Background: Basilar fenestration is a rare congenital anomaly. When present, it is commonly found at the proximal portion of the artery near the vertebrobasilar junction. Methods: This is a case report of a ruptured basilar fenestration aneurysm in a 47-year-male successfully treated with endovascular coiling. Results: A 47-year-old male presented with sudden onset headache, neck pain, blurry vision, nausea, vomiting, and diaphoresis. Cerebral angiogram revealed a saccular basilar fenestration aneurysm located at the vertebrobasilar junction measuring 3.1 x 2.6 x 3.4 mm with a 2.3 mm neck. Multiple coils were placed including Target 360 Nano 2mm x 4 cm (Stryker, Kalamazoo, MI, US), Target 360 Nano 1.5 mm x 2 cm (Stryker, Kalamazoo, MI, US), and Target Helical Nano 1.5 mm x 1 cm (Stryker, Kalamazoo, MI, US). A repeat angiogram revealed complete exclusion of the aneurysm with preservation of both vertebral arteries. Conclusions: A literature review was conducted on basilar fenestration aneurysms which included 158 patients from 39 studies. Overall, complete exclusion of the aneurysm was achieved in 75.8% of cases, with 22.4% of cases having residual flow and 1.8% of cases with unreported exclusion status.

The current study investigated the effects of pre-grazing herbage mass (PGHM, 1500 or 2500 kg dry matter (DM)/ha) and post-grazing sward height (PGSH, 4 or 6 cm) on herbage production and its nutritive value and DM intake, grazing behaviour and growth of Charolais steers (n = 96; 12 months of age; 396 ± 19.0 kg) during a 222-day grazing season, and the subsequent effect of an indoor finishing diet (grass silage alone or supplemented with concentrates) for 146 days, on performance and carcass traits. Steers were assigned to one of 12 grazing groups and group was assigned to a 2 (PGHM) × 2 (PGSH) factorial arrangement of treatments. At the end of the grazing season, live-weight was 16 kg heavier for PGHM-1500 than PGHM-2500 and 34 kg heavier for PGSH-6 than PGSH-4. After indoor finishing, there was no difference in carcass weight between PGHM treatments, but PGSH-6 had a 19 kg heavier carcass than PGSH-4. Herbage production was 881 and 517 kg DM/ha greater for PGHM-2500 than PGHM-1500 and for PGSH-4 than PGSH-6, respectively. Grazing stocking rate did not differ between PGHM treatments but PGSH-4 carried 1.35 more steers/ha than PGSH-6. Supplementing concentrates during the indoor period increased carcass weight (42 kg) and fat score (2.10 units). In conclusion, grazing to 6 rather than 4 cm, increased individual carcass weight but not carcass weight gain/ha. Compared to PGHM-2500, grazing PGHM-1500 increased steer live-weight gain at pasture, but did not affect carcass weight following indoor finishing.

The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.

This study uses isotope and microbotanical data from the analysis of teeth and dental calculus to investigate camelid diet and foddering practices at Quilcapampa (AD 835–900). By providing taxonomically specific evidence of foods consumed, botanical data from dental calculus complement the more general impressions of photosynthetic pathways obtained through isotopic analysis. Results suggest that the camelid diet incorporated maize (Zea mays), algarrobo (Prosopis sp.), potato chuño (Solanum sp.), and other resources. The life-history profile of one camelid (Individual 3) reveals dietary change from mainly C3 plants to more C4 plant contributions as the animal aged. This pattern is supported by carbonate isotope results indicating that this individual spent its youth in the mid-valley ecozone before becoming more mobile later in life. As this life-history example shows, isotopic and microbotanical analyses are complementary approaches, clarifying a pattern of seasonal transhumance that linked the lives of humans and animals along the Middle Horizon (AD 600–1000) caravan networks that crisscrossed the central Andes.

Very little is known about the fate of the large numbers of injured and orphaned wild animals taken to wildlife rehabilitation centres in the UK each year. We reviewed the reasons for admission and outcomes for 2,653 woodpigeons (Columba palumbus), 68% of which were juveniles, brought to an RSPCA wildlife rehabilitation centre in Cheshire, UK over a five-year period (2005-2009). Reasons for admission varied with the most common reason for adults and juveniles being ‘injury (cause uncertain)’ and ‘orphan’, respectively. Twenty-one percent of adults and 16% of juveniles had been attacked by cats. Sixty-five percent of adults and 37% of juveniles were euthanased on admission or within the first 48 h to prevent further suffering. Only 14% of adults and 31% of juveniles were released back into the wild. The remainder were either euthanased or died despite treatment more than 48 h after admission. Body condition on admission was not a good predictor of the likelihood of release, but age, weight on admission and severity of symptoms were significant factors. A reduction in the median number of days in care for those birds euthanased more than 48 h after being admitted was recorded for 2007 to 2009, possibly due to the introduction of radiography for all birds on admission. Leg-band recovery data for 15 birds revealed post-release survival ranging from 21-2,545 days (median = 231 days) compared to 1-2,898 days (median = 295) for non-rehabilitated birds.

Broad-spectrum antibiotics with once-daily dosing are often chosen for outpatient parenteral antibiotic therapy (OPAT) due to convenience even when narrower-spectrum antibiotics are appropriate. At our institution, up to 50% of select broad-spectrum OPAT regimens had potential to be narrowed, highlighting the need to re-evaluate regimens for de-escalation prior to discharge.

Nutrition during the periconceptional period influences postnatal cardiovascular health. We determined whether in vitro embryo culture and transfer, which are manipulations of the nutritional environment during the periconceptional period, dysregulate postnatal blood pressure and blood pressure regulatory mechanisms. Embryos were either transferred to an intermediate recipient ewe (ET) or cultured in vitro in the absence (IVC) or presence of human serum (IVCHS) and a methyl donor (IVCHS+M) for 6 days. Basal blood pressure was recorded at 19–20 weeks after birth. Mean arterial pressure (MAP) and heart rate (HR) were measured before and after varying doses of phenylephrine (PE). mRNA expression of signaling molecules involved in blood pressure regulation was measured in the renal artery. Basal MAP did not differ between groups. Baroreflex sensitivity, set point, and upper plateau were also maintained in all groups after PE stimulation. Adrenergic receptors alpha-1A (αAR1A), alpha-1B (αAR1B), and angiotensin II receptor type 1 (AT1R) mRNA expression were not different from controls in the renal artery. These results suggest there is no programmed effect of ET or IVC on basal blood pressure or the baroreflex control mechanisms in adolescence, but future studies are required to determine the impact of ET and IVC on these mechanisms later in the life course when developmental programming effects may be unmasked by age.

Conventional longitudinal behavioral genetic models estimate the relative contribution of genetic and environmental factors to stability and change of traits and behaviors. Longitudinal models rarely explain the processes that generate observed differences between genetically and socially related individuals. We propose that exchanges between individuals and their environments (i.e., phenotype–environment effects) can explain the emergence of observed differences over time. Phenotype–environment models, however, would require violation of the independence assumption of standard behavioral genetic models; that is, uncorrelated genetic and environmental factors. We review how specification of phenotype–environment effects contributes to understanding observed changes in genetic variability over time and longitudinal correlations among nonshared environmental factors. We then provide an example using 30 days of positive and negative affect scores from an all-female sample of twins. Results demonstrate that the phenotype–environment effects explain how heritability estimates fluctuate as well as how nonshared environmental factors persist over time. We discuss possible mechanisms underlying change in gene–environment correlation over time, the advantages and challenges of including gene–environment correlation in longitudinal twin models, and recommendations for future research.

Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.

Lipid-based nutrient supplements (LNS) may be beneficial for malnourished HIV-infected patients starting antiretroviral therapy (ART). We assessed the effect of adding vitamins and minerals to LNS on body composition and handgrip strength during ART initiation. ART-eligible HIV-infected patients with BMI <18·5 kg/m2 were randomised to LNS or LNS with added high-dose vitamins and minerals (LNS-VM) from referral for ART to 6 weeks post-ART and followed up until 12 weeks. Body composition by bioelectrical impedance analysis (BIA), deuterium (2H) diluted water (D2O) and air displacement plethysmography (ADP), and handgrip strength were determined at baseline and at 6 and 12 weeks post-ART, and effects of LNS-VM v. LNS at 6 and 12 weeks investigated. BIA data were available for 1461, D2O data for 479, ADP data for 498 and handgrip strength data for 1752 patients. Fat mass tended to be lower, and fat-free mass correspondingly higher, by BIA than by ADP or D2O. At 6 weeks post-ART, LNS-VM led to a higher regain of BIA-assessed fat mass (0·4 (95 % CI 0·05, 0·8) kg), but not fat-free mass, and a borderline significant increase in handgrip strength (0·72 (95 % CI −0·03, 1·5) kg). These effects were not sustained at 12 weeks. Similar effects as for BIA were seen using ADP or D2O but no differences reached statistical significance. In conclusion, LNS-VM led to a higher regain of fat mass at 6 weeks and to a borderline significant beneficial effect on handgrip strength. Further research is needed to determine appropriate timing and supplement composition to optimise nutritional interventions in malnourished HIV patients.

Bovine herpes virus 1 (BHV-1) manifests as a latent viral infection putatively affecting bovines. Understanding its effect on cattle herds is critical to maintaining sustainable beef and dairy production systems, as well as aiding in the development of herd health policies. The primary objective of the current study was, therefore, to use a whole-farm bio-economic model to evaluate the effect of herd seroprevalence to BHV-1 on the productive and economic performance of a spring calving beef cow herd. As part of a wider epidemiological study of herd pathogen status, a total of 4240 cows from 134 spring calving beef cow herds across the Republic of Ireland were blood sampled to measure the seroprevalence to BHV-1. Using data from a national breeding database, productive and reproductive performance indicators were used to parameterize a single year, static and deterministic whole-farm bio-economic model. A spring-calving, pasture-based suckler beef cow production system with an emphasis on calf-to-weanling production was simulated. The impact of BHV-1 seropositivity on whole-farm technical and economic performance was relatively small, with a marginal drop in the net margin of 4% relative to a baseline seronegative herd. Subsequent risk factors for increased pathogenicity were considered such as total herd size, percentage of intra-herd movements and vaccination status for BHV-1. In contrast to all others, scenarios representing herds that were either small in size or those which indicated an active vaccination policy for BHV-1 had no reduction in net margin against the baseline as a result of seropositivity to BHV-1.