This study examined the correlations between watershed and reservoir characteristics, and water quality parameters related to algal blooms in seven subtropical reservoirs. Analysis of the dissimilarity of physico-chemical parameters resulted in separation of the reservoirs into three main groups: four reservoirs with the highest proportion of agriculture and/or urban land use in their watersheds; two reservoirs with a high proportion of forest cover; and one small reservoir with a relatively pristine watershed intermediate between the other two groups. All reservoirs were dominated by cyanobacteria, and at times, had species capable of producing toxins. However, the three reservoirs with the lowest percentage forest cover ( approximately 50%) had the highest frequency and magnitude of toxic species, principally Cylindrospermopsis raciborskii. Analysis of dissimilarity of algal species composition resulted in three reservoir groups similar to that for the physico-chemical parameters, with the exception of the reservoir with the highest percentage urban land use being an outlier. Across all reservoirs, percentage forest cover in the watershed, watershed area and reservoir volume were all significantly correlated with algal cell concentrations and total nitrogen (TN), but not with chlorophyll a concentrations. Total phosphorus (TP) was only correlated with the proportion forest cover in the watershed, suggesting that reservoir volume and depth were of less importance for TP than for algal cell concentrations or TN. These results suggest that watershed pattern and reservoir characteristics, such as water volume and depth, have a measurable effect on the type of algal blooms in reservoirs.

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Introduction: Toxic Epidermal Necrolysis (TEN) is primarily associated with medication use. Presented is a patient with likely Mycoplasma pneumoniae infection and progression to TEN. Case: A 19-year-old male presented with 1-week history of pneumonia like symptoms and prescribed antibiotics for suspected community-acquired pneumonia. Onset of a new rash was noted and antibiotics were discontinued less than 24 hours after initiation. The diffuse, maculopapular, bullous rash with mucosal lesions ultimately reached skin involvement greater than 30%. Histological studies were consistent with TEN. Mycoplasma antibodies and cold agglutinins were positive. Discussion: Stevens-Johnson syndrome (SJS) and TEN are a spectrum of mucocutaneous disorders. The most common etiology of both is medications. Mycoplasma is the most common infectious cause of SJS, but has been poorly cited as a cause of TEN. Typical onset of rash from medications is greater than 14 days, whereas onset from infection is typically less than 14 days. The timing of rash onset in this presentation was congruent with infection rather than medication induced. Conclusion: Mycoplasma is a welldocumented etiology of SJS, but rarely documented as an etiology of TEN. This case suggests the potential of Mycoplasma infection causing more severe mucocutaneous disease in the spectrum of SJS and TEN. INTRODUCTIONToxic epidermal necrolysis (TEN) is a potentially lethal mucocutaneous process with mortality greater than 20%.1 Debate remains on pathogenesis of TEN and Stevens-Johnson syndrome (SJS) regarding whether the diagnoses are part of a spectrum. However, there is an agreement that body surface area (BSA) involvement defines the processes, with TEN involving greater than 30% BSA and SJS involving less than 10% BSA. The most common etiology of TEN is medication use, which is implicated in greater than 95% of cases.

The use of manual therapy in the form of OMT significantly reduced this pilot's pain in three visits and maintained flight status per aeromedical waiver guidelines.

Drug-induced parkinsonism (DIP) can be clinically indistinguishable from degenerative parkinsonism, and bedside assessments are needed to differentiate between these conditions. We examined 34 U.S. Veterans with DIP using 123I-FP-CIT (DAT-SPECT) to identify underlying nigrostriatal degeneration. Participants were 94% male with mean age of 64.5 ± 7.1 years. DAT-SPECT was abnormal in 12/34 (35%). Comparing normal and abnormal imaging groups, there were no differences in age, sex, race/ethnicity, psychiatric diagnosis, motor severity, or RBD Screening Questionnaire scores. Those with underlying neurodegeneration reported significantly more non-motor symptoms (NMS), worse olfactory function on the University of Pennsylvania Smell Identification Test, and greater turning duration/steps on the instrumented Timed Up and Go. Area under the curve (AUC) combining poor olfaction and total NMS burden was 0.84 (CI 0.71–0.97), while AUC for turn steps was 0.91 (CI 0.81–1.00). Gait impairment, hyposmia, and NMS may be useful alone and in combination to identify DIP patients with underlying dopaminergic degeneration.