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A response by M. Robinson and colleagues to a letter to the editor regarding their article "Child behaviour following low to moderate maternal drinking in pregnancy" in the August 2010 issue is presented.

The purpose of this study was to review the incidence of and risk factors for, developing complications following parotidectomy for benign disease. In an 11 year period, 162 parotidectomies were performed for benign disease, the commonest being PSA (43%), Warthin’s (30%) and sialadenitis (22%). There were 71 males/91 females, mean age was 58 years and 79% presented with a painless mass of 26 months. 134 patients underwent a superficial parotidectomy and the mean follow-up was 23 months. Post-operatively 40% developed a temporary facial palsy, 11% had Frey’s syndrome and 10% developed a salivary fistula. Sialadenitis was a significant risk factor for the development of facial nerve palsy (p < 0.01) and increased the risk of salivary fistulae. Parotid duct ligation increased the risk of nerve palsy in the distribution of the zygomatic and buccal branches. Operations for Warthin’s tumour were associated with an elevated risk of dysfunction of the cervical branch of the facial nerve. Half of the patients had intra-operative facial nerve stimulation and this uninfluenced the liklehood of facial paresis. The recovery of facial nerve function showed a biphasic distribution, with 90% of patients having normal function within 12 months, followed by a slower recovery rate for up to two years. In conclusion, the incidence of post-operative complications was influenced by the pathology, with inflammatory lesions significantly increasing the risk of facial nerve dysfunction and other complications, but also by variations in surgical practice, such as parotid duct ligation. Overall, the incidence of permanent facial palsy was under 2%, but a temporary nerve palsy was common at 40%, with most patients regaining normal function within one year of surgery. [ABSTRACT FROM AUTHOR]

Pterygium Syndrome is an extremely rare and complex congenital disorder consisting of severe contractures involving multiple flexural surfaces and associated craniofacial abnormalities, including mandibular hypoplasia and epicanthic folds. It is also often associated with other congenital abnormalities of the cardiovascular, respiratory and genitourinary systems. It may present in different forms including multiple Pterygium Syndrome of Escobar, lethal multiple Pterygium Syndrome, Popliteal Pterygium Syndrome and Arthrogryposis Multiplex Congenita. The incidence is unknown, a mutation in the IRF6 gene has been found in the Popliteal varient and it is postulated that the pterygia result from the embryonic onset of foetal akinesia. The clinical presentation, multidisciplinary management and longterm outcome of three patients with this condition, managed in the Australian CranioFacial Unit will be presented. [ABSTRACT FROM AUTHOR]

Reports global developments concerning disease-related issues. Use of nasal continuous positive airways pressure in treating sleep apnoea; Guidelines commonly used in clinical practices for dyspepsia; Litigation over the medical complications of breast implants.

Best Management Practices (BMPs) in urban drainage have been promoted in Scotland for a number of years in response to the need to combatpollution arising from diffuse sources in urban areas. This has led to the construction of around one hundred BMP installations using both source and end of pipe control. These are principally in the East of Scotland, and the number is growing rapidly as education and knowledge increases. A programme of investigations into the factors which influence the performance of the systems commenced in 1997. A range oftypes of BMP are under study including both source control and end of pipe systems. The sites have been divided into groups for which different depths of investigation are being undertaken. The programme involves a number of parallel investigations requiring field studies, data reviews and enquiries to confirm applicability and performance insitu. Many of the factors which influence the selection, installation and operation of a particular system are social, legal and administrative in addition to those which relate to its design and construction. The different strands of the study have been developed to ensure that all influences are identified and evaluated. [ABSTRACT FROM AUTHOR]

Background: Obesity, inflammation, insulin resistance and cardiovascular disease (CVD) risk are inter-related. Both weight-loss and long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA) are independently known to reduce metabolic risk, but the combined effects are unclear.Objective: This study examines whether addition of LC n-3 PUFA to a low fat/high carbohydrate weight-loss programme results in greater improvements in inflammation, insulin sensitivity and CVD risk, than weight-loss alone.Design: One hundred and sixteen overweight insulin-resistant women entered a 24-week randomised intervention study. Thirty-nine women were randomised to a weight-loss programme, with LC n-3 PUFA (WLFO), 38 to a weight-loss programme with placebo oil (WLPO), and 39 to receive placebo oil, with no weight-loss programme (control).Results: Ninety-three women completed the study (35 WLFO, 32 WLPO and 26 control), with significant weight-loss in WLFO (10.8+/-1.0%) and WLPO (12.4+/-1.0%) compared to the control group (P<0.0001). The WLFO, but not WLPO or control group, showed significant increases in adipose tissue LC n-3 PUFA (0.34+/-0.20 vs 0.17+/-0.10 and 0.16+/-0.10 %DHA, P<0.0001). Weight-loss showed significant improvements in insulin sensitivity (P<0.001), lipid profile (triglycerides P<0.05) and inflammation (sialic acid P<0.05). Time*group effects showed significant decreases in triglycerides (P<0.05) and increases in adiponectin (P<0.01) with LC n-3 PUFA, in the WLFO vs WLPO groups.Conclusions: Weight-loss improved risk factors associated with CVD, with some additional benefits of LC n-3 PUFA on triglycerides and adiponectin. Given the current low dietary intake of LC n-3 PUFA, greater attention should be given to increase these fatty acids in the treatment of obesity. [ABSTRACT FROM AUTHOR]

Abstract Study Objective There is a paucity of research on body image in pregnant and parenting youth (PPY). Study objectives were to examine: (1) profiles of PPY regarding body image, depression, and eating behaviors and any effects of age and pregnancy status on results; and (2) PPY perceptions of body image. Design, Setting, Participants, Interventions, and Main Outcome Measures Demographic data and scores from measures related to self-esteem, body esteem, eating behaviors, and depression were collected from 101 PPY from 2 urban centers. Two focus group sessions were held to further explore survey findings. Sessions were audio-recorded and transcribed verbatim for analysis. Results Participants (mean age, 19.8 years) reported a history of depression (79/101; 78.2%), anxiety (75/101; 74.3%), drug/alcohol abuse (45/101; 44.6%), and eating disorder (32/101; 31.7%). Parenting (nonpregnant; n = 64) participants had lower body esteem (P =.041) and more eating disorder behaviors (P =.026) compared with pregnant (n = 37) participants. A history of depression or eating disorder both independently increased risk for lower body esteem and self-esteem and higher depressive symptoms in pregnant youth. Four dominant themes emerged from qualitative data: (1) adapting to rapidly changing bodies; (2) inter-relationship between body image and mood; (3) added attention and perceptions of pressure to return to prepregnancy body size; and (4) reconciling change and striving to find a new normal. Conclusion This study highlights the importance of exploring past and current body image, mood, and eating disorder behavior in PPY for risk of current mental health issues. Future research exploring prepregnancy depression, eating disorder, body esteem, and depression in pregnant youth are needed. [ABSTRACT FROM AUTHOR]

Transposable elements (TEs), such as endogenous retroviruses (ERVs), are common in the genomes of vertebrates. ERVs result from retroviral infections of germ-line cells, and once integrated into host DNA they become part of the host's heritable genetic material. ERVs have been ascribed positive effects on host physiology such as the generation of novel, adaptive genetic variation and resistance to infection, as well as negative effects as agents of tumorigenesis and disease. The avian leukosis virus subgroup E family (ALVE) of endogenous viruses of chickens has been used as a model system for studying the effects of ERVs on host physiology, and approximately 30 distinct ALVE proviruses have been described in the Gallus gallus genome. In this report we describe the development of a software tool, which we call Vermillion, and the use of this tool in combination with targeted next-generation sequencing (NGS) to increase the number of known proviruses belonging to the ALVE family of ERVs in the chicken genome by 4-fold, including expanding the number of known ALVE elements on chromosome 1 (Gga1) from the current 9 to a total of 40. Although we focused on the discovery of ALVE elements in chickens, with appropriate selection of target sequences Vermillion can be used to develop profiles of other families of ERVs and TEs in chickens as well as in species other than the chicken. [ABSTRACT FROM AUTHOR]

Continental crust is displaced in strike-slip fault zones through lateral and vertical movement that together drive burial and exhumation. Pressure –temperature–deformation ( P–T–d) histories of orogenic crust exhumed in transcurrent zones record the mechanisms and conditions of these processes. The Skagit Gneiss Complex, a migmatitic unit of the North Cascades, Washington (USA), was metamorphosed at depths of ∼25–30 km in a continental arc under contraction, and is bounded on its eastern side by the long-lived transcurrent Ross Lake fault zone (RLFZ). The P–T–d conditions recorded by rocks on either side of the RLFZ vary along the length of the fault zone, but most typically the fault separates high-grade gneiss and plutons from lower-grade rocks. The Ruby Mt–Elijah Ridge area at the eastern margin of the Skagit Gneiss exposes tectonic contacts between gneiss and overlying rocks; the latter rocks, including slivers of Methow basin deposits, are metamorphosed and record higher-grade metamorphism than in correlative rocks along strike along the RLFZ. In this area, the Skagit Gneiss and overlying units all yield maximum P–T conditions of 8–10 kbar at >650 °C, indicating that slices of basin rocks were buried to similar mid-crustal depths as the gneiss. After exhumation of fault zone rocks to <15 km depth, intrusion of granitoid plutons drove contact metamorphism, resulting in texturally late andalusite–cordierite in garnet schist. In the Elijah Ridge area of the RLFZ, an overlapping step-over or series of step-overs that evolved through time may have facilitated burial and exhumation of a deep slice of the Methow basin, indicating that strike-slip faults can have major vertical displacement (tens of kilometres) that is significant during the crustal thickening and exhumation stages of orogeny. [ABSTRACT FROM AUTHOR]

BACKGROUND Basal cell carcinoma (BCC) of the nipple–areola complex is uncommon. It has been suggested that BCCs in this region behave more aggressively, with a higher potential for distant spread, than in other anatomical sites. OBJECTIVE To address questions about etiology, behavior, optimal treatment, and prognosis of this entity. METHODS AND MATERIALS A literature search identifying all cases of BCC of the nipple and nipple–areola complex in the English literature from 1893 to 2008. RESULTS Thirty-four cases of BCC of the nipple, areola, or both were identified, mostly affecting middle-aged men. The majority of patients were treated with tissue-sparing surgery. There was a metastatic rate of 9.1%, and one patient died from the disease (3.0%). CONCLUSIONS The optimal treatment of this condition should be local excision, but patients with this condition should be followed up for primary site recurrence and axillary metastasis, because there is greater incidence than with BCC at other anatomical sites. Furthermore, proven axillary metastasis should be surgically treated. [ABSTRACT FROM AUTHOR]

This paper outlines a rationale and scoring system for the stormwater treatment train assessment tool (STTAT) which is a proposed regulatory tool for Sustainable Urban Drainage Systems (SUDS). STTAT provides guidance and regulatory consistency for developers about the requirements of planners and the Scottish Environment Protection Agency (SEPA). The tool balances the risks of pollution to the receiving water body with the treatment provided in a treatment train. It encourages developers to take SUDS into account early, avoiding any misunderstanding of SUDS requirements at the planning stage of a development. A pessimistic view on pollution risks has been adopted since there may be a change of land use on the development in the future. A realistic view has also been taken of maintenance issues and the 'survivability' of a SUDS component. The development of STTAT as a response to the requirements of the Water Framework Directive is explored, the individual scores being given in tabular format for receiving water and catchment risks. Treatment scores are proposed for single SUDS components as well as multiple components within treatment trains. STTAT has been tested on a range of sites, predominantly in Scotland where both development and receiving water information was known. The operational tool in use by SEPA is presented. [ABSTRACT FROM AUTHOR]

This work investigated effects of carrying 0, 1, or 2 copies of the A allele resulting from the g+ 6723C-A transition in growth differentiation factor gene (GDF8) in New Zealand Texel-cross sheep at different lamb ages and carcass weights. Two Texel-cross sires carrying 1 copy of the A allele were mated to approximately 200 ewes carrying 0, 1, or 2 copies of the A allele. A total of 187 progeny were generated and genotyped to determine whether they were carrying 0, 1, or 2 copies of the A allele. The progeny were assigned to 1 of 4 slaughter groups balanced for the 3 genotypes, sex, and sire. The 4 groups were slaughtered commercially when their average BW (across all progeny in the slaughter group) reached 33, 40, 43, and 48 kg, respectively. Measurements of BW, and carcass dimensions arid yield were made on all animals using Viascan (a commercial 2-dimensional imaging system that estimates lean content of the carcass as a percentage of total carcass weight). Additional measurements were made on the fourth slaughter group, which was computed tomography scanned at each slaughter time point to obtain 4 serial measures of lean and fat as estimated from the computed tomography images, The A allele did not have an effect on any BW traits. The A allele was associated with increased muscle and decreased fat across the variety of measures of muscling and fat, explaining between 0.2 and 1.1 of a residual SD unit. Estimates for an additive effect were significant and were positive for muscle and negative for fat traits. No dominance effect estimates (positive or negative) were significant. There was no significant interaction between A allele number and carcass weight or slaughter group for any trait. This is the first systematic study of the effect of the A allele copy number over a range of carcass weights (13 to 20 kg) and ages and results suggest the size of the effect across these endpoints is proportionately the same. Testing for the A allele therefore offers breeders the potential to improve rates of genetic gain for lean-meat yield across most production systems. [ABSTRACT FROM AUTHOR]

Theoretical flaw-response modelling programs are used to simulate ultrasonic flaw detection and provide a cheap and fast alternative to test-piece trials during the Inspection Qualification (IQ) process. The selection of the most appropriate model for a given test scenario requires a high level of technical expertise, necessitating the use of a qualified NDT engineer. Moreover, due to the heterogeneous nature of these models, integration with other NDT software tools can be difficult and requires the user to be responsible for data management within the system. The multi-agent system (MAS) utilises intelligent software agents capable of autonomous behaviour and decision-making skills in order to create a single software environment to provide support for IQ. The motivation behind this MAS approach, the design and implementation of the agents and the benefits offered by the MAS will be described. A test scenario of a multi-agent IQ will be used to demonstrate the potential advantages offered by this novel systems approach. Specifically, the contribution of these modelling agents to the overall system and their interactions with other tools to automate the IQ process will be addressed. [ABSTRACT FROM AUTHOR]

BackgroundChronic mast cell-mediated inflammation may contribute significantly towards the extensive tissue remodelling that is a feature of lungworm infection in ruminants. Understanding the factors that control tissue remodelling is a necessary step toward effective management and treatment of conditions that feature such pathology. ObjectiveWe sought to define in a novel ovine model system, the cellular, immune and mast cell phenotypic events that occur following local lung challenge with a recombinant protein antigen, DvA-1, derived from the ruminant lungworm nematode, Dictyocaulus viviparus. MethodsTwo spatially disparate lung segments in systemically sensitized sheep were challenged on three occasions with DvA-1 (3xDVA) and two further segments were challenged with saline (3xSAL). Two months after the third challenge, one of the two segments previously repeatedly challenged with DvA-1 was challenged again with DvA-1 (3xDVA:DVA) whilst the other was challenged with saline (3xDVA:SAL). A similar protocol was followed with the saline challenged segments (3xSAL:SAL and 3xSAL:DVA). Bronchoalveolar lavage fluid (BALF) (n = 16) and tissue (n = 3) were collected after the last challenge. ResultsCellular changes 24 h after the fourth challenge were characterized by an increase in the absolute numbers of neutrophils and eosinophils in BALF from 3xDVA:DVA and 3xSAL:DVA segments. Local antibody production was implied through increased levels of antibody in both 3xDVA:DVA and 3xDVA:SAL segments, with the latter being unaffected by inflammation. Levels of active transforming growth factor beta-1 (TGF-β1) were significantly increased in 3xDVA:SAL segments and a trend towards an increase was apparent in 3xDVA:DVA segments. Total TGF-β1 levels were significantly correlated with eosinophil counts in all except the 3xDVA:SAL segments. Such changes in the bronchoalveolar space were complemented by increased ratios of sheep mast cell... [ABSTRACT FROM AUTHOR]

Despite recent advances in the inhibition of EGFR (epidermal growth factor receptor), there remains a clinical need for new EGFR Exon20 insertion (Ex20Ins) inhibitors that spare EGFR WT. Herein, we report the discovery and optimization of two chemical series leading to ether 23 and biaryl 36 as potent, selective, and brain-penetrant inhibitors of Ex20Ins mutants. Building on our earlier discovery of alkyne 5 which allowed access to CNS property space for an Ex20Ins inhibitor, we utilized structure-based design to move to lower lipophilicity and lower CL int compounds while maintaining a WT selectivity margin. During optimization, aldehyde oxidase (AO) metabolism was identified as a human clearance risk, and through SAR exploration, lower AO metabolism was achieved. Potency and WT margin were optimized across a range of Ex20Ins mutants including the potential acquired resistance T790M mutant and efficacy demonstrated in an LXF2478 Ex20Ins ASV model with margin to EGFR WT in vivo.

Within the adult rodent hippocampus, opioids suppress inhibitory parvalbumin-expressing interneurons (PV-INs), thus disinhibiting local micro-circuits. However, it is unknown if this disinhibitory motif is conserved in other cortical regions, species, or across development. We observed that PV-IN mediated inhibition is robustly suppressed by opioids in hippocampus proper but not primary neocortex in mice and nonhuman primates, with spontaneous inhibitory tone in resected human tissue also following a consistent dichotomy. This hippocampal disinhibitory motif was established in early development when PV-INs and opioids were found to regulate early population activity. Acute opioid-mediated modulation was partially occluded with morphine pretreatment, with implications for the effects of opioids on hippocampal network activity important for learning and memory. Together, these findings demonstrate that PV-INs exhibit a divergence in opioid sensitivity across brain regions that is remarkably conserved across evolution and highlights the underappreciated role of opioids acting through immature PV-INs in shaping hippocampal development., Competing Interests: DECLARATION OF INTERESTS The authors declare no competing interests.

Background: Post-operative infection following cleft palate repair can lead to wound dehiscence and subsequent fistula formation. To prevent this, many surgeons advocate using post-operative antibiotic prophylaxis. The use of antibiotics in children is not without risks and with limited published data and variability both countrywide and in our unit, we wanted to address this research question., Objective: To assess fistula rates and whether the provision of antibiotics post-operatively affected the incidence of oronasal fistula formation in patients with cleft palate., Methodology: We performed an institutional retrospective study using data from patients undergoing primary palatoplasty between August 2021 and August 2022. These patients were divided into 2 groups. Group A included patients who received antibiotics only on induction and Group B additionally received post-operative antibiotic prophylaxis for 7 days. All participants (97) were evaluated for incidence of post-operative fistula formation., Results: There was no evidence to suggest a difference in the fistula rate between the different timings of antibiotic regimen in Cycle 1; on induction + 2 intravenous doses (Group A) P = 0.807 and 7 days post-operatively (Group B) P = 0.820. Also, in cycle 2 there was no difference in the fistula rates between the 2 groups; P = 0.546 for Group A and P = 0.571 for Group B., Conclusion: Our study suggests that the use of antibiotics post-operatively does not influence the formation of post-operative fistulae in cleft palate. This calls for a national randomised controlled study to answer this research question and achieve standardisation of practice., (Crown Copyright © 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.)

In recent years, we and others have identified a number of enhancers that, when incorporated into rAAV vectors, can restrict the transgene expression to particular neuronal populations. Yet, viral tools to access and manipulate fine neuronal subtypes are still limited. Here, we performed systematic analysis of single cell genomic data to identify enhancer candidates for each of the cortical interneuron subtypes. We established a set of enhancer-AAV tools that are highly specific for distinct cortical interneuron populations and striatal cholinergic neurons. These enhancers, when used in the context of different effectors, can target (fluorescent proteins), observe activity (GCaMP) and manipulate (opto- or chemo-genetics) specific neuronal subtypes. We also validated our enhancer-AAV tools across species. Thus, we provide the field with a powerful set of tools to study neural circuits and functions and to develop precise and targeted therapy., Competing Interests: DECLARATION OF INTERESTS G.F. is a founder of Regel Therapeutics, which has no competing interests with the present manuscript. G.F. is an advisor for Neuron and Annual Review of Neuroscience. J.D. and K.A. are employees of Regel Therapeutics and J.D. is also a founder. A.I. is the founder of Tibbling Technologies. Patents are pending on all enhancers present in this manuscript. For BiCHATe27 and BiSSTe10 G.F. and J.D hold this patent. For the remainder of enhancer patents they are held by G.F., M.D. and Y.W.

Müller-Weiss disease (MWD) is a poorly understood orthopedic condition first described in 1927 that causes chronic pain across the midfoot and hindfoot. The etiology is uncertain but includes navicular dysplasia, osteochondritis, and trauma. The initial management is conservative, aiming to reduce the patient's symptoms, and includes analgesia, footwear, and activity modification. Surgical interventions such as joint fusion are considered when conservative measures fail, but there is little recorded for treatment beyond this. This case outlines the difficult management of a 52-year-old female patient with a long history of MWD. She had no history of previous trauma or neurological problems. A talonavicular fusion failed to unite, resulting in significant necrosis of the lateral navicular and navicular-cuneiform arthritis. We describe the novel use of a reverse vascularized pedicled fibular flap and extended midfoot fusion to manage the navicular bone defect. At six-year follow-up, the patient remains virtually pain-free and has returned to work with radiographs confirming good incorporation of the bone graft. We understand this to be the first documented use of a reverse vascularized fibular bone graft for recalcitrant MWD. Given the excellent clinical outcome in this case, surgeons should consider this combined ortho-plastics approach in the management of complex non-union with a bone defect in the midfoot., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Slater et al.)

Background: Intensive care outreach nurses are required to work as part of an ad hoc team to review and manage patients who are deteriorating outside of critical care environments. Nontechnical skills, such as those encompassed by crisis resource management principles, are essential when working in these situations. Used commercially for entertainment, escape rooms have recently been utilised by clinical educators to teach both technical and nontechnical skills., Objective: This exploratory study evaluates how advanced clinicians, intensive care outreach nurses, experience an escape room scenario designed to consolidate crisis resource management (CRM) principles., Methods: Three escape room sessions were conducted in a 1038-bed metropolitan tertiary referral hospital. A purposive sample of 12 intensive care outreach nurses were invited to participate. The participant's experience of the escape room scenario was determined by their responses to a post-escape room survey and focus group discussion. Transcripts of the audio recordings from focus group discussions were analysed using an inductive coding approach., Results: Two primary categories emerged from analysis of the focus group discussions: (i) the clinicians' experiences of the escape room and (ii) CRM principles. The first category included descriptions of emotions, including confusion, frustration, and a dislike for puzzles. The second category included both the participants understanding of the CRM principles, and how the principles influence the work within the escape room., Conclusions: Escape rooms have shown promise as novel educational environments, which challenge participants. Despite initial negative descriptions of the escape room, focus group discussions demonstrated that the participants were able to recognise the impact of CRM principles and acknowledge how these affect their clinical work in an ad hoc team., Competing Interests: Conflict of interest The authors have no conflicts of interest to disclose., (Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: There is debate amongst surgeons regarding the use of antibiotics to prevent fistulae after palatoplasty. Prescribing should be evidence based, as antibiotic stewardship is integral to reducing antibiotic resistance. Our aim was to determine whether differing perioperative regimens affect the prevalence of postoperative fistulae., Methods: The sample comprised participants from the Cleft Collective who had undergone palatoplasty. Participants were recruited across all 16 UK cleft centers between 2013 and 2021. The exposure was perioperative antibiotic regimen prescribed at the time of palatoplasty. The primary outcome was the presence of palatal fistula., Results: Fistula data were available for 167 participants when exploring antibiotic regimen and for 159 when exploring antibiotic agent. There was no evidence to suggest a difference in fistula rate between those receiving antibiotics on induction only versus as an inpatient or up to 7 days postoperatively (χ 2  = 4.57; P = 0.10). There was no evidence to suggest a difference in fistula rate between those who received co-amoxiclav and those who had an alternative antibiotic (χ 2  = 0.16; P = 0.69). Postoperative fistulae increased with the extent of the cleft (χ 2  = 20.39; P < 0.001). When adjusting for cleft type, no evidence of an association between antibiotic regimen and fistulae was found (inpatient antibiotics: OR 1.36; 95% confidence interval, 0.53-3.51; antibiotics up to 7 days postoperatively: OR 0.68; 95% confidence interval, 0.26-1.80)., Conclusions: The choice of antibiotic and dosing regimen does not influence the formation of postoperative fistulae. These results should be supported by interventional trials., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Bacteriophages Phonegingi and Dropshot were isolated from soil in North Carolina using the host Microbacterium foliorum . Both phages have siphovirus morphologies. Based on gene content similarity to one another and to other actinobacteriophages, both phages are assigned to phage cluster GA., Competing Interests: The authors declare no conflict of interest.

Infant feeding guidelines provide evidence-based recommendations to support optimal infant health, growth, and development, and exploring adherence to guidelines is a useful way of assessing diet quality. The aim of this study was to determine adherence to the recently updated Ministry of Health "Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)". Data were obtained from First Foods New Zealand, a multicentre observational study of 625 infants aged 7.0-10.0 months. Caregivers completed two 24-h diet recalls and a demographic and feeding questionnaire. Nearly all caregivers (97.9%) initiated breastfeeding, 37.8% exclusively breastfed to around six months of age, and 66.2% were currently breastfeeding (mean age 8.4 months). Most caregivers met recommendations for solid food introduction, including appropriate age (75.4%), iron-rich foods (88.3%), puréed textures (80.3%), and spoon-feeding (74.1%). Infants consumed vegetables (63.2%) and fruit (53.9%) more frequently than grain foods (49.5%), milk and milk products (38.6%), and meat and protein-rich foods (31.8%). Most caregivers avoided inappropriate beverages (93.9%) and adding salt (76.5%) and sugar (90.6%). Our findings indicated that while most infants met the recommendations for the introduction of appropriate solid foods, the prevalence of exclusive breastfeeding could be improved, indicating that New Zealand families may need more support.

This study investigated the effects of psychosocial stress on hormonal responses to a social interaction with an opposite-sex individual to test the hypothesis that stress may interfere with or suppress adaptive neuroendocrine responses to courtship opportunities. Heterosexual men and women were randomly assigned prior to arrival to either a control or psychosocial stress condition (Trier Social Stress Test) and subsequently went through a social interaction test with an opposite-sex individual. Expected increases of testosterone for control participants who interacted with opposite-sex individuals were not observed, and changes in testosterone were not observed for those in the psychosocial stress condition either. However, exploratory analyses in control participants showed main and interaction effects of relationship status were significant for both cortisol and testosterone. Specifically, single individuals showed higher levels of cortisol compared to those in a relationship, and single individuals showed significantly higher concentrations of cortisol after a social interaction when compared to individuals who were in a relationship. For testosterone, only individuals in a relationship decreased in testosterone following the social interaction. This study suggests that relationship status and psychosocial stress may be important variables moderating the relationship between an ecological cue of a potential courtship opportunity and subsequent adaptive physiological responses., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 McLean, Maestripieri. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Provision of light during incubation has shown the potential to enhance hatching traits and affect posthatch productivity, physiology, and behavior. In this study, 2 repeated trials were conducted to investigate the effect of photoperiod and strain on the embryo temperature, hatching traits and posthatch growth performance of 2 commercial strains of broilers (Ross 308 and Cobb 500). In each trial, hatching eggs were randomly distributed into 6 incubators with 3 photoperiod treatments: blue LED light for 12 h d -1 (12L:12D) or 18 h d -1 (18L:6D) during entire incubation were compared with no illumination condition (DARK). Data were analyzed as a 3 × 2 factorial arrangement with the trial as the blocking factor. Embryos incubated under 12L:12D and 18L:6D had lower air cell temperature (P < 0.05) than the DARK embryos from d 13 of incubation onward except on the day of candling. The response of air cell temperature to periodic illumination differed between 2 strains. Cobb embryos had lower air cell temperature in 12L:12D than those incubated with 18L:6D from d 16 of incubation onward, whereas lower air cell temperature was found in Ross embryos when illuminated with 18L:6D photoperiod compared to those under 12L:12D. The 12L:12D treatment was associated with improved (P < 0.05) navel closure condition of hatchlings. There were no differences in hatchability, embryo mortality, body weight, or length at hatch among photoperiod groups or its combination with strain. No differences in production parameters were found between DARK and illuminated groups. However, 12L:12D had heavier (P < 0.05) body weight on d 14 of age and higher (P < 0.05) body weight gain than 18L:6D from d 7 to 14 of age. The results of this study indicate that providing blue LED light up to 18 h d -1 has no detrimental effect on production of broilers, however, 12L:12D light regime improved chick quality at hatch compared to DARK and resulted in heavier birds by d 14 compared to 18L:6D., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objectives: To determine the prevalence of syndromic Robin sequence (RS) in the UK and if this group of patients had an increased need for airway and feeding management compared with a non-syndromic RS cohort., Design: A prospective national multicentre study of cases submitted to the Cleft Collective cohort studies., Setting: Specialist cleft services in the UK., Patients: 259 participants who fulfilled the diagnosis of RS. This group was compared with 548 participants with cleft palate only (CPO)., Main Outcome Measures: The primary outcome measure was the presence of a syndrome in patients with RS and CPO. Secondary outcome measures included the use of airway and feeding adjuncts., Results: An associated syndrome was seen in 28% of patients with RS and 14% of patients with CPO. The most common syndrome for the RS group was Stickler syndrome (27%). Syndromic status was significantly higher among patients with RS compared with those with CPO (OR 2.36, 95% CI 1.65 to 3.39; p<0.001). Patients with syndromic RS have an increased reliance on airway adjuncts compared with the patients without syndromic RS (OR 2.02, 95% CI 1.13 to 3.64; p=0.018). There was no evidence of a difference in the use of feeding adjuncts between syndromic and non-syndromic RS groups (OR 2.43, 95% CI 0.78 to 7.58; p=0.126)., Conclusion: The presence of a syndrome has implications for management of patients with RS. Early identification of a syndrome may help prevent the consequences of a missed syndromic diagnosis. Routine ophthalmological and genetic screening for Stickler syndrome should be mandatory for all patients with RS., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)