[Analysis of the prevalence of anticoagulant therapy in patients with cognitive disorders and cerebral amyloid angiopathy (CAA)]. / Analyse zur Häufigkeit einer gerinnungshemmenden Medikation bei Patientinnen mit kognitiven Störungen und zerebraler Amyloidangiopathie (CAA).

OBJECTIVES: To investigate the prevalence of coincident anticoagulation in patients with cognitive disorders and possible or probable cerebral amyloid angiopathy (CAA) as well as the relationship between the presence of oral anticoagulation and CAA-specific lesion load. MATERIALS AND METHODS: Patients with subjective cognitive decline (SCD), amnestic and non-amnestic mild cognitive impairment (aMCI/naMCI), Alzheimer's disease (AD), mixed dementia (MD) and vascular dementia (VD) who presented to our outpatient dementia clinic between February 2016 and October 2020 were included in this retrospective analysis. Patients underwent cranial magnetic resonance imaging (MRI). MRI data sets were analyzed regarding the presence of CAA-related MRI biomarkers to determine CAA prevalence. Presence of anticoagulant therapy was determined by chart review. RESULTS: Within the study period, 458 patients (209 male, 249 female, mean age 73.2 ± 9.9 years) with SCD (n = 44), naMCI (n = 40), aMCI (n = 182), AD (n = 120), MD (n = 68) and VD (n = 4) were analyzed. A total of 109 patients (23.8%) were diagnosed with possible or probable CAA. CAA prevalence was highest in aMCI (39.4%) and MD (28.4%). Of patients with possible or probable CAA, 30.3% were under platelet aggregation inhibition, 12.8% were treated with novel oral anticoagulants and 3.7% received phenprocoumon treatment. Regarding the whole study cohort, patients under oral anticoagulation showed more cerebral microbleeds (p = 0.047). There was no relationship between oral anticoagulation therapy and the frequency of cortical superficial siderosis (p = 0.634). CONCLUSION: CAA is a frequent phenomenon in older patients with cognitive disorders. Almost half of CAA patients receive anticoagulant therapy. Oral anticoagulation is associated with a higher number of cortical and subcortical microbleeds.

[Current findings on the coincidence of cerebral amyloid angiopathy and Alzheimer's disease]. / Aktuelle Befunde zur Koinzidenz von zerebraler Amyloidangiopathie und Alzheimer-Erkrankung.

Cerebral amyloid angiopathy (CAA) is closely related to Alzheimer's disease (AD) despite having distinct pathomechanisms. The CAA modulates cognitive impairment within AD by synergistic effects. The pathophysiologic relations are complex and incompletely understood, possibly due to the heterogeneous nature of CAA with its different subtypes. Both diseases are characterized by a pathologic amyloid metabolism but the pathologic processing of amyloid precursor proteins is distinct. The manifestation of vascular and parenchymal amyloid deposits can either overlap or occur independently and isolated. The investigation of the specific contribution of co-occurring CAA within AD to cognitive deficits requires diagnostic methods that sufficiently identify CAA severity and complexity as well as detailed neuropsychological testing to precisely characterize the cognitive deficits and to draw conclusions regarding their etiology.

[Intracerebral hemorrhage under platelet inhibition and oral anticoagulation in patients with cerebral amyloid angiopathy]. / Intrazerebrale Blutungen unter Plättchenaggregationshemmung und oraler Antikoagulation bei Patienten mit zerebraler Amyloidangiopathie.

Oral anticoagulation in patients with cerebral amyloid angiopathy is a therapeutic challenge. The association of cerebral amyloid angiopathy with intracerebral hemorrhage, a high mortality of intracerebral hemorrhage especially under oral anticoagulation and the high risk of recurrent bleeding require a multidisciplinary approach and a thorough risk-benefit analysis. Vitamin K antagonists increase the risk of intracerebral bleeding and the accompanying mortality by 60% and should be avoided if possible or reserved for special clinical situations (e.g. mechanical aortic valve replacement). Treatment with novel oral anticoagulants and antiplatelet drugs also increases the risk of cerebral bleeding and therefore needs a thorough risk-benefit evaluation. An interventional left atrial appendage closure is a promising therapeutic option especially in patients with an absolute arrythmia with atrial fibrillation. Furthermore, other clinical implications in patients with cerebral amyloid angiopathy are the subject of this review of the literature, such as special characteristics after acute ischemic stroke and the necessary secondary prophylaxis, with previous intracerebral hemorrhage and in patients with cognitive deficits.

Regulating, fostering and preserving: the production of sexual normates through cognitive ableism and cognitive othering.

People with cognitive disabilities are commonly positioned as risky sexual subjects. This article discusses the discursive production of sexual normates in the form of desirable and normative able-minded sexual subjects, in scientific research on the sexuality and cognitive disabilities of younger and older individuals (in particular those with dementia). We identify three interrelated discourses: regulating sexuality; fostering sexuality; and preserving sexuality. The first of these, regulation, pathologises sexuality of people with cognitive disabilities as faulty and in need of restriction. The second discourse, fostering, is more affirmative and argues for educating for a 'healthy' sexuality of people with cognitive disabilities, to mitigate risks of abuse. This discourse is more salient with younger people. The third discourse, preservation, in contrast, is more visible with older people with dementia and affirms sexuality so long as it is consistent with a 'genuine' or 'authentic' sexuality of the past. In conclusion, scientific research reinforces the cultural ideal of the rational and autonomous individual (and as such the mature/adult) capable of making independent decisions and engaging in healthy, good sex, based on stable sexual identities. Findings demonstrate how age intersects with cognitive ableism to intensify the cultural anxiety that exists around the sexualities of people with cognitive disabilities.

Homogeneous environmental selection dominates microbial community assembly in the oligotrophic South Pacific Gyre.

Oligotrophic subtropical gyres are the largest continuous biomes on Earth and play a key role in global biogeochemical cycles. Microbial communities govern primary production and carbon cycling in the oligotrophic South Pacific Gyre, yet the ecological processes which underpin microbial biogeography in the region remain understudied. We investigated microbial biogeography and community assembly processes at three depths over a ~2,000-km the transect was longitudinal, so ran from 32°S, 170°W to 32°S, 152°W). Thus the latitude (32°S) was constant. Microbial communities in the surface waters (15 and 50 m) were remarkably similar across the transect, whilst communities at the deep chlorophyll maximum were distinct from the surface waters and displayed greater compositional heterogeneity. An ecological null model approach indicated that homogeneous selection was the dominant community assembly process in both the surface waters (100%) and at the deep chlorophyll maximum (91.81%), although variable selection (2.34%) and stochastic processes (5.85%) had a minor influence at the deep chlorophyll maximum. Homogeneous selection (76.69%77.90%), dispersal limitation (15.00%-20.05%) and variable selection (3.01%-7.11%) influenced community assembly between the surface waters and the deep chlorophyll maximum. Seawater density and temperature, which were correlated, were the most important environmental modulators of the balance between stochastic and deterministic assembly processes. Our findings demonstrate remarkable similarity in microbial community composition across longitudinal scales in the oligotrophic South Pacific Gyre, underpinned by strong environmental selection which overwhelms the influence of ecological drift. These data significantly advance our understanding of microbial community dynamics in the oligotrophic subtropical gyres which dominate the Earth's surface.

Relationships between protein and energy consumed from milk replacer and starter and calf growth and first-lactation production of Holstein dairy cows.

The objective was to determine relationships between protein and energy consumed from milk replacer and starter and calf growth and first-lactation production of Holstein heifer calves. Milk replacer and starter protein intake and metabolizable energy (ME) intake data were collected from 4,534 Holstein heifer calves for growth and 3,627 Holstein cows for production from birth year of 2004 through 2014. Calves from 3 commercial dairy farms were assigned to 45 different calf research trials at the University of Minnesota Southern Research and Outreach Center, Waseca, Minnesota, from 3 to 195 d of life. Calves were moved to heifer growers at 6 mo of age, and calves were returned to their farm of birth a few weeks before calving. Most calves (85%) were fed a 20% crude protein and 20% fat milk replacer at a rate of 0.57 kg/calf daily. Metabolizable energy and protein consumed from milk replacer and starter were calculated for each individual calf for 6 and 8 wk of age. Mixed model analyses were conducted to determine the effect of protein and energy consumed from both milk replacer and starter on calf growth and first-lactation 305-d production of milk, fat, and protein, adjusting for herd, season of birth, year, average daily gain (ADG), and calf trial. Calves with ADG >0.80 kg/d consumed more combined protein and ME than calves with lower ADG. Protein and ME intake from calf starter affected growth more than protein and ME intake from milk replacer because most calves were fed the same fixed amount of milk replacer. Calves born during the fall and winter had greater combined protein and ME intake than calves born during the spring and summer. Milk replacer protein and ME intake did not have a relationship with first-lactation 305-d milk, fat, and protein production. However, starter protein and ME intake during the first 6 and 8 wk of age had a significant positive relationship with first-lactation 305-d milk, fat, and protein production. Consequently, combined protein and combined ME intake had a positive effect on 305-d milk, fat, and protein production. Variance in protein and ME intake was high, suggesting that additional factors affect calf growth during the first 8 wk of life and milk production in first lactation.

Deep carbon export from a Southern Ocean iron-fertilized diatom bloom.

Fertilization of the ocean by adding iron compounds has induced diatom-dominated phytoplankton blooms accompanied by considerable carbon dioxide drawdown in the ocean surface layer. However, because the fate of bloom biomass could not be adequately resolved in these experiments, the timescales of carbon sequestration from the atmosphere are uncertain. Here we report the results of a five-week experiment carried out in the closed core of a vertically coherent, mesoscale eddy of the Antarctic Circumpolar Current, during which we tracked sinking particles from the surface to the deep-sea floor. A large diatom bloom peaked in the fourth week after fertilization. This was followed by mass mortality of several diatom species that formed rapidly sinking, mucilaginous aggregates of entangled cells and chains. Taken together, multiple lines of evidence-although each with important uncertainties-lead us to conclude that at least half the bloom biomass sank far below a depth of 1,000 metres and that a substantial portion is likely to have reached the sea floor. Thus, iron-fertilized diatom blooms may sequester carbon for timescales of centuries in ocean bottom water and for longer in the sediments.

A 100-Year Review: Calf nutrition and management.

The first calf paper, published in the May 1919 issue of the Journal of Dairy Science (JDS), described factors affecting birth body weight of different breeds of calves. Other studies were done on nonmilk ingredients, growth charts were developed, and early weaning was followed to conserve milk fed to calves. Calf papers did not report use of statistics to control or record variation or to determine whether treatment means were different. Many experiments were more observational than comparative. Typically fewer than 5 calves, and sometimes 1 or 2 calves, were used per treatment. During the next 20 yr, calf studies increased and included colostrum feeding, milk and milk replacer feeding, minerals and vitamins, and fats and oils. Many concepts fundamental to current knowledge and understanding of digestion, rumen development, and milk replacer formulation were developed during this period. In addition, the concept of using antibiotic growth promoters in dairy calf diets was first evaluated and developed during the 1950s. During the 20-yr period of January 1957 through December 1976, a large number of universities in the United States and 1 in Canada contributed almost 150 papers on a variety of calf-related topics. These topics included genetics, physiology of the calf, review of calf immunity, antibiotic feeding, and milk replacer ingredients. This became the golden era of calf rumen development studies, which also engendered studies of calf starter rations and ingredients. A classic review of management, feeding, and housing studies summarized research related to calf feeding and management systems up to that point with an emphasis on maintaining calf growth and health while reducing labor and feed costs. It was also during this period that metric measurements replaced English units. In the 20-yr period from 1977 to 1996, more than 400 articles on calf nutrition and management were published in JDS. With the growing research interest in calves, a paper outlining standardized procedures for conducting and reporting data from calf experiments was first published. A very active area of calf nutrition research from the late 1970s to the mid 1980s was colostrum quality, feeding, and preservation; more than 60 such research articles were published in the journal during this time. Various nonmilk protein sources were evaluated. Extensive studies were done evaluating trace and major mineral requirements in calves along with some vitamin studies. Throughout the 1970s, 1980s, and 1990s, the primary objective of most calf research was how to wean healthy, adequately grown calves at an early age-generally less than 30 d of age. This program was reviewed in a 1979 publication. Research on calf starter ingredients, nutrient composition, and additives was minimal in the 1980s and 1990s given the importance of starter intake to the success of early weaning, but the role of water intake in starter intake and growth was established. Research on issues with calves continued to increase during the last 20-yr period as evidenced by publication of more than 580 articles in JDS as well as many more in other refereed journals. In addition to papers contributed by several universities in the United States and Canada, the number of papers authored by scientists at universities and institutes in other countries increased dramatically during this period. Factors influencing colostral antibody absorption, heat treatment of colostrum, and efficacy of colostrum supplements and replacers were reported. Most studies in this period related to nutrition. Studies were published supporting greater neonatal growth rates from feeding more milk replacer but with a higher crude protein content than traditional. Protein energy effects on growth and body composition were evaluated in concert with greater growth rates. Milk and nonmilk protein sources in milk replacers along with AA supplementation were evaluated. Limited studies were done with fat sources and fatty acid supplementation along with trace minerals and fat-soluble vitamins. Waste milk feeding and heat treatment became more prevalent. Studies established starter ingredient palatability and use of forage when fed with pelleted starters. With the advent of automatic milk and milk replacer feeders, factors influencing how and when to wean were established. Research programs established factors affecting calf behavior and welfare. Several databases were evaluated along with various published studies, and established calf growth during the first 2 mo was subsequently reflected in first- and later-lactation milk production of those calves. A new area of calf research that emerged from 1997 on was the effects of maternal environment and nutrition on calf health, growth, and future productivity. From a mechanistic standpoint, the field of epigenetics seems likely to explain many of these phenomena. Some possibilities for future calf nutrition and management were elaborated.

Prevalence of superficial siderosis following singular, acute aneurysmal subarachnoid hemorrhage.

INTRODUCTION: Superficial siderosis is presumably a consequence of recurrent bleeding into the subarachnoid space. The objective of this study was to assess the prevalence of superficial siderosis after singular, aneurysmal subarachnoid hemorrhage (SAH) in the long term. METHODS: We retrospectively identified all patients who presented with a singular, acute, aneurysmal SAH at our institution between 2010 and 2013 and in whom a magnetic resonance imaging (MRI) including T2*-weighted imaging was available at least 4 months after the acute bleeding event. MRI scans were judged concerning the presence and distribution of superficial siderosis. Influence of clinical data, Fisher grade, localization, and cause of SAH as well as the impact of neurosurgical interventions on the occurrence of superficial siderosis was tested. RESULTS: Seventy-two patients with a total of 117 MRIs were included. Mean delay between SAH and the last available MRI was 47.4 months (range 4-129). SAH was Fisher grade 1 in 2 cases, 2 in 4 cases, 3 in 10 cases, and 4 in 56 cases. Superficial siderosis was detected in 39 patients (54.2%). In all patients with more than one MRI scan, localization and distribution of superficial siderosis did not change over time. Older age (p = 0.02) and higher degree of SAH (p = 0.03) were significantly associated with the development of superficial siderosis. CONCLUSION: Superficial siderosis develops in approximately half of patients after singular, aneurysmal SAH and might be more common in patients with an older age and a greater amount of blood. However, additional factors must play a role in whether a patient is prone to develop superficial siderosis or not.

Diffusion tensor imaging of the trigeminal nerve in patients with trigeminal neuralgia due to multiple sclerosis.

INTRODUCTION: Neurovascular compression (NVC) is the most common cause of trigeminal neuralgia (TN), leading to microstructural changes in the affected nerve detectable using diffusion tensor imaging (DTI). But TN may also emerge as a symptom of multiple sclerosis (MS). The aim of this study was to evaluate if patients with MS-related TN feature the same DTI characteristics as patients with TN caused by NVC. METHODS: Twelve patients with MS-related TN, 12 age-matched patients with NVC-related TN, and 12 healthy controls were included. Using 3T-DTI, mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for each affected and contralateral trigeminal nerve in patients with MS and NVC-related TN as well as healthy controls. Furthermore, presence of NVC was evaluated for patients with TN. RESULTS: There was no significant difference concerning FA or ADC when comparing the affected and the non-affected sides in patients with MS. FA was significantly lower and ADC higher in patients with MS on the TN affected as well as on the non-affected side compared to the non-affected side of patients with idiopathic TN or healthy controls. Likewise, FA was significantly lower on the affected side compared to the non-affected side in patients with idiopathic TN or healthy controls. NVC was evident in 41.7/0% on the affected/contralateral side in MS patients and 100/8% in the patients with NVC-related TN. CONCLUSION: In patients with MS-related TN, DTI reveals microstructural changes within the trigeminal nerve not only on the affected side but also on the clinically non-affected side.

Six month outcomes in patients experiencing weight gain after gastric bypass who underwent gastrojejunal revision using an endoluminal suturing device.

BACKGROUND: Weight gain after Roux-en-Y gastric bypass occurs in approximately 25 % of cases, and this may contribute to recurrence of comorbid conditions. Currently, adequate treatment strategies for this group of patients are limited. Endoscopic narrowing of the gastrojejunal anastomosis may result in a low-risk, minimally invasive treatment alternative compared to standard surgical revision. We assessed short-term outcomes in patients undergoing endoscopic gastrojejunal revisions (EGJR) using an endoluminal suturing device. METHODS: We performed an institutional review board-approved retrospective analysis of 25 consecutive patients who underwent EGJR. Patients preoperatively presented with a dilated gastrojejunal anastomosis of greater than 15 mm and weight gain. An endoluminal suturing device (Overstitch(TM), Apollo Endosurgery, Austin TX) was used to reduce the diameter of the anastomosis. Follow-up occurred at 2 and 6 weeks, 3 and 6 months, and 1 year RESULTS: Prior to EGJR, patients regained an average of 23.4 ± 13.2 kg from their weight loss nadir and had a mean body mass index of 42.2 ± 6.6 kg/m(2). At 6 weeks, 100 % of patients experienced weight loss (average 5.8 ± 4.4 kg; p < .001). At 3 months, 94 % had weight loss (average 7.0 ± 6.2 kg; p < .001). At 6 months, 91 % maintained weight loss (average 5.6 ± 6.2 kg; p = 0.013). Lastly, at 1 year following EGJR, 100 % of available cases maintained weight loss (average 7.5 ± 6.4 kg; p = 0.057). The average percent excess weight loss was 12.5, 15.4, 12.4, and 17.1 % at 6 weeks, 3 and 6 months, and 1 year, respectively. There was a negative time effect in the mixed effect model using both on-treatment and intent-to-treat analyses, illustrating a significant weight reduction over time. The average follow-up per patient was 146 days. There were no complications reported during the follow-up period. CONCLUSIONS: Six month follow-up for EGJR patients demonstrated a low-risk, minimally invasive treatment option to reverse weight gain subsequent to a failed gastric bypass. Procedures presented no complications and may provide an attractive alternative to standard surgical revision.

Invited review: palmitic and stearic acid metabolism in lactating dairy cows.

Energy is the most limiting nutritional component in diets for high-producing dairy cows. Palmitic (C16:0) and stearic (C18:0) acids have unique and specific functions in lactating dairy cows beyond a ubiquitous energy source. This review delineates their metabolism and usage in lactating dairy cows from diet to milk production. Palmitic acid is the fatty acid (FA) found in the greatest quantity in milk fat. Dietary sources of C16:0 generally increase milk fat yield and are used as an energy source for milk production and replenishing body weight loss during periods of negative energy balance. Stearic acid is the most abundant FA available to the dairy cow and is used to a greater extent for milk production and energy balance than C16:0. However, C18:0 is also intimately involved in milk fat production. Quantifying the transfer of each FA from diet into milk fat is complicated by de novo synthesis of C16:0 and desaturation of C18:0 to oleic acid in the mammary gland. In addition, incorporation of both FA into milk fat appears to be limited by the cow's requirement to maintain fluidity of milk, which requires a balance between saturated and unsaturated FA. Oleic acid is the second most abundant FA in milk fat and likely the main unsaturated FA involved in regulating fluidity of milk. Because the mammary gland can desaturate C18:0 to oleic acid, C18:0 appears to have a more prominent role in milk production than C16:0. To understand metabolism and utilization of these FA in lactating dairy cows, we reviewed production and milk fat synthesis studies. Additional and longer lactation studies on feeding both FA to lactating dairy cows are required to better delineate their roles in optimizing milk production and milk FA composition and yield.

Time-of-flight angiography: a viable alternative to contrast-enhanced MR angiography and fat-suppressed T1w images for the diagnosis of cervical artery dissection?

OBJECTIVES: To compare the use of an unenhanced high-resolution time-of-flight MR angiography sequence (Hr-TOF MRA) with fat-suppressed axial/coronal T1-weighted images and contrast-enhanced angiography (standard MRI) for the diagnosis of cervical artery dissection (cDISS). METHODS: Twenty consecutive patients (9 women, 11 men, aged 24-66 years) with proven cDISS on standard MRI underwent Hr-TOF MRA at 3.0 T using dedicated surface coils. Sensitivity (SE), specificity (SP), positive and negative predictive values (PPV, NPV), Cohen's kappa (к) and accuracy of Hr-TOF MRA were calculated using the standard protocol as the gold standard. Image quality and diagnostic confidence were assessed on a four-point scale. RESULTS: Image quality was rated better for standard MRI (P = 0.02), whereas diagnostic confidence did not differ significantly (P = 0.27). There was good agreement between Hr-TOF images and the standard protocol for the presence/absence of cDISS, with к = 0.95 for reader 1 and к = 0.89 for reader 2 (P < 0.001). This resulted in SE, SP, PPV, NPV and accuracy of 97 %, 98 %, 97 %, 98 % and 97 % for reader 1 and 93 %, 96 %, 93 %, 96 % and 95 % for reader 2. CONCLUSIONS: Hr-TOF MRA can be used to diagnose cDISS with excellent agreement compared with the standard protocol. This might be useful in patients with renal insufficiency or if contrast-enhanced MR angiography is of insufficient image quality. KEY POINTS: • New magnetic resonance angiography sequences are increasingly used for vertebral artery assessment. • A high-resolution time-of-flight sequence allows the diagnosis of cervical artery dissection. • This technique allows the diagnosis without intravenous contrast medium. • It could help in renal insufficiency or when contrast-enhanced MRA fails.

Cow-level association between serum 25-hydroxyvitamin D concentration and Mycobacterium avium subspecies paratuberculosis antibody seropositivity: a pilot study.

Vitamin D deficiency has been associated with various human diseases. Therefore, the objective of this study was to evaluate the cow-level association between serum 25-hydroxyvitamin D [25(OH)D] concentration and Mycobacterium avium ssp. paratuberculosis (MAP) seropositivity of dairy cows, adjusting for diet, breed, hair coat color, stage of lactation, reproductive status, and cow age. The sera of 80 MAP antibody ELISA-positive and 80 test-negative herd mates from 5 Minnesota dairy herds were analyzed for 25(OH)D and 1,25-dihydroxyvitamin D [1,25(OH)(2)D]. The cows' age, production records, and hair coat color were recorded. Additionally, feed samples were obtained and analyzed for vitamin D(2) and vitamin D(3) content. A linear mixed model was used to identify potential predictors for serum 25(OH)D concentration, accounting for herd of origin. The majority of rations analyzed had over 22,000 IU of vitamin D/day (maximum: 52,000 I U/d) and the study cows' average serum 25(OH)D concentration was 62.5 ± 13.8 ng/mL. Serum ELISA-positive cows had, on average, 5.3 ng/mL lower 25(OH)D serum levels than test-negative herd mates. The reproductive status of cows was also associated with the 25(OH)D levels, with fresh cows having the lowest serum concentration. In this cross-sectional study, a temporal or causal association between MAP antibody ELISA status and serum 25(OH)D concentration could not be evaluated. In addition, the high levels of vitamin D in the rations of participating farms and the average 25(OH)D serum concentration suggest that additional supplementation with vitamin D in the ration is likely to be ineffective.

Effects of milk replacer program fed 2 or 4 times daily on nutrient intake and calf growth.

The aims of this study were to determine if feeding frequency (FF) of milk replacer (MR; meals/d) alters starter intake, growth, and efficiency of growth in nursery calves fed a conventional or accelerated MR. We hypothesized that smaller and more frequent MR meals would increase starter intake and growth when greater amounts of MR nutrients are fed to nursery calves. Forty-eight Holstein and Holstein-cross heifer and bull calves were assigned to treatments in a 2 × 2 factorial arrangement of MR and FF. Treatments included (1) standard 20% CP and 20% fat MR fed at 1.5% of body weight (BW; 2 meals/d; STD2), (2) standard 20% CP and 20% fat MR fed at 1.5% of BW (4 meals/d; STD4), (3) modified 26% CP and 18% fat MR fed at 2.0% of BW (2 meals/d; MOD2), and (4) modified 26% CP and 18% fat MR fed at 2.0% of BW (4 meals/d; MOD4; n=12). All calves were fed at 0600 and 1700 h and STD4 and MOD4 calves were fed 2 additional meals at 1100 and 1400 h, resulting in the same amount of MR offered for the 2 × and 4 × treatments. Treatments were fed from d 2 to 42 of age and all MR feeding rates were adjusted weekly to maintain MR solids intakes at 1.5 or 2.0% of BW for STD and MOD diets, respectively, and were reconstituted to 15% total solids. Milk replacer FF was reduced by 50% on d 36 and calves were weaned on d 42. Calves were housed in hutches bedded with straw and offered water and a texturized 18% CP starter ad libitum. Calf body weight and body structure were measured weekly and starter intake and fecal scores were measured daily. Through both 42 and 56 d, calves fed MOD had greater CP and fat intake, resulting in increased average daily gain, heart girth, circulating nonesterified fatty acids (NEFA), and muscle total lipid compared with calves fed STD diets. Calves fed MOD diets consumed less starter grain than STD calves but total dry matter intake was similar among treatments. Increased FF for STD calves resulted in greater starter intake at weaning but increasing FF of MOD calves did not have this effect. Due to differences in starter intake, total dry matter by calves through d 56 was similar across treatments. Additionally, increased FF tended to increase serum NEFA concentrations. Serum NEFA concentration was negatively correlated with starter intake. The BW of calves fed STD2 and STD4 treatments almost doubled and the BW of calves on the MOD2 and MOD4 treatments doubled by d 56. Increased FF of the conventional MR program but not accelerated MR program increased starter intake. Increased FF did not affect growth, starter intake, or gain:feed ratio.

Evaluation of Processed Nerve Allograft in Peripheral Nerve Surgery: A Systematic Review and Critical Appraisal.

Peripheral nerve injuries cause substantial problems when not treated properly. A specific problem is reconstruction of nerve defects, which can be treated in different ways. This study aimed to systematically review whether processed nerve allograft (PNA) is justified in reconstruction of a nerve defect in patients after posttraumatic or iatrogenic peripheral nerve injury and to compare PNA with other established methods. Methods: A systematic review with a focused question, PICO (patient, intervention, comparison, outcome) and constraints, was performed. A structured literature search, including several databases, was done to evaluate the existing evidence for outcomes and postoperative complications related to PNA. The certainty of evidence was classified according to Grading of Recommendations, Assessment, Development and Evaluations. Results: No conclusions, concerning differences in outcome of nerve reconstruction using PNA compared with the use of nerve autograft or conduits, could be drawn. The level of certainty for all evaluated outcomes was very low (⊕◯◯◯). Most published studies lack a control group to patients treated with PNA; being only descriptive, making it difficult to compare PNA with established methods without substantial risk of bias. For studies including a control group, the scientific evidence was of very low certainty, due to a low number of included patients, and large, undefined loss of patients during follow-up, rendering a high risk of bias. Finally, the authors often had financial disclosures. Conclusion: Properly conducted randomized controlled trial studies on the use of PNA in reconstruction of peripheral nerve injuries are needed to establish recommendations in clinical practice.

Volcaniclastic density currents explain widespread and diverse seafloor impacts of the 2022 Hunga Volcano eruption.

The impacts of large terrestrial volcanic eruptions are apparent from satellite monitoring and direct observations. However, more than three quarters of all volcanic outputs worldwide lie submerged beneath the ocean, and the risks they pose to people, infrastructure, and benthic ecosystems remain poorly understood due to inaccessibility and a lack of detailed observations before and after eruptions. Here, comparing data acquired between 2015 - 2017 and 3 months after the January 2022 eruption of Hunga Volcano, we document the far-reaching and diverse impacts of one of the most explosive volcanic eruptions ever recorded. Almost 10 km3 of seafloor material was removed during the eruption, most of which we conclude was redeposited within 20 km of the caldera by long run-out seafloor density currents. These powerful currents damaged seafloor cables over a length of >100 km, reshaped the seafloor, and caused mass-mortality of seafloor life. Biological (mega-epifaunal invertebrate) seafloor communities only survived the eruption where local topography provided a physical barrier to density currents (e.g., on nearby seamounts). While the longer-term consequences of such a large eruption for human, ecological and climatic systems are emerging, we expect that these previously-undocumented refugia will play a key role in longer-term ecosystem recovery.

No stimulation of nitrogen fixation by non-filamentous diazotrophs under elevated CO2 in the South Pacific.

Nitrogen fixation by diazotrophic cyanobacteria is a critical source of new nitrogen to the oligotrophic surface ocean. Research to date indicates that some diazotroph groups may increase nitrogen fixation under elevated pCO2 . To test this in natural plankton communities, four manipulation experiments were carried out during two voyages in the South Pacific (30-35o S). High CO2 treatments, produced using 750 ppmv CO2 to adjust pH to 0.2 below ambient, and 'Greenhouse' treatments (0.2 below ambient pH and ambient temperature +3 °C), were compared with Controls in trace metal clean deckboard incubations in triplicate. No significant change was observed in nitrogen fixation in either the High CO2 or Greenhouse treatments over 5 day incubations. qPCR measurements and optical microscopy determined that the diazotroph community was dominated by Group A unicellular cyanobacteria (UCYN-A), which may account for the difference in response of nitrogen fixation under elevated CO2 to that reported previously for Trichodesmium. This may reflect physiological differences, in that the greater cell surface area:volume of UCYN-A and its lack of metabolic pathways involved in carbon fixation may confer no benefit under elevated CO2 . However, multiple environmental controls may also be a factor, with the low dissolved iron concentrations in oligotrophic surface waters limiting the response to elevated CO2 . If nitrogen fixation by UCYN-A is not stimulated by elevated pCO2 , then future increases in CO2 and warming may alter the regional distribution and dominance of different diazotroph groups, with implications for dissolved iron availability and new nitrogen supply in oligotrophic regions.

Effects of feeding wheat straw or orchardgrass at ad libitum or restricted intake during the dry period on postpartum performance and lipid metabolism.

The objectives of this study were to investigate the effects of forage source [wheat straw (WS) or orchardgrass hay (OG)] and total amount of diet dry matter fed [ad libitum or restricted to 70% of predicted dry matter intake (DMI)] prepartum on postpartum performance. The study design was a 2×2 factorial design with 10 cows per treatment. Treatments were WS total mixed ration (TMR) ad libitum, OG TMR ad libitum, WS TMR restricted, and OG TMR restricted. The WS TMR (dry matter basis) contained 30% WS, 20.7% corn silage, 10.0% alfalfa hay, 18.2% ground corn, 16.8% soybean meal, and 4.3% molasses mineral mix (14.7% CP, 1.5 Mcal/kg of net energy for lactation, 37.0% neutral detergent fiber). The OG TMR contained 30% OG, 46.2% corn silage, 10.0% alfalfa hay, 9.5% soybean meal, and 4.3% molasses (14.2% CP, 1.5 Mcal/kg of net energy for lactation, 41.0% neutral detergent fiber). Cows received 1 lactation diet after calving (17.7% CP, 1.6 Mcal/kg of net energy for lactation, 27.3% neutral detergent fiber). Total diet DMI prepartum was higher for ad libitum than for restricted as designed, but forage source had no effect on DMI. Total tract apparent digestibilities of DM and NDF were greater for OG than for WS. Postpartum DMI expressed as a percentage of body weight for the first week of lactation was higher for ad libitum than for restricted diets. Postpartum DMI during the first 30 d of lactation was higher for OG than for WS, but no effect was observed for the amount fed prepartum. Milk yield during the first week of lactation was higher for OG than for WS; however, during the first 30 d, 3.5% fat-corrected milk yield and yield of milk fat were highest for OG TMR restricted and WS TMR ad libitum. Prepartum treatments had a limited effect on pre- and postpartum lipid metabolism; however, cows fed WS TMR ad libitum had the highest postpartum ß-hydroxybutyrate. Eating behavior was observed by 10-min video scans of 24-h video surveillance for 5d pre- and postpartum. Prepartum eating time and eating bouts tended to be greater by WS than for OG, and postpartum eating time per kilogram of neutral detergent fiber intake tended to be greater for WS than for OG. Results indicate that forage source and amount of DM fed prepartum affected postpartum performance and tended to alter the behavior of cows in tie-stall barns.