Improved adherence to hip fracture standards reduces mortality after hip fractures.

BACKGROUND: Hip fractures are increasing in incidence due to increasing life expectancy. Mortality continues to improve but it is important to explore which factors are responsible for driving improvements. METHODS: A cohort of hip fracture patients predating SARS-CoV-2 was examined to determine the predictors of adherence to the six Irish Hip Fracture Standards (IHFS) and the impact of adherence on short (30 day) and long term (1 year) mortality. Our primary aim was assess the impact of a single HFS and cumulative number of HFS on mortality after hip fracture. Our secondary aim was to determine the impact of the HFS which are intrinsically linked to specialist Geriatric care. RESULTS: Across 962 patients, over 5 years, the factors which were associated with adherence to HFS were female gender, increasing ASA grade and being nursed on an orthopaedic ward. Patients with increasing ASA were more likely to have met HFS 4-6 (Geriatrician review HFS4, bone health HFS5 & specialist falls assessment HFS6), less likely to have surgery within 48 h are more likely to develop a pressure ulcer. If the patient was not nursed on an orthopaedic ward all HFS were less likely to be met. At 30 days HFS 4-6 were associated with a statistically significant odds ratio (OR) of being alive, while at one year HFS 1 (admitted to an orthopaedic ward within 4 h), 5 and 6 were associated with a statistically significant OR of being alive. As increasing numbers of hip fracture standards were met patients were more likely to be alive at 30 days and one year. CONCLUSION: This study has identified that improved adherence to hip fracture standards are associated with improved mortality at 30 days and one year.

Associations between the postpartum uterine and vaginal microbiota and the subsequent development of purulent vaginal discharge vary with dairy cow breed and parity.

The objective of this study was to characterize the species composition and functional potential of the vaginal and uterine microbiota at 1 wk postpartum in dairy cows diagnosed with or without purulent vaginal discharge (PVD) at 3 wk postpartum. The hypothesis was that differences in the vaginal and uterine microbiota between cows diagnosed with (PVD+) or without (PVD-) PVD were dependent on parity and breed. Cytobrush samples of the vagina and uterus were collected at 1 wk postpartum from 36 Holstein-Friesian (7 primiparous and 29 multiparous) and 29 Jersey (10 primiparous and 19 multiparous) cows. Microbial DNA was isolated from each sample and processed for shotgun metagenomic sequencing. The odds of multiparous cows being diagnosed as PVD+ was less compared with primiparous cows (OR = 0.21). Neither the α-diversity nor ß-diversity of the uterine and vaginal microbiota were associated with PVD but the ß-diversity was different between breeds and between parities. In the vagina of primiparous cows, differences in the microbiota of PVD- and PVD+ cows were minor, but the microbiota of multiparous PVD+ cows had greater relative abundance of Fusobacterium necrophorum, Trueperella pyogenes, Porphyromonas levii, and greater functional potential for amino acid and protein synthesis, energy metabolism, and growth compared with PVD- cows. The uterus of primiparous PVD+ cows had lesser relative abundance of Bacteroides heparinolyticus compared with PVD- cows. In the uterine microbiota, differences included greater functional potential for cellulose biosynthesis and fucose catabolism in multiparous PVD+ cows compared with PVD- cows. In the uterine microbiota of primiparous PVD+ cows, the functional potential for gram-negative cell wall synthesis and for negative regulation of tumor necrosis factor signaling was lesser compared with multiparous PVD+ cows. In the vagina of Holstein-Friesian PVD+ cows, the relative abundance of Caviibacter abscessus was greater whereas in the vagina of Jersey PVD+ cows the relative abundance of Catenibacterium mitsuokai, Finegoldia magna, Klebsiella variicola, and Streptococcus anginosus was greater compared with PVD- cows. In the uterine microbiota of Holstein-Friesian cows, the functional potential for spermidine biosynthesis was reduced compared with PVD- cows. In summary, differences in the species composition and functional potential of the vaginal and uterine microbiota between PVD- and PVD+ cows were dependent on parity and breed. The findings suggest that alternative strategies may be required to treat PVD for different parities and breeds of dairy cow.

The importance of animal welfare and Veterinary Services in a changing world.

Animal welfare is an essential component of the future of sustainable agriculture and the United Nations Sustainable Development Goals. There is growing global recognition of the importance of animal welfare, which must always be considered as part of the decision-making around food and nutrition security. Veterinary Services, encompassing public and private veterinarians and para-veterinarians, are custodians of animal welfare and key players in future actions to improve it. The welfare of animals is everyone's responsibility, from the individual farmer and practitioner to policymakers at the national and intergovernmental level. In this paper, after providing background information about current animal welfare issues and identifying animal welfare risks, the authors make a number of recommendations for action at the institutional and individual level. They do so because while the former is essential to generate change at scale and effective resourcing, the latter can create immediate action at a local level and drive change from the ground up. Without coordinated action from Veterinary Services, opportunities to improve animal welfare, alongside human and environmental health and well-being, may very well be lost, and animal welfare may fail to improve or even be at risk of decline.

L'accélération de la perturbation numérique depuis quelques années est spectaculaire, transformant tous les secteurs de l'économie, y compris la production animale, la santé animale et le bien-être des animaux. Les auteurs s'intéressent à certaines technologies numériques de pointe qui pourraient influencer le devenir des Services vétérinaires. Toutes ces technologies sont orientées données et trouvent leur illustration dans trois exemples qui se répartissent dans les catégories suivantes : a) les technologies sans fil et mobiles appliquées au suivi de la santé animale, à la surveillance des maladies, aux notifications des foyers et à l'échange d'informations ; b) les technologies avancées de traitement des données, dont les mégadonnées et l'analytique de données qui servent à mettre en évidence des structures sous-jacentes, à extraire des schémas prédictifs, à relever des corrélations et à générer d'autres informations ; c) des technologies prometteuses comme les applications « blockchain ¼ (chaînes de blocs) utilisées pour une gestion efficace et efficiente de diverses chaînes d'approvisionnement en intrants. Les auteurs résument brièvement les défis actuels associés au recours accru à ces technologies dans le secteur de la santé animale et en font ressortir certaines répercussions sur les Services vétérinaires. Les technologies numériques vont profondément affecter les modalités de la prestation des services de santé animale ainsi que la gestion des systèmes de santé animale. Par conséquent, il est crucial que les Services vétérinaires anticipent cette évolution et s'adaptent à la transformation numérique en cours. L'investissement dans les nouvelles technologies et les efforts visant à doter les professionnels vétérinaires actuels et futurs des compétences et des connaissances numériques nécessaires pour rester informés et au centre de l'innovation numérique dans le domaine de la santé animale doivent être les priorités des prochaines années.

El bienestar animal es un componente esencial de la agricultura sostenible del futuro y de los Objetivos de Desarrollo Sostenible fijados por las Naciones Unidas. Su importancia está cada vez más clara en todo el mundo. El bienestar de los animales debe ser siempre tenido en cuenta en los procesos decisorios que tocan a la seguridad alimentaria y nutricional. Los Servicios Veterinarios, que comprenden tanto a los veterinarios públicos y privados como al personal paraveterinario, son custodios del bienestar animal y agentes clave de toda acción futura encaminada a mejorarlo. Para lograr que el bienestar animal mejore desde ahora mismo, allí donde haga falta, y asegurar que siga un rumbo de constante progreso en el futuro, es preciso que todos los interlocutores, desde los productores y cuidadores hasta los planificadores de políticas de ámbito nacional e intergubernamental, hagan suya esta responsabilidad. Tras presentar información básica sobre los actuales problemas de bienestar animal y señalar los riesgos existentes en la materia, los autores formulan una serie de recomendaciones para actuar tanto desde las instituciones como a título individual, sabedores de que el primer nivel es fundamental para inducir cambios a gran escala y movilizar recursos eficazmente, mientras que el segundo puede generar inmediatamente acciones a escala local e impulsar desde ahí cambios en sentido ascendente. A falta de una labor coordinada de los Servicios Veterinarios, es muy posible que se pierdan oportunidades para mejorar el bienestar animal, junto con la salud y el bienestar de personas y ecosistemas, y que los niveles de bienestar animal no mejoren o, incluso, corran peligro de deterioro.

Polymerase chain reaction for human parechovirus on blood samples improves detection of clinical infections in infants.

Human parechovirus (HPeV) is an emerging pathogen for infants. Improved diagnostics are needed due to the non-specific clinical presentation. Real-time reverse transcription polymerase chain reaction (RT-PCR) on blood samples may be an adjunct to diagnosis. A retrospective cohort of HPeV-affected infants was used to assess sensitivity and specificity of a HPeV RT-PCR on blood and cerebrospinal fluid (CSF). As a secondary analysis, the Ct value of the PCR results was compared to clinical correlates of severity. Between 2017 and 2018 blood samples were obtained from 97 infants of whom 44 had HPeV clinical and laboratory proven infection. Eighty-three concurrent CSF samples were available. Sensitivity was 93.3% [95% CI 82-99] for blood HPeV RT-PCR and 85% [95% CI 73.9-96.1] for CSF HPeV RT-PCR. Blood HPeV RT-PCR Ct values < 25 cycles were associated with age < 28 days and < 3 days of symptoms. No statistical associations were identified between potential clinical markers of severity and Ct value. HPeV RT-PCR on blood is a valuable adjunct to diagnostic testing for acute HPeV-related illness in infants. Results can be expected to be robust until at least day 5 of symptoms, with optimal sampling occurring close to onset of symptoms.

Evaluation of delayed timing of artificial insemination with sex-sorted sperm on pregnancy per artificial insemination in seasonal-calving, pasture-based lactating dairy cows.

The objective was to use ovulation synchronization with timed artificial insemination (TAI) to evaluate the effect of timing of artificial insemination (AI) with frozen sex-sorted sperm on fertility performance in pasture-based compact calving herds. Ejaculates from 3 Holstein-Friesian bulls were split and processed to provide frozen sex-sorted sperm (SS) at 4 × 106 sperm per straw, and frozen conventional sperm at 15 × 106 sperm per straw (CONV). A modified Progesterone-Ovsynch protocol was used for estrous synchronization, with TAI occurring 16 h after the second GnRH injection for cows assigned to CONV, and either 16 h (SS-16) or 22 h (SS-22) for cows assigned to SS. Pregnancy diagnosis was conducted by transrectal ultrasound scanning of the uterus 35 to 40 d after TAI (n = 2,175 records available for analysis). Generalized linear mixed models were used to examine the effects of treatment on pregnancy per artificial insemination (P/AI). Fixed effects included treatment (n = 3), bull (n = 3), treatment by bull interaction, parity (n = 4), days-in-milk category (n = 3), and treatment by days-in-milk category, with herd (n = 24) included as a random effect. Pregnancy per AI was greater for CONV compared with both SS-16 and SS-22 (61.1%, 49.0%, and 51.3%, respectively), and the SS treatments did not differ from each other (relative P/AI for SS-16 and SS-22 vs. CONV were 80.2% and 84.0%, respectively). There were significant bull and treatment by bull interaction effects. Additional analysis was undertaken using a model that included herd as a fixed effect. This analysis identified marked herd-to-herd variation (within-herd relative P/AI for the combined SS treatments vs. CONV ranged from 48-121%). The tertile of herds with the best performance achieved a mean relative P/AI of 100% (range = 91-121%), indicating that P/AI equivalent to CONV is achievable with SS. Conversely, the tertile of herds with the poorest performance achieved a mean relative P/AI of 67% (range = 48-77%). We found that SS resulted in poorer overall P/AI compared with CONV sperm regardless of timing of AI. Marked variation existed between herds; however, one-third of herds achieved P/AI results equal to CONV. Identification of factors responsible for the large herd-to-herd variation in P/AI with SS, and development of strategies to reduce this variation, warrant further research.

Detection of Rickettsia spp. and Bartonella spp. in Ctenocephalides felis fleas from free-ranging crab-eating foxes (Cerdocyon thous).

Fleas are insects with a worldwide distribution that have been implicated in the transmission of several pathogens. The present study aimed to investigate the presence of Rickettsia spp. (Rickettsiales: Rickettsiaceae) and Bartonella spp. (Rhizobiales: Bartonellaceae) in fleas from free-ranging crab-eating foxes Cerdocyon thous (Linnaeus, 1766) (Carnivora: Canidae) from Rio Grande do Sul, southern Brazil. Fleas were collected manually from animals and used for the molecular detection of Rickettsia spp. and Bartonella spp. Twenty-nine C. thous were sampled in six municipalities. Four foxes were parasitized by 10 fleas, all of which were identified as Ctenocephalides felis (Bouché, 1935) (Siphonaptera: Pulicidae). DNA from Rickettsia felis Bouyer et al., 2001 and Rickettsia asembonensis Maina et al., 2016 were found in three and eight fleas, respectively. In four fleas, DNA of Bartonella sp. was identified. Phylogenetic analysis grouped Bartonella sp. together with other genotypes previously reported in C. felis worldwide. The scenario described in the present study highlights a Neotropical canid parasitized by the invasive cosmopolitan cat flea, which in turn, is carrying potentially invasive vector-borne microorganisms. These findings suggest that C. felis is adapted to wild hosts in wilderness areas in southern Brazil, hypothetically exposing the Neotropical fauna to unknown ecological and health disturbances.

The relationship between anogenital distance and fertility, and genome-wide associations for anogenital distance in Irish Holstein-Friesian cows.

The evaluation of anogenital distance (AGD), the distance from the center of the anus to base of the clitoris, as a potential fertility trait for genetic selection in dairy cows has generated recent interest. The objectives of this cross-sectional observational study were to (1) characterize the distribution and variability of AGD, (2) determine factors associated with AGD, (3) estimate heritability for AGD, (4) identify single nucleotide polymorphisms (SNP) associated with phenotypic variation of AGD, and (5) validate the relationship between categories of AGD and fertility in Irish Holstein-Friesian cows. Anogenital distance was measured using digital calipers in 1,180 Holstein cows (mean ± standard deviation: 225 ± 79 d in milk) from 10 dairy herds located in Munster, Ireland. In addition, age (yr), weight (kg), height at hip (cm), and body condition score (BCS) at the time of AGD measurement were determined in a subset of 281 cows. Genotype information available from 908 cows was subsequently imputed to the Illumina Bovine High Density BeadChip (Illumina Inc., San Diego, CA) for genome-wide association analysis of phenotypic variation in AGD. Overall, AGD had a normal distribution and high variability (mean ± standard deviation; 119.2 ± 11.6 mm). Anogenital distance was weakly but positively associated with cow age, hip height, and body weight, and negatively associated with BCS; the phenotypic variation in AGD that was explainable by these variables was small (coefficient of determination; R2 = 0.09, 0.06, 0.10, and 0.02, respectively). The estimated heritability for AGD was 0.37 (standard error of mean ± 0.08). Six SNP of suggestive significance were identified on Bos taurus autosomes 6, 15, 20, and 26; however, none of these SNP was related to previously identified candidate genes for fertility. Cows were categorized into quartiles (Q1; 86 to 111 mm; n = 311, Q2; 112 to 120 mm; n = 330; Q3; 121 to 127 mm; n = 265, and Q4; 128 to 160 mm; n = 274) based on AGD and the association with reproductive outcomes examined (21-d submission rate, pregnancy to first AI, pregnancy rate within 21, 42 and 84-d after the farm mating start date, and number of times bred). None of the reproductive variables differed significantly between AGD categories. In summary, despite identification of high variability and moderate heritability for AGD in Irish Holstein-Friesian cows, reproductive outcomes did not differ between categories of AGD. This latter result differs from our previous finding of an inverse relationship between AGD and pregnancy outcomes in first- and second-parity Canadian Holstein cows, emphasizing the need to test and validate this new phenotype in diverse cow populations.

Domestication and genetic improvement: balancing improved production against increased disease risks from inbreeding.

Successful selective breeding programmes have been under way in aquacultural species for many decades. Gains in growth rate as high as 900% have been reported. Programmes selecting for resistance and/or tolerance of specific pathogens have had similar success. However, no more than 10-20% of global aquaculture production is sourced from well-documented breeding programmes. Direct selection for resistance and/or tolerance in biosecure breeding programmes is difficult when classical breeding methods are used. Genomic selection is widely expected to become the most effective mode of selection against pathogens in fish and shellfish. In this paper, the authors explore the possible negative effects of genetic improvement programmes, especially those that stem from interactions between genetics and other components of the aquaculture production system, particularly disease. The main focus is the interaction between selective breeding and biosecurity. They suggest that a self-amplifying feedback loop can be created when biosecurity regulation causes a progressive reduction in genetic diversity and an increase in inbreeding, especially in smallholder hatcheries and farms in developing countries. The resulting inbreeding depression causes increased susceptibility to disease, which in turn increases the frequency and severity of epizootics. Greater losses due to disease again increase regulatory pressures and the cycle begins once more. This 'biosecurity-agro-economic-genetic' feedback loop is analogous to an 'extinction vortex' in wild populations. The authors believe that the loop can be broken by biosecure, aquacultural, genetic exchange networks, modelled on existing breed associations for terrestrial domestic animals. Such networks would constitute a global aquacultural gene pool, with enhanced environmental resilience, long-term capacity for adaptation and minimal inbreeding depression. However, such networks will also require innovative new pathogen management procedures, documentation and regulations to facilitate the exchange of broodstock and seed while still maintaining effective biosecurity.

Des programmes d'élevage sélectif d'espèces aquacoles sont mis en œuvre avec succès depuis plusieurs décennies. Des gains de croissance atteignant 900 % ont ainsi été enregistrés. Les programmes de sélection pour la résistance et/ou la tolérance vis-à-vis de certains agents pathogènes ont également été couronnés de succès. Néanmoins, la production issue des programmes de sélection connus et documentés ne représente guère plus de 10 à 20 % de la production aquacole mondiale. Il est difficile de procéder à une sélection directe des traits de résistance et/ou de tolérance tout en garantissant un bon niveau de biosécurité dès lors que les méthodes utilisées relèvent de l'élevage classique. La sélection génomique présente un immense potentiel et deviendra sans aucun doute la méthode de sélection la plus efficace contre les agents pathogènes affectant les poissons, les mollusques et les crustacés. Les auteurs analysent les effets négatifs potentiels associés aux programmes d'amélioration génétique, en particulier ceux résultant d'interactions entre les composantes génétiques et d'autres aspects, notamment sanitaires, des systèmes de production aquacole. Leur analyse est principalement axée sur les interactions entre l'élevage sélectif et la biosécurité. Ils évoquent le risque de création d'une boucle de réaction auto-amplificatrice dans les contextes où l'application de la réglementation en matière de biosécurité entraîne un déclin progressif de la diversité génétique et une hausse de la consanguinité, en particulier dans les écloseries et fermes de petite dimension des pays en développement. Le phénomène de dépression de consanguinité qui en résulte entraîne une sensibilité accrue aux maladies, ce qui à son tour accroît la fréquence et la gravité des épizooties. Le regain des pertes dues à ces maladies se traduit par de nouvelles pressions exercées au plan réglementaire, de sorte que le cycle est relancé une nouvelle fois. Cette boucle de réaction biosécurité-agroéconomie-génétique est similaire à la « spirale de l'extinction ¼ qui affecte les populations sauvages. Les auteurs considèrent que cette boucle peut être rompue en mettant en place des réseaux d'échange de ressources génétiques biosécurisées pour l'aquaculture, sur le modèle des associations d'éleveurs opérant dans le domaine des espèces domestiques terrestres. Ces réseaux permettraient de constituer un patrimoine génétique mondial pour l'aquaculture doté d'une résilience environnementale améliorée, d'une capacité d'adaptation sur le long terme et d'un niveau minime de dépression de consanguinité. Néanmoins, de tels réseaux nécessiteront des procédures nouvelles et innovantes de gestion des agents pathogènes, ainsi qu'une documentation et des réglementations spécifiques afin de faciliter les échanges de stocks de géniteurs et de semence tout en garantissant un niveau approprié de biosécurité.

Hace ya muchos decenios que se vienen aplicando con éxito programas de reproducción selectiva de especies acuícolas, con aumentos de las tasas de crecimiento que llegan a veces hasta un 900%. Los programas de selección de rasgos de resistencia y/o de tolerancia a determinados patógenos han cosechado un éxito similar. Sin embargo, no más de un 10% a un 20% de la producción acuícola mundial tiene su origen en programas de reproducción bien documentados. La selección directa de rasgos de resistencia y/o tolerancia mediante programas reproductivos que ofrezcan garantías de seguridad biológica resulta difícil cuando se aplican métodos clásicos de cría. Ahora cunde la expectativa de que la selección genómica llegue a ser el modo de selección más eficaz contra la presencia de patógenos en el pescado y el marisco. Los autores examinan los posibles efectos negativos de los programas de mejora genética, sobre todo los que resultan de la interacción entre la genética y otros componentes del sistema de producción acuícola, en particular las enfermedades, prestando especial atención a la interacción entre cría selectiva y seguridad biológica y postulando que se puede engendrar un ciclo de retroalimentación que se va autoamplificando cuando los reglamentos de seguridad biológica inducen una progresiva reducción de la diversidad genética y un incremento de la consanguinidad (o endogamia), especialmente en los pequeños viveros y granjas de países en desarrollo. La consiguiente depresión endogámica genera una mayor sensibilidad a las enfermedades, lo que a su vez incrementa la frecuencia y gravedad de las epizootias. El aumento de las pérdidas por enfermedades se traduce en una mayor presión reglamentaria, y así da comienzo de nuevo el ciclo. Este ciclo de retroalimentación entre seguridad biológica, agroeconomía y genética es análogo a un «vórtice de extinción¼ en las poblaciones silvestres. Los autores piensan que es posible quebrar esta dinámica recurriendo a redes de intercambio de material genético biológicamente seguro en el ámbito de la acuicultura, a imagen de las asociaciones que existen entre los criadores de animales domésticos terrestres. Estas redes constituirían una reserva mundial de genes de acuicultura que ofrecerían mayor resiliencia a las condiciones ambientales y una duradera capacidad de adaptación, así como niveles mínimos de depresión endogámica. Semejantes redes, sin embargo, también exigirán nuevos y novedosos procedimientos de lucha contra patógenos, sistemas de documentación y reglamentos que faciliten el intercambio de genitores y alevines manteniendo a la vez niveles elevados de seguridad biológica.

Periapical infection may affect birth outcomes via systemic inflammation.

OBJECTIVES: Maternal dental periapical infections are associated with preterm birth and intrauterine growth restriction. This study investigates whether the association is mediated through bacterial spread from periapical lesions to placenta (direct pathway) or systemic inflammatory reaction (indirect pathway). MATERIALS AND METHODS: We compared birth outcomes in Malawian mothers with and without periapical infection. As markers of a direct pathway, we identified placental bacteria using a 16S rDNA approach and assessed histological evidence of inflammation in the placenta and amniotic membranes. We measured C-reactive protein, alpha-1-acid glycoprotein, and salivary cortisol as markers of an indirect pathway. We used regression models to associate the predictor variables with duration of pregnancy and newborn size. RESULTS: Of 1,024 women, 23.5% had periapical infection. There was no association of periapical infection with either bacterial DNA or histological inflammation in placenta or membranes. Periapical infection was associated with C-reactive protein, alpha-1-acid glycoprotein, and cortisol concentrations in a dose-dependent manner at 36 weeks. Addition of alpha-1-acid glycoprotein or cortisol concentration into regression models attenuated the association between periapical infection and pregnancy outcomes. CONCLUSION: There was no evidence of direct spread of periapical bacteria to the placenta. Periapical infections and adverse pregnancy outcomes are in part mediated through systemic inflammation.

Development and calibration of a multi-delay coherence imaging diagnostic on the MAST-U tokamak.

The MAST-U Super-X divertor provides the opportunity to study fusion plasma exhaust under novel conditions. However, in order to study these conditions, advanced diagnostics are required. Following the development of the MAST-U Multi-Wavelength Imaging (MWI) diagnostic, we present the installation of a multi-delay coherence imaging spectroscopy (CIS) system within the MAST-U MWI, along with modifications made to the MWI for effective operation. This diagnostic will measure either carbon ion flow velocities and temperatures or electron densities through Dγ emission. We have extended previously developed techniques for wavelength calibration to account for errors due to the misalignment of interferometer components. In addition, we have developed a comprehensive calibration procedure to account for the temperature dependence of the instrument's delays by fitting to a linearly modified version of the delay equation presented by Veiras et al. [Appl. Opt. 49(15), 2769 (2010)]. Together, these procedures reduce the cost and hardware complexity of implementing CIS instruments when compared to those that use in situ or tunable laser calibration systems, as calibrations can be generated to good accuracy using previously measured data.

PYY3-36 infused systemically or directly into the VTA attenuates fentanyl seeking in male rats.

More effective treatments for fentanyl use disorder are urgently needed. An emerging literature indicates that glucagon-like peptide-1 receptor (GLP-1R) agonists attenuate voluntary opioid taking and seeking in rodents. However, GLP-1R agonists produce adverse malaise-like effects that may limit patient compliance. Recently, we developed a dual agonist of GLP-1Rs and neuropeptide Y2 receptors (Y2Rs) that attenuates fentanyl taking and seeking at doses that do not produce malaise-like effects in opioid-experienced rats. Whether activating Y2Rs alone is sufficient to reduce opioid taking and seeking, however, is not known. Here, we investigated the efficacy of the Y2R ligand PYY3-36 to reduce fentanyl self-administration and the reinstatement of fentanyl-seeking behavior, a model of relapse in humans. Male rats were allowed to self-administer fentanyl (2.5 µg/kg, i.v.) for 21 days on a fixed-ratio 5 (FR5) schedule of reinforcement. Rats were then pretreated with vehicle or PYY3-36 (50 µg/kg s.c.; 0.1 and 1.0 µg/100 nL intra-VTA) prior to fentanyl self-administration test sessions. There were no effects of systemic or intra-VTA PYY3-36 on intravenous fentanyl self-administration. Opioid taking was then extinguished. Prior to subsequent reinstatement test sessions, rats were pretreated with vehicle or PYY3-36 (50 µg/kg s.c.; 0.1 and 1.0 µg/100 nL intra-VTA). Both systemic and intra-VTA administration of PYY3-36 attenuated fentanyl reinstatement in male rats at doses that did not affect food intake or produce adverse malaise-like effects. These findings indicate that Y2R agonism alone is sufficient to decrease fentanyl-seeking behavior during abstinence in opioid-experienced rats and further support strategies aimed at targeting Y2Rs for treating opioid use disorders.

The "Standing Peanut" Scaphoid View: A Semi-supinated Radiographic View for Intraoperative Evaluation of Screw Placement in Scaphoid Waist Fractures.

Scaphoid waist fractures are the most common fracture of the scaphoid. Operative management is indicated with unstable fractures and often for nondisplaced waist fractures to decrease time to union and return to work/sport. Screw placement within the central axis of the scaphoid is paramount and correlates with outcomes. Assessment of intrascaphoid screw placement is classically done via intraoperative fluoroscopy. An additional fluoroscopic view is presented to assist in confirming implant positioning. Along with the standard anterioposterior, lateral, pronated oblique, and "scaphoid" view we obtain a "standing peanut" view for assessment of central screw placement. This view also allows for further evaluation of center/center positioning and better assessment of fixation crossing the fracture into the proximal pole. The "standing peanut" view is best obtained in a sequential manner beginning with the forearm in neutral rotation. First, the forearm is then supinated 30 degrees; next, the wrist is placed at 45 degrees of ulnar deviation. Then finally, 10 degrees of wrist extension. We utilize this additional intraoperative view in conjunction with the standard fluoroscopic views for assessing and ensuring center-center implant positioning, particularly within the proximal pole. When ensuring center-center positioning, we prefer this view as an adjunct view to the standard fluoroscopic views intraoperatively. It provides a beneficial view of the proximal pole delineating the number of screw threads that have obtained proximal pole purchase. We have found it particularly useful in the setting of scaphoid waist fracture nonunion with the classic 'humpback' deformity after correction with volar interposition grafting. Standard radiographic views may be misinterpreted regarding implant positioning if there remains any residual flexion. The view requires little in the way of training to obtain once appreciated and exposes the patient to minimal additional radiation.

Intramedullary Threaded Nail Fixation Versus Plate and Screw Construct in Metacarpal Neck Fractures: A Biomechanical Study.

BACKGROUND: Indicated surgical management of metacarpal neck fractures varies with techniques, including Kirschner wire fixation, plate fixation, intramedullary fixation, and headless compression screw fixation, without demonstrated superiority. This study compares intramedullary threaded nail (ITN) fixation with a locking plate construct. METHODS: Index through small finger metacarpals were harvested from 10 embalmed cadavers. After application of appropriate exclusion criteria, remaining metacarpals underwent neck fracture creation by a three-point load to failure. Eight samples were randomly allocated to fixation with ITN fixation, and six were stabilized with a 2.3-mm seven-hole locking plate. Samples were then subjected to a second round of biomechanical testing using the same apparatus. Ultimate load between the intact tissue and the subsequently stabilized fracture was analyzed with a paired Student t -test. Percentage change in ultimate load in the intact tissue and stabilized tissue was calculated, and the magnitude of relative difference between the two groups was analyzed using unpaired Student t -tests. Statistical difference was defined by a P value of < 0.05. RESULTS: Both groups demonstrated the ability to handle a biomechanical load; however, both were significantly weaker than the intact tissue (paired Student t -test p ITN-fixed versus p ITN-intact = 0.006; p plate-fixed versus p plate-intact = 0.002). ITN samples demonstrated a higher load to failure (unpaired Student t -test p ITN-fixed versus p plate-fixed = 0.039). CONCLUSION: ITN provides a biomechanically stronger fixation constructed for vertically oriented metacarpal neck fractures compared with locking plate fixation. Both ITN and locking plate constructs provide stabilization capable of tolerating a biomechanical load; however, both fixation modalities are weaker than the native tissue.

Identifying the unmet supportive care needs of individuals affected by testicular cancer: a systematic review.

PURPOSE: To critically appraise studies to identify experiences of unmet supportive care needs of individuals affected by testicular cancer. METHODS: A registered priori systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. CINAHL, PsycINFO, and MEDLINE were searched for quantitative, qualitative, and mixed methods studies using a wide range of search terms. All articles were double screened according to a pre-determined eligibility criterion. Reference lists of the final included studies were checked for further eligible studies. The review process was managed using Covidence systematic review software. Data from the studies were extracted, methodological quality appraisal conducted, and a narrative synthesis conducted. RESULTS: Of the 72 papers identified, 36 studies were included. In descending order of frequency of need, psychological needs were identified in 26/36, physical needs 18/36, interpersonal/intimacy needs 19/36, health system/information needs 11/36, cognitive needs 9/36, social needs 7/36, and of equal frequencies counts of 4/36 for family, practical, and patient-clinician information needs. Only one study explored spiritual needs and no daily living needs were identified. CONCLUSIONS: The experience of needs varied in terms of frequency and distress which were commonly influenced by the age of the individual across the cancer care continuum persisting after 1-year post-treatment. IMPLICATIONS FOR CANCER SURVIVORS: When caring for individuals affected by testicular cancer, clinicians are encouraged to take a holistic lens to cancer care, particularly to explore issue or concerns that young men affected by testicular cancer might be embarrassed or reticent to discuss.

Isotopic and geochemical data from Barry Lake, Canada: A 900-year record of environmental change.

The data reported here consist of oxygen and hydrogen isotope compositions for 145 modern water samples, and geochemical measurements for gravity cores of sediment, all collected from Barry Lake, a small kettle lake located in Ontario, Canada. The geochemical measurements for the sediment organic matter include organic carbon and total nitrogen isotope compositions, organic carbon and total nitrogen contents and chlorophyll a content. The carbon and oxygen isotope compositions of marl contained in these sediments are also reported, along with the calcite and quartz contents of the sediment sample. Mass accumulation rates of total organic carbon, total nitrogen, chlorophyll a and calcite are reported. Dating of these sediments shows that they span ∼900 years. The stable isotope compositions of the modern waters and marl are useful to researchers studying how effective moisture (the net of water inputs vs outputs) changed in southern Ontario across the last ∼900 years. Proxies derived from the organic fraction of the lake sediments will be of interest to researchers of small Ontario lakes seeking to contextualize recent increases in primary production related to eutrophication. A discussion of these data, and a comparison of these data to other cores in the Great Lakes Region, is available in "A 900-year record of effective moisture in the Great Lakes Region" (Doyle et al., 2021).

∼14 000 years of geochemical and isotopic data from Lake Simcoe, Canada.

This dataset contains measurements of modern water and ancient core materials from Lake Simcoe, the fourth largest lake wholly in Ontario, Canada. These data consist of: (i) oxygen, hydrogen and carbon isotope (δ 18O, δ 2H and δ 13C) compositions for modern water samples; (ii) physical measurements of one piston core, PC-5; (iii) δ 13C and δ 18O values of ostracods collected from PC-5, and (iv) δ 13C and δ 18O values of ancient DIC and water, respectively, inferred from item (iii). Physical measurements performed on core PC-5 include magnetic susceptibility, mineralogy and grain size. Mass accumulation rates are also reported. These data will be of interest to those aiming to better characterize the timing and pathway of meltwater flow during and following deglaciation of the Laurentide Ice Sheet in the Laurentian Great Lakes region. These data will also be useful to researchers investigating the influence of deglaciation on the oxygen and carbon isotope systematics of ancient lake environments. A discussion of these data is available in "A ∼14 000-year record of environmental change from Lake Simcoe, Canada" [1].

Relationship between cancer and psychology: an updated history.

The mechanism and formation of cancer have always been topics of interest for scientists, even for doctors in ancient times. Nowadays a great role for cancer is played by psychological stress which promotes relevant changes in neuronal activity and gene regulations across the different brain areas. It has been reported by many authors that stress can have an important role in the immune system and may be relevant in the formation of cancer. Our observations, in accordance with other research studies, confirm the importance of the influence of depression, linked to neuroendocrine stress, on the enhancement of cancer pathogenesis by inhibiting anti-tumor immune responses. In this article we review the past and present history of the relationship between cancer and psychology.

Psychological stress and vitamins.

Conditions of stress and anxiety have complex interactions with insufficient vitamin intake and malnutrition. This study, based on literature research in Medline, analyzes the inter-relationship between vitamins and stress. This report concerns a number of vitamins that have been receiving much attention in earlier reviews of the literature, for their potential to protect against stress-related events, and focus is placed upon recent findings.

On the fit of statistical and the k-C* models to projecting treatment performance in a constructed wetland system.

The objective of this study was to assess the suitability of statistical and the k-C* models to projecting treatment performance of constructed wetlands by applying the models to predict the final effluent concentrations of a pilot field-scale constructed wetlands system (CWs) treating animal farm wastewater. The CWs achieved removal rates (in g/m(2).d) ranging from 7.1-149.8 for BOD(5), 49.8-253.8 for COD and 7.1-47.0 for NH(4)-N. Generally, it was found that the statistical models developed from multiple regression analyses (MRA) were stronger in predicting final effluent concentrations than the k-C* model. However, both models were inadequate in predicting the final effluent concentrations of NO(3)-N. The first-order area-based removal rate constants (k, m/yr) determined from the experimental data were 200.5 for BOD(5), 80.1 for TP and 173.8 for NH(4)-N and these indicate a high rate of pollutant removal within the CWs.