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Anthropogenic habitat modification can lead to chronic stress in wildlife. This can result in immunosuppression and higher disease prevalence. Chronically stressed individuals typically have elevated baseline GCs and decreased body condition. GCs are called FGMs when excreted in feces and can be used to noninvasively evaluate stress in free-ranging wildlife. In the deer mouse (Peromyscus maniculatus)–SNV system, SNV prevalence is higher in deer mice at peridomestic settings, which are human-modified habitats. This is problematic because SNV causes a fatal disease in humans, and thus the higher SNV prevalence may lead to higher risk of infection for humans. In our study, we hypothesized that SNV prevalence would be higher in deer mice at human-modified habitats due to chronic stress. To test our hypothesis, we compared two stress measures (i.e., baseline FGMs and body condition scores) in deer mice from one peridomestic and one sylvan grid over 2 months. Captured deer mice were tagged, weighed, sexed and sampled for feces and blood and were evaluated for reproductive status and body condition before release. Blood samples were analysed for SNV antibodies, and fecal samples were evaluated for FGMs. We found higher deer mouse numbers at the sylvan grid. There were no differences in baseline FGM levels between peridomestic and sylvan populations. However, peridomestic deer mice had overall lower body condition. Given the low SNV prevalence across both grids, we were unable to examine potential correlations between SNV prevalence and chronic stress. Regardless, we conclude that deer mice at human-modified habitats may not be chronically stressed, which may suggest that higher SNV prevalence at peridomestic settings may not be the result of chronic stress. Although we did find that peridomestic deer mice had lower body condition, this may not have been related to chronic stress because there were no differences in baseline FGMs. Longer studies with more site replication are needed to validate and expand on our findings. Our preliminary study adds to the existing body of knowledge that examines relationships between stress physiology and disease prevalence in human-modified environments.

OBJECTIVE To estimate the prevalence of Anaplasma marginale, the causative agent of bovine anaplasmosis, in beef herds from Ohio; evaluate farm identity and animal age as risk factors; and examine serologic cross-reactivity with Anaplasma phagocytophilum, an emerging disease agent. ANIMALS 4 beef cattle herds (n = 327) sampled between December 2020 and December 2021. PROCEDURES To address the broader investigation of characterizing Anaplasma spp and genotypes in Ohio, herds with a history of clinical anaplasmosis were targeted. Blood was screened for antibodies to Anaplasma spp using a competitive enzyme-linked immunosorbent assay with seropositive samples tested for A marginale using real-time PCR. If negative, samples were also tested for A phagocytophilum. RESULTS We estimated a statewide molecular prevalence of 38.53% (95% CI, 33.26% to 43.81%), with some farms exhibiting higher prevalence than others (19.40% to 56.86%). Accounting for farm identity, the odds of an animal becoming infected increased by 1.41 (95% CI, 1.28 to 1.58) for every year in age. Forty-four animals tested seropositive but PCR negative for A marginale. Out of these, 2 tested positive for A phagocytophilum. CLINICAL RELEVANCE Our study was the first to report prevalence estimates for bovine anaplasmosis in Ohio. Although prevalence was higher than other states, this is most likely due to our sampling approach. Our results suggested that older animals are more likely to be infected with A marginale, and when animals are instead infected with A phagocytophilum, serology alone can be misleading wherever the 2 species co-occur. Our study can guide wider epidemiological studies for informing management in Ohio.

Introduction: High-quality evidence regarding the use of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO) has been provided by recently completed randomized controlled clinical trials (RCTs). Methods: We conducted a systematic review and meta-analysis including all available RCTs that investigated efficacy and safety of EVT in addition to best medical treatment (BMT) versus BMT alone for BAO. The random-effects model was used, while the fragility index (FI) was calculated for dichotomous outcomes of interest. Results: Four RCTs were included comprising a total of 988 patients with acute BAO (mean age: 65.6 years, 70% men, median NIHSS: 24, 39% pretreatment with intravenous thrombolysis). EVT was related to higher likelihood of good functional outcome (RR: 1.54; 95% CI: 1.16–2.05; I2 = 60%), functional independence (RR: 1.83; 95% CI: 1.08–3.08; I2 = 79%) and reduced disability at 3 months (adjusted common OR: 1.96; 95% CI: 1.26–3.05; I2 = 59%) compared to BMT alone. Despite that EVT was associated with a higher risk for symptomatic intracranial hemorrhage (RR: 7.78; 95% CI: 2.36–25.61; I2 = 0%) and any intracranial hemorrhage (RR: 2.85; 95% CI: 1.50–5.44; I2 = 16%), mortality at 3 months was lower among patients that received EVT plus BMT versus BMT alone (RR: 0.76; 95% CI: 0.65–0.89; I2 = 0%). However, sufficient robustness was not evident in any of the reported associations (FI < 10) including the overall effect regarding the primary outcome. The former associations were predominantly driven by RCTs with recruitment limited in China. Conclusions: EVT combined with BMT is associated with a higher likelihood of achieving good functional outcomes and a lower risk of death at 3 months compared to BMT alone, despite the higher risk of sICH. An individual-patient data meta-analysis is warranted to uncover and adjust for potential sources of heterogeneity and to provide further insight.

Idiopathic normal pressure hydrocephalus (iNPH) is a gradually progressive disease affecting the elderly population. The diagnosis of probable iNPH is based on clinical history, physical findings, brain imaging. INPH involves non-obstructive enlargement of the cerebral ventricles combined with one or more symptoms of cognitive decline, impaired gait and balance, and urinary urgency. Our case describes an unusual coexistence of radiological and clinical iNPH symptoms with paroxysmal paraparesis.

Background The cerebrospinal fluid tap test (CSF TT) is used for selecting shunt surgery candidates in idiopathic normal pressure hydrocephalus (iNPH). Variations in performance, and different outcome measures and cut-off levels in previous research on the CSF TT make comparison of accuracy difficult between studies. We aimed to evaluate the CSF TT, by using the Hellström iNPH scale for shunted iNPH patients with a standardized method. Methods One hundred thirty-two shunt operated iNPH patients were retrospectively included in this study. The gait and balance domains in the iNPH scale were used as outcome measures for the CSF TT and the total iNPH scale score as postoperatively outcome. To identify responders a cut-off level ≥ 5 points was used. Differences between responders and non-responders to the CSF TT, as well as the sensitivity, specificity, positive and negative predictive values, accuracy and correlations between outcomes of the CSF TT and postoperatively were calculated. Results In the gait domain, there were 62.9% responders and correspondingly 42.7 % in the balance domain of the CSF TT. CSF TT responders had significantly better outcomes in both the gait and balance domains but not in the neuropsychology or continence domains postoperatively. The sensitivity and specificity of the CSF TT and the outcome of the total iNPH scale score postoperatively were 67.6% and 53.3% for gait and 47.5% and 73.3% for balance. For age ≥ 80 years, the sensitivity and specificity for gait were 52.2% and 60.0%, and for age ≤ 80 years 72.2% and 50.0%. Gait as an outcome measure for both the CSF TT and postoperatively had the highest sensitivity, (73.2%) and specificity (65.7%) for all ages. Conclusions The CSF TT, with Hellström´s iNPH scale as the outcome measure, has clear limitations in predicting postoperative results. The gait domain may be used to detect changes of outcomes in gait, but the balance domain is too insensitive to use as an assessment for the CSF TT. The value of the CFS TT for patients over 80 years of age appears to be even lower. Differential diagnostic considerations together with radiological assessments remain cornerstones in selecting eligible shunt responders.

Background Although there may theoretically be a disturbance in the eye or the visual pathways due to abnormal cerebrospinal fluid (CSF) dynamics in idiopathic normal pressure hydrocephalus (iNPH), it has not been studied systemically. Optical coherence tomography (OCT) is a noninvasive, reproducible procedure for quantitative and qualitative analysis of retinal morphology. Methods OCT was used to study the eye fundus before and after a CSF tap test in patients with iNPH compared with healthy individuals (HIs). Twelve patients with iNPH (6 females and 6 males) with a median age of 76 years (64–84 years) and 21 HIs (11 females and 10 males) with a median age of 73 years (64–79 years) were included. The patients underwent neurological, cognitive, and physiotherapeutic evaluation. Brain magnetic resonance imaging, CSF tap test via lumbar puncture, and subsequently CSF analysis were performed. OCT was performed before and after CSF removal. HIs underwent OCT once. Results The patients had significantly reduced retinal ganglion cell layer thickness 71 μm (56–81 μm) compared with the HIs, 79.5 μm (72–90 μm) (P = 0.001), but no significant changes were observed before or after the CSF tap test. All patients improved in motor function in a 10-m walk test after the CSF tap test. The median CSF pressure was 15 and 1 cm H2O, respectively, before and after lumbar puncture with removal of median 43.5 mL CSF. Conclusions This pilot study shows OCT findings that differ from HIs and implies a rational for becoming a valuable tool in the diagnosis of iNPH. Further studies are warranted to elucidate the pathology of the retina in iNPH.

Article impact statement: Parasite-induced shifts in host microbiota that lead to parasite resistance or tolerance may have unintended consequences for host fitness.

We generated reference ranges for seasonal leukocyte differential counts of the free-ranging deermouse (

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Thirteen consecutive iNPH-patients underwent a pre- and post-operative clinical work-up: 10 m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs); for cognitive function MMSE. Nine HI were included. DTI was performed before and 3 months after surgery, HI underwent DTI once. DTI differences analyzed by manually placing 12 regions-of-interest. In patients motor and balance function improved significantly after surgery (p = 0.01, p = 0.025). Higher nearly significant FA values found in the patients vs HI pre-operatively in the thalamus (p = 0.07) accompanied by an almost significant lower ADC (p = 0.08). Significantly FA and ADC-values were found between patients and HI in FWM (p = 0.02, p = 0.001) and almost significant (p = 0.057) pre- vs postoperatively. Postoperatively we found a trend towards the HIs FA values and a strong significant negative correlation between FA changes vs. gait results in the FWM (r = -0.7, p = 0.008). Our study gives a clear indication of an ongoing pathological process in the periventricular white matter, especially in the thalamus and in the frontal white matter supporting the hypothesis of a shunt reversible thalamo-cortical circuit dysfunction in iNPH.

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Thirteen consecutive iNPH-patients underwent a pre- and post-operative clinical work-up: 10 m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs); for cognitive function MMSE. Nine HI were included. DTI was performed before and 3 months after surgery, HI underwent DTI once. DTI differences analyzed by manually placing 12 regions-of-interest. In patients motor and balance function improved significantly after surgery (p = 0.01, p = 0.025). Higher nearly significant FA values found in the patients vs HI pre-operatively in the thalamus (p = 0.07) accompanied by an almost significant lower ADC (p = 0.08). Significantly FA and ADC-values were found between patients and HI in FWM (p = 0.02, p = 0.001) and almost significant (p = 0.057) pre- vs postoperatively. Postoperatively we found a trend towards the HIs FA values and a strong significant negative correlation between FA changes vs. gait results in the FWM (r = −0.7, p = 0.008). Our study gives a clear indication of an ongoing pathological process in the periventricular white matter, especially in the thalamus and in the frontal white matter supporting the hypothesis of a shunt reversible thalamo-cortical circuit dysfunction in iNPH.

Background: The pathogenesis of iNPH is inadequately known. Small vessel disease seems to play an important role but the link to a disturbed CSF dynamic is not described. The familial presentation of idiopathic normal pressure hydrocephalus is extremely rare. Nonetheless, the last years the disclosure of familial occurrence seems to be of interest. The increasing reports on familial iNPH indicate a potential genetic component. Except from iNPH and secondary NPH a third form of NPH, familial NPH, is being widely recognized.

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The pathogenesis of idiopathic normal pressure hydrocephalus (iNPH) takes place in structures close to the cerebral ventricular system. Suprachiasmatic nucleus (SCN), situated close to the third ventricle, is involved in circadian rhythm. Diurnal disturbances are well-known in demented patients. The cognitive decline in iNPH is potentially reversible after a shunt operation. Diurnal rhythm has never been studied in iNPH. We hypothesize that there is a disturbance of circadian rhythm in iNPH-patients and the aim was to study any changes of the diurnal rhythm (mesor and circadian period) as well as any changes of the diurnal amplitude and acrophase of the activity in iNPH-patients before and after a shunt operation.Twenty consecutive iNPH-patients fulfilling the criteria of the American iNPH-guidelines, 9 males and 11 females, mean age 73 (49-81) years were included. The patients underwent a pre-operative clinical work-up including 10m walk time (w10mt) steps (w10ms), TUG-time (TUGt) and steps (TUGs) and for cognitive function an MMSE score was measured. In order to receive circadian rhythm data actigraphic recordings were performed using the SenseWear 2 (BodyMedia Inc Pittsburgh, PA, USA) actigraph. Cosinor analyses of accelerometry data were performed in "R" using non-linear regression with Levenburg- Marquardt estimation. Pre- and post-operative data regarding mesor, amplitude and circadian period were compared using Wilcoxon-Mann-Whitney test for paired data.Twenty patients were evaluated before and three month post-operatively. Motor function (w10mt, w10ms, TUGt, TUGs) was significantly improved while MMSE was not significantly changed. Actigraphic measurements (mesor, amplitude and circadian period) showed no significant changes after shunt operation.This is the first systematic study of circadian rhythm in iNPH-patients. We found no significant changes in circadian rhythm after shunt surgery. The conceptual idea of diurnal rhythm changes in hydrocephalus is still interesting from a theoretical standpoint and warrants further studies that could include a combination of better designed actigraphic studies in combination with neuroendocrine markers and imaging methods.

Wild birds commonly are presented with trauma at wildlife clinics and rehabilitation centers. Trauma can affect multiple body systems including the nervous system. Since specific diagnosis of nervous system injuries is more difficult compared to other body system injuries and may require advanced imaging, individuals often are treated symptomatically. This retrospective study focused on wild birds that presented with primary neurologic signs after a confirmed or presumed impact injury (vehicular trauma, window collision, or wire strike). The case outcomes, mean number of days in rehabilitation prior to release, and most commonly affected species were identified from data collected by Tri–State Bird Rescue and Research, Inc., (TSBRR) over 10 years. Further studies could be done to investigate the influence of species, type and severity of neurologic signs, and different treatment modalities on case outcomes and duration of treatment.

There is some evidence that municipal waste collectors are at risk of Hepatitis B virus infection (HBV). Published information on risk of Hepatitis C Virus (HCV) infection among waste collectors is scant. We aimed to investigate the prevalence and possible risk factors of HBV and HCV infections among waste collectors in a municipality of the broader region of Attica, Greece. A cross-sectional sero-prevalence study was conducted in a municipality of the broader region of Attica, Greece. Fifty waste collectors participated in the study (response rate: 95%). The group of municipal waste collectors was compared to a convenient sample of white collar employees not exposed to waste (No 83). Waste collectors recorded a significantly higher prevalence of hepatitis B virus infection (anti-HBc positivity) in comparison to the reference group (15% vs. 2.5%, respectively; p .001). Waste collectors who reported frequent exposure to needle-stick injuries had higher risk of HBV infection (RR 8.28; 95% CI 1.076-63.79; p 0.033). Only one municipal waste collector was anti-HCV positive. Our study corroborates previous results of an increased prevalence of Hepatitis B infection among municipal waste collectors. In addition we found that needle stick injuries were associated with the risk of HBV infection. By contrast, HCV infection does not seem to represent a significant occupational hazard among waste collectors. Vaccination against HBV among municipal solid waste collectors and promotion and use of safer methods for the collection of non-hospital medical waste could represent potential measures for the prevention of Hepatitis B Virus infection among municipal waste collectors.

Background Contradictory reports have been published regarding the association of Carpal Tunnel Syndrome (CTS) and the use of computer keyboard. Previous studies did not take into account the cumulative exposure to keyboard strokes among computer workers. The aim of the present study was to investigate the association between cumulative keyboard use (keyboard strokes) and CTS. Methods Employees (461) from a Governmental data entry & processing unit agreed to participate (response rate: 84.1 %) in a cross-sectional study. Α questionnaire was distributed to the participants to obtain information on socio-demographics and risk factors for CTS. The participants were examined for signs and symptoms related to CTS and were asked if they had previous history or surgery for CTS. The cumulative amount of the keyboard strokes per worker per year was calculated by the use of payroll’s registry. Two case definitions for CTS were used. The first included subjects with personal history/surgery for CTS while the second included subjects that belonged to the first case definition plus those participants were identified through clinical examination. Results Multivariate analysis used for both case definitions, indicated that those employees with high cumulative exposure to keyboard strokes were at increased risk of CTS (case definition A: OR = 2.23;95 % CI = 1.09-4.52 and case definition B: OR = 2.41; 95%CI = 1.36-4.25). A dose response pattern between cumulative exposure to keyboard strokes and CTS has been revealed (p Conclusions The present study indicated a possible association between cumulative exposure to keyboard strokes and development of CTS. Cumulative exposure to key-board strokes would be taken into account as an exposure indicator regarding exposure assessment of computer workers. Further research is needed in order to test the results of the current study and assess causality between cumulative keyboard strokes and development of CT.