Decoding drivers of carbon flux attenuation in the oceanic biological pump.

The biological pump supplies carbon to the oceans' interior, driving long-term carbon sequestration and providing energy for deep-sea ecosystems1,2. Its efficiency is set by transformations of newly formed particles in the euphotic zone, followed by vertical flux attenuation via mesopelagic processes3. Depth attenuation of the particulate organic carbon (POC) flux is modulated by multiple processes involving zooplankton and/or microbes4,5. Nevertheless, it continues to be mainly parameterized using an empirically derived relationship, the 'Martin curve'6. The derived power-law exponent is the standard metric used to compare flux attenuation patterns across oceanic provinces7,8. Here we present in situ experimental findings from C-RESPIRE9, a dual particle interceptor and incubator deployed at multiple mesopelagic depths, measuring microbially mediated POC flux attenuation. We find that across six contrasting oceanic regimes, representing a 30-fold range in POC flux, degradation by particle-attached microbes comprised 7-29 per cent of flux attenuation, implying a more influential role for zooplankton in flux attenuation. Microbial remineralization, normalized to POC flux, ranged by 20-fold across sites and depths, with the lowest rates at high POC fluxes. Vertical trends, of up to threefold changes, were linked to strong temperature gradients at low-latitude sites. In contrast, temperature played a lesser role at mid- and high-latitude sites, where vertical trends may be set jointly by particle biochemistry, fragmentation and microbial ecophysiology. This deconstruction of the Martin curve reveals the underpinning mechanisms that drive microbially mediated POC flux attenuation across oceanic provinces.

Design and rationale of the Engage-HF study: the impact of a gamified engagement toolkit on participation and engagement in a heart failure registry.

Aims: Heart failure (HF) registries provide valuable insights into patient management and quality of care. However, healthcare professionals face challenges due to the administrative burden of participation in registries. This study aims to evaluate the impact of education through an engagement toolkit on HF nurse practitioners' participation rate and data completeness in a national registry: the Netherlands Heart Registration-Heart Failure (NHR-HF) registry. Methods and results: Engage-HF is an observational study (intervention at the HF nurse level) with a pretest-posttest design within the participating hospitals. Between December 2022 and April 2024, 28 HF nurse practitioners from 12 hospitals will participate in a 24-week educational programme using the Engage-HF engagement toolkit. The main interaction platform in this toolkit is a gamified smartphone-based educational application called BrightBirds. The complete toolkit includes this educational application with weekly challenges, interactive posters, pop-ups, and alert messages, and a follow-up call at Week 4. The primary endpoints are the NHR-HF participation rates and data completeness at 1 and 6 months after using the toolkit. Additionally, we will analyse the experience of participants with the toolkit concerning their HF registry and knowledge of ESC 2021 HF guidelines. Conclusion: The Engage-HF study is the first to explore the impact of education through a gamified engagement toolkit to boost participation rates in a HF registry (NHR-HF) and test participant knowledge of the ESC 2021 HF guidelines. This innovative approach addresses challenges in the rollout of healthcare registries and the implementation of guidelines by providing a contemporary support base and a time-efficient method for education.

Identification of Trichosporon yeast isolates from superficial infections in male patients from Central Brazil: an approach to the diversity of infections caused by this basidiomycete fungus.

The genus Trichosporon are currently recognized as opportunistic pathogens capable of causing superficial "white piedra" infections and potentially fatal invasive diseases (Trichosporonosis). In this work, determine the agent Trichosporon spp. isolated from the skin and appendages of a male population group in the Central-West region of Brazil. The isolates were analyzed by phenotypic, biochemical and molecular methods. Twenty-five strains of Trichosporon were isolated: T. asahii (18; 72%), followed by T. inkin (4; 16%) and T. faecale (3; 12%). Skin infections were the most affected (16; 64%) and the genitocrural region (13; 52%) was the most affected. The highest rate of isolation occurred between the ages of 21 and 30 years (9; 36%), with black men (African descent) (13; 52%) being the most affected by this type of superficial infection. After the advent of molecular techniques, more than 50 subspecies and about 16 different strains have been reported to cause human disease. In this series, three species of the genus Trichosporon of medical importance were highlighted, colonizing the genital and perigenital region of the studied population. For the identifications, classical phenotypic methods associated with genotypic identification were carried out, using molecular techniques based on the study of DNA; using sequence analysis of the DNA intergenic spacer region 1 (IGS1).

Retrospective comparison of thyroid hormones in Steller sea lions Eumetopias jubatus under professional care with and without thyroid disease.

An evaluation of morbidity and mortality in Steller sea lions (SSLs) Eumetopias jubatus under professional care identified a high prevalence of thyroid disease in aged animals. While studies have investigated the effects of age, season, nutrition, stressors, and pollutants on thyroid hormones in pinnipeds, data from individuals with known thyroid disease are lacking. Histopathological reports of adult SSLs in North American aquariums from 1979 to 2022 with banked serum (n = 14) were reviewed. Radioimmunoassays, which have been validated in this species, were used to determine triiodothyronine (TT3), total thyroxine (TT4), and free thyroxine (fT4). A solid-phase chemiluminescent immunometric assay for thyroid-stimulating hormone (TSH) quantification was validated by testing inter- and intra-assay repeatability, recovery, and parallelism. Lesions included follicular cysts (n = 5), adenoma with thyroglossal duct or follicular cysts (n = 2), medullary or follicular C-cell carcinoma with follicular cysts and nodular hyperplasia (n = 1), neuroendocrine carcinoma with follicular cysts (n = 1), and sarcomatoid carcinoma metastasis to the thyroid (n = 1). Significantly lower concentrations of TT3, TT4, and fT4 in SSLs with thyroid disease (n = 10) versus those without (n = 4) were attributed to space-occupying lesions, advanced age, and/or season. TSH was not significantly different between groups. Fifty percent of diseased SSL profiles were within reference ranges, and all individuals with lesions were clinically euthyroid. These data expand the current understanding of thyroid disease in SSLs and underscore the need for additional diagnostics (e.g. cervical ultrasound) concurrently with hormone assays to effectively screen for underlying abnormalities.

The phospholipase A of Neisseria gonorrhoeae lyses eukaryotic membranes and is necessary for survival in neutrophils and cervical epithelial cells.

Contact-dependent hemolysins are virulence factors in a number of human pathogens, including Helicobacter pylori, Rickettsia typhi, Bartonella bacilliformis, Mycobacterium tuberculosis, entero-invasive Escherichia coli, and Shigella. Here we demonstrate that Neisseria gonorrhoeae produces an outer membrane protein, phospholipase A, that exhibits contact-dependent lytic activity on host cell membranes. This enzyme can lyse human erythrocytes over a 3-day period, whereas a phospholipase A mutant cannot. We demonstrated phospholipase A activity in the parent strain but not in two, independent phospholipase A mutants. A gene for phospholipase A, pldA (hereafter referred to as pla to avoid confusion with the gene for phospholipase D, pld), is present in all sequenced gonococcal strains. Fluid phase, hemolytic activity assays showed that 25 of 29 gonococcal strains tested had hemolytic activity greater than 50% of the positive control. In support of PLA as a gonococcal outer membrane protein, supernatants from 24-, 48-, and 72-h cultures of N. gonorrhoeae strain 1291 did not contain hemolysin activity, and a monoclonal antibody specific for gonococcal phospholipase A failed to detect the enzyme in these supernatants. The organism must be viable for lysis to occur, and the inclusion of EDTA in the media removes all activity. Our studies have shown that a phospholipase A mutant has significantly reduced survival in human neutrophils and primary human cervical epithelial cells compared to the parent gonococcal strain after 3 h of incubation. Collectively, our data demonstrate that gonococcal PLA lyses host cell membranes, which is important for intracellular survival. IMPORTANCE: Intracellular survival is crucial to the success of Neisseria gonorrhoeae as a human pathogen. Multiple factors contribute to the intracellular survival of gonococci, including the ability to prohibit apoptosis of the epithelial cell the organism invades and mechanisms to evade host innate defense systems. The role of phospholipase A (PLA), an outer membrane protein, is important as it disrupts the host vacuolar and phagolysosomal membranes, preventing the effective delivery of innate immune factors that normally restrict organism growth within human cells. After cell entry, PLA disrupts the integrity of these host cell membranes, allowing the gonococcus to live free within disrupted vacuoles where it pilfers host cell nutrients that enable its survival and replication. A vaccine or drug that could neutralize PLA activity would disrupt the intracellular survival of the gonococcus.

"There is a life before and after cancer": experiences of resuming life and unmet care needs in stage I and II melanoma survivors.

Although the largest increase in melanoma incidence is observed for localised melanoma, little research has been done on its impact. Despite favourable prognoses and relatively short treatment trajectories, diagnosis and treatment may significantly impact life post-treatment. Therefore, the aim of this study was to gain an in-depth understanding of stage I and II melanoma survivors' experiences resuming life after treatment and their associated survivorship care (SSC) needs. A qualitative focus group study was conducted with 18 stage I or II melanoma survivors, divided over three focus groups with 6 survivors each. Transcripts were analysed through thorough thematic content analysis, using multiple phases of coding. In resuming life, survivors experienced profound initial impacts of disease and treatment, fed by a perceived lack of knowledge and underestimation of melanoma. They faced unexpected physical and emotional effects post-surgery, experiencing mixed feelings from relief to fear and uncertainty. Survivors felt misunderstood, had to adjust their lives, and managed personal and external expectations while experiencing a positive shift in life perspective, leading to a notable difference in life before and after cancer. In terms of SSC needs, survivors stressed the need for tailored information, accessible resources, patient-centered follow-up, and supportive care addressing the total impact of disease and treatment. These findings highlight the importance of improving melanoma awareness and providing holistic SSC not only to advanced, but also to localised melanoma survivors. A tailored survivorship care plan could facilitate access to information and supportive care, helping patients resume their lives.

Reproductive outcomes of prepubertal Bos indicus beef heifers raised in a pasture-based feeding system submitted to ovulation induction strategies prior to a timed-artificial insemination protocol.

Reproductive outcomes were evaluated in Nelore (Bos indicus) heifers submitted to one, two or no ovulation induction protocols based on progesterone (P4) and estradiol (E2) prior to a timed-artificial insemination (TAI) protocol. A total of 1,437 heifers (13.0 ± 0.8 mo old; 3.1 ± 0.1 of body condition score [BCS] and 279.9 ± 25.8 kg of body weight [BW]) were randomly assigned to 1 of 3 treatments: 0IND (n = 486): no ovulation induction protocol; 1IND (n = 481): one ovulation induction protocol; or 2IND (n = 470): two ovulation induction protocols. On Day -47, heifers from 2IND received a disinfected intravaginal P4 device (2 g, previously used for 21 d), kept until Day -40, when 0.5 mg of E2 cypionate (EC) was given. On Day -19, heifers from 2IND and 1IND underwent the same protocol. On Day 0, all heifers were submitted to the same TAI protocol, starting with a P4 device (0.5 g), 0.5 mg of cloprostenol sodium (PGF), and 1.5 mg of E2 benzoate. On Day 7, P4 device was removed, 0.5 mg of PGF, 0.5 mg of EC, and 200 IU of equine chorionic gonadotropin (eCG) were administered. The TAI was performed 2 d later (Day 9). Blood samples were collected on Days -47 and 0, to determine the presence of CL (circulating P4 concentrations ≥ 1.0 ng/mL). Ultrasound was performed on Days 40, 75 and between Day 150 and parturition to assess pregnancy per AI (P/AI) and pregnancy loss (PL). Statistical analyses were performed using SAS 9.4 (a-cP ≤ 0.05; A,B0.05 < P ≤ 0.10). The proportion of heifers with CL on Day -47 was similar among groups (3.4%). A greater proportion of heifers from 1IND had CL on Day 0, followed by 2IND, then 0IND (87.9a; 80.4b; 28.8c%). There was an effect of treatment on expression of estrus (2IND: 66.6a; 1IND: 67.2a; 0IND: 57.4b%), P/AI on Day 40 (2IND: 53.4a; 1IND: 43.9b; 0IND: 46.5b%), P/AI on Day 75 (2IND: 49.8a; 1IND: 40.5b; 0IND: 44.4ab%) and final P/AI (2IND: 45.5a; 1IND: 35.8b; 0IND: 40.5ab%). No differences were observed in PL (40-75 = 6.3%; 75-final = 9.6%; Total = 15.3%). Particularly within lighter heifers, there was an effect of treatment on P/AI on Day 40 (0IND: 39.2b; 1IND: 43.3ab; 2IND: 53.9a%) and on Day 75 (0IND: 36.6B; 1IND: 39.0AB; 2IND: 48.5A%). At the first pregnancy diagnosis, more nonpregnant heifers from 2IND had CL on Day 40 than 0IND, but 1IND did not differ from the other groups (85.4a; 74.8b; 80.8ab%). In conclusion, ovulation induction protocols performed prior to the TAI protocol increased the proportion of heifers with CL on Day 0. The use of two induction protocols resulted in greater fertility, particularly in lighter heifers, and increased cyclicity among nonpregnant heifers. These results indicate that this strategy may be an optimized method for inducing cyclicity and enhancing fertility of prepubertal Nelore heifers raised in pasture-based feeding systems.

Clinical Characteristics and Differential Diagnosis of Hypomineralised Second Primary Molars and Molar Incisor Hypomineralisation.

Molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPMs) are commonly seen dental developmental problems with a mean prevalence of around 14% and 9%, respectively, but with a large variability in the reported prevalences. From the dental development, we know that the enamel mineralisation of the second primary molar is taking place between the 19th week of pregnancy until 1 year of age. For the first permanent molars (FPMs) and incisors, the enamel mineralisation is taking place between birth until the age of 3-5. When there is a disturbance during this period, HSPM and/or MIH can occur. There is an overlap in the development of the second primary molars and the FPMs and incisors; the period between birth and the first birthday of the child. A disturbance in this period could cause both HSPM and MIH. There is a relation found in the occurrence of HSPM and MIH. Diagnosing HSPM and MIH can be challenging. All teeth present in the mouth need to be examined. The use of the European Association of Paediatric Dentistry scoring criteria is a good help. In these criteria also, the most common differential diagnoses are included.

Prodrug activation in malaria parasites mediated by an imported erythrocyte esterase, acylpeptide hydrolase (APEH).

The continued emergence of antimalarial drug resistance highlights the need to develop new antimalarial therapies. Unfortunately, new drug development is often hampered by poor drug-like properties of lead compounds. Prodrugging temporarily masks undesirable compound features, improving bioavailability and target penetration. We have found that lipophilic diester prodrugs of phosphonic acid antibiotics, such as fosmidomycin, exhibit significantly higher antimalarial potency than their parent compounds (1). However, the activating enzymes for these prodrugs were unknown. Here, we show that an erythrocyte enzyme, acylpeptide hydrolase (APEH) is the major activating enzyme of multiple lipophilic ester prodrugs. Surprisingly, this enzyme is taken up by the malaria parasite, Plasmodium falciparum, where it localizes to the parasite cytoplasm and retains enzymatic activity. Using a novel fluorogenic ester library, we characterize the structure activity relationship of APEH, and compare it to that of P. falciparum esterases. We show that parasite-internalized APEH plays an important role in the activation of substrates with branching at the alpha carbon, in keeping with its exopeptidase activity. Our findings highlight a novel mechanism for antimicrobial prodrug activation, relying on a host-derived enzyme to yield activation at a microbial target. Mutations in prodrug activating enzymes are a common mechanism for antimicrobial drug resistance (2-4). Leveraging an internalized host enzyme would circumvent this, enabling the design of prodrugs with higher barriers to drug resistance.

Physical activity at diagnosis is associated with tumor downstaging after neoadjuvant chemoradiotherapy in patients with rectal cancer.

BACKGROUND: Patients with rectal cancer are often treated with neoadjuvant chemoradiotherapy, followed by a waiting period and surgical resection. Good or complete response to neoadjuvant chemoradiotherapy might enable organ preservation, which highlights the need to increase response rates. Pre-clinical studies suggest that physical activity during neoadjuvant chemoradiotherapy may improve tumor downstaging. PURPOSE: To investigate whether physical activity and physical functioning of patients with rectal cancer at diagnosis are associated with tumor downstaging after neoadjuvant chemoradiotherapy. MATERIALS AND METHODS: Patients were included if they participated in the Dutch Prospective ColoRectal Cancer Cohort, a nationwide cohort providing an infrastructure for scientific research, and received neoadjuvant chemoradiotherapy for rectal cancer. Tumor downstaging was dichotomized into good/complete or moderate/poor downstaging. Physical activity (total physical activity, moderate-to-vigorous physical activity (MVPA), and Dutch physical activity guideline adherence) and physical functioning were assessed using questionnaires. Logistic regression analyses were performed to examine associations of physical activity and physical functioning with tumor downstaging, adjusted for relevant confounders. RESULTS: 268 patients (aged 62 ± 11 years, 33 % female) with rectal cancer were included. Patients with moderate (OR = 2.07; 95%CI = 1.07 - 4.07; p = 0.03) or high (OR = 2.05; 95%CI = 1.05 - 4.07; p = 0.04) levels of MVPA were more likely to have good/complete tumor downstaging than patients with low levels. No significant associations with tumor downstaging were found for total physical activity, Dutch physical activity guideline adherence, and physical functioning. CONCLUSIONS: We found augmented tumor downstaging in patients with rectal cancer with moderate or high levels of self-reported MVPA before the start of neoadjuvant chemoradiotherapy compared to patients with low levels.

The effect of rectus femoris transfer on kinematics and functional outcomes in adult stroke patients walking with a stiff knee gait.

BACKGROUND: Stiff knee gait is characterized by a reduced peak knee flexion during swing. Overactivity of the rectus femoris is often cited as a main cause for stiff knee gait. Little is known about the effect of an isolated rectus femoris transfer treatment on kinematic and functional outcomes in a group of stroke survivors. OBJECTIVE: To perform an experimental study to evaluate the effect of an isolated rectus femoris transfer on knee and hip kinematics and functional outcomes in adult stroke patients walking with a stiff knee gait. METHOD: In this experimental study, 10 stroke survivors were included. During the surgical procedure, the distal rectus femoris tendon of the affected side was transferred to the medial knee flexors to improve knee flexion during swing. Knee and hip kinematics and a variety of functional outcomes were measured within 3 weeks before surgery and between 6 and 7 months after the surgery. RESULTS: We found a statistically significant improvements in peak knee flexion during swing and knee range of motion of 10.6° (sd 4.7, p=0.000) and 10.5° (sd 6.2, p=0.001) post-surgery, respectively. Hip kinematics showed no significant differences. In addition, we found statistically significant improvements on the 6-minute walk test (42.5, sd 36.7, p=0.008), 10-meter walk test (1.26, sd 1.4, p=0.030), Timed up-and-go test (1.34, sd 1.18, p=0.009), L-test (2.97 sd 2.85, p=0.014) and on a subjective BORG scoring of foot clearance (1.8, sd 0.6, p=0.006). No significant differences were found on other measured functional outcomes. CONCLUSIONS: Rectus femoris transfer is a valuable treatment option for stroke patients walking with a stiff knee gait to improve knee kinematics and a selection of functional outcomes. There are no detrimental side effects on hip kinematics.

The developing pig respiratory microbiome harbors strains antagonistic to common respiratory pathogens.

In the global efforts to combat antimicrobial resistance and reduce antimicrobial use in pig production, there is a continuous search for methods to prevent and/or treat infections. Within this scope, we explored the relationship between the developing piglet nasal microbiome and (zoonotic) bacterial pathogens from birth until 10 weeks of life. The nasal microbiome of 54 pigs was longitudinally studied over 16 timepoints on 9 farms in 3 European countries (Germany, Ireland, and the Netherlands) using amplicon sequencing targeting the V3-V4 16S rRNA region as well as the tuf gene for its staphylococcal discrimination power. The piglets' age, the farm, and the litter affected the nasal microbiome, with piglets' age explaining 19% of the variation in microbial composition between samples. Stabilization of the microbiome occurred around 2 weeks post-weaning. Notably, while opportunistic pathogens were ubiquitously present, they did not cause disease. The piglet nasal microbiome often carried species associated with gut, skin, or vagina, which suggests that contact with the vaginal and fecal microbiomes shapes the piglet nasal microbiome. We identified bacterial co-abundance groups of species that were present in the nasal microbiomes in all three countries over time. Anti-correlation between these species and known bacterial pathogens identified species that might be exploited for pathogen reduction. Further experimental evidence is required to confirm these findings. Overall, this study advances our understanding of the piglet nasal microbiome, the factors influencing it, and its longitudinal development, providing insights into its role in health and disease. IMPORTANCE: Our study on the nasal microbiota development in piglets across farms in three European countries found that the microbiomes developed similarly in all locations. Additionally, we observed that the colonization of porcine pathogens was either positively or negatively associated with the presence of other bacterial species. These findings enhance our knowledge of co-colonizing species in the nasal cavity and the identified microbial interactions that can be explored for the development of interventions to control pathogens in porcine husbandry.

Metagenomics and vegetative growth of Salvia hispanica inoculated with Trichoderma harzianum.

The soil is a dynamic environment, influenced by abiotic and biotic factors, which can result in changes in plant development. This study aimed to assess the impact on vegetative growth of chia (Salvia hispanica L) inoculated with Trichoderma harzianum and on the rhizosphere microbiome. The experimentation was conducted in a greenhouse under controlled conditions growing chia plants in pots containing soil with a clayey texture. Different concentrations of T. harzianum (0; 2.5; 5.0; 10.0; 20.0 µL. g-1 of seed) were applied to the chia seeds before planting. Morphological parameters, including plant height (cm), number of branches, stem diameter (mm), number of days to flowering and shoot and root dry masses (g) were quantitatively assessed. After the cultivation period, soil samples from the rhizosphere region were collected for subsequent chemical and metagenomic analyses. These samples were also compared with the control soil, collected before installing the experiment. The results showed that increasing doses of T. harzianum promoted a significant increase in the diameter of the stem, number of branches, dry biomass of the root system and the number of days to flowering, without modifying the overall height of the plants. Soil metagenomics indicated that T. harzianum inoculation modified the microbial diversity of the rhizosphere environment, with more pronounced effects observed in samples treated with higher concentrations of the inoculant. Furthermore, there were changes in the chemical composition and enzymes related to soil quality in correlation with the concentrations of the applied inoculant. This study demonstrated that inoculating chia seeds with T. harzianum not only promotes specific morphogenetic characteristics of the plant, but it also has a significant impact on the microbial diversity and biochemical functionality of the soil, including an observed increase in the populations of T. harzianum and T. asperellum.

Pronouns reactivate conceptual representations in human hippocampal neurons.

During discourse comprehension, every new word adds to an evolving representation of meaning that accumulates over consecutive sentences and constrains the next words. To minimize repetition and utterance length, languages use pronouns, like the word "she," to refer to nouns and phrases that were previously introduced. It has been suggested that language comprehension requires that pronouns activate the same neuronal representations as the nouns themselves. We recorded from individual neurons in the human hippocampus during a reading task. Cells that were selective to a particular noun were later reactivated by pronouns that refer to the cells' preferred noun. These results imply that concept cells contribute to a rapid and dynamic semantic memory network that is recruited during language comprehension.

Butterfly abundance changes in England are well associated with extreme climate events.

Climate change exerts significant impacts on ecosystems through extreme climate events (ECEs), which are linked to various climate variables and can occur in different seasons. However, previous studies predominantly focus on a single type of ECE within specific seasons. We address this research gap by examining four typical types of ECEs: droughts, pluvials, heatwaves, and coldwaves, which are consistently defined and identified on a daily scale using a recently proposed statistical method. Butterflies in England serve as our study subject since their life stages occur throughout the year, and we had access to a 45-year dataset encompassing 57 butterfly species. First, we analyzed the correlation between abundance changes and the severity of ECEs, revealing varying sensitivity to ECEs across different life stages. Notably, abundance changes are negatively correlated with the severity of heatwaves in the hibernation, egg, and larval stages, as well as with the severity of pluvials in the larval, pupal, and adult stages. Second, we identified the most extreme climate events (MECEs) in England in the period from 1950 to 2020 and linked them with synchronized abundance changes for all species. MECEs in the sensitive stages of butterflies are frequently (for eight out of 11 MECEs) associated with synchronized decreases in their abundance. Our findings underscore the importance of considering diverse types of ECEs across all seasons to gain insights into their potential ecosystem effects. We draw attention to the fact that our analyses are primarily data-driven, with limited ecophysiological interpretation.

Closed laceration of the trachea, esophagus and guttural pouches in a mare caused by blunt trauma.

A mare was admitted for progressive swelling of the neck, lethargy and anorexia. Radiography revealed perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy revealed pharyngeal and tracheal roof collapse, and a small laceration on the trachea. Treatment with antimicrobials, fluids, and flunixin was initiated. To prevent exacerbation of the emphysema, temporary tracheostomy was performed. Clipping for the tracheostomy revealed a hoofprint mark on the ventral neck. Subsequent endoscopies revealed laceration of the esophagus and guttural pouch septum communicating with the visceral compartment of the neck. Four days after admission, an esophagostomy was performed to prevent leakage of ingesta into the neck and allow feeding. Complications occurred: Deep cervical infection requiring surgical drainage; Esophageal impaction with shavings on one occasion causing extensive mucosa erosions; Laminitis managed with restricted physical activity and corrective farriery. Tracheostomy tube removal, esophagostomy tube removal, and patient discharge occurred 10, 36 and 51 days after admission, respectively. The mare did well after discharge and returned to competing in children's showing classes. Blunt trauma to the neck can lacerate the trachea, esophagus and guttural pouches causing emphysema and deep cervical infection, which can be treated with antimicrobials, temporary tracheostomy, temporary esophagostomy, surgical drainage, and supportive care.

Contraceptive access and use among women with migratory experience living in high-income countries: a scoping review.

BACKGROUND: Women who have migrated often encounter difficulties in accessing healthcare and experience inequitable sexual and reproductive health outcomes in destination countries. These health inequities include contraceptive access and use. To better understand what influences contraceptive access and use, this scoping review set out to synthesize the evidence on contraceptive access and use and on associated interventions among women with migratory experience in high-income countries (HICs) in Europe, North America and Australasia. METHODS: The scientific databases PubMed, Web of Science and CINAHL were searched for peer-reviewed quantitative, qualitative and mixed method articles published between January 2000 and June 2023. Articles were included if they reported on studies exploring contraceptive use to prevent pregnancies among women of reproductive age with migratory experience living in HICs. Two researchers independently screened and extracted data from the articles. Findings were categorized by patient and health system level factors according to Levesque et al.'s framework of access to health care. RESULTS: A total of 68 articles were included, about half (n = 32) from North America. The articles focused on the individual level rather than the health system level, including aspects such as women's contraceptive knowledge, the influence of culture and religion on accessing and using contraception, partner involvement, and differing health insurance coverage. On the health system level, the articles highlighted lack of information on contraceptive services, cultural (in)adequacy of services and communication aspects, contraceptives' side effects, as well as geographic availability and cost of services. The review further identified three articles reporting on interventions related to contraceptive counselling. CONCLUSIONS: There is a lack of knowledge regarding how health systems impose obstacles to contraceptive services for women with migratory experience on an organizational level, as research has focused heavily on the individual level. This review's findings may serve as a foundation for further research and advances in policy and practice, specifically recommending early provision of health system related information and contraceptive education, engagement of male partners in contraceptive discourses, cultural competency training for healthcare professionals, and strengthening of interpretation services for contraceptive counselling.

Precision in situ cryo-correlative light and electron microscopy of optogenetically-positioned organelles.

Unambiguous targeting of cellular structures for in situ cryo-electron microscopy in the heterogeneous, dense, and compacted environment of the cytoplasm remains challenging. Here we have developed a cryogenic correlative light and electron microscopy (cryo-CLEM) workflow which combines thin cells grown on a mechanically defined substratum to rapidly analyse organelles and macromolecular complexes by cryo-electron tomography (cryo-ET). We coupled these advancements with optogenetics to redistribute perinuclear-localised organelles to the cell periphery, allowing visualisation of organelles otherwise positioned in cellular regions too thick for cryo-ET. This reliable and robust workflow allows for fast in situ analyses without the requirement for cryo-focused ion beam milling. Using this protocol, cells can be frozen, imaged by cryo-fluorescence microscopy and be ready for batch cryo-ET within a day.

Evaluating the impact of extended dosing intervals on mRNA COVID-19 vaccine effectiveness in adolescents.

BACKGROUND: Extending the dosing interval of a primary series of mRNA COVID-19 vaccination has been employed to reduce myocarditis risk in adolescents, but previous evaluation of impact on vaccine effectiveness (VE) is limited to risk after second dose. METHODS: We quantified the impact of the dosing interval based on case notifications and vaccination uptake in Hong Kong from January to April 2022, based on calendar-time proportional hazards models and matching approaches. RESULTS: We estimated that the hazard ratio (HR) and odds ratio (OR) of infections after the second dose for extended (28 days or more) versus regular (21-27 days) dosing intervals ranged from 0.86 to 0.99 from calendar-time proportional hazards models, and from 0.85 to 0.87 from matching approaches, respectively. Adolescents in the extended dosing groups (including those who did not receive a second dose in the study period) had a higher hazard of infection than those with a regular dosing interval during the intra-dose period (HR 1.66; 95% CI 1.07, 2.59; p = 0.02) after the first dose. CONCLUSIONS: Implementing an extended dosing interval should consider multiple factors including the degree of myocarditis risk, the degree of protection afforded by each dose, and the extra protection achievable using an extended dosing interval.

Death rituals and quality of life of bereaved relatives during the COVID-19 pandemic: Results of the observational CO-LIVE study.

Grief is a normal reaction after the death of a loved one. Death rituals are an integral part of the mourning processes. Not being able to carry out death rituals can affect relatives' quality of life. The aim was to evaluate death rituals during COVID-19 and their association with relatives' quality of life. In a Swedish nation-wide study relatives to persons who died during the COVID-19-pandemic received questionnaires about their quality of life and how they could perform death rituals. Association between quality of life and death rituals was analyzed with linear regression. Of the 324 relatives, a minority indicated that their loved one's funeral (17%) met their wishes. Not being able to carry out the funeral as desired was significantly associated with a lower quality of life (p = 0.006). The experiences during the pandemic revealed that it is important for people to perform death rituals according to their wishes.