Characterization of HDPE microparticles in sludge aerobic digestion and their influence on the process.

The occurrence of microplastics (MPs) in wastewater has been studied in the last years. The high efficiency of their removal from wastewater is linked to their transfer to the sludge. In this work, the effect of high-density polyethylene (HDPE) on aerobic digestion was evaluated and these MPs were monitored, characterizing them by three different techniques. Two parallel batch digesters were monitored. AD-Control (meaning Aerobic Digester) operated as a reference, with no external HDPE particles, whereas these polymeric fragments were introduced to the second aerobic digester (AD-HDPE) using ring pulls as microplastic support. FTIR, Raman spectroscopies and fluorescence analysis of these microparticles showed some relevant results that should be highlighted. Higher fluorescence appeared after 7 days in the digester. It coincided with an increase of active volatile suspended solids (AVSS) in the AD-HDPE, which means that an increase of the microbial activity took place. Despite the presence of HDPE particles in the sludge, the digester performance was not compromised. Besides, the HDPE particles did not affect the microbial diversity (Shannon index) of the bacterial community at the end of the experiment compared to the bacterial community of the aerobic digester control tank. Based on the analysis of the relative abundances of microbial taxa, it was concluded that HDPE had selective effects on sludge microbial community, increasing the relative abundance of Bacteroridota phylum.

Effect of polystyrene nanoplastics on the activated sludge process performance and biomass characteristics. A laboratory study with a sequencing batch reactor.

The fate and presence of nanoplastics in wastewater treatment systems is a topic of increasing interest. Furthermore, challenges related to their quantification and identification have made it difficult to set up experimental conditions and compare results between studies. In this study, the effect of 100 nm polystyrene nanoplastics on activated sludge was evaluated. A concentration of 2 µg/L was used to continuously feed a sequencing batch reactor (SBR-NPs). Under the experimental conditions used in this study, no changes were observed in the process performance of the SBR-NPs compared to the reactor used as a control. Neither nitrification nor organic matter removal efficiency, which was 96% for both SBRs, were affected by the presence of 100 nm polystyrene nanoplastics, which suggests that the tested nanoplastics were not sufficiently toxic to the biomass. Although no significant differences in the relative abundances of predominant phyla between SBR-Control and SBR-NPs were observed, a slight shift in the relative abundance of Patescibacteria (1.5 ± 0.6% and 3.7 ± 0.8% in SBR-Control and SBR-NPs, respectively, at the end of the test) occurred. The higher abundance of this phylum in SBR-NPs compared to SBR-Control may suggest that these bacteria have some sensitivity to the presence of 100 nm polystyrene nanoplastics. Furthermore, even with the absence of nitrification inhibition, it was observed stagnation of the growth of Nitrotoga bacteria in SBR-NPs, which also suggests that the polystyrene nanoplastics could have an inhibitory effect on these cells and an impact on nitrification in the long term.

Evidence of possible SARS-CoV-2 vertical transmission according to World Health Organization criteria in asymptomatic pregnant women.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vertical transmission has been investigated extensively. Recently, the World Health Organization (WHO) published strict criteria to classify the timing of mother-to-child transmission of SARS-CoV-2 into different categories. The aim of this study was to investigate the possibility of vertical transmission in asymptomatic SARS-CoV-2-positive women. METHODS: Pregnant women attending for delivery at a perinatology center in Mexico City, Mexico, who had a SARS-CoV-2-positive nasopharyngeal swab 24-48 h before delivery, were asymptomatic at the time of the test and had an obstetric indication for Cesarean section were eligible for inclusion in this study. Amniotic fluid was collected during Cesarean delivery, and neonatal oral and rectal swabs were collected at birth and at 24 h after birth. SARS-CoV-2 detection was carried out using real-time reverse-transcription polymerase chain reaction in all samples. Relevant medical information was retrieved from clinical records. The WHO criteria for classifying the timing of mother-to-child transmission of SARS-CoV-2 were applied to the study population. RESULTS: Forty-two SARS-CoV-2-positive asymptomatic pregnant women fulfilled the inclusion criteria. Twenty-five (59%) women developed mild disease after discharge. Neonatal death occurred in three (7%) cases, of which one had a positive SARS-CoV-2 test at birth and none had coronavirus disease 2019-related symptoms. There were five (12%) cases with strong evidence of intrauterine transmission of SARS-CoV-2, according to the WHO criteria, as amniotic fluid samples and neonatal samples at birth and at 24 h after birth were positive for SARS-CoV-2. Our results also showed that 40-60% of infected neonates would have been undetected if only one swab (oral or rectal) was tested. CONCLUSION: This study contributes evidence to reinforce the potential for vertical transmission of SARS-CoV-2 even in asymptomatic women and highlights the importance of testing more than one neonatal sample in order to increase the detection rate of SARS-CoV-2 in affected cases. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

SARS-CoV-2 contact tracing among disadvantaged populations during epidemic intervals should be a priority strategy: results from a pilot experiment in Barcelona.

OBJECTIVES: The aim of this study was to trace contacts of coronavirus disease 2019 (COVID-19) hospitalised patients and determine the risk factors of infection in urban areas. STUDY DESIGN: Longitudinal analysis of contacts identified from index cases. METHODS: A contact tracing study was carried out in the Northern Metropolitan area of Barcelona, Spain, during the inter-epidemic lapse of May to July 2020, a period of low SARS-CoV-2 incidence. Index cases were notified from the referral hospital. Contacts were traced and followed up for 14 days. Reverse transcription polymerase chain reaction was performed on day 0 and day 14 for contacts. RESULTS: In total, 368 contacts were identified from 81 index cases (median of seven contacts per index case), from which 308 were traced successfully. The median age of contacts was 28 years, 62% (223 of 368) were men. During the follow-up period, 100 contacts tested positive for COVID-19 (32.5% [95% confidence interval {CI} = 27.3-38.0]), with a secondary infection rate of 48.3% (95% CI = 40.8-55.9) among housemates. Clusters of index and respective contacts tended to aggregate within disadvantaged neighbourhoods (P < 0.001), and non-national index cases (N = 28, 34.1%) resulted in higher secondary infection rates compared with nationals (51.0% [95% CI = 41.0-60.9] vs 22.3% [95% CI = 16.8-28.8]; P < 0.001). CONCLUSIONS: Disadvantaged communities experience a disproportionate burden of COVID-19 and may act as infection reservoirs. Contact tracing with a cross-cutting approach among these communities is required, especially during inter-epidemic periods.

Unveiling introgression in bumblebee (Bombus terrestris) populations through mitogenome-based markers.

The bumblebee, Bombus terrestris, is an important pollinator commercially used on a global scale. The exported subspecies B. t. terrestris has colonised diverse environments, in some cases displacing wild pollinators to the verge of local extinction. In this sense, the native Iberian subspecies B. t. lusitanicus may be threatened by the subspecies B. t. terrestris, naturally distributed from the Pyrenees to Central Europe but also observed in southern Spain due to escapes from commercial nests. Mitochondrial genomes have a low recombination rate and a small effective population size owing to their maternal inheritance, thus providing an accurate approach to study hybridisation events between populations. Therefore, we present the sequences of the mitogenomes of both subspecies as a molecular framework to select suitable markers to detect possible introgression events between them. We used metagenomics to obtain approximately 17 kbp of the mitogenome from both subspecies. Their mitogenomes differed in 358 bp (excluding the AT-rich region). Four mitogenomic fragments were selected to be tested as subspecific diagnostic markers. A RFLP detected in the gene nad2 (NADH dehydrogenase subunit 2) has proven to be an efficient, quick and cost-effective tool to assess the dispersion of the non-endemic subspecies into Iberian native populations. Subspecific haplotypes were observed in both morphological subspecies, suggesting introgression events in the northern natural contact area and in the new human-mediated contact area in the south of the Iberian Peninsula.

Analysis of influenza data generated by four epidemiological surveillance laboratories in Mexico, 2010-2016.

The disease caused by the influenza virus is a global public health problem due to its high rates of morbidity and mortality. Thus, analysis of the information generated by epidemiological surveillance systems has vital importance for health decision making. A retrospective analysis was performed using data generated by the four molecular diagnostic laboratories of the Mexican Social Security Institute between 2010 and 2016. Demographics, influenza positivity, seasonality, treatment choices and vaccination status analyses were performed for the vaccine according to its composition for each season. In all cases, both the different influenza subtypes and different age groups were considered separately. The circulation of A/H1N1pdm09 (48.7%), influenza A/H3N2 (21.1%), influenza B (12.6%), influenza A not subtyped (11%) and influenza A/H1N1 (6.6%) exhibited well-defined annual seasonality between November and March, and there were significant increases in the number of cases every 2 years. An inadequate use of oseltamivir was determined in 38% of cases, and the vaccination status in general varied between 12.1 and 18.5% depending on the season. Our results provide current information about influenza in Mexico and demonstrate the need to update both operational case definitions and medical practice guidelines to reduce the inappropriate use of antibiotics and antivirals.

Vitamin D deficiency in solid-organ transplant recipients from a Spanish Mediterranean population.

BACKGROUND: Solid-organ transplant recipients (SOTRs) are at risk of developing vitamin D deficiency, mainly caused by reduced sunlight exposure with subsequent low vitamin D synthesis in the skin. AIM: To analyse whether SOTRs from a Spanish Mediterranean region were vitamin D-deficient. METHODS: This was a cross-sectional, descriptive and observational study in a transplantation-specialized Dermatological Unit from a Mediterranean area to determine the calcidiol levels of a cohort of 78 consecutively attending patients not receiving vitamin D supplements. Serum 25(OH)D3 levels were determined and clinical characteristics were collected. Logistic regression analysis was used to analyse variables associated with dichotomized 25(OH)D3 levels (≤ or > 10 ng/mL). RESULTS: The cohort comprised 30 lung, 29 kidney and 19 liver transplant recipients. Mean calcidiol was 18 ± 9 ng/mL. Deficiency of 25(OH)D3 was present in 19% of patients, while 68% had insufficient levels and 13% had sufficient levels. Following multivariate logistic regression analysis, the season of blood sampling remained the only predictor of deficient 25(OH)D3 levels. CONCLUSION: Despite living in a mid-latitude country with sunny weather, our SOTR population was at high risk of developing hypovitaminosis D, especially in autumn/winter. Avoiding sun exposure is important to prevent skin cancer, but careful monitoring of vitamin D status is recommended, with supplementation if hypovitaminosis D is detected.

Intracranial angiomatoid fibrous histiocytoma with Hodgkin lymphoma.

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumour of uncertain differentiation and low metastatic potential, which occurs predominantly in children and young adults. It occurs mostly within the extremities, trunk, head and neck. We report the case of a 32-year-old female that was operated in our hospital in 2016 and twice in 2017. The patient had headaches and neck pain initially in 2016. We discuss the radiographic and histologic features initially found and the findings that ultimately led to the diagnosis of AFH. The patient had a past history of Hodgkin lymphoma.

Impact of Chiropractic Manipulation on Bone and Skeletal Muscle of Ovariectomized Rats.

Evidence suggests that chiropractic manipulation might exert positive effects in osteoporotic patients. The aim of this study was to evaluate the effects of chiropractic manipulation on bone structure and skeletal muscle in rats with bone loss caused by ovariectomy (OVX). The 6-month old Sprague-Dawley rats at 10 weeks following OVX or sham operation (Sh) did not suffer chiropractic manipulation (NM group) or were submitted to true chiropractic manipulation using the chiropractic adjusting instrument Activator V® three times/week for 6 weeks as follows: Force 1 setting was applied onto the tibial tubercle of the rat right hind limb (TM group), whereas the corresponding left hind limb received a false manipulation (FM group) consisting of ActivatorV® firing in the air and slightly touching the tibial tubercle. Bone mineral density (BMD) and bone mineral content (BMC) were determined in long bones and L3-L4 vertebrae in all rats. Femora and tibia were analyzed by µCT. Mechano growth factor (MGF) was detected in long bones and soleus, quadriceps and tibial muscles by immunohistochemistry and Western blot. The decrease of BMD and BMC as well as trabecular bone impairment in the long bones of OVX rats vs Sh controls was partially reversed in the TM group versus FM or NM rats. This bone improvement by chiropractic manipulation was associated with an increased MGF expression in the quadriceps and the anterior tibial muscle in OVX rats. These findings support the notion that chiropractic manipulation can ameliorate osteoporotic bone at least partly by targeting skeletal muscle.

Changes in the process performance, sludge production and microbial activity in an activated sludge reactor with addition of a metabolic uncoupler under different operating conditions.

Sludge production in wastewater treatment plants is nowadays a big concern due to the high produced amounts and their characteristics. Consequently, the study of techniques that reduce the sludge generation in wastewater treatment plants is becoming of great importance. In this work, four laboratory sequencing batch reactors (SBRs), which treated municipal wastewater, were operated to study the effect of adding the metabolic uncoupler 3,3',4',5-tetrachlorosalicylanilide (TCS) on the sludge reduction, the SBRs performance and the microbial hydrolytic enzymatic activities (MHEA). In addition, different operating conditions of the SBRs were tested to study the effect of the TCS on the process: two dissolved oxygen (DO) concentrations (2 and 9 mg L-1) and two F/M ratio (0.18 and 0.35 g COD·g MLVSS-1·d-1). The sludge production decreased under high DO concentrations. At the same time, the DNA and EPS production increased in the four SBRs. After these stress conditions, the performance of the reactors were recovered when DO was around 2 mg L-1. From that moment on, results showed that TCS addition implied a reduction of the adenosine triphosphate (ATP) production, which implied a decrease in the sludge production. In spite of this reduction, the SBRs performances did not decay due to the increase in the global MHEA. Additionally, the sludge reduction was enhanced by the increase of the F/M ratio, achieving 28% and 60% of reduction for the low and the high F/M ratio, respectively.

Sludge reduction by uncoupling metabolism: SBR tests with para-nitrophenol and a commercial uncoupler.

Nowadays cost reduction is a very important issue in wastewater treatment plants. One way, is to minimize the sludge production. Microorganisms break down the organic matter into inorganic compounds through catabolism. Uncoupling metabolism is a method which promote catabolism reactions instead of anabolism ones, where adenosine triphosphate synthesis is inhibited. In this work, the influence of the addition of para-nitrophenol and a commercial reagent to a sequencing batch reactor (SBR) on sludge production and process performance has been analyzed. Three laboratory SBRs were operated in parallel to compare the effect of the addition of both reagents with a control reactor. SBRs were fed with synthetic wastewater and were operated with the same conditions. Results showed that sludge production was slightly reduced for the tested para-nitrophenol concentrations (20 and 25 mg/L) and for a LODOred dose of 1 mL/day. Biological process performance was not influenced and high COD removals were achieved.

Personality traits in patients with cluster headache: a comparison with migraine patients.

BACKGROUND: Cluster headache (CH) has been associated with certain personality traits and lifestyle features, but there are few studies assessing personality profiles in CH. We aimed to analyze personality traits in patients with CH, and to compare them with those found in migraine. METHODS: We included all consecutive patients with CH attending 5 outpatient offices between January and December 2013. Personality traits were evaluated using the Salamanca screening test, a validated inventory assessing 11 personality traits grouped in 3 clusters. We analyzed the test results in this population, and compared them with those of a migraine population previously assessed with the same test. RESULTS: Eighty patients with CH (75 men, 5 women; mean age, 43.2 ± 9.9 years) were recruited. The reference population consisted of 164 migraine patients (30 men, 134 women; mean age 36.4 ± 12.7 years). In CH patients, the most frequent personality traits were anancastic (52.5 %), anxious (47.5 %), histrionic (45 %), schizoid (42.5 %), impulsive (32.5 %) and paranoid (30 %). When compared to migraine patients, paranoid (p < 0.001; χ2 test), and schizoid traits (p = 0.007; χ2 test) were significantly more prevalent in CH patients. In logistic regression analysis the paranoid trait was significantly associated with CH (p = 0.001; OR: 3.27, 95 % CI [1.66-6.43]). CONCLUSION: According to the Salamanca screening test, personality traits included in cluster A (odd or eccentric disorders) are more prevalent in CH patients than in a population of migraineurs. Larger studies are needed to determine whether certain personality traits are related to CH.

Impulsivity among migraine patients: Study in a series of 155 cases. / Impulsividad en pacientes migrañosos: estudio en una serie de 155 casos.

INTRODUCTION: Impulsivity is a psychological phenomenon that has not been extensively studied in headache patients. We aim to assess the presence of impulsivity in patients with chronic migraine (CM) and medication overuse (MO). PATIENTS: All patients examined in an outpatient headache clinic between January 2013 and March 2014 were included. Episodic migraine, CM, and MO were diagnosed according to ICHD-III beta criteria. We prospectively gathered demographic and clinical characteristics. Mood disorders were evaluated using the Hospital Anxiety and Depression Scale (HADS) and impulsiveness was assessed with the Plutchik impulsivity scale. RESULTS: A total of 155 patients were included (22 men, 133 women). The mean age (SD) was 38.2 (11.7) years (range, 18-70); 104 patients (67.1%) presented CM and, among them, 74 (71.1%) had MO. Of the patient total, 28.4% met criteria for anxiety, 7.1% for depression and 16.1% for impulsivity. The CM group showed higher scores for HADS-anxiety (8.5 [SD 4.5] vs. 6.4 [SD 3.6], p=0.003) and HADS-depression (4.4 [4.3] vs. 1.9 [2.3], p<0.001). Among CM cases only, scores for HADS-anxiety (9.3 [4.4] vs. 6.8 [4.3], p=0.01) and HADS-Depression (5.1 [4.6] vs. 2.7 [2.9], p=0.002) were higher in patients who also had MO. We found no associations between Plutchik scale scores or presence of impulsivity with either CM or MO. CONCLUSION: Impulsivity is a common trait in our population of migraine patients, but unlike mood disorders, it is not correlated with either CM or MO.

Different in vitro culture systems affect the birth weight of lambs from vitrified ovine embryos.

It has been reported that different in vitro culture systems affect the birth weight of lambs. The aim of this study was to test body weight and lambing rate of lambs born from five different in vitro culture systems after vitrification. Oocytes of Sarda sheep were matured in TCM-199 plus 0.4% bovine serum albumin (BSA) using systems: (i) 4 mg/ml fatty acid-free BSA (BSA4); (ii) 8 mg/ml fatty acid-free BSA (BSA8); (iii) BSA8-hyaluronan (BSA8-HA); (iv) BSA8-charcoal-stripped FBS (BSA8-CH); or (v) with 10% fetal bovine serum (FBS; serum) and fertilized with fresh semen. The presumptive zygotes were cultured up to the blastocyst stage with BSA8, BSA8-HA, BSA8-CH or serum or BSA4. In the third and fifth days of culture 5% charcoal-stripped FBS was added into BSA8-CH and serum, while 8 mg/ml or 4 mg/ml fatty acid-free BSA was added as BSA8, BSA8-HA and BSA4 respectively; 6 mg/ml HA was added to BSA8-HA. In total, 240 vitrified blastocysts were transferred into synchronized ewes. The lambing rate was not significant different between BSA groups or between serum groups (BSA8-CH and serum), while serum groups showed significant lower values when compared with BSA groups. Only BSA8 groups produced heavy lambs (≥4.5 kg) with a significant difference between BSA4 and BSA8 groups (P < 0.05).

Assessment by self-organizing maps of element release from sediments in contact with acidified seawater in laboratory leaching test conditions.

Carbon capture and storage (CCS) is gaining interest as a significant global option to reduce emissions of CO2. CCS development requires an assessment of the potential risks associated with CO2 leakages from storage sites. Laboratory leaching tests have proved to be a useful tool to study the potential mobilization of metals from contaminated sediment in a decreased-pH environment that mimics such a leakage event. This work employs a self-organizing map (SOM) tool to interpret and analyze the release of dissolved organic carbon (DOC), As, Cd, Cr, Cu, Ni, Pb, and Zn from equilibrium, column, and pH-dependent leaching tests. In these tests, acidified seawater is used for simulating different CO2 leakage scenarios. Classification was carried out detailing the mobilization of contaminants for environments of varying pH, liquid-to-solid ratio, and type of contact of the laboratory leaching tests. Component planes in the SOMs allow visualization of the results and the determination of the worst case of element release. The pH-dependent leaching test with initial addition of either base or acid was found to mobilize the highest concentrations of metals.

Chronic migraine with and without medication overuse: experience in a hospital series of 434 patients.

INTRODUCTION: Chronic migraine (CM) is a complication of episodic migraine, favored by risk factors as medication overuse (MO). We intend to compare demographic and clinic characteristics of a series of CM patients, with and without MO. METHODS: The study included patients with CM (2006 revised criteria) attended in a headache outpatient office located in a tertiary hospital between January 2008 and May 2012. We recorded demographic characteristics, age at migraine onset, time from onset, previous use of symptomatic or preventive therapy, and headache impact measured with six-item headache impact test (HIT-6). RESULTS: A total of 434 patients (357 women, 77 men) were diagnosed with CM out of the 1868 (23.2%) that attended our clinic. Of these, 258 (72.2%) fulfilled criteria of MO, and 59.8% of those with MO, and 41.1% of cases without MO had previously received preventative treatment (P<.001). Age at onset of migraine was lower in MO patients (21.2±10.1 vs 23.8±12.5 years, P=.02) and time from onset to headache clinic consultation was higher in MO cases (23.8±14.1 vs 18.3±14.8 years, P<.001). We found no difference between both groups in average HIT-6 score and the percentage of patients with a HIT-6 score over 55. CONCLUSIONS: CM, with or without MO, is a burdensome group of patients in our headache clinic. Patients with MO are referred later and have more frequently received preventive treatments.

Blastocyst rate of in vitro embryo production in sheep is affected by season.

It has been reported that the number and quality of in vitro produced embryos is season related. This study was conducted to assess the effect of season on cleavage, blastocyst and lambing rates of in vitro produced ovine embryos during 3 years of collection data. Ovaries of Sarda sheep were collected from a slaughterhouse. In total, 5035 oocytes were recovered and matured in TCM-199 with 4 mg/ml bovine serum albumin (BSA), 100 µM cysteamine, 0.3 mM Na pyruvate, 0.1 UI/ml recombinant follicle-stimulating hormone (r-FSH), 0.1 UI/ml recombinant luteinising hormone (r-LH), and 1 µg/ml estradiol-17ß. Matured oocytes were fertilized with fresh semen in synthetic oviductal fluid (SOF) with 20% heat inactivated estrous sheep serum. The presumptive zygotes were cultured for 6-7 days (blastocyst stage) in SOF medium supplemented with 1% Basel Medium Eagle (BME), 1% Minimum Essential Medium, 1 mM glutamine and 8 mg/ml fatty acid-free BSA. The embryos produced were vitrified and a total of 165 blastocysts (80 from the breeding season and 85 from the anoestrous season) were transferred in pairs into recipient ewes during the reproductive period. There were no significant differences in cleavage rates between seasons in any of the 3 years examined (84% versus 83%, 81% versus 80% and 80% versus 79%, respectively). The blastocyst rate varied significantly between seasons in 2005 and 2007 (P < 0.05), and in 2006 (P < 0.001). There were no differences in pregnancy and lambing rates between embryos during anoestrous versus during the breeding season. In conclusion, only the blastocyst rate appeared to have been affected by season, possibly due to variation in the number of developmentally competent oocytes.

Headache in the elderly: characteristics in a series of 262 patients.

INTRODUCTION: Although headache prevalence decreases in patients older than 65, headaches are a common complaint and their different clinical and therapeutic features must be understood. This article analyses the clinical characteristics of elderly patients treated in an outpatient headache unit. METHODS: We collected demographic and clinical data from patients treated in a tertiary hospital headache unit between January 2008 and May 2013. Headaches were codified according to the International Classification of Headache Disorders, 2nd edition (ICHD-2). RESULTS: Of a total of 1868 patients treated, 262 patients (14%, 189 women and 73 men) were older than 65 years. Ninety-nine (68 women, 31 men, 5.3% of the total) were over 75. Headaches began after the age of 65 in only 136 patients (51.9%). The 362 headaches were codified as follows: 23.8% as Group 1 (Migraine) and 28.7% as Group 2 (Tension-type headache). We diagnosed 58 (16%) secondary headaches; 26 (7.2%) were classified as Group 13 (Cranial neuralgias) and 23 (6.4%) in Group 14 (Other headaches). Symptomatic medication overuse was detected in 38 patients (14.5%). We also identified headaches considered typical in the elderly, including chronic migraine (41 cases), hypnic headache (6), occipital neuralgia (4), SUNCT (2), cervicogenic headache (1), primary cough headache (1), and giant cell arteritis (2). CONCLUSIONS: Elderly patients were frequently treated in our outpatient headache unit. Tension-type headache was the most common diagnosis in this population. Geriatric headache syndromes such as hypnic headache or occipital neuralgia were also represented in our series.

Effect of combining the methanogenesis inhibitor 3-nitrooxypropanol and cottonseeds on methane emissions, feed intake, and milk production of grazing dairy cows.

No single enteric CH4 mitigating strategy has been consistently effective or is readily applicable to ruminants in grassland systems. When CH4 mitigating strategies are effective under grazing conditions, mitigation is mild to moderate at best. A study was conducted to evaluate the potential of combining two CH4 mitigation strategies deemed feasible to apply in grazing dairy cows, the methanogenesis inhibitor 3-nitrooxypropanol additive (3-NOP) and cottonseed supplementation (CTS), seeking to enhance their individual CH4 mitigating potential. Forty-eight dairy cows were evaluated in a continuous grazing study and supplemented with either a starch-based concentrate (STA) or one that contained cottonseeds (1.75 kg DM/d; CTS), and with either 19 g/d of 10% 3-NOP (Bovaer®) or the additive's carrier (placebo), in a 2 × 2 factorial arrangement of treatments. Treatments were supplied mixed with a concentrate supplement (5 kg/d as fed) and offered in two equal rations at milking. Methane emissions were measured on weeks 4 and 8 using the sulphur hexafluoride tracer gas technique over a 5-d period. The 3-NOP and CTS treatments tended to interact on absolute CH4 such that 3-NOP decreased CH4 by 13.4% with STA, but there was no mitigation with 3-NOP and CTS. Treatment interactions were also obtained for CH4 yield, where 3-NOP tended to decrease CH4 when supplied with STA, and tended to increase it with CTS. The increase in CH4 yield with the CTS diet was driven by a numerical decrease in DM intake. Methane intensity was not affected by the 3-NOP or CTS treatments. Total volatile fatty acids in ruminal fluid were not affected by 3-NOP supplementation, but a reduction in acetate and an increase in propionate proportion occurred, resulting in decreased acetate: propionate. The 3-NOP additive decreased grass intake; however, energy-corrected milk yield and milk composition were largely unaffected. Milk urea increased with 3-NOP supplementation. Combining twice daily supplementation of 3-NOP and CTS did not enhance their CH4 mitigation potential when fed to grazing dairy cows. The relatively low inhibition of CH4 production by 3-NOP compared to studies with total mixed rations may result from the mode of delivery (pulse dosed twice daily) and time gap caused by experimental handling and moving of animals to pasture after 3-NOP supplementation in the milking parlour, which could have impaired the synchrony between the additive presence in the rumen and grass intake in paddocks.