microscopic observations of the spots revealed that caespituli were dark brown and amphigenous, but abundant on the underside of the leaves. Mycelia were internal. Conidiophores were fasciculate, occasionally solitary, pale olivaceous-brown throughout, 0- to 3-septate, 27.9-115.8 (63.4±22.5) µm × 3.2-5.3 (4.3±0.87) µm (n=100). Conidial scars were conspicuously thickened. Conidia were solitary, hyaline, filiform, acicular to obclavate, strafter eight days, the typical symptoms of spots which were small, single, circular and dark gray appeared on the inoculated wounded leaves, while the inoculated unwounded leaves and the control leaves were symptomless. The pathogen was only re-isolated from the inoculated wounded leaves. The pathogen may be infected by wound. A total of 20 Cercospora and related species was found on Ipomoea spp. (García et al. 1996). Cercospora cf. citrulina has been reported on I. pes-caprae in Japan, although it was unclear if it was a pathogen or saprophyte (Groenewald et al. 2013). To our knowledge, this is the first report of C. cf. citrulina causing leaf spot of I. pes-caprae in China. This disease could threat the cultivation of I. pes-caprae in China.Russian olive, also known as, Persian olive or oleaster (Elaeagnus angustifolia L.) is a species in the Elaeagnaceae family native to western and central Asia. In some orchards in Iran, intercropping Russian olive or Prunus trees with vegetables is a common practice. In 2018, about 130 ha of E. angustifolia orchards in Shahrood, Semnan Province, Iran showed branch wilting and dieback. 4-hydroxy(phenyl)retinamide Symptoms on affected trees started with yellowing of the lower leaves, followed by wilting and finally death of affected branches. Sections of stems indicated brown or black streaks in the vascular tissues under the bark. Isolations were made from discolored vascular tissues by surface-disinfesting small pieces of tissue with 0.5% sodium hypochlorite for 2 min, plating them onto potato dextrose agar amended with 25 mg/l streptomycin sulfate and incubated in the dark for 14 days at 25°C. Fungi consistently isolated from symptomatic tissues. Fungal isolates were identified as Verticillium dahliae Kleb. based on characteristics of to tomato and potato crops, the majority of which are infested with V. dahliae. References Hiemstra, J. A., Korthals, G. W., Visser, J. H. M., Dalfsen, P. v., Sluis, B. J. v. d., and Smits, A. P. 2013. Control of Verticillium in tree nurseries through biological soil disinfestation. Pages 62-62 in 11th International Verticillium Symposium, Georg-August-Universität,Göttingen, Germany, 5-8 May 2013, B. Koopmann and A. von Tiedemann, eds. DPG Spectrum Phytomedizin, Göttingen. Keykhasaber, M., Faino L., van den Berg, G.C.M., Hiemstra, J. A., Thomma, B. P. H. J. 2017. A robust method for discriminating defoliating and the non-defoliating pathotypes of V. dahliae. . In; Keykhasaber M. thesis 62-84. Sun, M., and Lin, Q. 2010. A revision of Elaeagnus L. (Elaeagnaceae) in mainland China. J. Systematics and Evolution 48356-390.
New York's statewide "Get Screened, No Excuses" campaign has been one of the nation's most aggressive actions to improve access to breast cancer screening. Inner city and suburban county medical centers' initiatives were studied to compare outcomes of breast cancer screening and factors that influence access to care.

Women delinquent in breast cancer screening one year or greater were offered patient navigator services to aid in timely breast cancer screening. Time-to-event completion rates among different stages of breast cancer screening stages in City and County women were compared. Time-to-event completion rates among different stages of breast cancer screening stages.

2505 women aged ≥40years accepted PN services. Mean (SD) age of patients was 56.2 (10) years. The mean (SD) age of those who completed breast screening vs. those who did not was 56.8 (10) and 52.5 (.9) years, respectively (
< .01). The rates of screening completion during physical examination, mammography and biopsy stages were 74%, 78% and 100% in City vs. 98%, 85% and 100% in County, respectively (
< .001). Screening phase was the significant predictor of time to completion for breast cancer screening in Cox regression analysis. Over 85% of women completed the breast cancer screening, 74% in City and 97.6% in County (
< .001).

Screening phase is an important predictor of time-to complete breast cancer screening. Center location served as the effect modifier of the relationship. The rate of completing the screening was significantly higher and faster among Suburban County compared to Inner City women.
Screening phase is an important predictor of time-to complete breast cancer screening. Center location served as the effect modifier of the relationship. The rate of completing the screening was significantly higher and faster among Suburban County compared to Inner City women.
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