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The article focuses on the change in the use of telehealth in U.S. emergency departments (EDs) from 2016 to 2020, highlighting the variations in its adoption for different medical indications. It demonstrates how telehealth use increased significantly during the COVID-19 pandemic, particularly for psychiatry, pediatrics, and stroke/neurology, and explores the role of telehealth in enhancing access to specialty care, especially during times of healthcare strain.

To achieve health equity, there is a need to act on the social determinants of health. This reality is now understood more widely, and in greater detail, than ever. Amid this movement toward health equity, there has been a natural gravitation to community organizing, which has long worked to produce more equitable systems and policies. Community organizing builds power through cycles of listening, participatory research, collective action, and reflection. One manifestation of this power is that organizing initiatives can often influence which issues are up for public debate, and the terms of those debates. This dimension of community power is often described by practitioners as narrative change work, and involves intervening on, complicating, and resisting dominant societal narratives that hinder action on the systems that perpetuate inequity. This article reports results from a study of organizing initiatives in Detroit, MI and Cincinnati, OH which both engaged in intentional narrative change work around health and health equity. We analyzed data from interviews with 35 key leaders across both cities. Results describe the organizational processes and activities taking place in both sites, with an emphasis on one issue in each city: educational equity in Cincinnati and water equity in Detroit. We then use coded interview data to examine how narrative change work took place in organizing around these issues during the COVID‐19 pandemic, a challenging time for organizing initiatives. Results provide insights into adaptations taking place in community organizing during this time, as well as various approaches to narrative change work as part of holistic efforts to build and exercise community power to alter social determinants of health. Highlights: Prevailing public narratives often hinder action to change inequitable systems.Community organizing builds power that can be used to change public narratives.Narrative change work is deeply connected with other dimensions of power.Top‐down and programmatic approaches to narrative change may not be effective.Results illustrate the complementarity of community organizing and public health. [ABSTRACT FROM AUTHOR]

On grassland and savanna restoration sites, planted native C4 grasses can competitively exclude other co‐introduced plant functional groups, with negative implications for ecosystem functioning and restoration success. Previous studies have suggested that C4 grass competitive exclusion does not occur in longleaf pine savannas of the North American Coastal Plain; however these studies were primarily conducted on old growth xeric sites. We designed an experiment to test competitive interactions between C4 grasses and forbs introduced by seed to mesic savanna restoration sites. Research installations were established on three former bahiagrass (Paspalum notatum) pastures in Florida, within which six different seed treatments were applied: (1) C4 grasses and forbs together in years 1 and 2, (2) C4 grasses alone in year 1 and forbs alone in year 2, (3) forbs alone in year 1 and C4 grasses alone in year 2, (4) C4 grasses alone in both years, (5) forbs alone in both years, and (6) an unplanted control. All plots were sampled 1 year after the second seeding event. We found that C4 grasses competitively excluded forbs, reducing cover of forbs arriving on the site at the same time, as well as those arriving in the second year. The highest forb species richness and cover was found in the three treatments that did not contain C4 grasses in year 1, and different C4 grass species exhibited different community associations. These findings suggest that restoration seed mixes for longleaf pine savannas should account for the competitive interactions of C4 grasses. [ABSTRACT FROM AUTHOR]

Interaction β‐diversity is a measure essential for understanding and conserving species interactions and ecosystem functioning. Interaction β‐diversity explains the variation in species interactions across spatial and temporal gradients, resulting from species turnover or interaction rewiring. Each component of interaction β‐diversity has different ecological implications and practical consequences. While interaction β‐diversity due to species turnover is related to assembly processes and fragmentation, rewiring can support high biodiversity and confer resilience to ecological networks. However, it is unclear whether both components respond to the same or different ecological drivers. Here, we assessed the ecological drivers of plant–pollinator interaction β‐diversity and its components across 24 sites in 9 longleaf pine (LLP) savannas in north and central Florida. We evaluated the effects of flowering plant composition and flower abundance, vegetation, fire regime, soil moisture, terrain characteristics, climate, spatial context and geographic location. We used path analysis to evaluate the drivers of spatial interaction β‐diversity and its main components. We then used generalized linear mixed models to assess the temporal patterns of spatial β‐diversity among sites within preserves. We found that plant–pollinator networks in LLP savannas are highly variable across space and time, mainly due to species turnover and possibly in response to abiotic gradients and dispersal boundaries. Flower abundance and flowering plant composition, geographic location, fire seasonality, soil moisture, and landscape context were the main drivers of plant–pollinator β‐diversity, highlighting the role of fire management and habitat connectivity in preserving plant–pollinator networks. [ABSTRACT FROM AUTHOR]

The etiology of bladder cancer among never smokers without occupational or environmental exposure to established urothelial carcinogens remains unclear. Urinary mutagenicity is an integrative measure that reflects recent exposure to genotoxic agents. Here, we investigated its potential association with bladder cancer in rural northern New England. We analyzed 156 bladder cancer cases and 247 cancer‐free controls from a large population‐based case–control study conducted in Maine, New Hampshire, and Vermont. Overnight urine samples were deconjugated enzymatically and the extracted organics were assessed for mutagenicity using the plate‐incorporation Ames assay with the Salmonella frameshift strain YG1041 + S9. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of bladder cancer in relation to having mutagenic versus nonmutagenic urine, adjusted for age, sex, and state, and stratified by smoking status (never, former, and current). We found evidence for an association between having mutagenic urine and increased bladder cancer risk among never smokers (OR = 3.8, 95% CI: 1.3–11.2) but not among former or current smokers. Risk could not be estimated among current smokers because nearly all cases and controls had mutagenic urine. Urinary mutagenicity among never‐smoking controls could not be explained by recent exposure to established occupational and environmental mutagenic bladder carcinogens evaluated in our study. Our findings suggest that among never smokers, urinary mutagenicity potentially reflects genotoxic exposure profiles relevant to bladder carcinogenesis. Future studies are needed to replicate our findings and identify compounds and their sources that influence bladder cancer risk. [ABSTRACT FROM AUTHOR]

Understanding the relationships between exposure and disease incidence is an important problem in environmental epidemiology. Typically, a large number of these exposures are measured, and it is found either that a few exposures transmit risk or that each exposure transmits a small amount of risk, but, taken together, these may pose a substantial disease risk. Further, these exposure effects can be nonlinear. We develop a latent functional approach, which assumes that the individual effect of each exposure can be characterized as one of a series of unobserved functions, where the number of latent functions is less than or equal to the number of exposures. We propose Bayesian methodology to fit models with a large number of exposures and show that existing Bayesian group LASSO approaches are a special case of the proposed model. An efficient Markov chain Monte Carlo sampling algorithm is developed for carrying out Bayesian inference. The deviance information criterion is used to choose an appropriate number of nonlinear latent functions. We demonstrate the good properties of the approach using simulation studies. Further, we show that complex exposure relationships can be represented with only a few latent functional curves. The proposed methodology is illustrated with an analysis of the effect of cumulative pesticide exposure on cancer risk in a large cohort of farmers. [ABSTRACT FROM AUTHOR]

Background/Objective: Farmers conduct numerous tasks with potential for endotoxin exposure. As a first step to characterize endotoxin exposure for farmers in the Biomarkers of Exposure and Effect in Agriculture (BEEA) Study, we used published data to estimate task‐specific endotoxin concentrations. Methods: We extracted published data on task‐specific, personal, inhalable endotoxin concentrations for agricultural tasks queried in the study questionnaire. The data, usually abstracted as summary measures, were evaluated using meta‐regression models that weighted each geometric mean (GM, natural‐log transformed) by the inverse of its within‐study variance to obtain task‐specific predicted GMs. Results: We extracted 90 endotoxin summary statistics from 26 studies for 9 animal‐related tasks, 30 summary statistics from 6 studies for 3 crop‐related tasks, and 10 summary statistics from 5 studies for 4 stored grain‐related tasks. Work in poultry and swine confinement facilities, grinding feed, veterinarian services, and cleaning grain bins had predicted GMs > 1000 EU/m3. In contrast, harvesting or hauling grain and other crop‐related tasks had predicted GMs below 100 EU/m3. Significance: These task‐specific endotoxin GMs demonstrated exposure variability across common agricultural tasks. These estimates will be used in conjunction with questionnaire responses on task duration to quantitatively estimate endotoxin exposure for study participants, described in a companion paper. [ABSTRACT FROM AUTHOR]

Background: We developed an algorithm to quantitatively estimate endotoxin exposure for farmers in the Biomarkers of Exposure and Effect in Agriculture (BEEA) Study. Methods: The algorithm combined task intensity estimates derived from published data with questionnaire responses on activity duration to estimate task‐specific cumulative endotoxin exposures for 13 tasks during four time windows, ranging from "past 12 months" to "yesterday/today." We applied the algorithm to 1681 participants in Iowa and North Carolina. We examined correlations in endotoxin metrics within‐ and between‐task. We also compared these metrics to prior day full‐shift inhalable endotoxin concentrations from 32 farmers. Results: The highest median task‐specific cumulative exposures were observed for swine confinement, poultry confinement, and grind feed. Inter‐quartile ranges showed substantial between‐subject variability for most tasks. Time window‐specific metrics of the same task were moderately‐highly correlated. Between‐task correlation was variable, with moderately‐high correlations observed for similar tasks (e.g., between animal‐related tasks). Prior day endotoxin concentration increased with the total metric and with task metrics for swine confinement, clean other animal facilities, and clean grain bins. Significance: This study provides insight into the variability and sources of endotoxin exposure among farmers in the BEEA study and summarizes exposure estimates for future investigations in this population. [ABSTRACT FROM AUTHOR]

Onset of U/AE was more often immediate with Pfizer-BioNTech compared to Moderna (41% vs 21%; I p i = .08), and U/AE was more often delayed with Moderna compared to Pfizer-BioNTech (69% vs 26%; I p i < .001). Resolution times were diverse, but Moderna U/AE more commonly lasted >1 week than Pfizer-BioNTech U/AE (31% vs 6%; I p i = 0.014). Case 2) A white, Hispanic female patient receiving her first Pfizer-BioNTech vaccine developed urticaria, angioedema, and headache starting 4-24 h after vaccination. [Extracted from the article]

Summary: Background: Although survival rates have been reported after small intestinal surgery for strangulating diseases in horses, none have followed survival for periods relevant to the long lifespan of horses and none have described effect of age, disease and surgical treatments over such long survival periods. Objectives: To examine effects of age, disease and type of surgery on long‐term survival in horses after surgical treatment of small intestinal strangulating diseases over periods relevant to the expected lifespan of a horse. Study Design: Retrospective clinical study. Methods: Post‐operative data were gathered from medical records and owner contact for 89 horses with small intestinal strangulation. Survival times from surgery to the date of death or the date of last follow‐up were analysed by Kaplan‐Meier statistics. Variables of interest were age, type of strangulating disease and surgical correction. Cox proportional hazards regression was used to evaluate these variables. Results: Short‐term survival was not affected by any of the variables measured. For long‐term survival with Kaplan‐Meier statistics, horses ≥16 years old had significantly shorter (P =.002) median survival times (72 months; 95% CI 32.0‐96.0) than younger horses (121.7 months; 95% CI 90.0‐162), horses without resection had significantly longer (P =.02) survival times (120 months; 95% CI 86‐212) than horses that had jejunocecostomy (76.8 months; 95% CI 24‐125), and horses with miscellaneous diseases had significantly longer (P =.02) median survival times (161.9 months; 95% CI 72.0‐M) than horses with strangulating lipoma (79.8 months; 95% CI 32.0‐120.0). In the multivariable Cox Proportional Hazard model, age (HR = 2.67; 1.49‐4.75, P <.001) and anastomosis (HR = 0.65; 0.46‐0.92, P =.02) had the most significant effect on median survival time. Main Limitations: Limitations were small numbers in some categories, loss of cases to follow‐up, owner recall failures and lack of a control group. Conclusions: The remaining lifespan of older horses at the time of surgery had the greatest effect on survival. Age could influence long‐term survival studies after colic surgery, and therefore needs to be considered for survival analyses. Horses that did not require resection and anastomosis had favourable outcomes, underscoring the potential importance of early intervention to reduce the need for resection. [ABSTRACT FROM AUTHOR]

Hair and nail reactions represent a small proportion of all COVID-19 dermatologic reactions in an analysis of an international COVID-19 dermatological registry A total of 716 patients had dermatologic reactions to COVID-19, with 64 having hair/nail reactions. Pre-existing dermatologic conditions were uncommon, which was similar to patients experiencing other COVID-19 cutaneous manifestations in this registry.[2] Therefore, the development of skin, hair, or nail COVID-19-associated reactions is infrequent in patients with underlying dermatologic disease. [Extracted from the article]

Introduction: The experience of stigma can be multifaceted for people with HIV and cancer. Kaposi's sarcoma (KS), one of the most common HIV‐associated cancers in sub‐Saharan Africa, often presents with visible skin lesions that may put people at risk for stigmatization. In this way, HIV‐associated KS is unique, as people with KS can experience stigma associated with HIV, cancer, and skin disease simultaneously. The aim of this study is to characterize the intersectionality of HIV‐related, cancer‐related and skin disease‐related stigma in people living with HIV and KS. Methods: We used a convergent mixed‐methods approach nested within a longitudinal study of people with HIV‐associated KS in western Kenya. Between February 2019 and December 2020, we collected quantitative surveys among all participants and conducted semi‐structured interviews among a purposive sample of participants. Quantitative surveys were adapted from the abridged Berger HIV Stigma Scale to assess overall stigma, HIV‐related stigma, cancer‐related stigma, and skin disease‐related stigma. Qualitative data were coded using stigma constructs from the Health Stigma and Discrimination Framework. Results: In 88 semi‐structured interviews, stigma was a major barrier to KS diagnosis and treatment among people with HIV‐associated KS. Participant's stories of stigma were dominated by HIV‐related stigma, more than cancer‐related or skin disease‐related stigma. However, quantitative stigma scores among the 117 participants were similar for HIV‐related (Median: 28.00; IQR: 28.0, 34.0), cancer‐related (Median: 28.0; IQR: 28.0, 34.8), and skin disease‐related stigma (Median: 28.0; IQR: 27.0, 34.0). In semi‐structured interviews, cancer‐related and skin disease‐related stigma were more subtle contributors; cancer‐related stigma was linked to fatalism and skin‐related stigma was linked to visible disease. Participants reported resolution of skin lesions contributed to lessening stigma over time; there was a significant decline in quantitative scores of overall stigma in time since KS diagnosis (adjusted β = –0.15, p <0.001). Conclusions: This study highlights the role mixed‐method approaches can play in better understanding stigma in people living with both HIV and cancer. While HIV‐related stigma may dominate perceptions of stigma among people with KS in Kenya, intersectional experiences of stigma may be subtle, and quantitative evaluation alone may be insufficient to understand intersectional stigma in certain contexts. [ABSTRACT FROM AUTHOR]

Background: Dream‐enacting behavior is a characteristic feature of rapid eye movement sleep behavior disorder, the most specific prodromal marker of synucleinopathies. Pesticide exposure may be associated with dream‐enacting behaviors, but epidemiological evidence is limited. Objectives: To examine high pesticide exposure events in relation to dream‐enacting behaviors among farmers in the Agricultural Health Study. Methods: We conducted multivariable logistic regression analyses to examine high pesticide exposure events reported from 1993 to 1997 in relation to dream‐enacting behaviors assessed from 2013 to 2015 among 11,248 farmers (age 47 ± 11 years). Results: A history of dream‐enacting behaviors was reported by 939 (8.3%) farmers. Compared with farmers who did not report any high pesticide exposure event, those who reported were more likely to endorse dream‐enacting behaviors 2 decades later (odds ratio = 1.75; 95% confidence interval [CI], 1.49–2.05). The association appeared stronger when there was a long delay in washing with soap and water after the event (2.63 [95% CI, 1.62–4.27] for waiting >6 hours vs. 1.71 [95% CI, 1.36–2.15] for washing within 30 minutes) and when the exposure involved the respiratory or digestive tract (2.04 [95% CI, 1.62–2.57] vs. 1.58 [95% CI, 1.29–1.93] for dermal contact only). In the analyses of specific pesticides involved, we found positive associations with two organochlorine insecticides (dichlorodiphenyltrichloroethane and lindane), four organophosphate insecticides (phorate, ethoprop, terbufos, and parathion), two herbicides (alachlor and paraquat), and fungicides as a group. Conclusions: This study provides the first epidemiological evidence that high pesticide exposures may be associated with a higher risk of dream‐enacting behaviors. © 2022 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Summary: The current hypothesis proposed for strangulation of small intestine by a pedunculated lipoma in horses involves movement of the lipoma around the small intestine until it loops through its own pedicle. This mechanism is difficult to demonstrate during surgical correction. The objective was to examine an alternative explanation for strangulation by pedunculated lipomas that is logical and consistent with intraoperative findings by the analysis of the anatomical features of 11 cases of lipoma strangulation in horses. In the proposed hypothesis, the stalk of the lipoma is tensed by the weight of the lipoma alone or by external forces on it from adjacent intestine. This produces a slit‐like aperture formed by the stalk and the contiguous mesentery. One or more loops of intestine pass across the lateral edge of the stalk before turning into this aperture, either because of lack of space in the abdominal cavity or through the effects of peristalsis. The weight of the intestine itself causes the loop to 'fall' into the aperture and become entrapped. This creates a half‐hitch knot in which the loop of intestine uses the lipoma pedicle as a 'post' around which it becomes strangulated. It was concluded that the proposed hypothesis differs from the existing one by requiring intestinal movement to create the strangulation, which is more plausible than the current proposal that the strangulation is caused by movement of the lipoma itself. It is also more consistent with surgical findings. [ABSTRACT FROM AUTHOR]

Domestic cats Felis catus have a complex and contentious history. They fill multiple societal roles (e.g. as pest controllers and companion animals), which has led to a variety of animal welfare, conservation, and human health concerns. Popular press articles play an important role in how people learn about key issues surrounding cats, but they may present some issues more frequently than other issues.We conducted a global media content analysis of 796 articles in the English‐language media from 1990 to 2018 on issues related to free‐roaming cats, such as their environmental impacts, the threats and welfare issues cats face, and how they are managed. We aimed to determine whether non‐experts learning about the issues around free‐roaming cats exclusively from the popular press would be exposed to multiple stakeholder views or opinions.Over 95% of articles analysed were from North America. Most of the people interviewed in the popular press were from non‐governmental organizations, mainly from cat welfare or cat rights groups (which are often focused on only one side of the issue). Researchers, shelter organizations, veterinarians, and groups that have different opinions than cat rights or welfare organizations on how to resolve issues surrounding free‐roaming cats were rarely interviewed by the popular press. Most articles focused on cat welfare issues and the management strategies of euthanasia or trap–neuter–release (TNR), whereas less than one‐third of the articles acknowledged that cats have any impact on wildlife or the broader environment.We found that the popular press often presented an oversimplified picture of issues related to free‐roaming cats and provided unbalanced coverage. We also show evidence of framing by the popular press, including mainly presenting the viewpoints and perspectives from animal welfare and rights groups, focusing on TNR or euthanasia as the only viable cat management strategies when many alternatives exist and often have greater support from experts, and discussing the impacts of cats on birds and small mammals but not reptiles or amphibians. A free Plain Language Summary can be found within the Supporting Information of this article. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Singer-Freeman and Robinson (2020a; 2020b) conducted a national survey that identified four compelling challenges assessment professionals deem important, solvable, and impactful. Some assessment professionals are working with faculty and college administrators to use real-time assessment information to guide immediate interventions using adaptive learning, just-in-time material, and campus-wide crisis intervention teams. Singer-Freeman, Robinson, and Bastone (2021) discuss ways that assessment professionals can take a more active role in encouraging equity by supporting the development of a culture of inquiry among faculty. [Extracted from the article]

The purpose of assessment in higher education is to improve student learning. " Implementing a student assessment scholars program: Students engaging in continuous improvement." Although students are not present in large enough numbers to control committee decisions, including students as committee members can influence institutional culture by providing a formal role for the student voice in the assessment process. [Extracted from the article]

Understanding how events throughout the annual cycle are linked is important for predicting variation in individual fitness, but whether and how carry‐over effects scale up to influence population dynamics is poorly understood. Using 38 years of demographic data from Algonquin Provincial Park, Ontario, and a full annual cycle integrated population model, we examined the influence of environmental conditions and density on the population growth rate of Canada jays (Perisoreus canadensis), a resident boreal passerine that relies on perishable cached food for over‐winter survival and late‐winter breeding. Our results demonstrate that fall environmental variables, most notably the number of freeze–thaw events, carried over to influence late‐winter fecundity, which, in turn, was the main vital rate driving population growth. These results are consistent with the hypothesis that warmer and more variable fall conditions accelerate the degradation of perishable stored food that is relied upon for successful reproduction. Future warming during the fall and winter may compromise the viability of cached food that requires consistent subzero temperatures for effective preservation, potentially exacerbating climate‐driven carry‐over effects that impact long‐term population dynamics. [ABSTRACT FROM AUTHOR]

Diet quality during development can impact growth, physiology, behaviour and survival. The Canada jay is a resident boreal passerine that caches a wide variety of perishable food items in late summer and autumn for its over‐winter survival and late‐winter reproduction. A previous experiment found evidence that food supplementation of Canada jay pairs during the nestling period had a positive effect on the condition of their nestlings. However, given that foods cached by adults vary widely in nutritional content, the composition of nestling diets could also have an important influence on offspring development. In a population of Canada jays in Algonquin Provincial Park, Ontario, Canada, we investigated the influence of environmental conditions before and during the breeding season on nestling diet composition and the consequences of nestling diet composition on the body condition of nestlings and on their subsequent survival. Using stable‐carbon (δ13C) and ‐nitrogen (δ15N) isotopes, we estimated the proportion of three food groups (vertebrates + human food, invertebrates and plants) in feathers from almost 200 nestlings. Nestling diet in March and April was influenced by environmental conditions 5–6 months prior to hatching, with warmer and more variable autumn temperatures associated with a greater proportion of vertebrate flesh and human food in the diet. However, the proportion of vertebrates and human food in the diet had no influence on nestling body condition or whether an individual was observed the following fall. Our results, in conjunction with previous work on Canada jays, suggest that the quantity of food available to a nestling during development may be more important than diet composition. [ABSTRACT FROM AUTHOR]

Although density regulates the abundance of most wild animal populations by influencing vital rates, such as fecundity and survival, the mechanisms responsible for generating negative density dependence are unclear for many species. Site dependence occurs when there is preferential filling of high‐quality territories, which results in higher per capita vital rates at low densities because a larger proportion of occupied territories are of high quality. Using 41 yr of territory occupancy and demographic data, we investigated whether site dependence was a mechanism acting to influence fecundity and, by extension, regulate a population of Canada Jays in Algonquin Provincial Park, Ontario, Canada. As predicted by site dependence, the proportion of occupied territories that were of high quality was negatively correlated with population density and periods of vacancy were shorter for high‐quality territories than for low‐quality territories. We also found evidence that per capita fecundity was positively related to the proportion of occupied territories that were of high quality, but only when environmental conditions, which influence the entire population, were otherwise poor for breeding. Our results suggest that site dependence likely plays a role in regulating this population but that environmental conditions can modulate the strength of density dependence. [ABSTRACT FROM AUTHOR]

Background: Measurements of water consumed by fed healthy horses might not apply to horses that are unwilling or unable to drink or are not fed for any reason. Objective: To examine the effects of feed deprivation on voluntary water consumption compared with fed conditions. Study design: In vivo experiment. Methods: Eight healthy adult Thoroughbred geldings were used in a randomised crossover design so that each horse served as its own control for fed vs feed‐deprived conditions. Water intake, bodyweight, physical findings and vital signs were measured during 4 days of feeding and 4 days of feed deprivation. Daily measurements during the trial periods were PCV, TPP, electrolytes, osmolality and triglycerides. Plasma and extracellular fluid volumes were measured in the last 8 hours of the trial periods. Data were analysed with a two‐way analysis of variance with repeated measures, and statistical significance was P ≤.05. Results: Feed deprivation immediately and persistently reduced water consumption to ~16% of fed values, with laboratory evidence of mild dehydration on day 4. Main limitations: Changes in total body water and in water and electrolyte excretion or conservation through faeces and urine were not measured. Conclusions: Feed consumption has a marked effect on water requirements in healthy horses. Because current guidelines for water needs were obtained in the fed state, they might not apply to horses that are denied feed for any reason or have reduced feed intake. This study provides new information on water consumption in horses that should apply to this essential nutrient in health and disease. [ABSTRACT FROM AUTHOR]

Insecticide use has been linked to increased risk of non‐Hodgkin lymphoma (NHL), however, findings of epidemiologic studies have been inconsistent, particularly for NHL subtypes. We analyzed 1690 NHL cases and 5131 controls in the North American Pooled Project (NAPP) to investigate self‐reported insecticide use and risk of NHL overall and by subtypes: follicular lymphoma (FL), diffuse large B‐cell lymphoma (DLBCL) and small lymphocytic lymphoma (SLL). Odds ratios (OR) and 95% confidence intervals for each insecticide were estimated using logistic regression. Subtype‐specific associations were evaluated using ASSET (Association analysis for SubSETs). Increased risks of multiple NHL subtypes were observed for lindane (OR = 1.60, 1.20‐2.10: FL, DLCBL, SLL), chlordane (OR = 1.59, 1.17‐2.16: FL, SLL) and DDT (OR = 1.36, 1.06‐1.73: DLBCL, SLL). Positive trends were observed, within the subsets with identified associations, for increasing categories of exposure duration for lindane (Ptrend = 1.7 × 10−4), chlordane (Ptrend = 1.0 × 10−3) and DDT (Ptrend = 4.2 × 10−3), however, the exposure‐response relationship was nonlinear. Ever use of pyrethrum was associated with an increased risk of FL (OR = 3.65, 1.45‐9.15), and the relationship with duration of use appeared monotonic (OR for >10 years: OR = 5.38, 1.75‐16.53; Ptrend = 3.6 × 10−3). Our analysis identified several novel associations between insecticide use and specific NHL subtypes, suggesting possible etiologic heterogeneity in the context of pesticide exposure. What's new? Insecticides are persistent environmental pollutants that have been linked to increased risk of non‐Hodgkin lymphoma (NHL). Although NHL encompasses a heterogeneous group of malignancies, few studies have examined subtype‐specific associations for insecticide exposure. Analyzing data from population‐based case‐control studies of lymphatic cancers, the authors of this study show that lindane, chlordane, and DDT are associated with increased risk of multiple NHL subtypes. Analyses further uncovered a novel link between increased follicular lymphoma risk and pyrethrum use. None of the insecticides investigated, however, were associated with all NHL subtypes, suggesting a role for etiologic heterogeneity in pesticide exposure and NHL risk. [ABSTRACT FROM AUTHOR]

Zeolites are porous aluminosilicate materials that find various applications in the chemical industry in separations, catalysis, ion exchange, and so forth. However, despite their widespread use, the reaction mechanisms occurring during zeolite growth are still unclear. Herein, we use density functional theory calculations to gain insights into the thermodynamics of oligomerization, which constitute the initial steps of zeolite growth. By taking into consideration solvent and temperature effects, our results demonstrate that the growth of aluminosilicate systems is significantly more exothermic than their pure silicate counterparts. Under pH neutral conditions, water prefers to dissociate on the early‐growth‐stage aluminosilicate complexes rather than desorb, thus generating potential Brønsted acid sites on the oligomers. Additionally, (alumino)silicate growth pathways are evaluated in the presence of Na+ cation, as well as the Ca2+ cation for the pure silicate pathway. The presence of cations increases the exothermicity of growth, with Ca2+ exhibiting the most energetically favorable growth environment for the silicate systems. Importantly, we demonstrate through reaction extent analysis that the presence of cations modulates the speciation of the formed oligomers, with Na+ favoring linear species in addition to the generally preferred cyclic ones. Overall, this work provides a fundamental understanding of the thermodynamics of complex reaction paths that occur during early stages of zeolite growth and suggests that the initial growth steps can have significant impact on the final zeolite structure. [ABSTRACT FROM AUTHOR]

Summary: An unusual form of strangulation of mesentery only by pedunculated lipoma was identified as the cause of moderate to severe colic in four horses. The small intestinal mesentery was involved in three horses and the small colon mesentery in the fourth horse, but the associated intestine was not strangulated, haemorrhagic, nor obviously obstructed in any horse. In all horses, a patch of haemorrhagic mesentery of variable size was evident around the origin of a mesenteric lipoma and a major mesenteric vessel. One horse was subjected to euthanasia at the owner's request and the remaining three had surgery from which they made a complete recovery after the removal of the lipoma. Intestinal resection was not performed in any of the three horses undergoing surgery. An isolated mesenteric strangulation by lipoma is an uncommon cause of colic in older horses that have the typical presentation of a strangulating lipoma. The removal of the involved lipoma without mesenteric or intestinal resection can be associated with complete recovery. [ABSTRACT FROM AUTHOR]

Understanding space‐use patterns by elk (Cervus canadensis) is essential to alleviating human‐elk conflicts, particularly when crop depredation by elk can make it harder to justify to the public the need to restore elk populations to regions with agricultural landscapes. In 2016–2017, we used global positioning system data from 20 female elk to investigate their selection for agricultural cover during the agricultural season (1 May–31 Oct) in northwestern Minnesota, USA. We estimated resource selection functions with resource availability defined at the home range scale. Elk space use was primarily determined by distance to forest cover in areas proximate to agricultural fields. During diurnal periods, elk selected areas with forest cover near agricultural fields planted with legumes and cereal. During nocturnal periods, elk selected for agricultural fields with little to no canopy and that were planted with legumes. We suggest that management of elk in northwestern Minnesota will require practices that discourage the use of agriculture by elk while improving natural habitats within areas managed for elk restoration. We suggest that forestry practices (i.e., thinning and burning) could improve cover and forage openings for elk in restoration areas. Furthermore, managers could work with agricultural producers where elk occur to plant crops favored by elk (i.e., legumes) outside known home ranges and plant fields within home ranges with crops that elk avoided (i.e., hay). Collectively, these practices may shift the ranges of elk herds into restoration areas and lower conflict between the public and elk restoration efforts. © 2020 The Wildlife Society. Female elk in our study responded positively to edge density and interspersion of natural and agricultural land cover, suggesting that cover heterogeneity is important for providing sufficient cover and food resources to elk throughout the year. Management of elk in northwestern Minnesota will require management practices that discourage the use of agricultural areas by elk that create conflict between the public and elk restoration efforts while improving elk habitat in other areas to meet the foraging needs of female elk and their calves so that most of their life requisites are achieved on restoration areas rather than adjacent agricultural lands. [ABSTRACT FROM AUTHOR]

The convergence of several trends has caused changes both in the nature of work and in workforce demographics. Two of the major factors are the widespread availability of advanced information technology and the aging of the American workforce. Today, the government, like most organizations public and private, is struggling to hire skilled workers in a tight labor market. As a result, recruiting strategies are becoming more important. The World Wide Web is dramatically changing the way both federal and nonfederal employers recruit. Projections are that an overwhelming majority of medium and large companies in the U.S. will use Web-based recruiting by 2002. Emerging assessment technologies, such as computer-and Internet-based testing and computer simulations, can be incorporated into the assessment process. These technologies create new opportunities for more efficient and effective ways to administer tests to a wide audience as well as to assess competencies in new ways. In the future, organizations will be competing for extremely scarce human resources. In order to remain competitive, they must find ways to leverage their human capital just as they leverage other capital investments.

Summary: In an 18‐year‐old Paso Fino mare presented with mild colic of 36 h duration, a luminal obstruction was found on rectal palpation in the most oral part of the rectum, and this appeared to be caused by a tight band on the left side. A standing procedure was used that involved pararectal dissection with long‐handled instruments to the level of the constricting band, guided by a hand in the rectum. A hooked bistoury designed for treating entrapped epiglottis was used to transect the band, which immediately released the obstruction and allowed manual evacuation of the aboral end of the small colon. The band was most likely the pedicle of a pedunculated lipoma that had encircled the oral end of the rectum. The mare made a complete recovery. [ABSTRACT FROM AUTHOR]

Migratory behaviors such as the timing and duration of migration are genetically inherited and can be under strong natural selection, yet we still know very little about the specific genes or molecular pathways that control these behaviors. Studies in candidate genes Clock and Adcyap1 have revealed that both of these loci can be significantly correlated with migratory behaviors in birds, though observed relationships appear to vary across species. We investigated geographic genetic structure of Clock and Adcyap1 in four populations of blackpoll warblers (Setophaga striata), a Neotropical–Nearctic migrant that exhibits geographic variation in migratory timing and duration across its boreal breeding distribution. Further, we used data on migratory timing and duration, obtained from light‐level geolocator trackers to investigate candidate genotype–phenotype relationships at the individual level. While we found no geographic structure in either candidate gene, we did find evidence that candidate gene lengths are correlated with five of the six migratory traits. Maximum Clock allele length was significantly and negatively associated with spring arrival date. Minimum Adcyap1 allele length was significantly and negatively associated with spring departure date and positively associated with fall arrival date at the wintering grounds. Additionally, we found a significant interaction between Clock and Adcyap1 allele lengths on both spring and fall migratory duration. Adcyap1 heterozygotes also had significantly shorter migration duration in both spring and fall compared to homozygotes. Our results support the growing body of evidence that Clock and Adcyap1 allele lengths are correlated with migratory behaviors in birds. [ABSTRACT FROM AUTHOR]

Aim: To assess the drivers of plant functional group richness and beta diversity in fire‐maintained North American Coastal Plain (NACP) savannas. Location: The southern portion of the NACP, a global biodiversity hotspot. This region is characterized by fire‐dependent pine savanna fragments that are isolated within a matrix of agriculture, urban development, non‐pyrogenic plant communities and plantation forestry. Methods: We used nested quadrats to sample plant species on 30 fire‐maintained savanna preserves in Florida and Georgia, USA. We analysed between‐site Sørenson dissimilarity, a measure of beta diversity, using NMDS and PerMANOVA. We measured nestedness using NODF, and we used Betapart to partition Sørenson dissimilarity into nestedness and turnover components. We used linear and generalized linear mixed models to explore drivers of functional group richness and composition, including fire regime (return interval, number of fires, time since fire and seasonality), vegetation structure (herbaceous cover, woody cover and tree density) and spatial factors (surrounding landscape and geographic distance). Results: We found turnover‐dominated beta‐diversity patterns in all functional groups. Turnover was explained partly by spatial and environmental gradients, but roughly half of the turnover between sites was unexplained. Species richness was higher on sites where fire and fire surrogates had been used longer and more consistently, and these effects were partly independent of current vegetation structure. Fire regimes containing more growing season fire and more diversity of burn seasons promoted higher species richness. Relationships between small‐scale and large‐scale species richness varied by soil type and functional group. Main conclusions: Fire‐maintained savannas in the southeastern NACP vary greatly in their plant functional group richness, but high beta diversity resulting primarily from species turnover suggests that even species‐poor sites can harbour less‐common members of the regional plant metacommunity. Prescribed fire regimes that include growing season fire as well as a diversity of burn seasons may best promote species and functional group richness. [ABSTRACT FROM AUTHOR]

Summary: Based on available evidence, the embolisation methods guided by fluoroscopy (nitinol plugs and transarterial coil embolisation) are preferred when available to occlude the bleeding artery in horses with guttural pouch mycosis. All attempts should be made to submit suitable candidates to hospitals with the necessary equipment and expertise for these procedures. However, when this opportunity is not available, the nondetachable balloon catheter could still offer a viable and effective alternative. Although the risk of surgical site infection is a delayed complication of this method, risk of infection can be reduced by planned removal at 10–14 days after catheter placement. [ABSTRACT FROM AUTHOR]

Populations exposed to arsenic in drinking water have an increased bladder cancer risk and evidence suggests that several factors may modify arsenic metabolism, influencing disease risk. We evaluated whether the association between cumulative lifetime arsenic exposure from drinking water and bladder cancer risk was modified by factors that may impact arsenic metabolism in a population‐based case–control study of 1,213 cases and 1,418 controls. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between cumulative arsenic intake and bladder cancer stratified by age, sex, smoking status, body mass index (BMI), alcohol consumption and folate intake. P‐values for interaction were computed using a likelihood ratio test. We observed no statistically significant multiplicative interactions although some variations in associations were notable across risk factors, particularly for smoking and BMI. Among former smokers and current smokers, those with the highest cumulative arsenic intake had elevated risks of bladder cancer (OR = 1.4, 95% CI: 0.96–2.0 and OR = 1.6, 95% CI: 0.91–3.0, respectively; while the OR among never smokers was 1.1, 95% CI: 0.6–1.9, p‐interaction = 0.49). Among those classified as normal or overweight based on usual adult BMI, the highest level of cumulative arsenic intake was associated with elevated risks of bladder cancer (OR = 1.3, 95% CI: 0.89–2.0 and OR = 1.6, 95% CI: 1.1–2.4, respectively), while risk was not elevated among those who were obese (OR = 0.9, 95% CI: 0.4–1.8) (p‐interaction = 0.14). Our study provides some limited evidence of modifying roles of age, sex, smoking, BMI, folate and alcohol on arsenic‐related bladder cancer risk that requires confirmation in other, larger studies. What's new? Populations exposed to arsenic in drinking water have an increased bladder cancer risk, and evidence suggests that several factors may modify arsenic metabolism, influencing disease risk. In this large case–control study, the authors explored whether the association between lifetime arsenic exposure in a population with low‐to‐moderate levels of exposure in drinking water and bladder cancer risk may be modified by several biological and lifestyle factors reported to influence the metabolism of arsenic. The data provide some limited evidence of modifying roles of age, sex, smoking, BMI, folate, and alcohol on arsenic‐related bladder cancer risk that requires confirmation in larger studies. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether visual acuity is related to balance in older adults with peripheral vascular disease (PVD) or diabetes mellitus. Design: Cross‐sectional analysis. Setting: Canada. Participants: Community‐dwelling adults aged 45 to 85 from the Canadian Longitudinal Study on Aging (N=30,097). Measurements: Visual acuity was measured wearing habitual distance correction using the Early Treatment of Diabetic Retinopathy Study chart at a 2‐m distance. Poor balance was defined as being unable to stand on 1 leg for at least 60 seconds. PVD and diabetes mellitus were assessed according to self‐report of a physician diagnosis. Multiple logistic regression was used. Results: People who reported PVD (n=1,295) were more likely to have worse balance than those who did not (odds ratio (OR)=1.50, 95% confidence interval (CI)=1.29–1.77). In those who did not report PVD (n=26,211), a 1‐line worse score on the visual acuity test was associated with 23% higher odds of being unable to stand for at least 60 seconds after adjusting for age, sex, education, province, body mass index, and diabetes mellitus (OR=1.23, 95% CI=1.20–1.26). In those who reported PVD, the odds of being unable to stand was almost double (OR=1.41, 95% CI=1.22–1.62). The interaction between visual acuity and PVD was statistically significant (P=.02). Conclusions: Visual acuity and PVD interact in their relationship with balance. People with poor vision and PVD may be at an especially high risk of mobility difficulties. [ABSTRACT FROM AUTHOR]

Abstract: This qualitative study aims to explore how individuals who are seeking help and support for eating disorders use various forms of technology. Fifteen participants, recruited from an Eating Disorder Program in a hospital setting and an eating disorder community support centre, voluntarily participated in focus groups and individual interviews in 2015. The authors used thematic analysis to code and analyse the qualitative data, and three themes were identified: safety, connection and technology development. This study identifies the need for technology use to be addressed and integrated into clinical services for eating disorders, as well as for safe and helpful technology tools to be developed for this population. [ABSTRACT FROM AUTHOR]

Summary: Colic surgery is one of few treatments in which a veterinarian can use a skill to save an animal's life from a deadly disease within a short timeframe. Unfortunately, such success is not achieved without considerable risk for surgical failure, which is responsible for most complications in the immediate post‐operative period. The last 50 years have witnessed considerable improvements in colic surgery, although a ranking of the most important ones might not meet with universal agreement. Teamwork plays a critical role in the final outcome, starting and finishing with the referring veterinarian and owner. These individuals are responsible for promptly transferring the horse to a surgical facility and then dealing with aftercare and delayed complications. The surgeon is responsible for the intervening steps, including the decision on the need for surgery, and works with the anaesthesiologist to help a metabolically challenged patient to tolerate surgery and anaesthesia. Although early referral and improved diagnostic procedures can have a positive influence on survival, perceived improvements in surgery and anaesthesia need to be reviewed with some circumspection. Although more rigorous definitions and statistical analyses used in recent studies can invalidate comparisons with older studies, complication rates appear to be on the rise, despite putative improvements in dealing with them. This trend tends to diminish the value of colic surgery through increasing costs, overreliance on post‐operative pharmacological management, growing pessimism, high rates of intraoperative euthanasia, and possibly reduced long‐term survival. Future efforts should address these concerns, mostly through emphasis on prompt referral, good surgical technique and reducing the cost of colic surgery to an affordable level that saves more lives. [ABSTRACT FROM AUTHOR]

Key points: The uterine artery (UA) markedly vasodilates during pregnancy to direct blood flow to the developing fetus. Inadequate UA vasodilatation leads to intrauterine growth restriction and fetal death. The large‐conductance voltage‐ and Ca2+‐activated K+ (BKCa) channel promotes UA vasodilatation during pregnancy. We report that BKCa channel activation increases the UA diameter at late pregnancy stages in mice. Additionally, a BKCa channel auxiliary subunit, γ1, participates in this process by increasing channel activation and inducing UA vasodilatation at late pregnancy stages. Our results highlight the importance of the BKCa channel and its γ1‐subunit for UA functional changes during pregnancy. Abstract: Insufficient vasodilatation of the uterine artery (UA) during pregnancy leads to poor utero‐placental perfusion, contributing to intrauterine growth restriction and fetal loss. Activity of the large‐conductance Ca2+‐activated K+ (BKCa) channel increases in the UA during pregnancy, and its inhibition reduces uterine blood flow, highlighting a role of this channel in UA adaptation to pregnancy. The auxiliary γ1‐subunit increases BKCa activation in vascular smooth muscle, but its role in pregnancy‐associated UA remodelling is unknown. We explored whether the BKCa and its γ1‐subunit contribute to UA remodelling during pregnancy. Doppler imaging revealed that, compared to UAs from wild‐type (WT) mice, UAs from BKCa knockout (BKCa−/−) mice had lower resistance at pregnancy day 14 (P14) but not at P18. Lumen diameters were twofold larger in pressurized UAs from P18 WT mice than in those from non‐pregnant mice, but this difference was not seen in UAs from BKCa−/− mice. UAs from pregnant WT mice constricted 20–50% in response to the BKCa blocker iberiotoxin (IbTX), whereas UAs from non‐pregnant WT mice only constricted 15%. Patch‐clamp analysis of WT UA smooth muscle cells confirmed that BKCa activity increased over pregnancy, showing three distinct voltage sensitivities. The γ1‐subunit transcript increased 7‐ to 10‐fold during pregnancy. Furthermore, γ1‐subunit knockdown reduced IbTX sensitivity in UAs from pregnant mice, whereas γ1‐subunit overexpression increased IbTX sensitivity in UAs from non‐pregnant mice. Finally, at P18, γ1‐knockout (γ1−/−) mice had smaller UA diameters than WT mice, and IbTX‐mediated vasoconstriction was prevented in UAs from γ1−/− mice. Our results suggest that the γ1‐subunit increases BKCa activation in UAs during pregnancy. [ABSTRACT FROM AUTHOR]

Nitrate and nitrite are precursors of N-nitroso compounds (NOC), probable human carcinogens that cause pancreatic tumors in animals. Disinfection by-products (DBP) exposures have also been linked with digestive system cancers, but few studies have evaluated relationships with pancreatic cancer. We investigated the association of pancreatic cancer with these drinking water contaminants and dietary nitrate/nitrite in a cohort of postmenopausal women in Iowa (1986-2011). We used historical monitoring and treatment data to estimate levels of long-term average nitrate and total trihalomethanes (TTHM; the sum of the most prevalent DBP class) and the duration exceeding one-half the maximum contaminant level (>½ MCL; 5 mg/L nitrate-nitrogen, 40 µg/L TTHM) among participants on public water supplies (PWS) >10 years. We estimated dietary nitrate and nitrite intakes using a food frequency questionnaire. We computed hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression and evaluated nitrate interactions with smoking and vitamin C intake. We identified 313 cases among 34,242 women, including 152 with >10 years PWS use ( N = 15,710). Multivariable models of average nitrate showed no association with pancreatic cancer (HRp95 vs. Q1 = 1.16, 95% CI: 0.51-2.64). Associations with average TTHM levels were also null (HRQ4 vs. Q1 = 0.70, 95% CI:0.42-1.18). We observed no trend with increasing years of exposure to either contaminant at levels >½ MCL. Positive associations were suggested in the highest dietary nitrite intake from processed meat (HRp95 vs. Q1 = 1.66, 95% CI 1.00-2.75; ptrend = 0.05). We found no interactions of nitrate with known modifiers of endogenous NOC formation. Our results suggest that nitrite intake from processed meat may be a risk factor for pancreatic cancer. [ABSTRACT FROM AUTHOR]

Mesic savannas are dominated by trees that are strong resprouters caught in a frequent fire trap. Persistence within this fire trap has been described by a resprout curve of SizeNext ~ f(Pre-fire size), defined by the Michaelis-Menten function. A key feature of this resprout curve is a stable persistence equilibrium that represents the size of individual plants upon which a population will converge over successive inter-fire time steps under a given fire regime. Here, we contend that such a resprout curve does not adequately describe resprout tree dynamics in frequently burnt mesic savannas because it is constrained to an asymptote. We propose a new framework for modelling the resprout curve, which recognizes that local environmental stochasticity and growth patterns can interact to change the growth response function entirely, and thus more readily reflect the range of feasible resprout responses. Importantly, we define an unstable equilibrium representing the size above which individuals have escaped the fire trap and explore mechanisms that can shift an individual from persistence to escape. Through a case study from northern Australia, we confirm that our framework provides a simple yet practical approach to defining these critical aspects of savanna tree growth dynamics: persistence and escape. [ABSTRACT FROM AUTHOR]

Rainfall, fire and competition are emphasized as determinants of the density and basal area of woody vegetation in savanna. The semi-arid savannas of Australia have substantial multi-year rainfall deficits and insufficient grass fuel to carry annual fire in contrast to the mesic savannas in more northern regions. This study investigates the influence of rainfall deficit and excess, fire and woody competition on the population dynamics of a dominant tree in a semi-arid savanna. All individuals of Eucalyptus melanophloia were mapped and monitored in three, 1-ha plots over an 8.5 year period encompassing wet and dry periods. The plots were unburnt, burnt once and burnt twice. A competition index incorporating the size and distance of neighbours to target individuals was determined. Supplementary studies examined seedling recruitment and the transition of juvenile trees into the sapling layer. Mortality of burnt seedlings was related to lignotuber area but the majority of seedlings are fire resistant within 12 months of germination. Most of the juveniles (≤1 cm dbh) of E. melanophloia either died in the dry period or persisted as juveniles throughout 8.5 years of monitoring. Mortality of juveniles was positively related to woody competition and was higher in the dry period than the wet period. The transition of juveniles to a larger size class occurred at extremely low rates, and a subsidiary study along a clearing boundary suggests release from woody competition allows transition into the sapling layer. From three fires the highest proportion of saplings (1-10 cm dbh) reduced to juveniles was only 5.6% suggesting rates of 'top-kill' of E. melanophloia as a result of fire are relatively low. Girth growth was enhanced in wet years, particularly for larger trees (>10 cm dbh), but all trees regardless of size or woody competition levels are vulnerable to drought-induced mortality. Overall the results suggest that variations in rainfall, especially drought-induced mortality, have a much stronger influence on the tree demographics of E. melanophloia in a semi-arid savanna of north-eastern Australia than fire. [ABSTRACT FROM AUTHOR]

This qualitative study explored which core principles of family-based treatment (FBT) for adolescents with anorexia nervosa (AN) are perceived as most necessary for FBT to be effective in clinical practice. Paediatric interdisciplinary teams were recruited to discuss the delivery of FBT in eating disorder programmes in Ontario, Canada ( N = 6). Thematic analysis was used to analyze the data generated from focus groups. Three major themes emerged: (i) parental empowerment (PE) is the most salient principle of FBT; (ii) various adolescent, parental and family factors are viewed as interfering with or enhancing PE; (iii) a variety of clinical interventions are utilized by clinicians to cultivate and increase PE. PE is identified as essential for adolescents with AN to successfully recover. Greater focus on addressing barriers to empowering parents is needed throughout FBT. Future studies should include measurements of PE to ascertain effects on treatment outcomes. Training and supervision protocols focused on promoting PE are recommended. Practitioner points PE is the most salient principle of FBT., Strategies to enhance PE in phase 1 are imperative if there has been a long illness duration or parents experience mental health issues/burnout., Special clinical attention to individual factors is recommended: comorbid diagnoses, affect dysregulation and enduring eating disorder symptoms., Efforts to enhance parental involvement throughout the treatment is paramount to supporting adolescents to recover from AN. [ABSTRACT FROM AUTHOR]

This case report describes an unusual case of anaerobic peritonitis in a 2-year-old horse following castration. The horse was evaluated 2 weeks following castration for signs of acute, severe abdominal pain and swelling surrounding a previous castration site. Physical examination revealed marked scrotal and ventral abdominal oedema that was cool and crepitant upon palpation. Ultrasonographic evaluation was unrewarding because gas shadowing distributed throughout the subcutis prevented imaging of the abdominal cavity. Ventral midline celiotomy revealed a copious amount of malodorous, serosangious, cloudy peritoneal fluid that was submitted for culture. Abdominal exploration revealed the gastrointestinal tract to be in its anatomically correct position. There was diffuse petechiation of the small intestine and large intestine, oedema and crepitant swelling surrounding the left inguinal ring and body wall. The abdomen was lavaged with 10 l of sterile saline prior to closure of the celiotomy and the left castration incision was opened digitally, releasing a large volume of serosanguinous fluid and gas that flowed freely from the incision site and deeper inguinal tissues. The horse was placed in the recovery box where it suffered cardiac arrest. Culture of the peritoneal fluid revealed heavy growth of Clostridium septicum. This case of anaerobic peritonitis represents an unusual complication following castration not previously reported in the horse. [ABSTRACT FROM AUTHOR]