bluuebunny/crossref_metadata_2025 huggingface dataset:
From the inside out
Authors: Bogue Brad , Trestman Robert L.
Published: May 2015

Incarceration is, by design, a stressful and dehumanizing process. Those who become incarcerated are shaped and changed by the experience in many ways. For those of us who work with people who are inmates, it can be difficult to appreciate the range and intensity of their experiences. This chapter gives voice to some of those experiences. Ten individuals currently or recently incarcerated in the Colorado prison system were interviewed. The autobiographical interviews were transcribed and core elements and themes in their own words are presented; their names and some details are changed to protect their identities. Every individual who becomes incarcerated experiences imprisonment through the lens of personal experience. There is fear and humiliation, hope and frustration, isolation and friendship. Some people persist in illegal behavior; others turn their lives around. The opportunity and challenge of correctional psychiatry is to engage people during this vulnerable period: to understand patients as people, to treat illness, reduce suffering, and help them recover their lives. We believe they speak eloquently of human struggle, coping, failure, regret, and hope.
Ethics in correctional mental health
Authors: Candilis Philip J. , Huttenbach Eric D.
Published: May 2015

Working as a psychiatrist in a jail or prison presents many ethical issues, many unique to the correctional setting. Obligations to the law, professional standards, the community, and public health require a complex appreciation of competing values. It remains an extraordinary commentary on the state of mental health that the largest mental health institutions in the United States are jails and prisons. In daily practice, acknowledging healthcare, individual, and professional values in a robust vision of professionalism means advocating for clinical values and opposing mistreatment. Making the limits of confidentiality clear is a time-honored element of the informed consent process and need not be diluted in the correctional system. Honoring clear boundaries between treatment and forensic evaluation are the crux of this issue: confidentiality warnings and access to counsel cannot be one-off affairs that do not account for the cognitive, educational, or mental health vulnerabilities of the patient in a correctional setting. Developing trust, offering transparency, and delivering clear descriptions of procedural requirements are the lessons of an empirical database that supports this approach and can lead to more collaboration and less violence. This chapter presents a discussion of the critical concerns, including informed consent and coercion, dual agency, appropriate access to care, and managing professional boundaries and standards.
Funding of correctional health care and its implications
Authors: Trestman Robert L.
Published: May 2015

Correctional healthcare is funded through a range of mechanisms, reflecting many of the community fee-for-service and managed care parallels. Like community healthcare, utilization of healthcare in correctional settings is increasing. It is however, often under more significant budgetary constraints and tighter management. The funding of correctional healthcare is a complex enterprise, driven by constitutionally mandated care obligations on the one hand, and resource constraints on the other. Along with the dramatic increase in the incarcerated population during the past two decades, correctional healthcare has evolved as well. The costs of care are quite substantial, and the diversity of models of care delivery offer an administrative challenge, a financial challenge to the relevant jurisdiction, and a significant opportunity for cost effectiveness. Unfortunately, as of yet, no comparative study of funding models has been done. As integrated electronic health and financial records are gradually introduced into correctional settings, opportunities for such studies, and the policy guidance provided by those results, may yield important information applicable to health care cost and outcome management in society more broadly. This chapter includes a discussion of global capitation, per inmate costs, at-risk contracting, liability concerns, performance indicators, and a variety of contractual relationships.
Adjustment disorders
Authors: Glancy Graham D. , Treffers Stefan R.
Published: May 2015

Becoming incarcerated and the challenges associated with incarceration are for most people major life stressors. The development of acute adjustment disorders is very common in these settings. This chapter attempts to give guidance to clinicians who are on the front line in very difficult circumstances. They are often dealing with patients who are overwhelmed with significant adverse life events, whose history reveals that they have dealt with emotional disturbances by acting out, or have struggled with substance abuse for many years. The risk of suicide is a substantial concern, and may be substantially elevated in the presence of an adjustment disorder. Patients present with complex comorbidities, often complicated by substance use disorder and withdrawal. Clinicians often have very little information at their disposal, yet will have to make difficult decisions under pressure. For example, it is often not possible to collect collateral information or previous clinical records. Clinicians are required to balance an empathic approach while maintaining clear boundaries. In addition, the clinician is also required to bear in mind the security constraints of the institution. Often the clinician is working in relative isolation, without the added resources of a multidisciplinary team. In our view, treatment of adjustment disorders in correctional settings requires a keen application of the whole complement of clinical skills. This chapter discusses the presentation, assessment issues, and management concerns of adjustment disorders in jails and prisons.
Diversion programs and alternatives to incarceration
Authors: Rotter Merrill , Barber-Rioja Virginia
Published: May 2015

Decreasing the number of individuals with mental illness in the criminal justice system remains a public mental health priority – one that has even reached the U.S. Supreme Court. Diverting individuals with mental illness from jail or prison decreases their exposure to that traumatic environment and addresses security concerns of corrections professionals charged with their care and management. When diversion is coupled with the court-based, problem-solving approach of monitored care and treatment in the community, public safety is improved and the clinical success of the individual is enhanced. When treatment in the community includes an explicit focus on criminogenic factors, the ability to meet public safety goals are enhanced even further. Given these several goals, as well as the considerable variability from jurisdiction to jurisdiction in court resources, treatment resources, social supports, political philosophies, and fiscal realities, the types of diversion that will work for one community may not work for another. However, the overwhelming majority of the data is clear that diversion can be implemented with documented success in the domains described above, and that there are a number of beneficial models for client intercept and associated programming. This chapter reviews the major models used to divert those with serious mental illness from incarceration, paying attention to some of the legal and clinical issues that arise as a result of diversion initiatives. Brief overviews of those interventions, including drug and mental health courts, jail diversion programs, and alternatives to incarceration for the mentally ill, are presented.
Levels of care
Authors: Metzner Jeffrey L. , Appelbaum Kenneth L.
Published: May 2015

Just as in community settings, there is a continuum of care for mentally ill inmates in correctional settings. This continuum progresses from ambulatory care through supported residential housing to inpatient or infirmary care. The continuum of care for inmates with mental illness includes outpatient care, emergency services, day treatment, supported residential housing, infirmary care, and inpatient psychiatric hospitalization services. Outpatient treatment is the least intensive level of care. In some systems this may include a day treatment program, which provides enhanced mental health services similar to a residential program as described below. In the case of outpatient treatment, participating inmates live in a general population housing unit with other inmates, many of whom are not in need of mental health services. A residential program (i.e., housing unit) within the correctional setting is provided for inmates with chronic mental illness who do not require inpatient treatment but do require enhanced mental health services. Such a designated housing unit can provide a safe and therapeutic environment for those unable to function adequately within the general inmate population. Crisis intervention services include both brief counseling and supervised stabilization. The latter, often provided in an infirmary setting, serve short-term stabilization and/or diagnostic purposes. A psychiatric inpatient program is the most intensive level of care and is often provided by the state psychiatric hospital system. This chapter describes each level and how they may be adapted successfully to function in correctional settings to meet the needs of individuals with mental illness.
Intoxication and drugs in facilities
Authors: Ourada Jason D. , Appelbaum Kenneth L.
Published: May 2015

Active abuse of substances by inmates poses a challenge for correctional psychiatrists. Substance use disorders (SUD) are common among inmates, with higher prevalence usually found in those with general psychiatric conditions. Knowledge about substance use in correctional facilities fosters competent clinical intervention and enhances management at all levels. Psychiatrists working in jails and prisons have the challenging task of maintaining therapeutic alliances with patients who have co-occurring SUDs and also may be actively using substances. Patients might not spontaneously report use during incarceration because they fear retribution by correctional staff or not receiving needed treatment for medical and mental health problems. Psychiatrists need to remain aware of this and to screen for SUD and active substance use as part of comprehensive treatment planning. The clinical challenges in jails and prisons differ, and the substances found in facilities vary geographically. Active substance abuse by inmates presents clinical and systemic challenges for correctional psychiatrists. The interplay among mental health, medical, and custody staff regarding screening, detection, triage, management, and treatment lies at the heart of these challenges. Correctional psychiatrists make important contributions by providing direct assessment and treatment to inmates, and by offering educational, clinical, and policy consultations to other staff. These contributions help prevent potentially life-threatening complications of intoxication and withdrawal, ensure integrated and evidence-based care, and avoid misguided or ill-informed disciplinary or other institutional practices. This chapter highlights these differences, outlines clinical management, and describes an interdisciplinary approach to intervention.
Use of restraint and emergency medication
Authors: Gagné Gerard G.
Published: May 2015

Most community hospitals have seen a reduction in the use of restraints in inpatient psychiatric units. The use of emergency medication remains a mainstay in emergency departments and inpatient units. The correctional setting makes use of both practices, modified for the unique characteristics of the correctional setting. The use of seclusion and/or restraint (S/R) in mental health settings has long been fraught with legal and ethical concerns; the practice can be dangerous. This is perhaps accentuated in the more punitive environment of jails and prisons within the United States. While some may perceive S/R as an intervention ultimately to be eliminated, facilities that use S/R for mentally ill patients, be they hospitals, jails, or prisons, should not aim to eliminate it as an intervention; in limited cases it is an appropriate option, particularly for acutely aggressive, agitated patients who require immediate intervention. The use of S/R preserves the safety of the patient, other patients or inmates, and staff. This chapter reviews current guidelines on the use of S/R in correctional health care, and discusses pragmatic issues of implementation and management. Of note, the focus is solely on the use of S/R for mentally ill patient-inmates and not their use by custody staff for safety or security reasons. It also highlights the differences between seclusion and restraint in the community compared to jails and prisons. This chapter discusses the use of restraints and emergency medications, legal precedents that guide their use, as well as best practice demonstrated to minimize their routine application.
Prescribed medication abuse
Authors: Tamburello Anthony C.
Published: May 2015

Community abuse of prescription medication is typically limited to overuse or inappropriate sharing of medication. In jails and prisons, the demand characteristics are dramatically altered, creating an elaborate laboratory for medication alteration, diversion, and abuse. While prescription medications are sometimes used to achieve a ‘high,’ they may also be sought to ease discomforts commonly experienced in a jail or prison. Some may seek stimulating medications to counteract the effects of prescribed sedatives to allow them to be ready to respond to real or perceived dangers. Thus, inmates may feign or exaggerate mood, anxiety, psychotic, or somatic symptoms with the goal of being prescribed medications with the desired effects. More insidious is the diversion of prescribed medications to a third party. Many prescribed medicines have a ‘street value’ in correctional settings. A patient with a legitimate need for medication, who may already have poor illness insight, may be enticed or coerced into transferring their medication to a peer. This creates several dangerous problems. The source inmate may worsen or fail to improve, which may lead to dose escalation, an incorrect conclusion about a treatment failure, poor functioning, and behavioral sequelae including disruptive or violent conduct. Meanwhile, the recipient is exposed to medication risks without the benefits of informed consent or medical supervision. This chapter presents data on specific classes of prescribed medication abuses, methods of abuse, and approaches to minimize abuse or diversion of prescribed medications.
Anxiety disorders including post traumatic stress disorder (PTSD)
Authors: Lewis Catherine F.
Published: May 2015

Increasing numbers of studies of correctional populations have emphasized diagnosis with structured clinical instruments over the past two decades. These studies have primarily focused on serious mental illness (i.e., psychotic and mood disorders), substance use disorders, and personality disorders. The focus has made sense because of the need to identify the severely mentally ill who are incarcerated and to identify the most common disorders. Anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, and specific phobias. One anxiety disorder that stands apart from others is PTSD, which is prevalent at much higher rates in both incarcerated men and women than in the community. Despite this fact, other anxiety disorders are often co-morbid and add to overall disease burden and impair ability to function. Individuals with a greater disease burden (i.e., number of diagnoses, symptom counts) have worse outcomes than those with uncomplicated disorders. These impaired outcomes include a deteriorating trajectory of illness, increased health service utilization, poor prognosis, and increased likelihood of morbidity and mortality. Thus, while anxiety disorders may not be the primary focus of the correctional system, they must be recognized as important. Unrecognized anxiety disorders can result in behavior that is disruptive and may appear to be volitional. They can also lead to overutilization of health services that are already facing substantial demands. Appropriate, available, and consistent assessment, diagnosis, and treatment that are well integrated can successfully intervene in the range of anxiety disorders that present in correctional settings.
Suicide risk management
Authors: Hughes Kerry C. , Metzner Jeffrey L.
Published: May 2015

There are many risks associated with incarceration, and a substantial one is suicide. Virtually every completed suicide generates litigation. Prevalence, demographics, trends, screening and assessment of suicide risk, and recognition of the key factors associated with increased risk and managing that risk safely and appropriately in jails is presented. The factors relating to increasing suicide risk in prisons are often quite distinct from other correctional settings. Issues such as restrictive housing, facility transfers, loss of community social supports, and chronic management all play potential roles. Proactive recognition of such concerns and active management is critical to effective risk reduction. This chapter discusses such factors in the context of changing prison dynamics and trends. Following completed suicides, a formal protocol is often followed to assist staff in understanding the events that led to the suicide and specifically intervening to address staff feelings that follow such a trauma. Such a process assists quality improvement initiatives, whether in the form of a root cause analysis or other format. Best practice approaches to post-mortem review and staff intervention/ support have been developed and are in use in many facilities. Working to eliminate or reduce the frequency of suicide attempts absolutely requires a staff culture committed to continued learning and improving of both knowledge and skills. This chapter presents a review of the current standards of suicide risk reduction training.
Programming
Authors: Hairston Patrece , Binswanger Ingrid A.
Published: May 2015

The nexus of substance use disorders and criminal justice involvement is considerable. This is particularly the case in the United States, where 48% of individuals in federal prisons were incarcerated for drug-related convictions in 2011. In the last year for which national data are available, approximately half of the individuals incarcerated in state and federal prisons met criteria for drug abuse or dependence. Tobacco and alcohol use are also more common in correctional populations than in the general, non-institutionalized population. Thus, criminal justice populations have a significant need for evidence-based treatment of addiction and interventions to reduce the medical complications of drug use. While many programs to address substance use disorder among correctional populations exist, many individuals fail to receive adequate care and continue to experience complications of substance use disorders. Thus, correctional clinicians and staff, researchers, and patients will need to continue to advocate for improved and enhanced dissemination of integrated, evidence-based behavioral and pharmacological treatment for substance use disorder across the continuum of criminal justice involvement. This chapter describes the evolution of addiction programming within correctional settings from the late 1700s to contemporary practices. Beginning with a discussion of mutual aid societies as one of the earliest providers of ‘treatment,’ this chapter outlines important aspects of early treatment. Additionally, current levels of care and specialized modalities for individuals involved in the criminal justice system are presented, such as cognitive-behavioral interventions, drug courts, therapeutic communities, pharmacologically supported therapy, and harm reduction approaches.
Transition to the community
Authors: Meyer Jaimie P. , Altice Frederick L.
Published: May 2015

Re-incarceration of former prisoners is commonly associated with relapse to drug and alcohol use because of ineffective treatment of substance use disorders (SUDs) after release. High entry rates of people who use drugs (PWUDs) into prisons or jails results in the criminal justice system (CJS) bearing a disproportionate burden of the epidemic of people with SUDs. In contrast to 8% of U.S. adults in the general population, up to 65% of prisoners meet DSM-IV criteria for having a SUD and, depending on geographical location, 70% of HIV-infected prisoners meet criteria for opioid dependence. Though substantial efforts have focused on providing support for those with SUDs as they transition back to the community, evidence-based interventions are not commonly deployed. Despite scientific evidence supporting transitional programs for prisoners with SUDs (e.g., medication assisted therapies, contingency management, adherence support strategies), there are significant logistical constraints to introducing evidence-based interventions into correctional systems and delivering them to prisoners prior to release. Innovative solutions are needed that involve partnerships between all existing stakeholders, including individual patients with SUDs, the CJS and communities, in order to overcome existing impediments. This chapter discusses best practice and evidence-based models in use for jails and prisons to support successful community re-entry.
Gender-specific treatment
Authors: Lewis Catherine F.
Published: May 2015

Despite a roughly equal number of men and women in the general population, women consistently have lower rates of incarceration than their male peers. The difference is not trivial; there are 10 men incarcerated for each woman in the United States. The correctional system was confronted with issues specific to female inmates in part as a product of the War on Drugs from the mid-1980s to the mid-1990s. During this period, the number of women incarcerated rose 888%. The bulk of this rise was attributable to arrests for non-violent drug related charges. As the correctional system began to experience an influx of women, it became clear that they were different from their male peers. The differences included epidemiology of psychiatric disorders, intensity of health service utilization, social stressors, and patterns of offending. The logical question arose as to whether women needed a different treatment approach in the correctional system than men. The term ‘gender responsive programming’ emerged and represented the idea that women have specific needs distinct from male peers that could best be met with treatment designed for women. The purpose of this chapter is to describe, given the current knowledge base: the patterns of offending and arrests for women versus men; the socio-demographics of incarcerated women; the psychopathology exhibited by incarcerated women; and finally, how best to treat incarcerated women and implement this treatment within jails and prisons.
Traumatic brain injury
Authors: Diamond Pamela M.
Published: May 2015

During the past decade, traumatic brain injury (TBI) has become a frequent topic in the media. It has been a decade of expanding awareness, increased research, and growing concern about TBI of all severity levels. Consistent with this increased attention, researchers and policymakers have made strides toward greater understanding of the risks of TBI, the scope and complexity of the symptom profiles seen after TBI, and the types of treatments that optimize recovery. Recent studies have confirmed a 50 to 60% prevalence of TBI among prisoners. Most have experienced multiple injuries and experienced their first TBI in their mid-teens. Routine screening for TBI is rarely done in these settings in spite of there being a number of tested instruments available. The cognitive deficits associated with mild to moderate TBI are often indistinguishable from those associated with many mental illnesses and substance abuse. Etiology is difficult to establish; nevertheless, the common symptom patterns often make adjustment to jail or prison difficult. Educational interventions designed to improve staff knowledge of the prevalence of TBI and frequent symptom patterns are important first steps. Training staff how to modify their behavior and facilitate communication with inmates expressing these symptoms may reduce episodes of misunderstanding and potential aggression. Similarly, current programming may be modified to accommodate the cognitive deficits suffered by inmates with TBI as well as other disorders. This chapter reviews the prevalence of TBI in correctional settings, its impact on co-occurring mental illness and substance use, and opportunities to recognize, intervene, and treat patients with TBI.
Clinical and legal implications of gangs
Authors: Hanson Annette L.
Published: May 2015

Gangs are a fact of life in jails and prisons. The extent and impact of gang activity on a facility will depend upon the size and geographic location of the facility. Smaller jails and prisons, or facilities in rural areas, are more likely to be involved with local or regional groups, also known as street gangs, while large facilities in urban areas will be affected more by nationally known or connected gangs. One survey of Florida prisoners found that inmates who were suspected or confirmed gang members were 35% more likely to commit violent acts than non-members. In a study of 2,158 male inmates in the Arizona Department of Corrections, gang-affiliated inmates were more than twice as likely as nonaffiliated inmates to commit an assault during the first three years of confinement Since institutional management often involves restriction of privileges, placement on long-term segregation, or transfer to a control unit prison, advocacy groups and individual inmates have filed suit against these policies based on First and Eighth Amendment, religious freedom, and anti-discrimination claims. Gang validation procedures themselves have been challenged as arbitrary and inaccurate, leading to inappropriate segregation or restrictions on prisoners who have exhibited no institutional violence. Psychiatrists need to be aware of the dynamics of gang leadership, membership or involvement when working with any gang member, as that will affect their ability and interest in collaborative treatment. These issues and best practices for intervention will be presented in this chapter.
Treatment of incarcerated sex offenders
Authors: Saleh Fabian M. , Grudzinskas Albert J. , Malin H. Martin
Published: May 2015

Sex offenders are incarcerated in substantial numbers for a variety of non-violent and violent crimes, with or without diagnoses of paraphilias. The treatment of sex offenders in correctional contexts is arguably one of the most challenging undertakings for psychiatrists. Sex offenders comprise a highly stigmatized population that typically engenders intense negative feelings in both the professional and lay communities. The growing number of sex offenses in recent years has had a profound impact on public perception. In 2012, the latest year for which comprehensive data have been compiled, there were 73,080 incidents of sex ‘crimes against persons’ in the United States involving 79,625 individual victims and individual 76,927 offenders. The potential contributions of psychiatry to sex offender management span a considerable segment of the patient’s life: from post-arrest evaluation and emergent care, through adjudication in the courts, incarceration, possible civil commitment, and supervised release. Nevertheless, psychiatrists, as physicians and healers, bring much needed medical expertise to the discussion. Foremost is the ability of psychiatry to demonstrate that sex offenders are a heterogeneous population. Further, a rational, effective, and humane approach to the social problem of sex offending depends upon accurate assessment, diagnosis, and treatment approaches to the offender. Psychiatrists can also inform the ongoing debate about competency, dangerousness, the appropriateness of civil commitment, life-long sex offender registration, compulsory medication and other medically relevant issues in sex offender management. This chapter reviews the nosology, assessment, diagnosis, best and evidence-based practice issues relevant to the care of convicted sex offenders in correctional settings.
Hunger strikes
Authors: Keram Emily A.
Published: May 2015

The management of hunger strikes in correctional settings presents the psychiatrist with unique clinical and ethical challenges. The potential for such complex tensions between medical decision-making and medical ethics rarely exists in other practice settings. A physician’s primary consideration involves the health of their patient and respect for human life. The correctional psychiatrist treating or evaluating a hunger striker may be involved in medical decisions that lead to opposite extremes, from death by starvation to forced-feeding. Concepts such as respect for human life, respect for patient autonomy, beneficence, and non-maleficence present new and difficult considerations in the context of a correctional hunger strike. The psychiatric evaluation and treatment of hunger strikers within the management protocols of the institution is discussed. The lack of international consensus in this area is reviewed. Participating in the management of a hunger-striking prisoner can pose clinical and ethical dilemmas for the correctional psychiatrist. The psychiatrist should have a clear understanding of the international guidelines for physicians on the ethical management of hunger strikes and their institution’s policies and procedures regarding hunger strikes and force-feeding. Consultation with experts in the field may be of assistance in balancing potentially conflicting roles and responsibilities. This chapter provides correctional psychiatrists with the historical, clinical, legal, and ethical background for working with hunger strikers.
Rare diseases
Authors: Provan Drew , Baglin Trevor , Dokal Inderjeet , de Vos Johannes
Published: May 2015

Gaucher disease - Niemann–Pick disease - Castleman disease - Kikuchi disease - The porphyrias - Retroperitoneal fibrosis - Langerhans cell histiocytosis - Osteopetrosis
Brome mosaic virus Infection of Rice Results in Decreased Accumulation of RNA1
Authors: Kitayama Masahiko , Hoover Haley , Middleton Stefani , Kao C. Cheng
Published: May 2015

Brome mosaic virus (BMV) (the Russian strain) infects monocot plants and has been studied extensively in barley and wheat. Here, we report BMV can systemically infect rice (Oryza sativa var. japonica), including cultivars in which the genomes have been determined. The BMV capsid protein can be found throughout the inoculated plants. However, infection in rice exhibits delayed symptom expression or no symptoms when compared with wheat (Triticum aestivum). The sequences of BMV RNAs isolated from rice did not reveal any nucleotide changes in RNA1 or RNA2, while RNA3 had only one synonymous nucleotide change from the inoculum sequence. Preparations of purified BMV virions contained RNA1 at a significantly reduced level relative to the other two RNAs. Analysis of BMV RNA replication in rice revealed that minus-strand RNA1 was replicated at a reduced rate when compared with RNA2. Thus, rice appears to either inhibit RNA1 replication or lacks a sufficient amount of a factor needed to support efficient RNA1 replication.
Accuracy of Rain Forecasts for Use in Scheduling Late Blight Management Tactics in the Columbia Basin of Washington and Oregon
Authors: Johnson Dennis A. , Cummings Thomas F. , Fox Alan D.
Published: May 2015

Accuracy of prediction was analyzed for 17- and 30-day rain forecasts at two locations in the Columbia Basin to determine whether forecasts were sufficiently accurate to be included as a model component to schedule fungicide applications for potato late blight. Accuracy was partitioned into specificity (percentage of forecasted nonrainfall events classified correctly) and sensitivity (percentage of forecasted daily rainfall events classified correctly). An adjusted sensitivity, which included the forecasted rain day plus the next 2 days, was also used to give a wider target than only 1 day for evaluating accuracy of forecasted rain events. For 17-day forecasts, specificity during the seasonal test period was ≥70% from mid-June through September and specificity over the days of the forecast was >70% for the first 8 days at both locations both years. Adjusted sensitivity over days of the forecast was initially >80% and then decreased as forecasts increased from 7 to 17 days for 17-day forecasts at both locations and years. Sensitivity and adjusted sensitivity during the seasonal test period were both positively correlated with the number of rainy days while specificity was negatively correlated. Adjusted sensitivity was considerably higher for May (month with highest incidence of rain) than July (month with lowest incidence of rain) at both locations. For 30-day forecasts, specificity during the test period was >75% in July and August and adjusted sensitivity ranged from 60 to 100% for time periods occurring in May and June during both sample seasons. Specificity was generally above 80% as days of the forecast increased and adjusted sensitivity varied greatly over days of the forecasts, with extremes between 0 and 100% at both locations and years for the 30-day forecasts. Specificity of 17- and 30-day rain forecasts and adjusted sensitivity of 17-day rain forecasts have utility in scheduling late blight fungicides in the Columbia Basin.
Archaeophytopathology of Phakopsora pachyrhizi, the Soybean Rust Pathogen
Authors: Haudenshield James S. , Hartman Glen L.
Published: May 2015

Herbarium specimens are useful to compare attributes of the past to attributes of today and predictions into the future. In this study, herbarium specimens from 1887 to 2006 were used to identify Phakopsora pachyrhizi and P. meibomiae, the two known fungal species that cause soybean rust. Historically, these two species differed in geographic distribution, with P. pachyrhizi confined to Asia and Australia, and P. meibomiae confined to the Americas. In our analyses, herbarium specimens were used to determine whether it was possible to extract adequate useful DNA from the fungal structures. If present, quantitative PCR primers specific to P. pachyrhizi, P. meibomiae, or to a third group inclusive of many rust species could be used to speciate the fungus. Of the 38 archival specimens, 11 were positive for P. pachyrhizi, including a 1912 specimen from Japan; 15 were positive for P. meibomiae, including a 1928 specimen from Brazil and two 1923 specimens from the Philippines; and 12 (including all African accessions) were negative for both species. Five specimens were positive in the more inclusive rust assay; all had been labeled as P. pachyrhizi and none were on soybean. These results demonstrate the feasibility of DNA genotyping in archaeophytopathological investigations.
Bacterial Wilt of Cucurbits: Resurrecting a Classic Pathosystem
Authors: Rojas Erika Saalau , Batzer Jean C. , Beattie Gwyn A. , Fleischer Shelby J. , Shapiro Lori R. , Williams Mark A. , Bessin Ricardo , Bruton Benny D. , Boucher T. Jude , Jesse Laura C. H. , Gleason Mark L.
Published: May 2015

Bacterial wilt threatens cucurbit crop production in the Midwestern and Northeastern United States. The pathogen, Erwinia tracheiphila, is a xylem-limited bacterium that affects most commercially important cucurbit species, including muskmelon, cucumber, and squash. Bacterial wilt is transmitted and overwintered by striped and spotted cucumber beetles. Since there are few commercially available resistant cultivars, disease management usually relies on use of insecticides to suppress vector populations. Although bacterial wilt was initially described more than 100 years ago, our knowledge of disease ecology and epidemiology advanced slowly for most of the 20th century. However, a recent wave of research has begun to fill in missing pieces of the bacterial wilt puzzle. This article—the first review of research toward understanding the cucurbit bacterial wilt pathosystem—recounts early findings and updates our understanding of the disease cycle, including pathogen and vector biology. We also highlight research areas that could lead to more efficient and ecologically based management of bacterial wilt.
Comparison of Posterior Lumbar Interbody Fusion Versus Posterolateral Fusion for the Treatment of Isthmic Spondylolisthesis
Authors: Luo Jiaquan , Cao Kai , Yu Ting , Li Liangping , Huang Sheng , Gong Ming , Cao Cong , Zou Xuenong
Published: May 2015

Study Design:

Systematic review and meta-analysis.

Background:

Posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) were widely used in the treatment of lumbar isthmic spondylolisthesis (IS). There was a great controversy over the preferred fusion method.

Objective:

The purpose of this study is to evaluate the clinical outcomes between PLF and PLIF for the treatment of IS.

Materials and Methods:

Related studies that compared the clinical effectiveness of PLIF and PLF for the treatment of IS were acquired by a comprehensive search in 4 electronic databases (PubMed, EMBASE, Cochrane Controlled Trial Register, and MEDLINE) from January 1950 through December 2014. Included studies were performed according to eligibility criteria. The main endpoints included: improvement of clinical satisfaction, complication rate, reoperation rate, fusion rate, and reoperation rate.

Results:

A total of 9 studies were included in the meta-analysis; 6 were low-quality evidence and 2 were high-quality evidence as indicated by the Jadad scale. Compared with PLIF, PLF patients showed lower fusion rates [P=0.005, odds ratio (OR)=0.29 (0.14, 0.58)] and shorter operation times [P<0.00001, weighted mean difference (WMD)=−0.5(−0.61, −0.39)]. No significant difference was found in the term of postoperative visual analogue scale leg score [P=0.92, WMD=0.02 (−0.39, 0.44)] and visual analogue scale back score [P=0.41, WMD=0.20 (−0.28, 0.68)], blood loss [P=0.39, WMD=121.17 (−152.68, 395.01)], complication rate [P=0.42, OR=1.50 (0.56, 4.03)], postoperative Oswestry Disability Index [P=0.3, WMD=1.09 (−0.97, 3.15)], and postoperative clinical satisfaction [P=0.84, OR=1.06 (0.60, 1.86)].

Conclusions:

In conclusion, our meta-analysis suggested that PLF shows significant lower fusion rate compared with PLIF. Although PLIF had more operation time than PLF, there was no significant difference in global assessment of clinical outcome between the 2 fusion procedures. However, future well-designed, randomized-controlled trials are still needed to further confirm our results.
Novel Parameter of Corneal Biomechanics That Differentiate Normals From Glaucoma
Authors: Lee Rachel , Chang Robert T. , Wong Ian Y.H. , Lai Jimmy S.M. , Lee Jacky W.Y. , Singh Kuldev
Published: May 2015

Purpose:

To identify novel corneal biomechanical parameters differentiating glaucomatous from normal eyes.

Patients and Methods:

Sixty subjects with varying degrees of glaucoma severity and 61 normal controls underwent corneal biomechanical measurements including corneal deformation amplitude, inward and outward applanation length and velocity, and highest concavity time in 1 eye per subject at Queen Mary Hospital, Hong Kong. Measurements were taken with the Corvis ST device, a noncontact tonometer coupled with a high-speed Scheimpflug camera. The intraocular pressure (IOP) and central corneal thickness (CCT) were also measured.

Results:

Significant findings included differences in outward applanation velocity (glaucoma: −0.37±0.01 m/s; control: −0.32±0.01 m/s; P=0.001), peak distance (glaucoma: 2.37±0.03 mm; control: 2.30±0.02 mm; P=0.005), and highest concavity time (glaucoma: 16.75±0.08 ms; control: 17.05±0.07 ms; P=0.002) between the 2 groups, after correcting for IOP, CCT, and age. Both outward applanation velocity and peak distance were moderately correlated with IOP and CCT. However, highest concavity time was not correlated with either IOP or CCT (R
2=0.0140 and 0.000055, respectively). Age was not correlated with any of the 3 parameters.

Conclusions:

Glaucomatous eyes have a greater mean outward applanation velocity and peak distance, but shorter time to highest concavity than eyes without glaucoma. The difference in time to highest concavity does not correlate with age, IOP, or CCT, suggesting that this parameter may be a marker of increased pressure susceptibility that is independently associated with glaucoma risk.
Epidural Injection With or Without Steroid in Managing Chronic Low-Back and Lower Extremity Pain: A Meta-Analysis of 10 Randomized Controlled Trials
Authors: Zhai Jinshuai , Zhang Long , Li Mengya , Tian Zhi , Tian Yiren , Zheng Wang , Chen Jia , Huang Teng , Li Xicheng
Published: May 2015

Chronic low-back and lower extremity pain is mainly caused by lumbar disc herniation and radiculitis. Various surgery and nonsurgical modalities, including epidural injections, have been used to treat lumbar disc herniation or radiculitis. Therefore, we conducted this meta-analysis to assess the effects of the 2 interventions in managing various chronic low and lower extremity pain. A systematic literature search was conducted to identify randomized controlled trials, which compared the effect of local anesthetic with or without steroids. The outcomes included pain relief, functional improvement, opioid intake, and therapeutic procedural characteristics. Pooled estimates were calculated using a random-effects or fixed-effects model, depending on the heterogeneity between the included studies. Ten randomized controlled trials (involving 1111 patients) were included in this meta-analysis. The pooled results showed that 41.7% of patients who received local anesthetic with steroid (group 1) and 40.2% of patients who received local anesthetic alone (group 2) had significant improvement in pain relief, and the Numeric Rating Scale pain scales were significantly reduced by 4.09 scores [95% confidence interval (CI), −4.26 to −3.91] and 4.12 (95% CI, −4.35 to −3.89) scores, respectively. Similarly, 39.8% of patients in group 1 and 40.7% in group 2 achieved significantly improved functional status. The Oswestry Disability Indices in the 2 groups were reduced by 14.5 (95% CI, −15.24 to −13.75) and 12.37 (95% CI, −16.13 to −8.62), respectively. The average procedures per year in group 1 were 3.68 ± 1.17 and 3.68 ± 1.26 in group 2, with an average total relief per year of 31.67 ± 13.17 and 32.64 ± 13.92 weeks, respectively. The opioid intake decreased from baseline by 8.81 mg (95% CI, −12.24 to −5.38) and 16.92 mg (95% CI: −22.71 to −11.12) in the 2 groups, respectively. This meta-analysis confirms that epidural injections of local anesthetic with or without steroids have beneficial but similar effects in the treatment of patients with chronic low-back and lower extremity pain.
Combination Therapies of Diacerein and Febuxostat Inhibit IL-1β Responses and Improve Clinical Symptoms in Patients With Refractory Gout
Authors: Yu Yi-Kai , Yu Fei , Ye Cong , Shen Gui-Fen , Lei Xiao-Mei , Zhang Sheng-Tao , Hu Shao-Xian
Published: May 2015

There are several therapeutic strategies available for the treatment of an acute gout attack and the prevention of recurrent gout flares, and they include nonsteroid anti-inflammatory drugs. This prospective study was aimed at evaluating the efficiency and safety of diacerein in combination with febuxostat on urate control, global assessments of disease activity, self-monitored gouty acute flare times, inflammatory markers, and clinical symptoms associated with their life quantity in patients with refractory gout. A total of 64 patients with refractory gout were sequentially recruited and prescribed with oral febuxostat alone or febuxostat plus diacerein daily for 12 weeks. The intensity of joint pain, numbers of acute flare, disease activity and the levels of serum amyloid A, mature IL-1β, IL-18, C-reactive protein, and urate in individual subjects were routine analyzed. In comparison with that treatment with febuxostat alone, treatment with both drugs for 12 weeks had a better therapeutic effect on reducing the values of visual analog scales, acute flares, and healthy assessment questionnaire scores in these gout patients. Furthermore, treatment with both drugs also significantly reduced the mean daily dose of etoricoxib and the levels of serum IL-1β and serum amyloid A. There was no significant difference in the frequency of patients with adverse effect between these 2 groups of patients. In conclusion, combination of diacerein and febuxostat had better therapeutic effect on reducing acute gout flares, inflammation, and clinical symptoms in patients with refractory gout.
Paenibacillus xanthinilyticus sp. nov., isolated from agricultural soil
Authors: Kim Dong-uk , Kim Song-Gun , Lee Hyosun , Chun Jongsik , Cho Jang-Cheon , Ka Jong-Ok
Published: May 2015

A bacterial strain designated 11N27T was isolated from an agricultural soil sample. Cells of this strain were Gram-reaction-variable, facultatively anaerobic, endospore-forming, white-pigmented, peritrichously flagellated and hydrolysed xanthine. The major fatty acids of strain 11N27T were anteiso-C15 : 0, iso-C16 : 0 and C16 : 0. The polar lipid profile contained phosphatidylethanolamine, two unknown phospholipids, two unknown aminolipids, one unknown aminophospholipid and two unknown polar lipids. The G+C content of the genomic DNA of strain 11N27T was 50.3 mol%. MK-7 was the predominant respiratory quinone. meso-Diaminopimelic acid was the diagnostic diamino acid in the peptidoglycan. 16S rRNA gene sequence analysis showed that strain 11N27T was phylogenetically related to Paenibacillus mendelii C/2T (96.2  % sequence similarity) and Paenibacillus sepulcri CMM 7311T (96.0  %). The genotypic and phenotypic data showed that strain 11N27T could be distinguished from phylogenetically related species and that this strain represents a novel species of the genus Paenibacillus. The name Paenibacillus xanthinilyticus sp. nov. is proposed with the type strain 11N27T( = KACC 17935T = NBRC 109108T).
Oceanobacillus arenosus sp. nov., a moderately halophilic bacterium isolated from marine sand
Authors: Kim Wonyong , Siamphan Chatuphon , Kim Jong-Hwa , Sukhoom Ampaitip
Published: May 2015

A Gram-stain-positive, spore-forming, rod-shaped, motile, strictly aerobic bacterium, designated CAU 1183T, was isolated from marine sand and its taxonomic position was investigated by using a polyphasic approach. The bacterium grew optimally at 30 °C, at pH 8.5 and in the presence of 2 % (w/v) NaCl. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain CAU 1183T formed a distinct lineage within the genus Oceanobacillus and exhibited the highest similarity to Oceanobacillus chungangensis CAU 1051T (97.6 %). The strain contained MK-7 as the predominant isoprenoid quinone and anteiso-C15 : 0 was the major cellular fatty acid. The cell-wall peptidoglycan contained meso-diaminopimelic acid. The polar lipid pattern of strain CAU 1183T consisted of diphosphatidylglycerol, phosphatidylglycerol and unidentified lipids, including two phospholipids, two glycolipids, a phosphoglycolipid and two lipids. The G+C content of the genomic DNA was 37.5 mol%. On the basis of phenotypic, chemotaxonomic and phylogenetic data, strain CAU 1183T should be assigned to a novel species in the genus Oceanobacillus, for which the name Oceanobacillus arenosus sp. nov. is proposed. The type strain is CAU 1183T ( = KCTC 33037T = CECT 8560T).