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Approximately 197 species comprise the widespread syrphid tribe, the Cerioidini (Diptera: Syrphidae), but rearing data are known for <5% of species. We obtained puparia of 10 species from fieldwork in Costa Rica. Cuba, and México and from material loaned to us from Australia, Brazil, Costa Rica, and the United States. These species are included in four of the five genera recognized in the tribe: two species of Ceriana Rafinesque, 1815; three species of Monoceromyia Shannon, 1925; four of Polybiomyia Shannon, 1925; and one species of Sphiximorpha Rondani, 1850. We describe and compare these puparia. They all possessed the diagnostic characters for the tribe. However, no early stage characters were correlated, hence early stages did not form groups based on shared characters. Some structures were relatively constant in form such its head skeletons and locomotory organs, but characters that showed plasticity included integumental vestiture and respiratory, organs. A few features such as the unusually broader than long posterior respiratory process of Ceriana ornotta Saunders, 1845, the spicules on the dorsum of the prothorax of Sphiximorpha barbipes (Loew, 1853), and the mesothoracic hooks of Monoceromyia tricolor (Loew, 1861) were unique to these species. Most cerioidine larvae were reared from tree sap but others crone from tree holes, the liquid center of a cut agave (Agavaceae) and bee nests (Hymenoptera, Apidae). Field observations of larvae and their breeding site suggested functional explanations for some morphological features. [ABSTRACT FROM AUTHOR]

Background. We set out to examine which treatment option available in the United States was most cost-effective in treating children with endemic group A streptococcal pharyngitis to prevent rheumatic heart disease.Methods. Cost-effectiveness was calculated from the societal perspective and expressed in cases of rheumatic heart disease prevented annually in the U.S. pediatric population aged 5 to 17 based on U.S. Census data. We used a decision-analysis model to assess the cost-effectiveness of five treatment options for patients with pharyngitis: (1) “treat all,” (2) “treat none,” (3) “rapid test,” where only patients with a positive rapid antigen test are treated, (4) “culture,” where only patients with a positive throat culture are treated, and (5) “rapid test with culture” or (RTCX), where confirmatory cultures are used on patients with negative rapid tests. Cost data were gathered from existing empirical data or estimated. We performed sensitivity analyses of the antigen test sensitivity and antibiotic effectiveness and examined whether changes in these variables would alter our outcome.Results. The “rapid test” was the most cost-effective option. Using “rapid tests” prevented 85 cases of rheumatic heart disease annually and cost society $727,000 per case prevented. Performing throat cultures instead of “rapid tests” would pick up an additional 11 cases of rheumatic heart disease but would cost $13.7 million for each of these additional cases prevented. The current standard of using throat cultures as a confirmatory test on patients with a negative “rapid” test would detect an additional 21 cases of rheumatic heart disease but cost society an additional $8 million per case prevented.Conclusions. To reduce the incidence of rheumatic heart disease cost-effectively, the management of pediatric pharyngitis may best be accomplished by using antigen testing. The added costs associated with the remaining treatment options may not be justified, especially, as the sensitivity of the antigen tests continues to improve and closely approaches the sensitivity of the practice standard, throat culture. [Copyright &y& Elsevier]