Tick development on sexually-active bull moose is more advanced compared to that of cow moose in the winter tick, Dermacentor albipictus.

We performed a complete survey of ticks on 100 cm2 skin samples collected from 30 moose (Alces alces) harvested in 2017 in central and northern Maine, U.S.A. The samples were collected from 15 bulls, 13 cows, and 2 calves in mid-October when moose are breeding and winter ticks (Dermacentor albipictus) quest for a host. We identified only winter ticks with 99.2% in a juvenile stage; 3 adult ticks were found. Unfed nymphs were most common on bulls, whereas most ticks were fed larvae on cows and calves. The mean total count on bull samples was 21 ±â€¯4.4 (range = 0-55) and higher than on cows (6 ±â€¯0.5; range = 2-8). Unlike previous surveys, tick abundance was lowest on calves. Tick abundance was independent of age or weight of adult moose. The higher abundance and more rapid development of winter ticks on adult bulls likely reflects the seasonal influence of increased movements and hormonal cycles associated with reproduction.

Comparison of Different In Vivo Incubation Sites to Produce Tissue-Engineered Small Intestine.

OBJECTIVE: The objective of this study was to compare the impact of different in vivo incubation sites on the production of tissue-engineered small intestine (TESI). MATERIALS AND METHODS: Green fluorescent protein transgenic rat pups (3-5 days) were used as donors of intestinal organoids. Harvested intestine was exposed to enzymatic digestion to release intestinal stem cell-containing organoids. Organoids were purified, concentrated, and seeded onto tubular polyglycolic acid scaffolds. Seeded scaffolds were implanted in each of five locations in recipient female nude rats: wrapped with omentum, wrapped with intestinal mesentery, wrapped with uterine horn membrane, attached to the abdominal wall, and inserted into the subcutaneous space. After 4 weeks of in vivo incubation, specimens from each site were explanted for evaluation. RESULTS: Wrapping seeded scaffolds with vascularized membranes produced TESI with variable lengths of vascularized pedicles, with the longest pedicle length from uterine horn membrane, the shortest pedicle length from intestinal mesentery, and intermediate length from omentum. The quantity of TESI, as expressed by volume and neomucosal length, was identical in TESI produced by wrapping with any of the three membranes. The smallest quantity of TESI was found in TESI produced from insertion into the subcutaneous space, with an intermediate quantity of TESI produced from attachment to the abdominal wall. Periodic acid-Schiff and immunofluorescence (IF) staining confirmed the presence of all intestinal epithelial cell lineages in TESI produced at all incubation sites. Additional IF staining demonstrated the presence of enteric nervous system components and blood vessels. Wrapping of seeded scaffolds with vascularized membranes significantly increased the density of blood vessels in the TESI produced. CONCLUSION: Wrapping of seeded scaffolds in vascularized membranes produced the largest quantity and highest quality of TESI. Attaching seeded scaffolds to the abdominal wall produced an intermediate quantity of TESI, but the quality was still comparable to TESI produced in vascularized membranes. Insertion of seeded scaffolds into the subcutaneous space produced the smallest quantity and lowest quality of TESI. In summary, wrapping seeded scaffolds with vascularized membranes is favorable for the production of TESI, and wrapping with omentum may produce TESI that is most easily anastomosed with host intestine.

The utility of the model for end-stage liver disease score: a reliable guide for liver transplant candidacy and, for select patients, simultaneous hospice referral.

Patients with chronic liver disease are referred late to hospice or never referred. There are several barriers to timely referral. First, liver transplantation (LT) and hospice care have always been perceived as mutually exclusive. Yet the criteria for hospice referral and for LT are more similar than different (for example, advanced liver disease and imminent death). Second, physicians, patients, and families have not had a reliable metric to guide referral. However, many patients wait for transplantation but never receive an organ. We hypothesized that the Model for End-Stage Liver Disease (MELD) score already in use to prioritize LT could be used in selected patients for concurrent hospice referral. Furthermore, we hypothesized that patients awaiting LT can receive hospice care and remain eligible for transplantation. Patients with advanced or end-stage liver disease were referred to the University of California Davis Health System hospice program. We correlated the MELD score at admission to length of stay (LOS) in hospice. A total of 157 end-stage liver disease patients were admitted to the hospice service. At the time of hospice admission the mean MELD score was 21 (range, 6-45). The mean length of hospice stay was 38 days (range, 1-329 days). A significant correlation was observed between hospice LOS and MELD score at hospice admission (P < 0.01). Six patients were offered a liver graft while on the combined (LT and hospice) program. MELD can be used to guide clinician recommendation to families about hospice care, achieving one of the national benchmark goals of increasing hospice care duration beyond the current median of 2-3 weeks. A higher MELD score might augment physician judgment as to hospice referral. Hospice care for selected patients may be an effective strategy to improve the care of end-stage liver disease patients waiting for LT.