The challenge of ecological validity in temporomandibular disorders research.

OBJECTIVE: To review the ecological validity of outcomes from current research involving temporomandibular disorders (TMDs), with an emphasis on chronic myofascial pain and the precocious development of degenerative disease of the temporomandibular joint (TMJ). MATERIALS AND METHODS: Current approaches used to study TMDs in terms of neuromechanics, masticatory muscle behaviours, and the dynamics of the autonomic nervous system (ANS) were assessed for ecological validity in this review. In particular, the available literature was scrutinized regarding the effects of sampling, environmental and psychophysiological constraints and averaging data across biological rhythms. RESULTS: Validated computer-assisted numerical modelling of the neuromechanics used biological objective functions to accurately predict muscle activation patterns for jaw-loading tasks that were individual-specific. With respect to masticatory muscle behaviour, current findings refute the premise that sustained bruxing and clenching at high jaw-loading magnitudes were associated with painful TMDs such as myofascial pain. Concerning the role of the ANS in TMDs, there remains the need for personalized assessments based on biorhythms, and where the detection of dysregulated physiologic oscillators may inform interventions to relieve pain and restore normal function. CONCLUSIONS: Future human research which focuses on TMD myofascial pain or the precocious development and progression of TMJ degenerative joint disease requires experimental designs with ecological validity that capture objectively measured data which meaningfully reflect circadian and ultradian states.

Masticatory Muscles Activation and TMJ Space During Asymmetrically Loaded Jaw Closing.

Masticatory muscle activation and temporomandibular joint (TMJ) load generated during asymmetrically loaded jaw closing are largely unknown. Two different strategies were developed to explain how the central nervous system (CNS) generates muscle activation patterns during motion: minimization of joint load (MJL) vs. minimization of muscle effort (MME). The aim of the present study was to investigate, experimentally, the neuromuscular strategy selected by the CNS to coordinate jaw closing in reaction to the application of an external asymmetric load. Masticatory muscle activation was measured with electromyography (EMG) and the minimum intra-articular distance (MID) was assessed by dynamic stereometry to infer joint loading. Ten healthy subjects performed jaw-closing movements against an asymmetric mandibular load set from 0.0 to 2.0 kg in 0.5-kg steps. Recordings were analyzed by exploratory and graphical statistical tools. Moreover, the observed differences in MID and EMG among the various mandibular loads were tested using non-parametric tests for repeated measures data. The ipsilateral-contralateral differences in MID and EMG of the anterior temporalis showed a significant increase (p < 0.001, p = 0.01) with increasing asymmetrical load with both joints being most heavily loaded at 1 kg. EMG signals of the masseter did not change significantly with increasing load. This study is the first to have analyzed the changes in the TMJ intra-articular space during asymmetrically loaded jaw-closing movements, not only three dimensionally and dynamically, but also combined with EMG. Asymmetrical load affected the TMJ space and masticatory muscle activation patterns, primarily resulting in an increased activation of the anterior temporalis muscle. This might suggest the involvement of a control mechanism to protect the joints from overloading. However, the results do not fully support the hypothesis of MJL nor the MME strategy.

Standardised Tool for the Assessment of Bruxism.

OBJECTIVE: This paper aims to present and describe the Standardised Tool for the Assessment of Bruxism (STAB), an instrument that was developed to provide a multidimensional evaluation of bruxism status, comorbid conditions, aetiology and consequences. METHODS: The rationale for creating the tool and the road map that led to the selection of items included in the STAB has been discussed in previous publications. RESULTS: The tool consists of two axes, specifically dedicated to the evaluation of bruxism status and consequences (Axis A) and of bruxism risk and etiological factors and comorbid conditions (Axis B). The tool includes 14 domains, accounting for a total of 66 items. Axis A includes the self-reported information on bruxism status and possible consequences (subject-based report) together with the clinical (examiner report) and instrumental (technology report) assessment. The Subject-Based Assessment (SBA) includes domains on Sleep Bruxism (A1), Awake Bruxism (A2) and Patient's Complaints (A3), with information based on patients' self-report. The Clinically Based Assessment (CBA) includes domains on Joints and Muscles (A4), Intra- and Extra-Oral Tissues (A5) and Teeth and Restorations (A6), based on information collected by an examiner. The Instrumentally Based Assessment (IBA) includes domains on Sleep Bruxism (A7), Awake Bruxism (A8) and the use of Additional Instruments (A9), based on the information gathered with the use of technological devices. Axis B includes the self-reported information (subject-based report) on factors and conditions that may have an etiological or comorbid association with bruxism. It includes domains on Psychosocial Assessment (B1), Concurrent Sleep-related Conditions Assessment (B2), Concurrent Non-Sleep Conditions Assessment (B3), Prescribed Medications and Use of Substances Assessment (B4) and Additional Factors Assessment (B5). As a rule, whenever possible, existing instruments, either in full or partial form (i.e. specific subscales), are included. A user's guide for scoring the different items is also provided to ease administration. CONCLUSIONS: The instrument is now ready for on-field testing and further refinement. It can be anticipated that it will help in collecting data on bruxism in such a comprehensive way to have an impact on several clinical and research fields.

Lactation modeling and the effects of rotational crossbreeding on milk production traits and milk-spectra-predicted enteric methane emissions.

Rotational crossbreeding has not been widely studied in relation to the enteric methane emissions of dairy cows, nor has the variation in emissions during lactation been modeled. Milk infrared spectra could be used to predict proxies of methane emissions in dairy cows. Therefore, the objective of this work was to study the effects of crossbreeding on the predicted infrared proxies of methane emissions and the variation in the latter during lactation. Milk samples were taken once from 1,059 cows reared in 2 herds, and infrared spectra of the milk were used to predict milk fat (mean ± SD; 3.79 ± 0.81%) and protein (3.68 ± 0.36%) concentrations, yield (21.4 ± 1.5 g/kg dry matter intake), methane intensity (14.2 ± 2.0 g/kg corrected milk), and daily methane production (358 ± 108 g/d). Of these cows, 620 were obtained from a 3-breed (Holstein, Montbéliarde, and Viking Red) rotational mating system, and the rest were purebred Holsteins. Milk production data and methane traits were analyzed using a nonlinear model that included the fixed effects of herd, genetic group, and parity, and the 4 parameters (a, b, c, and k) of a lactation curve modeled using the Wilmink function. Milk infrared spectra were found to be useful for direct prediction of qualitative proxies, such as methane yield and intensity, but not quantitative traits, such as daily methane production, which appears to be better estimated (450 ± 125 g/d) by multiplying a measured daily milk yield by infrared-predicted methane intensity. Lactation modeling of methane traits showed daily methane production to have a zenith curve, similar to that of milk yield but with a delayed peak (53 vs. 37 d in milk), whereas methane intensity is characterized by an upward curve that increases rapidly during the first third of lactation and then slowly till the end of lactation (10.5 g/kg at 1 d in milk to 15.2 g/kg at 300 d in milk). However, lactation modeling was not useful in explaining methane yield, which is almost constant during lactation. Lastly, the methane yield and intensity of cows from 3-breed rotational crossbreeding are not greater, and their methane production is lower than that of purebred Holsteins (452 vs. 477 g/d). Given the greater longevity of crossbred cows, and their lower replacement rate, rotational crossbreeding could be a way of mitigating the environmental impact of milk production.

Novel insights into the associations between immune cell population distribution in mammary glands and milk minerals in Holstein cows.

Udder health has a crucial role in sustainable milk production, and various reports have pointed out that changes in udder condition seem to affect milk mineral content. The somatic cell count (SCC) is the most recognized indicator for the determination of udder health status. Recently, a new parameter, the differential somatic cell count (DSCC), has been proposed for a more detailed evaluation of intramammary infection patterns. Specifically, the DSCC is the combined proportions of polymorphonuclear neutrophils and lymphocytes (PMN-LYM) on the total SCC, with macrophages (MAC) representing the remainder proportion. In this study, we evaluated the association between DSCC in combination with SCC on a detailed milk mineral profile in 1,013 Holstein-Friesian cows reared in 5 herds. An inductively coupled plasma-optical emission spectrometry was used to quantify 32 milk mineral elements. Two different linear mixed models were fitted to explore the associations between the milk mineral elements and first, the DSCC combined with SCC, and second, DSCC expressed as the PMN-LYM and MAC counts, obtained by multiplying the proportion of PMN-LYM and MAC by SCC. We observed a significant positive association between SCC and milk Na, S, and Fe levels. Differential somatic cell count showed an opposite behavior to the one displayed by SCC, with a negative association with Na and positive association with K milk concentrations. When considering DSCC as count, Na and K showed contrasting behavior when associated with PMN-LYM or MAC counts, with decreasing of Na content and increasing K when associated with increasing PMN-LYM counts, and increasing Na and decreasing K when associated with increasing MAC count. These findings confirmed that an increase in SCC is associated with altered milk Na and K amounts. Moreover, MAC count seemed to mirror SCC patterns, with the worsening of inflammation. Differently, PMN-LYM count exhibited patterns of associations with milk Na and K contents attributable more to LYM than PMN, given the nonpathological condition of the majority of the investigated population. An interesting association was observed for milk S content, which increased with increasing of inflammatory conditions (i.e., increased SCC and MAC count) probably attributable to its relationship with milk proteins, especially whey proteins. Moreover, milk Fe content showed positive associations with the PMN-LYM population, highlighting its role in immune regulation during inflammation. Further studies including individuals with clinical condition are needed to achieve a comprehensive view of milk mineral behavior during udder health impairment.

MRI Assessment of Cesarean Scar Pregnancies: A Case Series.

Cesarean scar pregnancies (CSPs) are a type of ectopic pregnancy that occur when an embryo implants within the fibrous scar tissue of a previous cesarean surgery. If not promptly detected and treated, CSPs can result in serious maternal complications, such as uterine rupture and hemorrhage. TVUS (transvaginal ultrasonography) represents the imaging of choice for the diagnosis of CSPs; however, recent studies proposed a complementary role of MRI due to its capability in soft tissue characterization that may impact the therapeutical decision-making process. The purpose of our study was to explore the role of MRI in the diagnosis and its impact on therapeutical options in CSPs. Our experience showed that MRI has a complementary role to TVSU in correctly diagnosing CSPs, identifying the type, and guiding the therapeutical approach.

Subclinical Mastitis from Streptococcus agalactiae and Prototheca spp. Induces Changes in Milk Peptidome in Holstein Cattle.

Early detection of bovine subclinical mastitis may improve treatment strategies and reduce the use of antibiotics. Herein, individual milk samples from Holstein cows affected by subclinical mastitis induced by S. agalactiae and Prototheca spp. were analyzed by untargeted and targeted mass spectrometry approaches to assess changes in their peptidome profiles and identify new potential biomarkers of the pathological condition. Results showed a higher amount of peptides in milk positive on the bacteriological examination when compared with the negative control. However, the different pathogens seemed not to trigger specific effects on the milk peptidome. The peptides that best distinguish positive from negative samples are mainly derived from the most abundant milk proteins, especially from ß- and αs1-casein, but also include the antimicrobial peptide casecidin 17. These results provide new insights into the physiopathology of mastitis. Upon further validation, the panel of potential discriminant peptides could help the development of new diagnostic and therapeutic tools.

The role of sense of presence in expressing cognitive abilities in a virtual reality task: an initial validation study.

There is a raised interest in literature to use Virtual Reality (VR) technology as an assessment tool for cognitive domains. One of the essential advantages of transforming tests in an immersive virtual environment is the possibility of automatically calculating the test's score, a time-consuming process under natural conditions. Although the characteristics of VR can deliver different degrees of immersion in a virtual environment, the sense of presence could jeopardize the evolution of these practices. The sense of presence results from a complex interaction between human, contextual factors, and the VR environment. The present study has two aims: firstly, it contributes to the validation of a virtual version of the naturalistic action test (i.e., virtual reality action test); second, it aims to evaluate the role of sense of presence as a critical booster of the expression of cognitive abilities during virtual reality tasks. The study relies on healthy adults tested in virtual and real conditions in a cross-over research design. The study's results support the validity of the virtual reality action test. Furthermore, two structural equation models are tested to comprehend the role of sense of presence as a moderator in the relationship between cognitive abilities and virtual task performance.

Advanced Cardiac Imaging and Women's Chest Pain: A Question of Gender.

Awareness of gender differences in cardiovascular disease (CVD) has increased: both the different impact of traditional cardiovascular risk factors on women and the existence of sex-specific risk factors have been demonstrated. Therefore, it is essential to recognize typical aspects of ischemic heart disease (IHD) in women, who usually show a lower prevalence of obstructive coronary artery disease (CAD) as a cause of acute coronary syndrome (ACS). It is also important to know how to recognize pathologies that can cause acute chest pain with a higher incidence in women, such as spontaneous coronary artery dissection (SCAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance imaging (CMR) gained a pivotal role in the context of cardiac emergencies. Thus, the aim of our review is to investigate the most frequent scenarios in women with acute chest pain and how advanced cardiac imaging can help in the management and diagnosis of ACS.

Impact of innovative rearing strategies for the Italian heavy pigs: Technological traits and chemical composition of dry-cured hams.

To explore the influence of 4 feeding strategies on dry-cured ham quality, 336 barrows and gilts (3 batches, 112 pigs/batch) of 90 kg body weight (BW), were divided into 4 groups and housed in 8 pens with automated feeders. In the control group (C), the pigs were fed restrictively medium-protein feeds and slaughtered at 170 kg BW (SW) and 265 d of slaughter age (SA). With the older age (OA) treatment, the pigs were restrictively fed low protein feeds and slaughtered at 170 kg SW and 278 d SA. The other two groups were fed ad libitum high protein feeds, the younger age (YA) group was slaughtered at 170 kg SW and 237 d SA, the greater weight (GW) at 265 d of SA and 194 kg SW. The hams were dry-cured and seasoned for 607 d, weighed before and after seasoning and deboning. Sixty hams were sampled and sliced. The lean and the fat tissues were separated and analyzed for proximate composition and fatty acid profile. The model of analysis considered sex and treatment as fixed factors. With respect to C: i) OA lowered the ham weight, the lean protein content, increased marbling and decreased the PUFA proportion in intramuscular and subcutaneous fat; ii) YA hams had thicker fat cover with lower PUFA in intramuscular and subcutaneous fat; iii) GW increased the deboned ham weight, fat cover depth and marbling, reduced PUFA in intramuscular and subcutaneous fat, without alteration of the lean moisture content. Sex had a negligible impact.

Associations between the detailed milk mineral profile, milk composition, and metabolic status in Holstein cows.

The causes of variation in the milk mineral profile of dairy cattle during the first phase of lactation were studied under the hypothesis that the milk mineral profile partially reflects the animals' metabolic status. Correlations between the minerals and the main milk constituents (i.e., protein, fat, and lactose percentages), and their associations with the cows' metabolic status indicators were explored. The metabolic status indicators (MET) that we used were blood energy-protein metabolites [nonesterified fatty acids, ß-hydroxybutyrate (BHB), glucose, cholesterol, creatinine, and urea], and liver ultrasound measurements (predicted triacylglycerol liver content, portal vein area, portal vein diameter and liver depth). Milk and blood samples, and ultrasound measurements were taken from 295 Holstein cows belonging to 2 herds and in the first 120 d in milk (DIM). Milk mineral contents were determined by ICP-OES; these were considered the response variable and analyzed through a mixed model which included DIM, parity, milk yield, and MET as fixed effects, and the herd/date as a random effect. The MET traits were divided in tertiles. The results showed that milk protein was positively associated with body condition score (BCS) and glucose, and negatively associated with BHB blood content; milk fat was positively associated with BHB content; milk lactose was positively associated with BCS; and Ca, P, K and S were the minerals with the greatest number of associations with the cows' energy indicators, particularly BCS, predicted triacylglycerol liver content, glucose, BHB and urea. We conclude that the protein, fat, lactose, and mineral contents of milk partially reflect the metabolic adaptation of cows during lactation and within 120 DIM. Variations in the milk mineral profile were consistent with changes in the major milk constituents and the metabolic status of cows.

Peritoneal Carcinosis: What the Radiologist Needs to Know.

Peritoneal carcinosis is a condition characterized by the spread of cancer cells to the peritoneum, which is the thin membrane that lines the abdominal cavity. It is a serious condition that can result from many different types of cancer, including ovarian, colon, stomach, pancreatic, and appendix cancer. The diagnosis and quantification of lesions in peritoneal carcinosis are critical in the management of patients with the condition, and imaging plays a central role in this process. Radiologists play a vital role in the multidisciplinary management of patients with peritoneal carcinosis. They need to have a thorough understanding of the pathophysiology of the condition, the underlying neoplasms, and the typical imaging findings. In addition, they need to be aware of the differential diagnoses and the advantages and disadvantages of the various imaging methods available. Imaging plays a central role in the diagnosis and quantification of lesions, and radiologists play a critical role in this process. Ultrasound, computed tomography, magnetic resonance, and PET/CT scans are used to diagnose peritoneal carcinosis. Each imaging procedure has advantages and disadvantages, and particular imaging techniques are recommended based on patient conditions. Our aim is to provide knowledge to radiologists regarding appropriate techniques, imaging findings, differential diagnoses, and treatment options. With the advent of AI in oncology, the future of precision medicine appears promising, and the interconnection between structured reporting and AI is likely to improve diagnostic accuracy and treatment outcomes for patients with peritoneal carcinosis.

Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7-14 Years.

The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7-14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7-10) and adolescents (aged 11-14) of both sexes were invited to participate in this study (n = 1468). Descriptive statistics for all observed variables and Mann-Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants (n = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low.

COVID-19: Correlation between HRCT findings and clinical prognosis and analysis of parenchymal pattern evolution.

Objectives: Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) is a single-stranded positive ribonucleic acid virus of the coronaviridae family. The disease caused by this virus has been named by the World Health Organization coronavirus disease 19 (COVID-19), whose main manifestation is interstitial pneumonia. Aim of this study is to describe the radiological features of SARS-CoV-2 infection in its original form, to correlate the high-resolution computed tomography (HRCT) patterns with clinical findings, prognosis and mortality, and to establish the need for treatment and admission to the intensive care unit. Material and Methods: From March 2020 to May 2020, 193 patients (72 F and 121 M) who were swab positive for SARS-CoV-2 were retrospectively selected for our study. These patients underwent HRCT in the clinical suspicion of SARS-CoV-2 interstitial pneumonia. Results: Our results confirm the role of radiology and, in particular, of chest HRCT as a technique with high sensitivity in the recognition of the most peculiar features of COVID-19 pneumonia, in the evaluation of severity of the disease, in the correct interpretation of temporal changes of the radiological picture during the follow-up until the resolution, and in obtaining prognostic information, also to direct the treatment. Conclusion: Chest computed tomography cannot be considered as a substitute for real-time - polymerase chain reaction in the diagnosis of COVID-19, but rather supplementary to it in the diagnostic process as it can detect parenchymal changes at an early stage and even before the positive swab, at least for patients who have been symptomatic for more than 3 days.

Body and milk production traits as indicators of energy requirements and efficiency of purebred Holstein and 3-breed rotational crossbred cows from Viking Red, Montbéliarde, and Holstein sires.

This study aimed to compare rotational 3-breed crossbred cows of Viking Red, Montbéliarde, and Holstein breeds with purebred Holstein cows for a range of body measurements, as well as different metrics of the cows' productivity and production efficiency. The study involved 791 cows (440 crossbreds and 351 purebreds), that were managed across 2 herds. Within each herd, crossbreds and purebreds were reared and milked together, fed the same diets, and managed as one group. The heart girth, height at withers, and body length were measured, and body condition score (BCS) was determined on all the cows on a single test day. The body weight (BW) of 225 cows were used to develop an equation to predict BW from body size traits, parity, and days in milk, which was then used to estimate the BW of all the cows. Equations from the literature were used to estimate body protein and lipid contents using the predicted BW and BCS. Evidence suggests that maintenance energy requirements may be closely related to body protein mass, and Holstein and crossbred cows may be different in body composition. Therefore, we computed the requirements of net energy for maintenance (NEM) on the basis either of the metabolic weight (NEM-MW: 0.418 MJ/kg of metabolic BW) or of the estimated body protein mass according to a coefficient (NEM-PM: 0.631 MJ/kg body protein mass) computed on the subset comprising the purebred Holstein. On the same day when body measurements were collected, individual test-day milk yield and fat and protein contents were retrieved once from the official Italian milk recording system, and milk was sampled to determine fresh cheese yield. Measures of NEM were used to scale the production traits. Statistical analyses of all variables included the fixed effects of herd, days in milk, parity, and genetic group (purebred Holstein and crossbred), and the herd × genetic group interaction. External validation of the equation predicting BW yielded a correlation coefficient of 0.94 and an average bias of -4.95 ± 36.81 kg. The crossbreds had similar predicted BW and NEM-MW compared with the Holsteins. However, NEM-PM of crossbreds was 3.8% lower than that of the Holsteins, due to their 11% greater BCS and different estimated body composition. The crossbred cows yielded 4.8% less milk and 3.4% less milk energy than the purebred Holsteins. However, the differences between genetic groups were no longer significant when the production traits were scaled on NEM-PM, suggesting that the crossbreds and purebreds have the same productive ability and efficiency per unit of body protein mass. In conclusion, measures of productivity and efficiency that combine the cows' production capability with traits related to body composition and the energy cost of production seem to be more effective criteria for comparing crossbred and purebred Holstein cows than just milk, fat, and protein yields.

Serious Games in the new era of digital-health interventions: A narrative review of their therapeutic applications to manage neurobehavior in neurodevelopmental disorders.

Children and adolescents with neurodevelopmental disorders generally show adaptive, cognitive and motor skills impairments associated with behavioral problems, i.e., alterations in attention, anxiety and stress regulation, emotional and social relationships, which strongly limit their quality of life. This narrative review aims at providing a critical overview of the current knowledge in the field of serious games (SGs), known as digital instructional interactive videogames, applied to neurodevelopmental disorders. Indeed, a growing number of studies is drawing attention to SGs as innovative and promising interventions in managing neurobehavioral and cognitive disturbs in children with neurodevelopmental disorders. Accordingly, we provide a literature overview of the current evidence regarding the actions and the effects of SGs. In addition, we describe neurobehavioral alterations occurring in some specific neurodevelopmental disorders for which a possible therapeutic use of SGs has been suggested. Finally, we discuss findings obtained in clinical trials using SGs as digital therapeutics in neurodevelopment disorders and suggest new directions and hypotheses for future studies to bridge the gaps between clinical research and clinical practice.

Prediction of detailed blood metabolic profile using milk infrared spectra and machine learning methods in dairy cattle.

The adoption of preventive management decisions is crucial to dealing with metabolic impairments in dairy cattle. Various serum metabolites are known to be useful indicators of the health status of cows. In this study, we used milk Fourier-transform mid-infrared (FTIR) spectra and various machine learning (ML) algorithms to develop prediction equations for a panel of 29 blood metabolites, including those related to energy metabolism, liver function/hepatic damage, oxidative stress, inflammation/innate immunity, and minerals. For most traits, the data set comprised observations from 1,204 Holstein-Friesian dairy cows belonging to 5 herds. An exception was represented by ß-hydroxybutyrate prediction, which contained observations from 2,701 multibreed cows pertaining to 33 herds. The best predictive model was developed using an automatic ML algorithm that tested various methods, including elastic net, distributed random forest, gradient boosting machine, artificial neural network, and stacking ensemble. These ML predictions were compared with partial least squares regression, the most commonly used method for FTIR prediction of blood traits. Performance of each model was evaluated using 2 cross-validation (CV) scenarios: 5-fold random (CVr) and herd-out (CVh). We also tested the best model's ability to classify values precisely in the 2 extreme tails, namely, the 25th (Q25) and 75th (Q75) percentiles (true-positive prediction scenario). Compared with partial least squares regression, ML algorithms achieved more accurate performance. Specifically, elastic net increased the R2 value from 5% to 75% for CVr and 2% to 139% for CVh, whereas the stacking ensemble increased the R2 value from 4% to 70% for CVr and 4% to 150% for CVh. Considering the best model, with the CVr scenario, good prediction accuracies were obtained for glucose (R2 = 0.81), urea (R2 = 0.73), albumin (R2 = 0.75), total reactive oxygen metabolites (R2 = 0.79), total thiol groups (R2 = 0.76), ceruloplasmin (R2 = 0.74), total proteins (R2 = 0.81), globulins (R2 = 0.87), and Na (R2 = 0.72). Good prediction accuracy in classifying extreme values was achieved for glucose (Q25 = 70.8%, Q75 = 69.9%), albumin (Q25 = 72.3%), total reactive oxygen metabolites (Q25 = 75.1%, Q75 = 74%), thiol groups (Q75 = 70.4%), total proteins (Q25 = 72.4%, Q75 = 77.2.%), globulins (Q25 = 74.8%, Q75 = 81.5%), and haptoglobin (Q75 = 74.4%). In conclusion, our study shows that FTIR spectra can be used to predict blood metabolites with relatively good accuracy, depending on trait, and are a promising tool for large-scale monitoring.

Preaxial polydactyly of the foot in an adult patient diagnosed by X-ray after a trauma.

Polydactyly, or hyperdactyly, is a frequent malformation, with a reported incidence between 0.37 and 1.2 per 1000 live births. Most cases encountered in medical practice are sporadic cases, usually presenting one-sided manifestations. More frequently, polydactyly can be detected prenatally through an ultrasound examination, if not, it is usually diagnosed at birth, during the first physical examination. Although the clinical diagnosis is relatively easy in patients with manifest cases, it can sometimes be present with mild or partial forms that are not clinically evident on physical examination, resulting in later diagnosis and treatment. We reported a particular case of polydactyly of the foot not clinically manifest, diagnosed in a 39-year-old Caucasian Male patient with a history of recurrent localized pain in the big toe often associated with subungual bleeding, since he was a child who came to our emergency room following a car accident. Polydactyly is a frequently reported congenital malformation which may present in many different varieties of deformities. In this case, the X-ray, which was required after a car accident, leads to the incidental diagnosis of polydactyly in an adult patient. As described, because of the functional limitations related to this malformation, as well as to limit recurrent pain, and subungual anomalies, the patient underwent to a surgical correction to improve its quality of life.

Management of Non-Melanoma Skin Cancer: Radiologists Challenging and Risk Assessment.

Basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma are the three main types of nonmelanoma skin cancers and their rates of occurrence and mortality have been steadily rising over the past few decades. For radiologists, it is still difficult to treat patients with advanced nonmelanoma skin cancer. Nonmelanoma skin cancer patients would benefit greatly from an improved diagnostic imaging-based risk stratification and staging method that takes into account patient characteristics. The risk is especially elevated among those who previously received systemic treatment or phototherapy. Systemic treatments, including biologic therapies and methotrexate (MTX), are effective in managing immune-mediated diseases; however, they may increase susceptibility to NMSC due to immunosuppression or other factors. Risk stratification and staging tools are crucial in treatment planning and prognostic evaluation. PET/CT appears more sensitive and superior to CT and MRI for nodal and distant metastasis as well as in surveillance after surgery. The patient treatment response improved with advent and utilization of immunotherapy and different immune-specific criteria are established to standardized evaluation criteria of clinical trials but none of them have been utilized routinely with immunotherapy. The advent of immunotherapy has also arisen new critical issues for radiologists, such as atypical response pattern, pseudo-progression, as well as immune-related adverse events that require early identification to optimize and improve patient prognosis and management. It is important for radiologists to have knowledge of the radiologic features site of the tumor, clinical stage, histological subtype, and any high-risk features to assess immunotherapy treatment response and immune-related adverse events.

Milk metagenomics and cheese-making properties as affected by indoor farming and summer highland grazing.

The study of the complex relationships between milk metagenomics and milk composition and cheese-making efficiency as affected by indoor farming and summer highland grazing was the aim of the present work. The experimental design considered monthly sampling (over 5 mo) of the milk produced by 12 Brown Swiss cows divided into 2 groups: the first remained on a lowland indoor farm from June to October, and the second was moved to highland pastures in July and then returned to the lowland farm in September. The resulting 60 milk samples (2 kg each) were used to analyze milk composition, milk coagulation, curd firming, and syneresis processes, and to make individual model cheeses to measure cheese yields and nutrient recoveries in the cheese. After DNA extraction and Illumina Miseq sequencing, milk microbiota amplicons were also processed by means of an open-source pipeline called Quantitative Insights Into Microbial Ecology (Qiime2, version 2018.2; https://qiime2.org). Out of a total of 44 taxa analyzed, 13 bacterial taxa were considered important for the dairy industry (lactic acid bacteria, LAB, 5 taxa; and spoilage bacteria, 4) and for human (other probiotics, 2) and animal health (pathogenic bacteria, 2). The results revealed the transhumant group of cows transferred to summer highland pastures showed an increase in almost all the LAB taxa, bifidobacteria, and propionibacteria, and a reduction in spoilage taxa. All the metagenomic changes disappeared when the transhumant cows were moved back to the permanent indoor farm. The relationships between 17 microbial traits and 30 compositional and technological milk traits were investigated through analysis of correlation and latent explanatory factor analysis. Eight latent factors were identified, explaining 75.3% of the total variance, 2 of which were mainly based on microbial traits: pro-dairy bacteria (14% of total variance, improving during summer pasturing) and pathogenic bacteria (6.0% of total variance). Some bacterial traits contributed to other compositional-technological latent factors (gelation, udder health, and caseins).