TP53 R249S Mutations, Exposure to Aflatoxin, and Occurrence of Hepatocellular Carcinoma in a Cohort of Chronic Hepatitis B Virus Carriers from Qidong, China

Hepatocellular carcinoma (HCC) has a high mortality in East Asia and Sub-Saharan Africa, two regions where the main etiologic factors are chronic infections with hepatitis B vir-us and dietary exposure to aflatoxin. A single base substitution at the third nucleotide of codon 249 of TP53 (R249S) is common in HCC in these regions and has been associated with aflatoxin-DNA adducts. To determine whether R249S may be detected in plasma DNA before HCC diagnosis, we conducted a case-control study nested in a cohort of adult chronic hepatitis B virus carriers from Qidong County, People's Republic of China. Of the 234 plasma specimens that yielded adequate DNA, only 2 (0.9%) were positive for R249S by restriction fragment length polymorphisms, and both of them were controls. Of the 249 subjects tested for aflatoxin-albumin adducts, 168 (67%) were positive, with equal distribution between cases and controls. Aflatoxin-albumin adduct levels were low in the study, suggesting an overall low ongoing exposure to aflatoxin in this cohort. The R249S mutation was detected in 11 of 18 (61%) available tumor tissues. To assess whether low levels of mutant DNA were detectable in pre-diagnosis plasma, 14 plasma specimens from these patients were analyzed by short oligonucleotide mass analysis. Nine of them (64%) were found to be positive. Overall, these results suggest that HCC containing R249S can occur in the absence of significant recent exposure to aflatoxins. The use of short oligonucleotide mass analysis in the context of low ongoing aflatoxin exposure may allow the detection of R249S in plasma several months ahead of clinical diagnosis. (Cancer Epidemiol Biomarkers Prev 2009;18(5):1638-43)

The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE): Study protocol for a randomized controlled trial

BACKGROUND: Glaucoma is the leading cause of irreversible blindness. Although primary open-angle glaucoma is more common, primary angle-closure glaucoma (PACG) is more likely to result in irreversible blindness. By 2020, 5·3 million people worldwide will be blind because of PACG. The current standard care for PACG is a stepped approach of a combination of laser iridotomy surgery (to open the drainage angle) and medical treatment (to reduce intraocular pressure). If these treatments fail, glaucoma surgery (eg, trabeculectomy) is indicated. It has been proposed that, because the lens of the eye plays a major role in the mechanisms leading to PACG, early clear lens extraction will improve glaucoma control by opening the drainage angle. This procedure might reduce the need for drugs and glaucoma surgery, maintain good visual acuity, and improve quality of life compared with standard care.EAGLE aims to evaluate whether early lens extraction improves patient-reported, clinical outcomes, and cost-effectiveness, compared with standard care.

METHODS/DESIGN: EAGLE is a multicentre pragmatic randomized trial. All people presenting to the recruitment centres in the UK and east Asia with newly diagnosed PACG and who are at least 50 years old are eligible.The primary outcomes are EQ-5D, intraocular pressure, and incremental cost per quality adjusted life year (QALY) gained. Other outcomes are: vision and glaucoma-specific patient-reported outcomes, visual acuity, visual field, angle closure, number of medications, additional surgery (e.g., trabeculectomy), costs to the health services and patients, and adverse events.A single main analysis will be done at the end of the trial, after three years of follow-up. The analysis will be based on all participants as randomized (intention to treat). 400 participants (200 in each group) will be recruited, to have 90% power at 5% significance level to detect a difference in EQ-5D score between the two groups of 0·05, and a mean difference in intraocular pressure of 1·75 mm Hg. The study will have 80% power to detect a difference of 15% in the glaucoma surgery rate.

TRIAL REGISTRATION: ISRCTN44464607.

The Revival of Private Property and Its Limits in Post-Mao China

This monograph examines the nature and significance of the re-emergence of private property in rapidly changing post-Mao China.

In examining this issue, the study explores a key dichotomy in Chinese law, that is, ‘public versus private’, and examines the manner in which the Chinese define ownership. The study stresses the importance of lack of clarity in the boundaries between the public and the private in property rights.

While there is a limited move towards the recognition of private property in real estate in contemporary China, this analysis also shows that ownership in the law, and ownership as understood and practised socially, often diverge significantly.

From the Qing dynasty reforms of the late nineteenth century onwards, ‘modernist’ law and entrenched social practice have often opposed each other. In contrast to the official, and indeed legal, support for unitary and exclusive property rights, the reality of the property regime has been a fragmentation of property rights. ‘Modern’ conceptions and theories of property rights emerged in the context of nation-building from the late Qing onwards, and unitary and exclusive property rights were considered as ‘badges’ of modernity.

These conceptions and theories served (and still serve) the purposes of control and governance but were, and still are, often resisted in social practice and popular thinking, leading to alienation and conflict. As a result, analysis of the nature and the social and political implications of re-emerging private property rights provides important insights for our understanding of the changing nature of modern China.

Human height since 1820

Average height is an important indicator of people’s well-being. It is also a relatively undistorted and easy-to-measure indicator, which makes it particularly suitable for comparisons across time and space. Drawing upon an extensive body of research, the chapter describes the strengths and weaknesses of this indicator. It finds that during the 19th century, average height in Western Offshoots was much higher than elsewhere. Differences between Western Europe and the rest of the world (Eastern Europe, East Asia) were marginal, in spite of the much higher real incomes in the former region. This changed after about 1870, when people’s height began to increase in Western Europe, whereas this lagged behind elsewhere. Africans were relatively tall during much of the period studied, but experienced declining height in many countries after the 1960s. People in Southeast Asia stayed relatively short throughout the period.

Burkholderia pseudomallei:another emerging pathogen in cystic fibrosis

BACKGROUND: Burkholderia pseudomallei is an important cause of acute fulminant pneumonia and septicaemia in tropical regions of northern Australia and south east Asia. Subacute and chronic forms of the disease also occur. There have been three recent reports of adults with cystic fibrosis (CF) who presumably acquired B pseudomallei infection during extended vacations or residence in either Thailand or northern Australia.

METHODS: The clinical course, molecular characteristics, serology and response to treatment are described in four adult CF patients infected with B pseudomallei. Polymerase chain reaction (PCR) based methods were used to confirm B pseudomallei and exclude B cepacia complex. Genotyping was performed using randomly amplified polymorphic DNA (RAPD) PCR and pulsed field gel electrophoresis (PFGE).

RESULTS: Four patients are described with a mean duration of infection of 32 months. All but one patient lived in tropical Queensland. Two patients (with the longest duration of infection) deteriorated clinically and one subsequently died of respiratory failure. Both responded to intravenous treatment specifically targeting B pseudomallei. Another patient suffered two severe episodes of acute bronchopneumonia following acquisition of B pseudomallei. Eradication of the organism was not possible in any of the cases. PFGE of a sample isolate from each patient revealed the strains to be unique and RAPD analysis showed retention of the same strain within an individual over time.

CONCLUSIONS: These findings support a potential pathogenic role for B pseudomallei in CF lung disease, producing both chronic infection and possibly acute bronchopneumonia. Identical isolates are retained over time and are unique, consistent with likely environmental acquisition and not person to person spread. B pseudomallei is emerging as a significant pathogen for patients with CF residing and holidaying in the tropics.

Technological Learning in Developing Countries

Technological learning refers to the learning processes involved in improving the productive capabilities of an enterprise, sector or economy to enable it to produce higher quality goods or services with increasing levels of efficiency. Approaches to the study of technological learning include case studies of particular countries, sectors and firms; measures of export sophistication; and composite indicators of innovation and competitiveness. The present review draws on these approaches to provide an overview of the policies and practices that have been successful in different regions (East-Asia and Latin America) ; contexts (import substitution and liberalization) ; sectors (pulp and paper, IT services, electronics and passenger cars); and firms (Embrear and Lenovo). While it is clear that there is strong complementarity between domestic technological capability and the ability to absorb foreign technology, there is no simple policy recipe which is appropriate for all times, industries or places. Technological learning builds on and is shaped by what is already known. It requires time, space and resources all of which are influenced by the wider domestic and international context. The current international context is challenging but countries and firms have to find ways of moving forward despite the limited strategy space.

Phylogeographical analyses of shellfish viruses: inferring a geographical origin for ostreid herpesviruses OsHV-1 (Malacoherpesviridae)

Mortality episodes have regularly been affecting the shellfish industry throughout its history. Some of these mortalities, especially in the oyster industry, have been attributed to herpesviruses. Purification of viral particles and molecular characterization have led to the development of routine monitoring, as well as improved taxonomic classification. Ostreid herpesviruses (Malacoherpesviridae), mostly affecting Pacific oysters Crassostrea gigas, have been sporadically recorded in the French oyster industry since the early 1990s (OsHV-1 'reference'). From 2008, a new variant of ostreid herpesvirus (OsHV-1 mu Var) has emerged and seriously impacted oyster production in France and other European countries. Consequently, the presence of ostreid herpesviruses has been monitored in different oyster producing areas around the world. The present study compiles molecular data that are available from survey efforts and takes a biogeographical approach, in order to infer an origin for ostreid herpesviruses. The highest genotype diversity was found in East Asia, despite a lower survey effort in that area than in Europe. Genotype network analyses show that both populations of ostreid herpesviruses present in Europe (OsHV-1 'reference' and OsHV-1 mu Var) are closely related to genotypes recorded in Asia. Moreover, ostreid herpesviruses have been detected in wild and symptom-free populations of various Asian native Crassostrea species. In the rest of the world, ostreid herpesvirus genotypes were recorded from cultivated C. gigas, and mostly associated with mortality episodes. Results of this study are therefore highly suggestive of an Asian origin for these viruses, which can be pathogenic under farming conditions. It also highlights the risks of European stock improvements, by means of overseas shellfish imports.

European urban spaces in crisis - the mapping of affective pracitices with Living with Difference: introduction

The introduction outlines the notion of urban space and crisis in Europe while taking into account the more recent protests and riots in different cities, in and beyond Europe. It is argued that the phenomen of protest is happening alongside the economic crisis underscoring an alternative political public civic spirit expressing to a certain degree the renaissance and timely making of, what might be called in the digital age, #œuvre. Its forces and emotional properties capture a political realm that unfolds as a globalized urban transnational public space, still progressing. Further, it introduces the collection of papers for the special themed feature. Five papers look at affective practices through a Continental European lens, which places the meaning of race, migration and intersecting identity angles at the centre of debates of individual encounters in public spaces. The final and sixth paper, written by Brenda Yeoh, looks through a Singapore/East Asia lens, and comments on the common European threats as well as on the historical specificity and implications of distinctive geo-political spaces for affective practices.

Practical Application of Glaucoma Care in Different Societies

Diagnosis of glaucoma and delivery of effective treatment is difficult everywhere, but additional challenges are evident in less affluent parts of the world, where the largest numbers of patients with this disease are living. The problems of providing good glaucoma care are examined with especial reference to south-east Asia including China and India and countries in sub-Saharan Africa. The relatively low priority given to glaucoma by vision-related and other nongovernmental organizations (NGOs) due to difficulties faced in delivering effective glaucoma screening and therapeutic interventions are discussed, together with possible future directions for increasing resources and priority for glaucoma care in poor areas.

Evidence for an "epidemic" of myopia.

INTRODUCTION:

It has been widely suggested that the prevalence of myopia is growing worldwide, and that the increases observed in East Asia, in particular, are sufficiently severe as to warrant the term "epidemic". Data in favour of a cohort effect in myopia prevalence are reviewed, with attention to significant shortcomings in the quality of available evidence. Additional factors contributing to myopia prevalence, including near work, genetics and socioeconomic status, are detailed.

MATERIALS AND METHODS:

Medline search of articles regarding myopia prevalence, trends and mechanisms.

RESULTS:

Age-related changes in myopia prevalence (increase during childhood, and regression in the fifth and sixth decades) are discussed as an alternative explanation for cross-sectional patterns in myopia prevalence. There have only been a handful of studies that have examined the relative contribution of longitudinal changes in refraction over life and birth cohort differences on age-specific myopia prevalence as measured in cross-sectional studies. Available data suggest that both longitudinal changes and cohort effects may be present, and that their relative contribution may differ in different racial groups.

CONCLUSIONS:

In view of the relatively weak evidence in favour of a large cohort effect for myopia in East Asia, and the even greater lack of evidence for increased prevalence of secondary ocular pathology, there appears to be inadequate support for large-scale interventions to prevent or delay myopia at the present time.

Pupil constriction can alter the accuracy of dark room provocative test.

BACKGROUND: Primary angle-closure glaucoma (PACG) is a major cause of visual morbidity in East Asia. Dark-room provocative test (DRPT) has been used to determine which narrow angles have the risk to develop angle closure. However, the accuracy of DRPT might be altered because that after emerging from the dark room, the configuration of the angle is affected by the light of the slit-lamp and the appositionally closed angle reopens. The aim of this study was to examine the pupillary diameter in different light conditions and use it as a parameter to assess the accuracy of dark-room provocative test. METHODS: Patients with suspected primary angle-closure glaucoma undergoing DRPT were recruited. The anterior chamber angle was examined by anterior segment optical coherence tomography under the following conditions: (1) in standard room illumination; (2) after short-term dark-adaptation and (3) after DRPT. Mean values of pupil size and numbers of appositionally closed angle under different conditions were compared. RESULTS: A total of 47 eyes of 47 patients were analyzed. The pupil size after DRPT was smaller than that after short-term dark-adaptation (P < 0.001) and smaller than that in standard room illumination (P = 0.026). The numbers of appositionally closed angles after short-term dark-adaptation were significantly larger than those after DRPT (P < 0.001). There was no significant difference between the numbers of appositionally closed angles in standard room illumination and after DRPT (P = 0.157). CONCLUSIONS: Constriction of pupil size immediately after prolonged dark room provocative test may lead to change in the angle configuration, which may lead to false negative results. We suggest a modified protocol of recording intraocular pressure immediately after DRPT and performing gonioscopy following short-term dark adaptation to improve the accuracy of angle closure assessment.

Pine wilt disease: global issues, trade and economic impact

Pine wilt disease (PWD) is perhaps the most serious threat to pine forests worldwide. Since it´s discovery in the early XXth century by Japanese forest researchers, and the relationship with its causative agent, the pinewood nematode (PWN) Bursaphelenchus xylophilus, in the 1970s, PWD has wreaked havoc wherever it appears. Firstly in the Far East (Japan, China and Korea) and now, more recently in 1999, in the EU (Portugal). The forest sector in Portugal plays a major role in the Portuguese economy with a 12% contribution to the industrial gross domestic product, 3.2% of the gross domestic product, 10% of foreign trade and 5% of national employment. Maritime pine (Pinus pinaster) is one of the most important pine productions, and industrial activity, such as the production of wood and resin, as well as coastal protection associated with sand dunes. Also, stone pine (Pinus pinea) plays an important role in the economy with a share derived from the exports of high-quality pineon seed. Thus, the tremendous economical and ecological impact of the introduction of a pest and pathogen such as the PWN, although as far as is known, the only species susceptible to the nematode is maritime pine. Immediately following detection, the research team involved (Univ. Évora, INIAP) informed the national plant quarantine and forest authorities, which relayed the information to Brussels and the appropriate EU authorities. A task force (GANP), followed by a national program (PROLUNP) was established. Since then, national surveys have been taking place, involving MADRP (Ministry of Agriculture), the University of Évora and several private corporations (e.g. UNAC). Forest growers in the area are particularly interested and involved since the area owned by the growers organizations totals 700 000 ha, largely affected by PWD. Detection of the disease has led to serious consequences and restrictions regarding exploration and commercialization of wood. A precautionary phytosanitary strip, 3 km-wide, has been recently (2007) established surrounding the affected area. The Portuguese government, through its national program PROLUNP, has been deeply involved since 1999, and in conjunction with the EU (Permanent Phytosanitary Committee, and FVO) and committed to controlling this nematode and the potential spread to the rest of the country and to the rest of the EU. The global impact of the presence of Bursaphelenchus xylophilus or the threat of its introduction and the resulting pine wilt disease in forested areas in different parts of the world is of increasing concern economically. The concern is exacerbated by the prevailing debate on climate change and the putative impact this could have on the vulnerability of the world’s pine forests to this disease. The scientific and regulatory approach taken in different jurisdictions to the threat of pine wilt disease varies from country to country depending on the perceived vulnerability of their pine forests to the disease and/or to the economic cost due to lost trade in wood products. Much of the research surrounding pine wilt disease has been located in the northern hemisphere, especially in southern Europe and in the warmer, coastal, Asian countries. However, there is an increased focus on this problem also in those countries in the southern hemisphere where plantations of susceptible pine have been established over the years. The forestry sector in Australia and New Zealand are on “high alert” for this disease and are practicing strict quarantine procedures at all ports of entry for wood products. As well, there is heightened awareness, as there is worldwide, for the need to monitor wood packaging materials for all imported goods. In carrying out the necessary monitoring and assessment of products for B. xylophilus and its vectors substantial costs are incurred especially when decisions have to be made rapidly and regardless of whether the outcome is positive or negative. Australia’s response recently to the appearance of some dying pines in a plantation illustrated the high sensitivity of some countries to this disease. Some $200,000 was spent on the assessment in order to save a potential loss of millions of dollars to the disease. This rapid, co-ordinated response to the report was for naught, because once identified it was found not to be B. xylophilus. This illustrates the particular importance of taking the responsibility at all levels of management to secure the site and the need of a rapid, reliable diagnostic method for small nematode samples for use in the field. Australia is particularly concerned about the vulnerability of its 1million hectares of planted forests, 80% of which are Pinus species, to attack from incursions of one or more species of the insect vector. Monochamus alternatus incursions in wood pallets have been reported from Brisbane, Queensland. The climate of this part of Australia is such that the Pinus plantations are particularly vulnerable to the potential outcome of such incursions, and the state of Queensland is developing a risk management strategy and a proactive breeding programme in response to this putative threat. New Zealand has 1.6 million hectares of planted forests and 89% of the commercial forest is Pinus radiata. Although the climate where these forests are located tends to be somewhat cooler than that in Australia the potential for establishment and development of the disease in that country is believed to be high. The passage alone of 200,000 m³/year of wood packaging through New Zealand ports is itself sufficient to require response. The potential incursion of insect vectors of pinewood nematode through the port system is regarded as high and is monitored carefully. The enormous expansion of global trade and the continued use of unprocessed/inadequately-processed wood for packaging purposes is a challenge for all trading nations as such wood packaging material often harbours disease or pest species. The extent of this problem is readily illustrated by the expanding economies and exports of countries in south-east Asia. China. Japan and Korea have significant areas of forestland infested with B. xylophilus. These countries too are among the largest exporting countries of manufactured goods. Despite the attempts of authorities to ensure that only properly treated wood is used in the crating and packaging of goods B. xylophilus and/or its insect vector infested materials is being recorded at ports worldwide. This reminds us, therefore, of the ease with which this nematode pest can gain access to forest lands in new geographic locations through inappropriate use, treatment or monitoring of wood products. It especially highlights the necessity to find an alternative to using low-grade lumber for packaging purposes. Lest we should believe that all wood products are always carriers of B. xylophilus and its vectors, it should be remembered that international trade of all kinds has occurred for thousands of years and that lumber-born pests and diseases do not have worldwide distribution. Other physico-biological factors have a significant role in the occurrence, establishment and sustainability of a disease. The question is often raised as to why the whole of southern Europe doesn’t already have B. xylophilus and pine wilt disease. European countries have traded with countries that are infested with B. xylophilus for hundreds of years. Turkey is an example of a country that appears to be highly vulnerable to pine wilt disease due to its extensive forests in the warm, southern region where the vector, Monochamus galloprovincialis, occurs. However, there is no record of the presence of B. xylophilus occurring there despite the importation of substantial quantities of wood from several countries In many respects, Portugal illustrates both the challenge and the dilemma. In recent times B. xylophilus was discovered there in the warm coastal region. The research, administrative and quarantine authorities responded rapidly and B. xylophilus appears to have been confined to the region in which it was found. The rapid response would seem to have “saved the day” for Portugal. Nevertheless, it raises again the long-standing questions, how long had B. xylophilus been in Portugal before it was found? If Lisbon was the port of entry, which seems very likely, why had B. xylophilus not entered Lisbon many years earlier and established populations and the pine wilt disease? Will the infestation in Portugal be sustainable and will it spread or will it die out within a few years? We still do not have sufficient understanding of the biology of this pest to know the answers to these questions.

Assessment of the genetic diversity of the pinewood nematode, Bursaphelenchus xylophilus, in Portugal

O nemátode da madeira do pinheiro (NMP), Bursaphelenchus xylophiius, tem uma extensa distribuição na América do Norte, e encontra-se atualmente distribuído ao longo da maioria dos territórios de Canadá e dos Estados Unidos. Durante o último século, esta espécie foi transportada pelo Homem para outras regiões do mundo (não-nativas), associadas com o comércio e o fluxo global de produtos de origem florestal. Atualmente, esta espécie invasiva está reportada para algumas regiões do SE asiático (China, Japão, Coreia e Taiwan) e mais recentemente para a Europa (Portugal). Devido ao impacto que este organismo agente da doença da murchidão dos pinheiros causa nas florestas nativas destas regiões esta espécie assume uma elevada importância económica a nível mundial Em Portugal, a distribuição do NMP encontra-se confinada a uma área restrita e limitada (500 000 ha), a sul de Lisboa (península de Setúbal); contudo, constitui uma das maiores ameaças às florestas de pinheiro do país e da UE. Ate recentemente, nenhum consenso existia quanto à origem do NMP em Portugal. Diversas hipóteses têm sido colocadas para explicar esta introdução, nomeadamente a partir de zonas onde o nematode ocorre naturalmente (América do Norte), ou de outras áreas (não-nativas) onde o nematode se comporta como uma espécie invasiva (Leste da Ásia). A fim de avaliar a variabilidade genética do NMP proveniente da área afetada em Portugal, foram utilizadas várias técnicas moleculares, designadamente o random amplified polymorphic DNA (RAPD-PCR) e o satellite DNA (satDNA). No caso do RAPD-PCR, foram utilizados 24 isolados do NMP provenientes de Portugal, 1 proveniente da América do Norte e 1 da Ásia, tendo sido utilizado como out-group um isolado de B. mucronatus. A partir dos 28 RAPD primers utilizados obtiveram-se 640 fragmentos. No caso do satDNA, foram utilizados 21 isolados do NMP provenientes de Portugal, obtendo-se no total 206 sequências da família MspI. Ambos os métodos revelaram uma elevada similaridade genética entre os vários isolados do NMP da área afetada em Portugal O nível reduzido de diversidade genética obtido entre os isolados portugueses do NMP, permite concluir que se trata de uma única introdução deste organismo em Portugal, e proveniente de uma região asiática. A inexistência de uma de correlação entre a variabilidade genética e a distribuição geográfica do NMP dentro da área afetada em Portugal, indica que o NMP se encontra distribuído de forma uniforme ao longo de toda a área afetada, provavelmente relacionado com a distribuição e a expansão natural do inseto vector. The pinewood nematode (PWN), Bursaphelenchus xylophilus, has a wide distribution in North America, and is present throughout most of the territories of Canada and the United Stata. During the last century, this species has been transported by man to several non-native regions of the world, associated with trade and the global flow of forest products. Up to date, this invasive species has been reported from Asia (PR China, Japan, Korea and Taiwan) and more recently in Europe (Portugal). Due to the impact on native pine forests of these regions, this nematode species, the causal agent of pine wilt disease, is of great economic importance worldwide. In Portugal, the distribution of the PWN has been constrained to a relatively small area (500 000 ha) in the south of Lisbon (Setúbal Peninsula); however, it has become the most serious threat to pine forests in the country. Until recently, no consensus had emerged on the possible pathway of the PWN introduction in Portugal. Several hypotheses have been put forward to explain this introduction, such as an origin from endemic areas where the nematode naturally occurs (North America), or non-endemic areas where the nematode behaves as an exotic pest (East Asia). Random amplified polymorphic DNA (RAPD-PCR) and satellite DNA (satDNA) techniques were used in order to assess the level of genetic variability and genetic relationships, among several isolates of the PWN, representative of the entire affected area in Portugal. In the case of RAPD-PCR, 24 Portuguese isolates, plus two additional isolates of B. xylophilus, representing North America and East Asia were included. B. mucronatus was used as an out-group. Twenty-eight random primers generated a total of 640 DNA fragments. With satDNA, 206 Mspl sequence repeats were obtained from 21 Portuguese isolates of B. xylophilus. Both molecular methods revealed a high genetic similarity among the Portuguese isolates, and the low level of genetic diversity strongly suggests that they were dispersed recently from a single introduction, and from East Asia. The lack of apparent relationship between the genetic variability and the geographic distribution of the PWN within the affected area, suggests that the recent introduction of this pest (and pathogen) in Portugal has been uniformly distributed since its establishment, probably following the natural distribution and expansion of the insect vector.