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Chronic wasting disease (CWD) is a transmissible spongiform encephalopathy that was first detected in captive cervids in Colorado, United States (US) in 1967, but has since spread into free-ranging white-tailed deer (Odocoileus virginianus) across the US and Canada as well as to Scandinavia and South Korea. In some areas, the disease is considered endemic in wild deer populations, and governmental wildlife agencies have employed epidemiological models to understand long-term environmental risk. However, continued rapid spread of CWD into new regions of the continent has underscored the need for extension of these models into broader tools applicable for wide use by wildlife agencies. Additionally, efforts to semi-automate models will facilitate access of technical scientific methods to broader users. We introduce software (Habitat Risk) designed to link a previously published epidemiological model with spatially referenced environmental and disease testing data to enable agency personnel to make up-to-date, localized, data-driven predictions regarding the odds of CWD detection in surrounding areas after an outbreak is discovered. Habitat Risk requires pre-processing publicly available environmental datasets and standardization of disease testing (surveillance) data, after which an autonomous computational workflow terminates in a user interface that displays an interactive map of disease risk. We demonstrated the use of the Habitat Risk software with surveillance data of white-tailed deer from Tennessee, USA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier Ltd.)

Acne vulgaris is among the most common skin disorders afflicting adolescents worldwide, and though well-established guidelines of care exist for acne management, these guidelines do not uniformly consider or address the unique psychosocial and medical needs of transgender and gender diverse (TGD) youth. Part 2 of this two-part review provides guidance on a stepwise approach to the medical treatment of acne in TGD youth, with an emphasis on safety, efficacy, and the delivery of medical care in a culturally humble, thoughtful, and gender-affirming manner., (© 2022 Wiley Periodicals LLC.)

Acne vulgaris is among the most common skin disorders afflicting adolescents worldwide, and though well-established guidelines of care exist for acne management, these guidelines do not uniformly consider or address the unique psychosocial and medical needs of transgender and gender diverse (TGD) youth. TGD youth may possess distinct goals of therapy when treating their acne; the use of medicines routinely employed to treat acne may also expose TGD adolescents receiving gender affirming medical therapy to greater risk of adverse events. Part 1 of this two-part review provides dermatologists an understanding of gender affirming care and its timing, as well as its potential impacts on the development of acne in TGD youth., (© 2022 Wiley Periodicals LLC.)

Mange, a parasitic skin disease caused by various species of mites, is found in free-ranging wildlife populations and has been increasingly reported in American black bears (Ursus americanus) over the last decade in New York State (NYS), USA. Our goal was to describe the geographic, seasonal, and demographic factors associated with mange in this species in NYS. Our retrospective study used historic, opportunistic data from diagnostic necropsy records and visual sighting reports collected by the NYS Wildlife Health Program from 2009 to 2018. We used chi-square tests for independence and odds ratios to examine whether geographic location, year, season, sex, age, and reason for laboratory submission were associated with mange in bears. We used maps and seasonal analysis to investigate emerging patterns. We confirmed increased black bear mange reports in recent years. Necropsy data revealed more bears submitted to the laboratory because of mange, mainly caused by Sarcoptes scabiei; females were more likely than males to present with sarcoptic mange. We found that cases of mange in the Northern Zone were widely disseminated throughout the region, whereas cases in the Southern Zone were concentrated in two areas along the Pennsylvania border. Seasonally, mange cases showed peaks occurring in late spring to early summer and in fall. Our results were on the basis of available data; a comprehensive statewide surveillance program would be useful to better understand the apparent increase in mange and its potential impact on both the welfare of individual animals and the population of black bears in NYS. Additional research on the timing of transmission dynamics associated with females in winter dens may be helpful to wildlife managers to identify strategies to mitigate deleterious spread of the disease in black bears., (© Wildlife Disease Association 2022.)

Anticoagulant rodenticides (ARs) continue to be used across the United States as a method for controlling pest rodent species. As a consequence, wild birds of prey are exposed to these toxicants by eating poisoned prey items. ARs prevent the hepatic recycling of vitamin K and thereby impede the post-translational processing of coagulation factors II, VII, IX, and X that are required for procoagulant complex assembly. Through this mechanism of action, ARs cause hemorrhage and death in their target species. Various studies have documented the persistence of these contaminants in birds of prey but few have attempted to use affordable and accessible diagnostic tests to diagnose coagulopathy in free-ranging birds of prey. In our study free-ranging red-tailed hawks were found to be exposed to difethialone and brodifacoum. Eleven of sixteen (68%) livers tested for AR exposure had detectable residues. Difethialone was found in 1/16 (6%), and brodifacoum was detected in 10/16 (62%) liver samples that were tested for rodenticide residues. Difethialone was found at a concentration of 0.18 ug/g wet weight and brodifacoum concentrations ranged from 0.003-0.234 ug/g wet weight. Two out of 34 (6%) RTHA assessed for blood rodenticide had brodifacoum in serum with measured concentrations of 0.003 and 0.006 ug/g. The range of clotting times in the prothrombin time (PT) and Russell's viper venom time assays for control RTHA were 16.7 to 39.7 s and 11.5 to 91.8 s, respectively. One study bird was diagnosed with clinical AR intoxication with a brodifacoum levels in blood of 0.006 and 0.234 ug/g wet weight in blood and liver respectively, a packed cell volume (PCV) of 19%, and PT and RVVT times of >180 s. No correlation was found between PT and RVVT in the control or free-range RTHA, and there was no relationship found between the presence of liver anticoagulant residues and clotting times in the PT and RVVT., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Precision-cut human liver slice cultures (PCLS) have become an important alternative immunological platform in preclinical testing. To further evaluate the capacity of PCLS, we investigated the innate immune response to TLR3 agonist (poly-I:C) and TLR4 agonist (LPS) using normal and diseased liver tissue. Pathological liver tissue was obtained from patients with active chronic HCV infection, and patients with former chronic HCV infection cured by recent Direct-Acting Antiviral (DAA) drug therapy. We found that hepatic innate immunity in response to TLR3 and TLR4 agonists was not suppressed but enhanced in the HCV-infected tissue, compared with the healthy controls. Furthermore, despite recent HCV elimination, DAA-cured liver tissue manifested ongoing abnormalities in liver immunity: sustained abnormal immune gene expression in DAA-cured samples was identified in direct ex vivo measurements and in TLR3 and TLR4 stimulation assays. Genes that were up-regulated in chronic HCV-infected liver tissue were mostly characteristic of the non-parenchymal cell compartment. These results demonstrated the utility of PCLS in studying both liver pathology and innate immunity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Wu, Roberto, Knupp, Greninger, Truong, Hollingshead, Kenerson, Tuefferd, Chen, Koelle, Horton, Jerome, Polyak, Yeung and Crispe.)

Abundant long-lived liver-resident macrophages, termed Kupffer cells, are activated during chronic liver injury. They secrete both pro-inflammatory and pro-fibrotic cytokines, which act on hepatic stellate cells causing their transdifferentiation into myofibroblasts that deposit collagen. In other tissues, wound-associated macrophages go further, and transdifferentiate into fibrocytes, secreting collagen themselves. We tested Kupffer cells for this property in two experimental models: mixed non-parenchymal cell culture, and precision-cut liver slice culture. Using the Emr1-Cre transgene as a driver and the RiboTag transgene as a reporter, we found that Kupffer cells undergo transdifferentiation under these circumstances. Over time, they lose the expression of both Kupffer cell-specific and macrophage-specific genes and the transcription factors that control their expression, and they begin to express multiple genes and proteins characteristic of either myofibroblasts or tissue fibroblasts. These effects were strongly conserved between non-parenchymal cell culture and liver tissue slice culture, arguing that such transdifferentiation is a conserved function of Kupffer cells. We conclude that in addition to supporting fibrosis through an action on stellate cells, Kupffer cells also participate in liver fibrosis through transdifferentiation into fibrocytes., (© 2021 Wiley-VCH GmbH.)

Wildlife rehabilitation is a publicly popular practice, though not without controversy. State wildlife agencies frequently debate the ecological impact of rehabilitation. By analyzing case records, we can clarify and quantify the causes for rehabilitation, species involved, and treatment outcomes. This data would aid regulatory agencies and rehabilitators in making informed decisions, as well as gaining insight into causes of species mortality. In New York State, the Department of Environmental Conservation (NYSDEC) has licensed rehabilitators since 1980 and annual reporting is required. In this study, we analyzed 58,185 individual wildlife cases that were attended by New York rehabilitators between 2012 and 2014. These encompassed 30,182 (51.9%) birds, 25,447 (43.7%) mammals, 2,421 (4.2%) reptiles, and 75 (0.1%) amphibians. We identified patterns among taxonomic representation, reasons for presentation to a rehabilitation center, and animal disposition. Major causes of presentation were trauma (n = 22,156; 38.1%) and orphaning (n = 21,679; 37.3%), with habitat loss (n = 3,937; 6.8%), infectious disease (n = 1,824; 3.1%), and poisoning or toxin exposure (n = 806; 1.4%) playing lesser roles. The overall release rate for animals receiving care was 50.2% while 45.3% died or were euthanized during the rehabilitation process. A relatively small number (0.3%) were permanently non-releasable and placed in captivity; 4.1% had unknown outcomes. A comparable evaluation in 1989 revealed that wildlife submissions have increased (annual mean 12,583 vs 19,395), and are accompanied by a significant improvement in release (50.2% in the study period vs 44.4% in 1989) (χ2(1) = 90.43, p < 0.0001). In this manuscript, we aim to describe the rehabilitator community in New York State, and present the causes and outcomes for rehabilitation over a three-year period., Competing Interests: The authors have declared that no competing interests exist.

All-trans-retinoic acid (atRA), the active metabolite of vitamin A, has antifibrogenic properties in vitro and in animal models. Liver vitamin A homeostasis is maintained by cell-specific enzymatic activities including storage in hepatic stellate cells (HSCs), secretion into circulation from hepatocytes, and formation and clearance of atRA. During chronic liver injury, HSC activation is associated with a decrease in liver retinyl esters and retinol concentrations. atRA is synthesized through two enzymatic steps from retinol, but it is unknown if the loss of retinoid stores is associated with changes in atRA formation and which cell types contribute to the metabolic changes. The aim of this study was to determine if the vitamin A metabolic flux is perturbed in acute liver injury, and if changes in atRA concentrations are associated with HSC activation and collagen expression. At basal levels, HSC and Kupffer cells expressed key genes involved in vitamin A metabolism, whereas after acute liver injury, complex changes to the metabolic flux were observed in liver slices. These changes include a reproducible spike in atRA tissue concentrations, decreased retinyl ester and atRA formation rate, and time-dependent changes to the expression of metabolizing enzymes. Kinetic simulations suggested that oxidoreductases are important in determining retinoid metabolic flux after liver injury. These early changes precede HSC activation and upregulation of profibrogenic gene expression, which were inversely correlated with atRA tissue concentrations, suggesting that HSC and Kupffer cells are key cells involved in changes to vitamin A metabolic flux and signaling after liver injury. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC? Vitamin A is metabolized in the liver for storage as retinyl esters in hepatic stellate cell (HSCs) or to all-trans-retinoic acid (atRA), an active metabolite with antifibrogenic properties. Following chronic liver injury, vitamin A metabolic flux is perturbed, and HSC activation leads to diminished retinoid stores. WHAT QUESTION DID THIS STUDY ADDRESS? Do changes in the expression of vitamin A metabolizing enzymes explain changes in atRA concentrations and the regulation of fibrosis following acute liver injury? WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE? In healthy liver, both HSC and Kupffer cells may mediate vitamin A homeostasis. Following acute liver injury, complex changes in metabolizing enzyme expression/activity alter the metabolic flux of retinoids, resulting in a transient peak in atRA concentrations. The atRA concentrations are inversely correlated with profibrogenic gene expression, HSC activation, and collagen deposition. HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE? Improved understanding of altered vitamin A metabolic flux in acute liver injury may provide insight into cell-specific contributions to vitamin A loss and lead to novel interventions in liver fibrosis., (© 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics.)

The liver contains a rich mix of T cells, including activated T cells, tissue-resident memory T cells and cells undergoing apoptosis. When antigens are presented in this milieu the default result is functional tolerance. T cell tolerance in the liver could be constitutive, or it could be adaptive, in which case liver cells would become unresponsive after encountering antigen in the liver context. To test this model, we evaluated the potential of human liver T cells to respond to T cell receptor ligation in liver tissue slice cultures. These T cells contained an actively motile subset of CD4+ T cells marked by CCR7 and CD62L, and fully functional subsets of CD4+ and CD8+ T cells that synthesized effector cytokines but subsequently assumed an exhausted phenotype. These data favor the model that human liver T cells are not constitutively tolerant but undergo adaptive tolerance after activation., (Copyright © 2020. Published by Elsevier Inc.)

Human liver myeloid cells are imperfectly defined, but it is broadly agreed that cells of stellate appearance in situ , expressing the markers CD11b and CD68, are the liver's resident macrophages, classically termed Kupffer cells. Recent investigations using single cell RNA sequencing and unsupervised clustering algorithms suggest there are two populations of cells with the characteristics of tissue macrophages in human liver. We therefore analyzed dissociated human liver tissue using the markers CD11b and CD68 to define macrophage-like cells and found within this population two subsets that differ in their expression of multiple surface markers. These subsets were FACS-sorted based on CD32 expression, and gene expression analysis identified them with human liver myeloid cell subsets that were previously defined by two independent single cell RNA sequencing studies. Using qRT-PCR we found that the two subsets differed in the expression of genes associated with T cell activation and immunosuppression, suggesting distinct roles in T cell tolerance. In addition, one subset expressed two markers, CD1C and CD11c, more often seen on classical dendritic cells. Criteria used to distinguish macrophages from dendritic cells in other tissues may need to be revised in the human liver., (Copyright © 2020 Wu, Hollingshead, Roberto, Knupp, Kenerson, Chen, Strickland, Horton, Yeung, Soysa and Crispe.)

Study Objectives: To assess the effects of a yoga versus educational film (EF) program on restless legs syndrome (RLS) symptoms and related outcomes in adults with RLS., Methods: Forty-one community-dwelling, ambulatory nonpregnant adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or EF program (n = 22). In addition to attending classes, all participants completed practice/treatment logs. Yoga group participants were asked to practice at home 30 minutes per day on nonclass days; EF participants were instructed to record any RLS treatments used on their daily logs. Core outcomes assessed pretreatment and posttreatment were RLS symptoms and symptom severity (International RLS Study Group Scale (IRLS) and RLS ordinal scale), sleep quality, mood, perceived stress, and quality of life (QOL)., Results: Thirty adults (13 yoga, 17 EF), aged 24 to 73 (mean = 50.4 ± 2.4 years), completed the 12-week study (78% female, 80.5% white). Post-intervention, both groups showed significant improvement in RLS symptoms and severity, perceived stress, mood, and QOL-mental health (P ≤ .04). Relative to the EF group, yoga participants demonstrated significantly greater reductions in RLS symptoms and symptom severity (P ≤ .01), and greater improvements in perceived stress and mood (P ≤ .04), as well as sleep quality (P = .09); RLS symptoms decreased to minimal/mild in 77% of yoga group participants, with none scoring in the severe range by week 12, versus 24% and 12%, respectively, in EF participants. In the yoga group, IRLS and RLS severity scores declined with increasing minutes of homework practice (r = .7, P = .009 and r = .6, P = .03, respectively), suggesting a possible dose-response relationship., Conclusions: Findings of this exploratory RCT suggest that yoga may be effective in reducing RLS symptoms and symptom severity, decreasing perceived stress, and improving mood and sleep in adults with RLS., Clinical Trial Registration: Registry: Clinicaltrials.gov; Title: Yoga vs. Education for Restless Legs: a Feasibility Study; Identifier: NCT03570515; URL: https://clinicaltrials.gov/ct2/show/NCT03570515., (© 2020 American Academy of Sleep Medicine.)

Increased mortalities of adult Eastern Bluebirds, Sialia sialis , breeding in artificial nesting boxes were recorded in New York State, US. A total of 46 dead bluebirds were reported from 23 sites between early April and mid-August 2017. The maximum distance between sites was over 600 km. A total of 27 carcasses were available for postmortem examination. The most common cause of death was necrotizing enteritis, found in 56% (9/16) of birds that could be examined histopathologically. Lesions consisted of foci of hypereosinophilic debris and inflammation rich in Gram-negative bacteria. Aerobic and anaerobic culture of intestines from 4/8 birds with necrotizing enteritis yielded no growth. Plagiorhynchus cylindraceus acanthocephalids were often (6/9, 67%) but not invariably present in affected birds. Occasional incidental lesions included foreign-body microgranulomas in the wall of the ventriculus and intravascular nematodiasis at the base of the heart. The cause of sporadic outbreaks of necrotizing enteritis in breeding bluebirds remains undetermined and warrants further investigation.

Halogenated aromatic hydrocarbons (HAH) are ubiquitous environmental contaminants. Studies in rats have shown that HAH treatment can lead to dysregulation of circulating hormone levels, including prolactin. Reduction of prolactin levels in both rats and mice is inhibitory to immune function. Previous studies have reported suppression of alloantigen-specific cytotoxic T-lymphocyte (CTL) activity in mice treated with 3,3', 4,4', 5,5'-hexachlorobiphenyl (HxCB). Here we report that treatment of mice with HxCB (10 mg/kg body weight) leads to a significant reduction of serum prolactin levels (by 89% to 3.7 ng/ml) on day 10 post alloantigen injection (P815 mastocytoma), the day of peak alloantigen-specific CTL activity. Prolactin levels were not altered on day 3 post alloantigen injection. Treatment with bromocriptine (5 mg/kg/day) reduced serum prolactin levels slightly on day 3 and significantly (94% to 2.1 ng/ml) on day 10 post alloantigen injection. Splenic CTL activity was not altered by treatment with bromocriptine. The data presented here suggest that reduction of prolactin levels alone, to the extent observed in HxCB-treated mice, is not causative for CTL suppression.

To provide long-term gastric fistulas for collection of third-compartment gastric contents, Janeway mucosal tube gastrostomy was performed, using a gastrointestinal stapling instrument, in 6 castrated adult male llamas. Mean operative time (+/- SEM) was 65 +/- 4.16 minutes. All llamas survived the 6-week study period. Of the 6 llamas, 5 did not have signs of abdominal pain and returned to preoperative food consumption amounts within 36 hours. One llama had mild intermittent signs of abdominal pain daily for 7 days before returning to preoperative amount of food consumption. All gastrostomies leaked small amounts of gastric contents around indwelling 6- to 8-mm cannulas at the skin surface. Gastric contents did not leak when cannulas were dislodged from gastrostomy stomas. Replacement of cannulas was rapid and easy. Gravity-flow sample collection was best accomplished through 8-mm cannulas. Mean (+/- SEM) weight loss was detected in all llamas (15 +/- 3 kg) and was associated with frequent nonfeeding and stress of sample collection. Gross necropsy findings were unremarkable in 5 of 6 llamas. All mucosal tube gastrostomies were patent, and there was no evidence of peritonitis. One llama had a single fibrous adhesion connecting the operative site with the ascending colon. Histologically, small (2.5- to 15-mm diameter) partial-thickness mucosal erosions identified at the tube gastrostomy-gastric wall junctions may have been associated with indwelling gastric cannulas. The Janeway gastrostomy was generally well tolerated in the llamas and should be considered as a useful long-term fistulation technique.