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The impact of thiopurine de-escalation while on vedolizumab versus continuing thiopurine therapy in ulcerative colitis (UC) is unclear. We aimed to determine the effect of thiopurine withdrawal for patients with UC in remission on vedolizumab. This multicenter randomized controlled trial recruited UC patients on vedolizumab 300 mg intravenously every 8 weeks and a thiopurine. Patients in steroid-free clinical remission for ≥6 months and endoscopic remission/improvement (Mayo endoscopic subscore ≤1) were randomized 2:1 to withdraw or continue thiopurine. Primary outcome was comparing week 48 vedolizumab trough concentrations. Secondary outcomes were clinical relapse (partial Mayo score ≥3 and fecal calprotectin >150 μg/g or increase in Mayo endoscopic subscore ≥1 from baseline), fecal calprotectin remission (<150 μg/g), C-reactive protein remission (<5 mg/L), centrally read endoscopic remission (Mayo endoscopic subscore = 0), histologic remission (Nancy index = 0), histo-endoscopic remission, and adverse events. In total, 62 patients were randomized to continue (n = 20) or withdraw (n = 42) thiopurine. At week 48, vedolizumab trough concentrations were not significantly different between continue and withdrawal groups (14.7 μg/mL, interquartile rate [IQR], 12.3–18.5 μg/mL versus 15.9 μg/mL, IQR, 10.1–22.7 μg/mL, respectively, P = 0.36). The continue group had significantly higher fecal calprotectin remission (95.0%, 19/20 versus 71.4%, 30/42; P =.03), histologic remission (80.0%, 16/20 versus 48.6%, 18/37; P =.02), and histo-endoscopic remission (75.0%, 15/20 versus 32.4%, 12/37; P =.002) than the withdrawal group. Histologic activity (hazard ratio [HR], 15.5; 95% confidence interval [CI], 1.6–146.5; P =.02) and prior anti-tumor necrosis factor exposure (HR, 6.5; 95% CI, 1.3–33.8; P =.03) predicted clinical relapse after thiopurine withdrawal. Thiopurine withdrawal did not affect vedolizumab trough concentrations. However, it may increase fecal calprotectin, histologic, and histo-endoscopic activity. Histologic activity and prior anti-tumor necrosis factor exposure may predict disease relapse on thiopurine withdrawal for patients using vedolizumab for UC. Australian and New Zealand Trial Registry, number ACTRN12618000812291. [Display omitted] [ABSTRACT FROM AUTHOR]

Ammonia oxidation to hydroxylamine is catalyzed by the ammonia monooxygenase enzyme and copper (Cu) is a key element for this process. We investigated the effect of soil bioavailable Cu changes induced through the application of Cu-complexing compounds on nitrification rate, ammonia-oxidizing bacteria (AOB) and archaea (AOA) amoA gene abundance, and mineral nitrogen (N) leaching in urine patches using the Manawatu Recent soil. Further, evaluated the combination of organic compound calcium lignosulphonate (LS) with a growth stimulant Gibberellic acid (GA). Treatments were applied in May 2021 as late-autumn treatments: control (no urine), urine-only at 600 kg N ha−1, urine + dicyandiamide (DCD), urine + co-poly-acrylic-maleic acid (PA-MA), urine + LS, urine + split-application of LS (2LS), and urine + combination of GA plus LS (GA + LS). In addition, another four treatments were applied in July 2021 as mid-winter treatments: control, urine-only at 600 kg N ha−1, urine + GA, and urine + GA + LS. Soil bioavailable Cu and mineral N leaching were examined during the experimental period. The AOB/AOA amoA genes were quantified using quantitative polymerase chain reaction. Changes in soil bioavailable Cu across treatments correlated with nitrification rate and AOB amoA abundance in late-autumn while the AOA amoA abundance did not change. The reduction in soil bioavailable Cu induced by the PA-MA and 2LS was linked to significant (P < 0.05) reduction in mineral N leaching of 16 and 30%, respectively, relative to the urine-only. The LS did not induce a significant effect on either bioavailable Cu or mineral N leaching relative to urine-only. The GA + LS reduced mineral N leaching by 10% relative to LS in late-autumn, however, there was no significant effect in mid-winter. This study demonstrated that reducing soil bioavailable Cu can be a potential strategy to reduce N leaching from urine patches. [Display omitted] • Soil Cu influenced nitrification rate and AOB amoA but not AOA amoA abundance. • Application of PA-MA, 2LS and GA + LS reduced mineral N leaching in late-autumn. • There was no effect of GA + LS on reducing mineral N leaching in mid-winter. [ABSTRACT FROM AUTHOR]

Raw biochar with high pH possibly stimulated ammonia (NH 3) volatilization in the agricultural soil. We hypothesized that the modified biochar (MBC) with low pH can synchronically decrease the NH 3 and nitrous oxide (N 2 O) losses. We performed a two-year experiment to clarify how citric acid MBC influence the NH 3 volatilization and N 2 O emission as well as the underlying mechanisms. Two typical paddy soils, i.e., Hydragric Anthrosol and Haplic Acrisol, receiving equal urea N with 240 kg ha−1 but varied rates of MBC with 0, 5, 10, and 20 t ha−1 (named Urea, Urea + MBC5, Urea + MBC10, and Urea + MBC20, respectively) were studied. The results showed that MBC-amended treatments effectively mitigated the NH 3 volatilization from Hydragric Anthrosol and Haplic Acrisol by 29.6%–57.9% and 30.5%–62.4% in 2017, and by 16.5%–21.0% and 24.5%–35.0% in 2018, respectively, compared to Urea treatment. In addition, significantly lower N 2 O emissions with averaged 38.3% and 43.1% in 2017, and 51.7% and 26.7% were recorded under Hydragric Anthrosol and Haplic Acrisol, respectively, following the MBC application (P < 0.05). Increased MBC addition performed higher efficacy on mitigating NH 3 volatilization, particularly in the first rice season, while this "dosage effect" was not found for N 2 O reduction. Lowered pH in overlying water, enhanced adsorption of NH 4 +-N and its nitrification rate likely contributed to the lower NH 3 volatilization as result of MBC addition. The nir S and nos Z gene copies were not changed by MBC, while the nir K gene copies were decreased as result of MBC amendment by 8.3%–25.2% under Hydragric Anthrosol and by 21.8%–24.9% under Haplic Acrisol. Consequent lower ratio of nir K/(nir S + nos Z) explained the mitigation effect of MBC on N 2 O emission. In conclusion, the present two-year study recommends that MBC applied at a low dosage can perform positive effect on controlling the nitrogenous gas pollutants from paddy soil. [Display omitted] • MBC addition synchronically mitigates the NH 3 volatilization and N 2 O emission. • "Dosage effect" of MBC on reducing NH 3 loss was found, but not for N 2 O emission. • Reduced pH in floodwater mainly lead to the lower NH 3 loss after MBC addition. • Lower nir K/(nir S + nos Z) explained the mitigation effect of MBC on N 2 O emission. [ABSTRACT FROM AUTHOR]

Background Advancements in endoscopic technology have increased the ability to distinguish neoplastic polyps during colonoscopy. If a minimum accuracy can be achieved, then a resect-and-discard model can be implemented, although studies to date have demonstrated limited success, especially in the assessment of serrated polyps. Objective To perform a proof-of-principle study assessing the accuracy of narrow-band imaging with near focus in predicting polyp histology including serrated polyps and to determine whether the minimum requirements can be achieved for a resect-and-discard policy. Design Dual-center, prospective case series. Setting Two tertiary-care referral endoscopic centers in Australia. Patients Two hundred consecutive patients undergoing colonoscopy for routine indications were recruited. Interventions Any polyps identified were assessed by using standard white light followed by narrow-band imaging with near focus for Kudo pit patterns and modified Sano capillary patterns. Based on this assessment and the macroscopic appearance, the polyp histology was predicted and subsequently compared with histopathology results. Main Outcome Measurements Correlation in postpolypectomy surveillance intervals between endoscopic and pathologic assessments as well as negative predictive value for rectosigmoid hyperplastic polyps. Results There was a 96% agreement for surveillance intervals between endoscopic assessment and histology by using the American Society for Gastrointestinal Endoscopy guidelines. There was a 96% negative predictive value in assessing rectosigmoid hyperplastic polyps. Limitations Because this was a proof-of-principle study, there was no control arm, and there were small numbers, especially in assessing subgroups. The results have limited generalizability with the training requirements for polyp recognition, with confidence to be determined. Conclusion Narrow-band imaging with near focus can predict polyp histology (including serrated polyps) accurately in the hands of trained endoscopists. Further studies with larger numbers are required to further validate this practice. [ABSTRACT FROM AUTHOR]

Biochar (BC) application to agricultural soil can impact two nitrogen (N) gases pollutants, i.e., the ammonia (NH 3) and nitrous oxide (N 2 O) losses to atmospheric environment. Under rice-wheat rotation, applied at which growth cycle may influence the aforementioned effects of BC. We conducted a soil column (35 cm in inner diameter and 70 cm in height) experiment to evaluate the responses of wheat N use efficiency (NUE), NH 3 volatilization, and N 2 O emission from wheat season to biochar applied at rice (R) or wheat (W) growth cycle, meanwhile regarding the effect of inorganic fertilizer N input rate, i.e., 72, 90, and 108 kg ha−1 (named N72, N90, and N108, respectively). The results showed that BC application influenced the wheat growth and grain yield. In particular, BC applied at rice season increased the wheat grain yield when receiving 90 and 108 kg N ha−1. The improved wheat grain yield was attributed to that N90 + BC(R) and N108 + BC(R) enhanced the wheat NUE by 53.8% and 52.8% over N90 and N108, respectively. More N input led to higher NH 3 volatilization and its emission factor. Interestingly, 19.7%–34.0% lower NH 3 vitalizations were recorded under treatments with BC applied in rice season, compared with the treatments only with fertilizer N. BC applied at rice season exerted higher efficiency on mitigating N 2 O emission than that applied at wheat season under three N input rates, i.e., 60.5%–77.6% vs 29.8%–34.8%. Overall, considering the crop yield and global warming potential resulting from NH 3 volatilization and N 2 O emission of wheat season, N90 + BC(R) is recommended. In conclusion, farmers should consider the application time and reduce inorganic fertilizer N rate when using BC. [Display omitted] • Biochar was applied at rice (BC-R) or wheat growth cycle (BC–W) with three N application rate. • Biochar added at both crop seasons increased the wheat NUE under medium and high N treatments. • BC decreased NH 3 vitalization only when being applied at rice growth cycle. • BC-R exerted higher mitigation efficiency on N 2 O emission than BC-W. [ABSTRACT FROM AUTHOR]

Multiple studies have demonstrated an age-related attenuation in risk associations of lipoproteins and lipoprotein ratios with cardiovascular disease events. We recently reported a similar age-related attenuation in risk associations of lipoproteins and lipoprotein ratios with coronary artery calcium. We assessed risk associations of lipoproteins and lipoprotein ratios with carotid intima-media thickness (CIMT), which has not been reported previously. We performed multivariable linear regression using data from the Multi-Ethnic Study of Atherosclerosis (MESA). MESA participants were community-dwelling adults 45 to 84 years of age without clinically apparent cardiovascular disease at baseline, and 4,961 met inclusion criteria for these analyses. In fully adjusted models, differences in CIMT were similar across the MESA age spectrum, with differences in internal CIMT per SD increase in low-density lipoprotein of 0.037 mm (95% confidence interval 0.018 to 0.055) for those 45 to 54 years old and 0.087 mm (95% confidence interval 0.027 to 0.146) for those 75 to 84 years old (p for interaction = 0.2). Similarly, the difference in internal CIMT per SD increase in the total/high-density lipoprotein cholesterol ratio was 0.029 mm (95% confidence interval 0.009 to 0.049) for those 45 to 54 years old and 0.101 mm (95% confidence interval 0.033, 0.169) for those 75 to 84 years old (p for interaction = 0.03). In general, risk associations of lipoproteins and lipoprotein ratios were associated with similar differences in CIMT across all age categories. In conclusion, abnormal lipoproteins and lipoprotein ratios in middle-aged and older patients are powerful risk factors for early atherosclerosis as manifested by an increased CIMT. [ABSTRACT FROM AUTHOR]

Abstract: Background: It is well known that cardiovascular disease is the number one killer of men and women in the United States and in many parts of the developed world. However, early detection of atherosclerosis remains a challenging area of research and development. Stress echo and myocardial perfusion studies were not designed to be screening tests and the majority of literature using these tests is in populations with a high probability of disease. It must be emphasized that negative stress echo and stress MPI tests only imply a lack of flow limiting disease; they do not indicate lack of atherosclerotic disease. It is important to remember that when these tests are “negative,” the implication is favorable short-term prognosis rather than any implication regarding lack of disease. In contrast, carotid intima-media thickness (CIMT) scanning protocols can detect atherosclerotic disease in early and asymptomatic stages. For a number of reasons reviewed in this article, CIMT may be a more optimal screening and risk-stratifying technology: CIMT directly visualizes vasculature unlike biomarkers such as LDL cholesterol, hsCRP, or PLA2. Methods: We performed medline searches for original articles and reviews of carotid IMT from 1985 to the present. We particularly emphasized large multi-center epidemiologic studies of the natural history of patients with carotid IMT measurements. Conclusion: There is substantial evidence that CIMT is a suitable surrogate for the coronary tree. CIMT is also (along with coronary calcium scoring) recognized by the American Heart Association as a surrogate marker for coronary artery disease. A recent commentary by Stein, et al reviewed the comparison of CIMT to coronary calcium scoring, with favorable findings for CIMT especially in the healthy young and middle-aged populations, as well as women and African American individuals where coronary calcification has more limited utility. Recent findings of the Multi-Ethnic Study of Atherosclerosis indicate further that increased CIMT predicted CVD events in individuals without coronary calcification. [Copyright &y& Elsevier]

Background: The combination of niacin and statin has proven value in the management of hyperlipidemia and prevention of heart disease. However, the efficacy of the nonprescription time-release niacin, Slo-Niacin®, is little studied alone and not at all with atorvastatin. We studied Slo-Niacin® and atorvastatin, singly and together, to determine efficacy on the combined abnormalities of triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Methods: A total of 42 men and women with LDL-C >130mg/dL and HDL-C <45mg/dL (men) or <55mg/dL (women) were randomized to 3 months of atorvastatin 10mg/d or incremental doses of Slo-Niacin® to 1500mg/d. The alternate drug was added in the next 3-month segment. Lipid profiles and transaminases were measured monthly and other measures at baseline and the end of each treatment sequence. Results: Mean entry lipids (in mg/dL) were as follows: TG 187, LDL-C 171, and HDL-C 39. Mean body mass index was 32.6kg/m2. Monotherapy with Slo-Niacin® decreased median TG 15%, mean LDL-C 12%, and non-HDL-C 15% and increased HDL-C 8%. Atorvastatin decreased median TG 26%, mean LDL-C 36%, and non-HDL-C 36% and increased HDL-C 6%. Combined therapy decreased median TG 33% and mean LDL-C and non-HDL-C each 43%. HDL-C increased 10% (all P < .001). Median remnant-like lipoprotein-C decreased 55%, mean apo-B 40%, median high-sensitivity C-reactive protein 23% (all P < .05), tumor necrosis factor α 12%, and no change in interleukin-6. Mean LDL buoyancy increased 15%, apo-A-I 5%, and median HDL2-C 20% (all P < .05). ALT decreased with Slo-Niacin® treatment alone compared with atorvastatin and also decreased when Slo-Niacin® was added to atorvastatin. Six subjects dropped out of the study, 3 for niacin-related symptoms. Conclusions: Slo-Niacin® 1.5g/d with atorvastatin 10mg/d improved lipoprotein lipids, apoproteins, and inflammation markers without hepatotoxicity. Slo–Niacin® deserves further study as a cost-effective treatment of hyperlipidemia. (ClinicalTrials.gov Identifier: NCT00194402) [Copyright &y& Elsevier]

Abstract: We have asked whether the prevalence of combined hyperlipidemia (CHL) differs by race/ethnicity, obesity, and insulin resistance in a contemporary, multiethnic, US cohort. We determined the prevalence and adjusted odds of CHL in a cohort of 5923 men and women free of clinically recognized cardiovascular disease and diabetes according to race/ethnicity (white, Chinese, African American, and Hispanic), obesity, and insulin resistance. Untreated lipid values were imputed for those on lipid-lowering therapy. Combined hyperlipidemia was defined using age- and sex-specific greater than or equal to 75th percentile cut points for low-density lipoprotein cholesterol and triglycerides obtained from a predominantly white North American population study. Compared with whites, adjusted odds ratios for CHL were 0.48 in African Americans (95% confidence interval [CI], 0.30-0.75), 1.33 in Hispanics (95% CI, 0.93-1.91), and 1.06 in Asians (95% CI, 0.62-1.82). Within the entire population, the adjusted odds of CHL were over 2-fold higher in overweight and obese participants compared with normal-weight participants and more than 4-fold higher in quartiles 2 through 4 of insulin resistance compared with quartile 1. African Americans had lower odds for CHL than whites despite higher body mass index and abdominal adiposity. Hispanics had a nonsignificantly higher trend, and Asians had no significantly different odds than whites. Modest increases in weight and insulin resistance were associated with significantly higher odds of CHL in a multiethnic US population. Further research is needed to determine the most efficacious diet, exercise, and drug management to decrease the risk of CHL and coronary heart disease among racial/ethnic groups in the United States. [Copyright &y& Elsevier]

Objective: The purpose of this study was to describe the prevalence of human papillomavirus infection and the likelihood of human papillomavirus expression and Papanicolaou test abnormalities among women who have and who are at risk of having human immunodeficiency virus infection.Study Design: Cross-sectional analysis of 767 women who had human immunodeficiency virus infection and 390 women who were at risk of having human immunodeficiency virus infection in 4 cities in the United States.Results: Women who were infected with human immunodeficiency virus were more likely than women who were not infected to have human papillomavirus infection (prevalence ratio, 2.3; 95% CI, 2.0-2.8) but had similar human papillomavirus types. Among women who tested positive for human papillomavirus by polymerase chain reaction, human immunodeficiency virus infection was associated with a high level of human papillomavirus expression (prevalence ratio, 1.3-1.6) and multiple human papillomavirus infections (prevalence ratio, 1.9). However, among women with a high level of human papillomavirus expression or infection with multiple types, there was no association between human immunodeficiency virus serostatus and risk of cervical dysplasia.Conclusion: Through its association with a high level of expression and multiple human papillomavirus infections, human immunodeficiency virus infection may increase the risk of cervical dysplasia in women who are infected with human papillomavirus. [ABSTRACT FROM AUTHOR]

Background & Aims Fecal microbiota transplantation (FMT) can induce remission in patients with ulcerative colitis (UC). In a randomized controlled trial of FMT in patients with active UC, we aimed to identify bacterial taxonomic and functional factors associated with response to therapy. Methods We performed a double-blind trial of 81 patients with active UC randomly assigned to groups that received an initial colonoscopic infusion and then intensive multidonor FMT or placebo enemas, 5 d/wk for 8 weeks. Patients in the FMT group received blended homogenized stool from 3–7 unrelated donors. Patients in the placebo group were eligible to receive open-label FMT after the double-blind study period. We collected 314 fecal samples from the patients at screening, every 4 weeks during treatment, and 8 weeks after the blinded or open-label FMT therapy. We also collected 160 large-bowel biopsy samples from the patients at study entry, at completion of 8 weeks of blinded therapy, and at the end of open-label FMT, if applicable. We analyzed 105 fecal samples from the 14 individual donors (n = 55), who in turn contributed to 21 multidonor batches (n = 50). Bacteria in colonic and fecal samples were analyzed by both 16S ribosomal RNA gene and transcript amplicon sequencing; 285 fecal samples were analyzed by shotgun metagenomics, and 60 fecal samples were analyzed for metabolome features. Results FMT increased microbial diversity and altered composition, based on analyses of colon and fecal samples collected before vs after FMT. Diversity was greater in fecal and colon samples collected before and after FMT treatment from patients who achieved remission compared with patients who did not. Patients in remission after FMT had enrichment of Eubacterium hallii and Roseburia inulivorans compared with patients who did not achieve remission after FMT and had increased levels of short-chain fatty acid biosynthesis and secondary bile acids. Patients who did not achieve remission had enrichment of Fusobacterium gonidiaformans , Sutterella wadsworthensis , and Escherichia species and increased levels of heme and lipopolysaccharide biosynthesis. Bacteroides in donor stool were associated with remission in patients receiving FMT, and Streptococcus species in donor stool was associated with no response to FMT. Conclusions In an analysis of fecal and colonic mucosa samples from patients receiving FMT for active UC and stool samples from donors, we associated specific bacteria and metabolic pathways with induction of remission. These findings may be of value in the design of microbe-based therapies for UC. ClinicalTrials.gov , Number NCT01896635 Graphical abstract [ABSTRACT FROM AUTHOR]

Biofertilizer can improve soil quality, especially the microbiome composition, which potentially affect soil nitrogen (N) cycling. However, little is known about the responses of nitrous oxide (N 2 O) emission and ammonia (NH 3) volatilization from biochar-amended paddy soil to the biofertilizer application. Therefore, we conducted a soil column experiment using four 240 kg N ha−1 (equivalent to 1.7 g N pot−1) treatments consisting of biofertilizer (3 t ha−1, equivalent to 21.2 g pot−1), biochar (7.5 t ha−1, equivalent to 63.6 g pot−1), and a mixture of biofertilizer and biochar at the same rate and a control (CK). The results showed that the N 2 O emissions and NH 3 volatilizations were equivalent to 0.15–0.28% and 18.0–31.5% of rice seasonal N applied to the four treatments, respectively. Two treatments with biofertilizer and biochar individual amendment significantly increased (P < 0.05) the N 2 O emissions to same degree by 30.2%, while co-application of biochar and biofertilizer further increased the N 2 O emission by 74.4% compared to the control. The higher N 2 O emission was likely attributed to the increased gene copies of AOA, nirK , and nirS. Applying biofertilizer significantly increased (P < 0.05) NH 3 volatilization by 24.7% relative to the control, while applying biochar had no influence on NH 3 volatilization. Co-application of biofertilizer and biochar significantly decreased (P < 0.05) NH 3 volatilization by 12.3% compared to the control. Overall, the net global warming potential based on NH 3 and N 2 O in current study increased by 13.0–26.0% in both the individual- and co-application of biofertilizer and biochar. Interestingly, both individual- and co-applications of biofertilizer and biochar increased the rice grain yield by 16.5–38.3%. Therefore, applications of biofertilizer and biochar did not increase the GHGI. Particularly, the co-applying of them significantly lowered (P < 0.05) the GHGI by 15.2%. In conclusion, biofertilizer and biochar should be co-applied to achieve the goals of environment protection and food security. Image 1 • Systematic evaluation of the effects of biofertilizer and/or biochar on NH 3 and N 2 O losses in paddy soil. • Biofertilizer individual application stimulate both NH 3 volatilization and N 2 O emission. • Co-applying biofertilizer and biochar suppresses the NH 3 volatilization by 12.3%. • Biofertilizer and/or biochar increase rice grain yield by 16.5%–38.3%. • GHGI was mitigated by 15.2% under co-applying biofertilizer and biochar treatment. [ABSTRACT FROM AUTHOR]

The two forage species used in New Zealand pastoral agricultural systems, chicory (Cich orium intybus) and plantain (Plantago lanceolata) show differential ability to absorb and translocate cadmium (Cd) from roots to shoots. Chicory can accumulate Cd from even low Cd soils to levels that might exceed regulatory guidelines for Cd in fodder crops and food. Chicory and plantain were grown in soil-filled rhizocolumns under increasing Cd levels (0 (Control), 0.4, 0.8 and 1.6 mg Cd/kg soil) for 60 days and showed variable secretion of oxalic, fumaric, malic and acetic acids as a function of Cd treatment. Plant roots secrete such Low Molecular Weight Organic Acids into the rhizosphere soil, which can influence Cd uptake. Chicory showed significantly (P < 0.05) lower secretion of fumaric acid, and higher secretion of acetic acid than plantain at all Cd treatments. We propose that the significant secretion differences between the two species can explain the significantly (P < 0.05) higher shoot Cd concentration in chicory for all Cd treatments. Understanding the mechanism for increased uptake in chicory may lead to breeding or genetic modification which yield low Cd uptake cultivars needed to mitigate the risk of Cd accumulation in pastoral agricultural food chains from this increasingly important fodder crop. Image 1 • We studied the role of soil Cd on root organic acid secretion by forage species. • Chicory showed higher Cd uptake than plantain. • Chicory roots secreted lower fumaric acid and higher acetic acid than plantain. • We explain differential uptake of Cd based on acid secretion by the plants. 'Differences in organic acid secretion between two species explain the higher shoot Cd concentration in chicory over plantain'. [ABSTRACT FROM AUTHOR]

Objective: We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery. Study Design: Data on singleton infants were obtained from the 2004-2005 Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Results: The rates of Agency for Healthcare Research and Quality PSI and all birth trauma were 2.45 and 25.85 per 1000 births, respectively. Compared with vaginal, cesarean delivery was associated with increased odds of PSI birth trauma (odds ratio [OR], 1.71), primarily due to an increased risk for “other specified birth trauma” (OR, 2.61). Conversely, cesarean delivery was associated with decreased odds of all birth trauma (OR, 0.55), due to decreased odds of clavicle fractures (OR, 0.07), brachial plexus (OR, 0.10), and scalp injuries (OR, 0.55). Conclusion: Infants delivered by cesarean are at risk for different types of birth trauma from infants delivered vaginally. [Copyright &y& Elsevier]