Alder yellows (ALY) phytoplasma (16SrV-C) is associated with ALY, a disease of several Alnus (alder) species in Europe and A. rubra in North America. In all affected species, the symptoms are similar. However, latent infections are common. ALY phytoplasma includes different strains which may be occasionally transmitted to grapevines leading to some grapevine yellows diseases. In the current study, visual symptom assessment and PCR-based methods using universal and group-specific phytoplasma primers were used to update and extend knowledge on the occurrence, impact, and genetic diversity of ALY phytoplasma in declining and non-symptomatic A. glutinosa and A. cordata trees in the Basilicata and Campania regions of southern Italy. ALY phytoplasma was detected in 80% of alder trees examined. In symptomatic trees, no other cause of disease was observed. More than half of alder trees that tested phytoplasma-positive proved to be latently infected. A considerable genetic variability was observed among the newly recorded ALY phytoplasma strains in southern Italy in almost of the genes examined. These included 16S rRNA, 16S/23S rDNA spacer region, ribosomal protein rpsV (rpl22) and rpsC (rps3), map, imp, and groEL genes. Eleven new genotypes were identified at map gene sequence level. However, the genetic differences observed were not related to plant host species, geographical origin, and symptoms shown by infected alder trees. Also, this study indicates that ALY phytoplasma is more widespread than previously thought.

UNASSIGNED: Several efforts have been put in place to reduce the global burden of malaria especially in children and in sub-Saharan Africa. The study aimed to evaluate the impact of malaria control activities on the trend of childhood malarial diseases at a tertiary hospital in South-south Nigeria.
UNASSIGNED: A retrospective review of the case records of all malaria diagnoses including in-patient, out-patient, and emergency room, seen in the Department of paediatrics at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018 was conducted.
UNASSIGNED: There were 41, 863 malaria cases diagnosed over the 12 years with a decline in yearly diagnosis and admissions, from the year 2006 through 2018. Total malaria admissions were 578, (44.5/ year), giving a severe malaria incidence of 1.26%, and there were 164 malaria death cases, with a yearly average of 12. The causes of death in the children with malarial parasitaemia were severe anaemia in 75 (45.7%), hypoglycaemia in 14 (8.5%), cerebral malaria in 17 (10.4%), and prostration with other co-morbidities, 22 (13.4%). Thirty-six children (22%) were convulsing and died soon after admission, with a compounding diagnosis of aspiration and respiratory failure.
UNASSIGNED: There is a gradual reduction in childhood malaria disease, admission, and death, though this is slower than anticipated based on efforts and strategies put in place by the Nigerian government and various organizations.

OBJECTIVE: End stage kidney disease can be a slow process and it may be challenging to achieve required follow-up for sufficient events. Therefore, a surrogate kidney endpoint, such as estimated glomerular filtration rate (eGFR) slope maybe attractive to assess the kidney in cardiovascular trials, especially heart failure (HF).
RESULTS: eGFR slope can generate informative results in a shorter follow-up period, has decreased risk of type-2 error, and is less sensitive to eGFR shifts compared with other surrogate kidney endpoints (eGFR decline≥40% or doubling creatinine). However, eGFR slope has its limitations with acute effects, heterogeneity in slope calculation/reporting, and deviations from linearity. eGFR slope is a kidney endpoint which may be well-suited for HF trials. Cross-collaborated guideline recommendations are needed to optimize the use of eGFR slope as a kidney endpoint in patients with HF.

Phoenix dactylifera L. is an economically and aesthetically important tree in the southwestern US. Approximately 4900 ha of dates are commercially grown for its edible fruit in the US, including about 1600 ha in the Yuma area and the Hyder Valley of Arizona (USDA, 2023). In October 2022, a severe rot was observed on three date palms in the Phoenix Metropolitan area. Early symptoms were brown spots that turned to a black scorch appearance extending along the leaf base and rachis, leading to the lower fronds\' wilting, drying, and folding. As the disease progressed upwards, the terminal bud became necrotic and eventually collapsed. Isolation from the necrotic leaf lesions on a potato dextrose agar (PDA) consistently yielded a fast-growing fungus that was initially white with abundant fluffy aerial mycelium, which gradually turned dark olivaceous after growing at 22-25oC under 12 h light for a week. Pycnidial conidiomata formed on pine needles in a water agar were black and globose. Conidiogenous cells were hyaline and cylindrical. The conidia exhibited a thick-walled, ovoid to ellipsoid morphology, initially appearing hyaline and aseptate and transitioned to 1-septate with a dark brown, striated appearance, measuring 19.6 to 23.0 μm x 10.3 to 12.2 µm (n = 20). For molecular identification, genomic DNA was extracted from the mycelia of two isolates. Partial DNA sequences of the internal transcribed spacer (ITS) region of rDNA and β-tubulin (TUB) gene were amplified and sequenced using primers ITS5/ITS4 (White et al. 1990) and Bt2a/Bt2b (Glass and Donaldson 1995). The resulting sequences of ITS (PP346666) and TUB (PP372690) were deposited in the GenBank. A BLASTn search of ITS and TUB sequences revealed a 99 to 100% similarity with the sequences (JX456475, KF766198, and OK338070) of Neodeightonia phoenicum strains causing palm rot in Greece (Ligoxigakis et al. 2013), leaf spot on pygmy date palm in China (Zhang and Song 2022), and an ex-type CBS 122528 culture. Based on these morphological and molecular data, the fungus was identified as N. phoenicum. A pathogenicity test was conducted twice in a greenhouse (daily temperatures:18 ~ 30 oC, relative humidity: 45% ~ 95%) on 4 healthy 1-year-old date palm plants. The petioles of 3 older leaves per plant were wounded by pricking the epidermis of the leaf with a needle (ca 20 pricks per petiole) and inoculated with agar discs from a 4-day-old PDA culture of the fungus. The control consisted of 4 mock-inoculated plants by placing plain PDA on the wounds of leaf petioles. Five weeks after inoculation, all the inoculated leaves showed symptoms of black scorch, petiole rot, and leaf necrosis, which were the same as those symptoms observed on the original diseased trees, while the controls did not show any symptoms. The fungus was re-isolated and confirmed as N. phoenicum by morphology. N. phoenicum has been reported to cause leaf spot, shoots blights, stalk and root rots as well as black scorch on different palm species all over the world. However, to our knowledge, this is the first report of N. phoenicum causing black scorch and rot disease in Arizona. The possible spread of N. phoenicum could have a significant economic impact and requires immediate attention through suitable disease management initiatives.

Children with sickle cell disease (SCD) may experience cognitive difficulties, including slowed processing speed. Thus, we investigated if processing speed changes over time. From 1992-2001, 103 participants with SCD aged 3-16 years (n ≤ 8.99 = 45; n ≥ 9.00 = 58) completed cognitive assessments. MRI was available for 54 participants. Between 1992-2002, 58 participants consented to one or two further assessments. A repeated measures regression using linear mixed-effects modelling determined longitudinal changes in processing speed index (PSI), examining the interaction between age (continuous variable) and timepoint (i.e., assessment 1 or 3) and controlling for MRI infarct status (i.e., no infarct, silent infarct, or stroke). Those aged ≤8.99 and ≥9.00 at first assessment experienced PSI decline. Declines were most prominent for the processing speed coding subtest, with a significant interaction between timepoint and age, t(31) = 2.64, p = 0.01. This decline may reflect a developmental delay, likely due to disease progression, with slower improvements in processing speed. Although there have been significant improvements in SCD treatments, mostly in high-income countries, processing speed still remains a target; thus, incorporating clinical monitoring of processing speed may help identify delay and allow for early intervention.

UNASSIGNED: Child sex ratio signifies the proportion of girls compared with boys in 0 to 6 years of age group. It is an important indicator for any population and most significantly about the status of the girl child in the society. The study tried to approach in a qualitative manner to study the rationale behind the declining of child sex ratio.
UNASSIGNED: We conducted a qualitative study using five focus group discussions and 12 in-depth interviews among various age groups, pregnant women, and other stake holders. The participants were approached with a semi-structured open-ended interview guide regarding the rationale of declined child sex ratio and measures to normalize it. After a thematic analysis, main themes and subthemes were selected after consensual agreement.
UNASSIGNED: The study showed that male child preference is the main theme identified in the rationale part with subthemes of female vulnerability, socioeconomic status, literacy, cultural, and caste and religion as subthemes. The theme of female child preference also came up with as second child, care taking, affectionate, and cultural factors as subthemes. In the area of suggestions/interventions, education, counseling, government policies and media along with suggestions regarding sex determination and female feticide were identified.
UNASSIGNED: The decline in child sex ratio should be taken as an active social issue thus focusing more into female upliftment and enlightening into the issues of patriarchal nature, with reduction of cultural/religious beliefs.

OBJECTIVE: Emerging evidence suggests that there is a close relationship between the human lung and kidney. This study evaluated whether decreased renal function was associated with accelerated pulmonary function decline in a large-scale community-based cohort.
METHODS: A total of 10,028 subjects of the prospective Ansung-Ansan cohort were eligible for the longitudinal analysis of changes in pulmonary function associated with decreased renal function (glomerular filtration rate <60 ml/min/1.73 m2). Logistic regression analysis was performed to evaluate factors associated with decreased baseline renal function, and a linear mixed model compared changes in pulmonary function in participants with and without decreased renal function after propensity score matching (PSM).
RESULTS: At baseline, subjects with and without decreased renal function showed distinct characteristics, and the factors associated with decreased renal function were age, baseline forced vital capacity, hypertension, and white blood cell (WBC) count. A 1:4 PSM of age, sex, body mass index, and smoking status showed that the proportion of those with hypertension and the WBC count differed between the patients with decreased and normal renal function. In the PSM population, those with decreased renal function had a greater decline in forced expiratory volume in the first second (FEV1) than those without (p=0.0402); however, these differences were not found to be evident when hypertension and WBC count were further matched (p=0.0807).
CONCLUSIONS: The results of our study demonstrated that decreased renal function was not directly associated with the rapid decline in pulmonary function in a community-based general population setting.

The main goals of this research are to determine the developmental tendency of salmonellosis in the Republic of North Macedonia and to determine the index of dynamics and the rate of decline/increase of salmonellosis in the Republic of North Macedonia. The research covers the period from 01.01.2012 until 31.12.2022. The data used to implement this study were obtained from the Institute of Public Health of the Republic of North Macedonia. The research included 2711 subjects who were sick with salmonellosis from 2012 to 2022. The following statistical methods of work are used: linear trend, dynamic index with a constant base, dynamic index with a variable base (chain index), rate of decline, and rate of increase. The results of the study suggest that in the period 2012-2022, the highest number of patients (n=373) and the highest incidence (18/100000) of salmonellosis were registered in 2018, and the lowest in 2020 (n=119, I=5.8/100000). From the linear trend values, it can be concluded that salmonellosis in the Republic of North Macedonia shows a decreasing tendency. The biggest increase in salmonellosis in the Republic of North Macedonia was in 2015 by 71% compared to 2014. The biggest decrease in salmonellosis in the Republic of North Macedonia was in 2020 by 48% compared to 2019. From the study, it can be concluded that food operators and manufacturers are observing the procedures of the HACCP control system for food safety, leading to a possible decrease in salmonellosis.

BACKGROUND: Mucopolysaccharidosis (MPS) II is a rare, X-linked lysosomal storage disease. Approximately two-thirds of patients have central nervous system involvement with some demonstrating progressive cognitive impairment (neuronopathic disease). The natural history of cognitive and adaptive function in patients with MPS II is not well-defined. This 2-year, prospective, observational study evaluated the neurodevelopmental trajectories of boys with MPS II aged ≥ 2 years and < 18 years.
RESULTS: Overall, 55 patients were enrolled. At baseline, mean (standard deviation [SD]) age was 5.60 (3.32) years; all patients were receiving intravenous idursulfase. Cognitive and adaptive function were assessed using the Differential Ability Scales, Second Edition (DAS-II) General Conceptual Ability (GCA) and the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) Adaptive Behavior Composite (ABC) scores, respectively. Baseline mean (SD) DAS-II GCA and VABS-II ABC scores were 78.4 (19.11) and 83.7 (14.22), respectively, indicating low cognitive function and moderately low adaptive behavior. Over 24 months, modest deteriorations in mean (SD) scores were observed for DAS-II GCA (-3.8 [12.7]) and VABS-II ABC (-2.0 [8.07]). Changes in DAS-II GCA scores varied considerably, and data suggested the existence of four potential patient subgroups: (1) patients with marked early impairment and rapid subsequent decline, (2) patients with marked early impairment then stabilization, (3) patients with mild early impairment then stabilization, and (4) patients without impairment who remained stable. Subgroup analyses revealed numerically greater DAS-II GCA score reductions from baseline in patients aged < 7 years at baseline (vs. those aged ≥ 7 years) and in patients with DAS-II GCA scores ≤ 70 at baseline (vs. those with scores > 70); between-group differences were nonsignificant. No clear subgroups or patterns were identified for individual changes in VABS-II ABC scores. In total, 49 patients (89.1%) reported ≥ 1 adverse event (AE) and nine patients (16.4%) reported serious AEs.
CONCLUSIONS: Some patients with MPS II had rapid declines in cognitive ability, whereas others remained relatively stable after an initial decline. These insights provide a basis for more detailed analyses of different patient subgroups, which may enhance the definition and understanding of factors that influence cognitive and adaptive function in MPS II.
BACKGROUND: ClinicalTrials.gov, NCT01822184. Registered retrospectively: April 2, 2013.

UNASSIGNED: Social prescribing (SP) is part of universal personalised care and available to everyone in the UK National Health Service. However, emerging evidence suggests access disparities in social prescribing. This study aimed to investigate the feasibility of using primary care records to access and analyse data on social prescribing. Our secondary aim was to compare characteristics of patients who are offered referral, referred to or decline referral for social prescribing to explore possible inequalities in access to social prescribing.
UNASSIGNED: Patient records (n=3086) were extracted from 11 GP practices across Northwest England for accepted, offered and declined social prescribing referrals. Patient demographics collected included sex, age, ethnicity, mental and physical health diagnoses. Patient characteristics in social prescribing referrals were compared to the overall practice population (practice information from Public Health England). Referral and decline rates were compared by group (e.g. male/female decline rates).
UNASSIGNED: GP referral data showed inconsistent recording of wider determinants of health. Patient age, sex and mental and physical health conditions were consistently recorded. Other variables (marital status, interpreter need, education, disability, sexual orientation, non-English language, nationality) were recorded only sporadically and could not be used for analysis. Practices varied in referral patterns. Our preliminary findings identified under-referring of younger age groups and Asians, and higher declined referrals among individuals with physical health diagnoses.
UNASSIGNED: Recording discrepancies meant that many patient factors could not be used to identify trends in social prescribing referrals and declines and assess equity. Primary care data recording must be consistent to understand SP referral trends and inequalities relating to the wider determinants of health. Preliminary results suggest some patient groups may be underrepresented in SP referrals, however this requires further investigation.