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Introduction: Suicidality is a growing problem in the US, and the emergency department (ED) is often the front line for the management and effective treatment of acutely suicidal patients. There is a dearth of interventions that emergency physicians may use to manage and effectively treat acutely suicidal patients. To the extent that recently described interventions are available for ED personnel, no review has been conducted to identify them. This scoping review is intended to fill this gap by systematically reviewing the literature to identify recently described interventions that can be administered in the ED to reduce symptoms and stabilize patients.Methods: We conducted a search of PubMed, SCOPUS, and CINAHL in January 2024 to identify papers published between 2013–2023 for original research trialing recent interventions for the effective treatment of suicidality in the ED. We assessed 16 full-text articles for eligibility, and nine met inclusion criteria. Included studies were evaluated for features and characteristics, the fit of the intervention to the ED environment, and interventional efficacy.Results: Four studies assessed the efficacy of a single dose of the anesthetic/analgesic agent ketamine. Three studies assessed the efficacy of a brief psychosocial intervention delivered in the ED, two of which paired this intervention with the provision of follow-up care (postcard contact and referral assistance/case management, respectively). The remaining two studies trialed a brief, motivational interviewing-based intervention. Included studies had strong experimental designs (randomized controlled trials) but small sample sizes (average 57). Among the interventions represented across these nine studies, a single dose of ketamine and the brief psychosocial intervention Crisis Response Planning (CRP) show promise as ED-appropriate interventions for suicidality. Ketamine and CRP demonstrated the strongest fit to the ED environment and most robust efficacy findings.Conclusion: This review identified one drug (ketamine) and four unique psychological/behavioral interventions that have been used to treat acute suicidality in the ED. There is currently insufficient evidence to suggest that these interventions will prove efficacious and well-suited to be delivered in the ED environment. Future studies should continue to test these interventions in the ED setting to determine their feasibility and efficacy.

Abstract Objectives Neuroimaging studies of dyskinetic cerebral palsy (CP) are scarce and the neuropathological underpinnings are not fully understood. We delineated the corticospinal tract (CST) and cortico‐striatal‐thalamocortical (CSTC) pathways with probabilistic tractography to assess their (1) integrity and (2) association with motor functioning in people with dyskinetic CP. Methods Diffusion weighted magnetic resonance images were obtained for 33 individuals with dyskinetic CP and 33 controls. Fractional anisotropy (FA) and mean diffusivity (MD) for the CST and the CSTC pathways were compared between groups. Correlation analyses were performed between tensor metric values and motor function scores of participants with dyskinetic CP as assessed by the Gross Motor Function Classification System (GMFCS), the Bimanual Fine Motor Function (BFMF), and the Manual Ability Classification System (MACS). Results White matter integrity in both the CST and the CSTC pathways was reduced in people with dyskinetic CP. The GMFCS, MACS and, less commonly, the BFMF were associated with FA and, particularly, MD in most portions of these pathways. Interpretation The present study advances our understanding of the involvement of white matter microstructure in sensorimotor pathways and its relationship with motor impairment in people with dyskinetic CP. Our results are consistent with well‐described relationships between upper limb function and white matter integrity in the CST and CSTC pathways in other forms of CP. This knowledge may ultimately help prognosis and therapeutic programmes.

ABSTRACT: Dairy cows experiencing heat stress (HS) during the precalving portion of the transition period give birth to smaller calves and produce less milk and milk protein. Supplementation of rumen-protected methionine (RPM) has been shown to modulate protein, energy, and placenta metabolism, making it a potential candidate to ameliorate HS effects. We investigated the effects of supplementing RPM to transition cows under HS induced by electric heat blanket (EHB) on cow-calf performance. Six weeks before expected calving, 53 Holstein cows were housed in a tiestall barn and fed a control diet (CON, 2.2% Met of MP) or a CON diet supplemented with SmartamineM (MET, 2.6% Met of MP, Adisseo Inc., France). Four weeks precalving, all MET and half CON cows were fitted with an EHB. The other half of the CON cows were considered thermoneutral (TN), resulting in 3 treatments: CONTN (n = 19), CONHS (n = 17), and METHS (n = 17). Respiratory rate (RR), skin temperature (ST), and rectal temperature (RT) were measured thrice weekly and core body temperatures recorded biweekly. Postcalving BW and BCS were recorded weekly, and DMI was calculated and averaged weekly. Milk yield was recorded daily and milk components were analyzed every third DIM. Biweekly AA and weekly nonesterified fatty acids (NEFA), BHB, insulin, and glucose were measured from plasma. Calf birth weight and 24 h growth, thermoregulation, and hematology profile were measured and apparent efficiency of absorption (AEA) of immunoglobulins was calculated. Data were analyzed using the MIXED procedure of SAS with 2 preplanned orthogonal contrasts: CONTN versus the average of CONHS and METHS (C1) and CONHS versus METHS (C2). Relative to TN, EHB cows had increased RT during the postcalving weeks and increased RR and ST during the entire transition period. Body weight, BCS, DMI, and milk yield were not affected by the EHB or RPM. However, protein percentage and SNF were lower in CONHS, relative to METHS cows. At calving, METHS dams had higher glucose concentrations, relative to CONHS, and during the postcalving weeks, the EHB cows had lower NEFA concentrations than TN cows. Calf birthweight and AEA were reduced by HS, whereas RR was increased by HS. Calf withers height tended to be shorter and RT were lower in CONHS, compared with METHS heifers. Overall, RPM supplementation to transition cows reverts the negative effect of HS on blood glucose concentration at calving and milk protein percentage in the dams and increases wither height while decreasing RT in the calf.

Abstract Switching of light polarization on the sub-picosecond timescale is a crucial functionality for applications in a variety of contexts, including telecommunications, biology and chemistry. The ability to control polarization at ultrafast speed would pave the way for the development of unprecedented free-space optical links and of novel techniques for probing dynamical processes in complex systems, as chiral molecules. Such high switching speeds can only be reached with an all-optical paradigm, i.e., engineering active platforms capable of controlling light polarization via ultrashort laser pulses. Here we demonstrate giant modulation of dichroism and birefringence in an all-dielectric metasurface, achieved at low fluences of the optical control beam. This performance, which leverages the many degrees of freedom offered by all-dielectric active metasurfaces, is obtained by combining a high-quality factor nonlocal resonance with the giant third-order optical nonlinearity dictated by photogenerated hot carriers at the semiconductor band edge.

We study the time-momentum representation of the kernel needed to compute the hadronic vacuum polarization contribution to the muon g-2 in the space-like region at next-to-leading order. For small values of the time, we present analytical series expansions; for large values of the time, we present numerical series expansions which overcome the problems showed by naïve asymptotic expansions. These results are to be employed in lattice QCD determination of the hadronic vacuum polarization contribution to the muon g-2 at next-to-leading order.

Internal and external factors can change an individual's phenotype. A significant external threat to humans and livestock is environmental heat load, a combination of high ambient temperatures and humidity. A heat stress response occurs when an endothermal animal is exposed to a heat load that challenges its’ thermoregulation capacity. With the ongoing climate change trends, the incidence of chronically elevated temperatures causing heat stress is expected to rise, posing an even greater risk to the health and survival of all species. Heat stress is generally related to adverse effects on food intake, health, and performance in mammal livestock species and humans. Evidence from epidemiological and experimental studies of humans and livestock demonstrated that exposing pregnant females to heat stress affects the phenotype of the newborn in various ways. For instance, in utero heat stress is related to lower BW at birth and changes in metabolic and immune functions in the newborn. In cows, the effects of heat stress on the performance of the offspring last for three or four generations, suggesting intergenerational effects. The molecular mechanism orchestrating these effects of heat stress may be epigenetic regulation, as various epigenetic mechanisms control genome reprogramming. Epigenetic modifications are attached to DNA and histone proteins and can influence how specific genes are expressed, resulting in phenotypic changes. Epigenetic modifications can be triggered in response to environmental heat stress without altering the DNA sequence. Heat stress insults during critical periods of organ development (i.e., fetal exposure) can trigger epigenetic modifications that impact health and productivity across generations. Thus, epigenetic changes caused by extreme temperatures can be passed down to the offspring if the mother is exposed to the insult during pregnancy. Understanding the phenotypic and molecular consequences of maternal heat stress, including the carry-over lingering effects on the resulting progeny, is necessary to develop effective mitigation strategies and gain translational knowledge about the fundamental processes leading to intergenerational and transgenerational inheritance. This review examines the phenotypic and molecular evidence of how maternal exposure to extreme heat can affect future generations in several species, including humans, swine, sheep, goats, and cattle. The current knowledge of the molecular mechanisms involved in intergenerational and transgenerational epigenetic inheritance will also be presented and discussed.

Abstract Background Deforestation is an important driver of malaria dynamics, with a relevant impact on mosquito ecology, including larval habitat availability, blood-feeding behaviour, and peak biting time. The latter is one of several entomological metrics to evaluate vectorial capacity and effectiveness of disease control. This study aimed to test the effect of forest cover percentage on the peak biting time of Plasmodium-uninfected and infected Nyssorhynchus darlingi females. Methods Mosquitoes were captured utilizing human landing catch (HLC) in the peridomestic habitat in field collections carried out in the wet, wet-dry transition, and dry seasons from 2014 to 2017 in areas with active malaria transmission in Amazonian Brazil. The study locations were in rural settlements in areas with the mean annual malaria parasite incidence (Annual Parasite Incidence, API ≥ 30). All Ny. darlingi females were tested for Plasmodium spp. infection using real time PCR technique. Forest cover percentage was calculated for each collection site using QGIS v. 2.8 and was categorized in three distinct deforestation scenarios: (1) degraded, 70% forest cover. Results The highest number of uninfected female Ny. darlingi was found in degraded landscape-sites with forest cover 70% forest cover, a peak biting at 19:00–20:00, and in sites with 30–70% forest cover at 22:00–23:00. Conclusions Results of this study show empirically that degraded landscapes favour uninfected Ny. darlingi with a peak biting time at dusk (18:00–19:00), whereas partially degraded landscapes affect the behaviour of Plasmodium-infected Ny. darlingi by shifting its peak biting time towards hours after dark (21:00–23:00). In preserved sites, Plasmodium-infected Ny. darling i bite around dusk (18:00–19:00) and shortly after (19:00–20:00).

ABSTRACT: In dairy cows, the lactating mammary glands synthesize serotonin, which acts in an autocrine-paracrine manner in the glands and is secreted into the periphery. Serotonin signaling during lactation modulates nutrient metabolism in peripheral tissues such as adipose and liver. We hypothesized that the elevation of circulating serotonin during lactation would increase nutrient partitioning to the mammary glands, thereby promoting milk production. Our objective was to elevate circulating serotonin via intravenous infusion of the serotonin precursor 5-hydroxytryptophan (5-HTP) to determine its effects on mammary supply and extraction efficiency of AA, and milk components production. Twenty-two multiparous mid-lactation Holstein cows were intravenously infused with 5-HTP (1 mg/kg body weight) or saline, in a crossover design with two 21-d periods. Treatments were infused via jugular catheters for 1 h/d, on d 1 to 3, 8 to 10, and 15 to 17 of each period, to maintain consistent elevation of peripheral serotonin throughout the period. Milk and blood samples were collected in the last 96 h of each period. Whole-blood serotonin concentration was elevated above saline control for 96 h after the last 5-HTP infusion. Dry matter intake was decreased for cows receiving 5-HTP, and on average they lost body weight over the 21-d period, in contrast to saline cows who gained body weight. Milk production and milk protein yield were lower in cows receiving 5-HTP during the 3 infusion days, but both recovered to saline cow yields in the days after. Although milk fat yield exhibited a day-by-treatment interaction, no significant difference occurred on any given day. Milk urea nitrogen concentration was lower in 5-HTP cows on the days following the end of infusions, but not different from saline cows on infusion days. Meanwhile, plasma urea nitrogen was not affected by 5-HTP infusion. Circulating concentrations of AA were overall transiently decreased by 5-HTP, with concentrations mostly returning to baseline within 7 h after the end of 5-HTP infusion. Mammary extraction efficiency of AA was unaffected by 5-HTP infusion. Overall, both lactation performance and circulating AA were transiently reduced in cows infused with 5-HTP, despite sustained elevation of circulating serotonin concentration.

Cold and heat stress present welfare challenges for dairy calves. The consequences of thermal stress on biological functioning have been well documented, and many housing and management strategies have been evaluated to mitigate those detrimental impacts. In cold weather, mitigation strategies have largely focused on nutritional interventions or limiting heat loss with resources such as bedding or jackets. In hot weather, heat abatement strategies such as supplemental shade, increased environmental air exchange through passive ventilation, and forced air movement through mechanical ventilation have been evaluated. Recently in Wisconsin's continental climate, our group evaluated how 2 aspects of calf welfare—the needs for thermal comfort and social contact (i.e., pair or group housing vs. individual housing)—may align or conflict in winter and summer, respectively. In both seasons, calves pair-housed in outdoor hutches preferred social proximity. When 2 calves shared a hutch, the heat load was greater than for a single calf, which may be beneficial for thermal comfort in winter. In summer, the potential detriments from the additional heat load of 2 calves was mitigated with passive hutch ventilation, which calves preferred. Nonetheless, knowledge gaps remain regarding the impacts of thermal stress on calves' affective states, and much remains unknown about their preferences and motivations for specific thermal stress mitigation resources. Future research to address these gaps could improve our understanding of calf welfare and inform best practices for calf management.

Objetivo. Este estudo teve como objetivo estimar a prevalência da doença de Chagas (DC) crônica (DCC) na população brasileira, em mulheres e em mulheres em idade fértil. Métodos. Foi realizada uma metanálise da literatura para extrair dados de prevalência de DCC na população brasileira, em mulheres e em mulheres em idade fértil, em municípios do Brasil, no período 2010–2022. Indicadores relacionados com a DCC disponíveis nos sistemas de informação em saúde foram selecionados em escala municipal. A modelagem estatística dos dados extraídos da metanálise em função daqueles obtidos dos sistemas de informação foi aplicada a modelos lineares, lineares generalizados e aditivos. Resultados. Foram selecionados os cinco modelos mais adequados de um total de 549 modelos testados para obtenção de um modelo de consenso (R2 ajustado = 54%). O preditor mais importante foi o cadastro autorreferido de DCC do sistema de informação da Atenção Primária à Saúde. Dos 5 570 munícipios brasileiros, a prevalência foi estimada como zero em 1 792 (32%); nos 3 778 municípios restantes, a prevalência média da doença foi estimada em 3,25% (± 2,9%). O número de portadores de DCC foi estimado na população brasileira (~3,7 milhões), mulheres (~2,1 milhões) e mulheres em idade fértil (~590 mil). A taxa de reprodução da doença foi calculada em 1,0336. Todas as estimativas se referem ao intervalo 2015–2016. Conclusões. As prevalências estimadas de DCC, especialmente entre mulheres em idade fértil, evidenciam o desafio da transmissão vertical em municípios brasileiros. Estas estimativas são comparadas aos padrões de projeções matemáticas, sugerindo sua incorporação ao Pacto Nacional para a Eliminação da Transmissão Vertical da DC.

Introduction: Childhood caries remains a major public health issue in Brazil’s impoverished communities. Although government-sponsored programs have targeted improvement of oral health in children from public schools, more information is needed on the effectiveness of these programs. Objective: The objective was to analyze the prevalence and factors associated with caries in children aged 5 and 12 years in public versus private schools. Methods: This cross-sectional study included 857 children aged 5 (n=509) and 12 years (n=348) who attended public (n=416) or private (n=441) schools in Patos, PB-Brazil. Between March–September 2018 we examined caries from this study population using the DMFT/dmft index and obtained data on its demographics, toothbrushing frequency, socioeconomic status and schools’ oral health program and services via questionnaires. Statistical analyses were performed using multiple logistic regression (p

Introduction: In the WHO eligibility criteria, there is agreement that hypertensive women taking Oral Contraceptive Hormonal Combined (OCHC) may be at increased risk of cardiovascular disease. The risk-to-benefit ratio hinges on the severity of the condition. While a mild increase in blood pressure is a common occurrence in consumers of OCHC, the potential for developing high blood pressure exists during oral contraceptive use. Consequently, there is a possibility of increased cardiovascular risk, with limited available data on this issue. Objective: To evaluate the potential effects of OCHC on blood pressure through a systematic review with statistical analysis of existing randomized controlled trials. Method: This systematic review with statistical comparison adheres to the recommendations outlined in the PRISMA (Principal Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The analysis strategy involves comparing the mean difference in blood pressure change according to the type of treatment, in addition to the calculation of clinically relevant outcomes (CRO). Results: Our findings suggest a clinically relevant outcome related to the increase in blood pressure in users of ethinyl estradiol combined with gestodene in a cyclic regimen over 6 months. Conversely, a decrease in blood pressure was observed among users of ethinyl estradiol combined with chlormadinone over 24 months of usage. Conclusion: While our study found minor variations in blood pressure across varying forms of oral contraceptives, these differences are not significant enough to warrant specific clinical recommendations. However, the results suggest that individuals with hypertension should exercise caution with ethinyl estradiol, particularly when administered cyclically alongside gestodene, due to the potential risk of increased blood pressure. Additionally, the use of oral contraceptives containing ethinyl estradiol paired with chlormadinone acetate or ethinyl estradiol combined with drospirenone may be more suitable for individuals at a high risk of developing hypertension.

The dormant state of bacterial spores is generally thought to be devoid of biological activity. We show that despite continued dormancy, spores can integrate environmental signals over time through a preexisting electrochemical potential. Specifically, we studied thousands of individual Bacillus subtilis spores that remain dormant when exposed to transient nutrient pulses. Guided by a mathematical model of bacterial electrophysiology, we modulated the decision to exit dormancy by genetically and chemically targeting potassium ion flux. We confirmed that short nutrient pulses result in step-like changes in the electrochemical potential of persistent spores. During dormancy, spores thus gradually release their stored electrochemical potential to integrate extracellular information over time. These findings reveal a decision-making mechanism that operates in physiologically inactive cells.

Homeostasis and thermoregulation are influenced by the interplay of hair coat and skin characteristics. Our previous work indicated that hair and skin adaptations, triggered by in utero heat stress, affect thermoregulation in postnatal life. Herein, we investigate multigenerational carry-over effects of late-gestation heat stress on hair and skin characteristics beyond the first generation. Pregnant Holstein dams (F0, grand-dams) were heat stressed (HT, shade, n = 41) or provided active cooling (CL, shade, fans, and water soakers, n = 41) for the last 56 d of gestation during summer (temperature-humidity index ≥68). The first generation of heifers (F1, daughters) who were in utero heat stressed (HTF1, n = 36) or not (CLF1, n = 37) were born and raised as a cohort from birth to first calving. Thirty second-generation heifers (F2, granddaughters), born to HTF1 (HTF2, n = 12) and CLF1 (CLF2, n = 18), were raised as a cohort from birth to 70 d of age. Hair samples and skin biopsies from HTF2 and CLF2 were collected on postnatal d 70 (n = 6/group). Hair samples were subdivided into topcoat and undercoat, and skin tissue was fixed for ~18 h in 10% formalin, dehydrated, paraffin-embedded, sectioned, and stained with hematoxylin and eosin to visualize morphology. Variables analyzed included hair length and diameter; stratum corneum cross-sectional area and thickness; epidermis thickness; sweat gland depth, number, cross-sectional area, and average size; and sebaceous gland number, cross-sectional area, and average size. Measurements were performed using the ImageJ software and analyzed using PROC MIXED in SAS (SAS Institute Inc.). Hair length and diameter tended to be shorter and thicker in HTF2, compared with CLF2. The HTF2 skin had smaller stratum corneum cross-sectional area and tended to a thinner epidermis. to CLF2, HTF2 skin had more but smaller sebaceous glands, whereas no differences in sweat glands were observed. In summary, we report phenotypic alterations in hair and skin characteristics of granddaughters. Whether these adaptations grant improved postnatal thermoregulatory ability for the granddaughters remains to be investigated.

Although active ventilation via fans is an effective and widely adopted heat abatement method for use with adult dairy cattle, it has yet to be investigated in outdoor hutch-housed dairy calves despite most US calves being raised in such systems. We investigated a solar-powered fan system for outdoor calf hutches and its effect on hutch microclimate and calf thermoregulation. During summer, a 3 × 3 Latin square was replicated 4 times (n = 12 preweaning heifers) with 4-d exposure periods to minimally (CON; rear windows closed), passively (PASS; rear windows opened), or actively (ACT; solar-powered fan, activated at dry bulb temperature [Tdb] > 21°C) ventilated hutch systems. Hutch microclimate and calf thermoregulation were evaluated either continuously (Tdb, humidity, rectum surface temperature, and behavior) or after a daily 30-min inside restriction (air speed, air particle number, noise level, respiration, and sweating rate, and skin and rectal temperature). Active ventilation substantially increased hutch air speed relative to PASS and CON (1.76 vs. 0.19 vs. 0.05 m/s). However, PASS hutches had the lowest INT Tdb (27.2 vs. 26.4 vs. 27.8°C), whereas ACT INT Tdb was reduced at 0900 and 1000 h relative to CON but not PASS. Similarly, ACT reduced calf respiration rates and lowered rectum surface temperature at 0800 and 0900 h when compared with CON but not PASS. The lack of strong ACT influence on calf outcomes over PASS could partially be explained by the decreased proportion of time ACT calves spent inside their hutch (48.7 vs. 67.3 vs. 64.1% of each hour). Overall, ACT improved hutch microclimate and calf responses relative to CON but not PASS. Either ACT or PASS ventilation may be sufficient to provide heat abatement to continental hutch-housed calves.

Purpose The aim of the present study was to analyse the within-week variations according to the internal (rate of perceived exertion [RPE], and session-RPE) and external (jump height average, minimum jump, maximal jump, range of jump, number of jumps and density) intensity. Methods Twelve male elite/international volleyball athletes from the Portuguese 1st division (age: 21.7 ± 4.19 years of age; experience: 6.2 ± 3.8 years; body mass: 85.7 ± 8.69 kg; height: 192.4 ± 6.25 cm; body mass index: 23.1 ± 1.40 kg/m 2 ) participated in this study. The players were monitored over 26 microcycles, 101 training sessions, and 20 matches. To assess the workload, the CR10 Borg scale and an inertial measurement unit (IMU) were used. Results According to the internal workload, RPE revealed significant differences between MD-4 and MD-2, MD-4 and MD1, MD-3 and MD-1, and MD-2 and MD-1 ( p < 0.05). In the same line, session RPE showed significant differences between MD-4 and MD-2, MD-4 and MD-1, MD-3 and MD-2, MD-3 and MD-1, and MD-2 and MD-1 ( p < 0.05). On the other hand, the external load demands revealed statistical differences regarding the number of jumps (MD-4 and MD-2, MD-4 and MD-1, MD-3 and MD-1, and MD-2 and MD-1) and the density of the training sessions (MD-4 and MD-1, and MD-2 and MD-1). Conclusions The primary findings of this study suggest that higher-intensity training sessions tend to occur during the middle of the week, with a tapering effect observed as the competition date approaches.

ABSTRACT: The objective was to unravel the peripartum immune and metabolic changes associated with metritis in Holstein cows. Holstein cows (n = 128) had blood collected at −14, 0, 3, and 7 d relative to parturition (DRP). Flow cytometry was used to evaluate blood leukocyte counts, proportions, and activation. Total cells, live cells, single cells, monocytes (CD172α+/CD14+), polymorphonuclears (CD172α+/CD14-/SSChigh), B-cells (CD21+/MHCII+), CD4+ T-cells (CD4+), CD8+ T-cells (CD8+), and γδ T-cells (γδTCR+) were evaluated. Both CD62L and CD11b were used as markers of cell activation. Major histocompatibility complex class II was used as a marker of antigen presentation in monocytes. A Milliplex Bovine Cytokine/Chemokine 08-plex kit was used to evaluate plasma concentrations of IFN-γ, IL-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, and tumor necrosis factor-α. The body weight (BW) change prepartum was calculated as the difference between calving BW and prepartum BW divided by the number of days between measurements. Plasma fatty acids (FA) were measured at −14 and 0 DRP using untargeted gas chromatography with time-of-flight mass spectrometry. Data were analyzed by ANOVA for repeated measures. Cows that developed metritis (n = 57) had greater prepartum BW, prepartum BW loss, and greater FA concentrations at calving. Plasma FA at calving was positively correlated with IL-1β. Cows that developed metritis had persistent systemic inflammation, which was demonstrated by greater B-cell activation, greater pro-inflammatory cytokine concentrations, and greater cell damage pre- and postpartum. Postpartum, we observed greater polymorphonuclear cell activation and extravasation but lesser monocytes and CD4+ T-cells activation and extravasation, which suggests postpartum immune tolerance. Greater prepartum adiposity in cows that developed metritis may lead to systemic inflammation pre- and postpartum and immune tolerance postpartum, which may lead to failure to prevent bacterial infection, and development of puerperal metritis.

(1) The prevention of cytomegalovirus (CMV) in lung transplant recipients (LTx) is based on the administration of VGC for a period of 6–12 months, but there is little information on the premature discontinuation of the drug. Our objective was to evaluate the reasons for early cessation of VGC and the dynamics of CMV replication after discontinuation. (2) We carried out a retrospective study of LTx on VGC prophylaxis according to guidelines, with an outpatient follow-up period of >90 days. The detection of any level of CMV-DNA in the plasma (Cobas, Roche Diagnostics®) during a period of 18 months after the discontinuation of VGC was considered positive. (3) We included 312 patients (64% male, mean age 53.50 ± 12.27; 71% D+R+, 15% D−R+, and 14% D+R−) in our study. The prescribed prophylaxis was completed by 179 patients (57.05%). The mean duration of prophylaxis was 7.17 ± 1.08 months. The recorded reasons for VGC discontinuation in 133 patients (43%) were myelotoxicity (n = 55), impaired renal function (n = 32), and gastrointestinal disturbances (n = 11). The reason for discontinuation was not recorded for 29 patients. CMV-DNA was detected in 79% (n = 246) of cases, and D+R+ and D+R− recipients showed a high risk of detection (p < 0.001). The median times to onset of CMV-DNA detection were 35 days in D+R−, 73 days in D+R+, and 96 days in D−R+ (p < 0.001). (4) Adverse effects of VGC are frequent in LTx. CMV-DNA detection is very common after the discontinuation of VGC and is related to the CMV donor and recipient serostatus.

Disorders affecting the neurological and musculoskeletal systems represent international health priorities. A significant impediment to progress in trials of new therapies is the absence of responsive, objective, and valid outcome measures sensitive to early disease changes. A key finding in individuals with neuromuscular and musculoskeletal disorders is the compositional changes to muscles, evinced by the expression of fatty infiltrates. Quantification of skeletal muscle composition by MRI has emerged as a sensitive marker for the severity of these disorders; however, little is known about the composition of healthy muscles across the lifespan. Knowledge of what is ‘typical’ age-related muscle composition is essential to accurately identify and evaluate what is ‘atypical’. This innovative project, known as the MuscleMap, will achieve the first important steps towards establishing a world-first, normative reference MRI dataset of skeletal muscle composition with the potential to provide valuable insights into various diseases and disorders, ultimately improving patient care and advancing research in the field.

Postoperative urinary retention (POUR) is a well-known complication after gynecologic surgery. Our objective was to investigate whether the choice of pharmacologic agent for reversing neuromuscular blockade at the end of a hysterectomy is a risk factor for POUR. Among adult patients undergoing hysterectomy with general anesthesia from 2012 to 2017, those who received aminosteroid nondepolarizing neuromuscular agents followed by pharmacologic reversal were identified, and electronic health records were reviewed. The cohort was dichotomized into two groups by reversal agent: 1) sugammadex and 2) neostigmine with glycopyrrolate. The primary outcome, POUR, was defined as unplanned postoperative bladder recatheterization. A propensity-adjusted analysis was performed to investigate the association between POUR and reversal agent by using inverse probability of treatment weighting to adjust for potential confounders. We identified 1,974 patients, of whom 1,586 (80.3%) received neostigmine-glycopyrrolate and 388 (19.7%) received sugammadex for reversal of neuromuscular blockade. The frequency of POUR was 24.8% (393/1,586) after reversal with neostigmine-glycopyrrolate and 18.3% (71/388) with sugammadex. Results from the propensity-adjusted analysis showed that sugammadex was associated with a lower POUR risk than neostigmine-glycopyrrolate (odds ratio 0.53, 95% confidence interval [CI] 0.37 - 0.76, P < 0.001). A post hoc analysis of sugammadex recipients who received glycopyrrolate for another indication showed a higher POUR risk than among those who did not receive glycopyrrolate (odds ratio 1.86, 95% CI 1.07 - 3.22, P = 0.03). Use of sugammadex to reverse aminosteroid neuromuscular blocking agents is associated with decreased risk of POUR after hysterectomy. A potential mechanism is the omission of glycopyrrolate, which is coadministered with neostigmine to mitigate unwanted cholinergic effects.