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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected over 200 million people worldwide and has likely exposed millions of neonates to SARS-CoV-2 in utero. A large body of literature has examined the possibility of vertical transmission from pregnant women infected with SARS-CoV-2 to their neonates. In this chapter, we review mechanisms of—and evidence for—vertical transmission of SARS-CoV-2, including transplacental, through other biospecimens and breastfeeding, and discuss neonatal outcomes following in utero exposure. Based on the available literature, we conclude vertical transmission of SARS-CoV-2 is rare, and exposed neonates generally show favorable health outcomes.

Neuropsychiatric disorders including anxiety and depression can be induced by stress, but not all individuals exposed to stress develop psychopathology. Therefore, probing the neural substrates that underlie trait vulnerability to stress may open the door for preventive approaches that use biological markers to identify at-risk populations. Here, we developed a novel tracing technique to probe local connectivity patterns as predictors of individual variability in stress responses. Specifically, we combined a retrograde transsynaptic rabies tracing system with cFos colocalization immediately after an acute stressor to elucidate local structural and stress-activated (functional) differences in connectivity within the amygdala complex in female and male mice along a spectrum of social approach/avoidance following acute social defeat stress. While we find no structural or functional connections within the amygdala complex as predictors of individual variability in our behavioral readout, our methods provide a novel approach to investigating cellular and behavioral individual variability in stress responses. Furthermore, we identify overall stress-activation as a predictor of social approach/avoidance in two subregions, medial amygdala and piriform-amygdala area, which may serve as potential biological markers of trait vulnerability, with possible clinical applicability.Significance StatementExposure to stress is ubiquitous, but the outcomes of stress exposure vary greatly between individuals. Our work introduces a novel tracing technique to probe for structural and functional connectivity patterns across a broad spectrum of behavioral responses to social stress. Utilizing pre-clinical classification in conjunction with representative behavioral classification introduces to the field a mechanism to identify potential clinical targets for preventative screening for neuropsychiatric disorders as well as further individualized treatment. Notably, our work identifies two intra-amygdalar neural correlates of social stress, opening the door for future investigation of the role these regions play in mediating social stress.

Weight and appetite loss in cancer patients, referred to as the cancer anorexia-cachexia syndrome, is a complex, multifactorial syndrome, defined by an ongoing loss of skeletal muscle mass, with or without loss of fat mass, which cannot be fully reversed by conventional nutritional support, and may lead to progressive functional impairment. It is a hypercatabolic state in the context of chronic inflammatory response best described in the setting of cancer but can also be seen in other advanced chronic illness. Cancer cachexia occurs in approximately 50% of cancer patients, and in 80% of those with advanced cancer. It impacts adversely on function, treatment tolerability and treatment response, and health service utilization, but most importantly, dignity, sense of self, quality of life, and survival. The pathophysiology of cancer cachexia is complex and multifactorial. It is characterized by a negative protein and energy balance, driven by a variable combination of reduced food intake, increased resting energy expenditure, and net loss of lean tissue. The best approach to weight and appetite loss among cancer patients is a multimodal therapy, in which a personalized combination of pharmacologic and nonpharmacologic treatments is implemented. This chapter will provide an overview of the cancer anorexia cachexia syndrome as relevant to the practice of clinicians of all disciplines managing cancer patients.