University of Missouri Health System

Summary A 5‐day‐old Friesian colt was presented to the University of Missouri Veterinary Health Center with lethargy, progressive abdominal distension and failure to urinate. Upon examination, the colt appeared dehydrated with marked abdominal distension and dull mentation. Bloodwork revealed severe azotaemia, electrolyte derangements and an inflammatory leucogram. Transabdominal ultrasound revealed a large volume of free peritoneal fluid and evidence of a ruptured bladder. The uroperitoneum was confirmed via abdominocentesis. The colt was stabilised, and an exploratory laparotomy was performed. A ruptured bladder and concurrent membranous obstruction at the level of the penile urethra, consistent with congenital urethral atresia‐like abnormality and hypospadias, were identified. The bladder tear was repaired in routine fashion, and a functional urethral opening was created. Postoperatively, a urinary catheter was maintained for 4 days, and the colt received intravenous antibiotics, anti‐inflammatory medications and gastroprotectants. Azotaemia and electrolyte imbalances progressively improved. The colt is reportedly doing well after discharge from the hospital.

Endometriosis is a chronic, estrogen-dependent inflammatory condition that affects approximately 10% of reproductive-age women and is frequently associated with infertility and pelvic pain. Unlike many estrogen-dependent disorders, epidemiologic studies have reported inconsistent associations between obesity, measured by BMI, and endometriosis. Caloric restriction diet (CRD), a dietary regimen that reduces energy intake without malnutrition, has demonstrated anti-inflammatory and anti-proliferative effects in various chronic diseases but remains underexplored in endometriosis. Here, we investigated the effects of CRD on endometriosis using a mouse model with a GFP reporter. Endometriosis was surgically induced by inoculating endometrial fragments, and mice were randomized to receive either ad libitum feeding (regular diet, RD) or CRD. After 90 days, CRD mice exhibited 24.5% reduction in body weight compared to RD mice, without impairment of female fertility. Notably, both the number and weight of ectopic lesions were significantly reduced in the CRD group compared to the RD group. Immunohistochemical analysis revealed decreased epithelial and stromal cell proliferation, increased apoptosis, and elevated stromal progesterone receptor expression in ectopic lesions from CRD mice. Furthermore, phosphorylation of STAT3 and ERK1/2, key inflammatory and proliferative signaling molecules, was significantly reduced in ectopic lesions from CRD mice. These findings suggest that CRD, without compromising fertility, exerts beneficial effects on endometriosis by targeting cell proliferation, survival, and inflammation. Our results support lifestyle-based dietary interventions as a promising non-hormonal strategy for endometriosis management.

Healthcare workers are at the forefront of the global battle against COVID-19. Their vaccination perspectives, particularly in regions like Sierra Leone that have faced health crises such as the Ebola outbreak, are essential for shaping public health strategies in low-income countries that routinely face infectious disease outbreaks. This research sought to understand the perceptions and experiences of Sierra Leone's healthcare workers concerning COVID-19 vaccination and booster doses, set against the backdrop of global health resource disparities and regional vaccine distribution challenges. Utilizing a mixed-methods approach, the study analyzed data from an online survey, which saw 1001 complete responses from 2060 participants across six Ebola-impacted districts (October-November 2022), and in-depth interviews with 24 health workers from three of these districts (February-July 2022). Approximately 80% of respondents reported having received a COVID-19 vaccine, predominantly Sinopharm and AstraZeneca, yet only 34% of vaccinated participants had received a booster dose. In multivariable analyses, personally knowing someone who experienced serious COVID-19 illness or death was associated with higher odds of both initial vaccination and booster uptake (p < 0.05). By contrast, prior Ebola-related experiences were not consistently associated with vaccination outcomes. Qualitative findings contextualized these patterns, highlighting the roles of professional exposure, limited booster-related information, and inequities in vaccine availability and distribution. These findings indicate that vaccination strategies must move beyond initial rollout to address barriers to sustained engagement, particularly for booster uptake among healthcare workers. They also emphasize the need for equitable vaccine access and transparent, locally tailored communication to mitigate structural and informational constraints in low-income settings.

716 Background: Controversy endures regarding the role of radiotherapy (RT) in operable pancreatic ductal adenocarcinoma (PDAC). Neoadjuvant studies have used a range of RT doses, with a recent surge in enthusiasm for dose-escalated RT. No randomized comparisons of the efficacy of different RT dosing regimens are available. We report pathologic response and survival in PDAC patients who received a range of neoadjuvant RT doses in a prospectively maintained single-institution dataset. Methods: This cohort includes 148 PDAC patients treated with preoperative RT. Conventionally fractionated RT (CFRT) was defined as daily dose of ≤3 Gy in ≥10 fractions, and stereotactic body RT (SBRT) as daily dose of ≥5 Gy in ≤5 fractions. Biologic effective dose (BED) was calculated as follows: BED = nd * (1 + d/α:β), where n = the number of doses, d = dose per fraction; α:β was set at 10. Major pathologic response (MPR) was defined as a College of American Pathologists (CAP) tumor regression grade of 0-1. P&lt;0.05 was the threshold for statistical significance. Survival was calculated from diagnosis. Results: Median age was 66 years; 56% of patients were women. Most (96%) patients received chemotherapy; 57% received SBRT (BED 10 54.8-87.5 Gy), and 43% CFRT (BED 10 39.0-70.1 Gy). Mean BED 10 was significantly higher in the SBRT group (73.7 Gy vs 51.9 Gy, p = 0.05). No significant differences were noted between CFRT and SBRT in terms of tumor response (MPR in 13% vs 19%, respectively), nodal status (N0 in 60% vs 45%, respectively), or R0 resection rates (71% vs 58%); χ 2 p &gt;0.05 for all comparisons. Mean BED 10 did not differ significantly among patients with or without MPR (67.0 vs 63.8 Gy, p=0.36) or with or without R0 resection (63.2 vs 67.5 Gy). Similarly, receiving BED10 ≥ median was not associated with a higher likelihood of MPR or N0 resection, but was associated with a lower likelihood of R0 resection (51 vs 72%, p=0.02). Binary logistic regression showed no relationship between increased BED10 and likelihood of MPR (R 2 =0.012, p=0.33). There was no difference in median overall survival (OS) between CFRT and SBRT (median OS 29.3 vs. 31.6 months, p-NS), nor were there any OS or local control (LC) differences in patients treated with doses above or below the median BED. Similarly, Cox regression demonstrated no relationship between increasing RT dose and OS or LC. Margin status was associated with OS: median OS was 34.7 (95% CI 25.0-44.3) vs 21.4 (14.0-28.9) months in patients with negative vs positive margins, respectively (p &lt; 0.01). A trend towards improved OS was noted in patients with MPR (46.5 vs 29.6 months, p =0.08). Conclusions: No RT dose-response effects on MPR, LC, or OS were observed in a large cohort of PDAC patients treated with neoadjuvant RT, suggesting that alternative strategies to dose escalation should be explored in studies of neoadjuvant RT for PDAC.

The neuromuscular junction (NMJ) is a specialized synapse essential for effective motor neuron-muscle communication and is increasingly recognized as a vulnerable site in aging and neuromuscular disease. While traditionally considered a final common pathway for motor deficits, accumulating evidence demonstrates that NMJ dysfunction is an early and critical driver of disease onset and progression in conditions such as amyotrophic lateral sclerosis and Charcot-Marie-Tooth disease. This review highlights shared and disease-specific mechanisms contributing to NMJ impairment, including presynaptic, postsynaptic, and perisynaptic Schwann cell defects in these diseases. We also discuss age-related changes at the NMJ, emphasizing its role in sarcopenia and muscle weakness in older adults. Furthermore, we explore emerging molecular drivers of NMJ dysfunction uncovered through studies in congenital myasthenic syndromes, autoimmune disorders, and advanced omics approaches. By integrating insights across diseases and aging, we underscore the potential for shared therapeutic strategies aimed at stabilizing NMJ function. Promising interventions targeting presynaptic neurotransmitter release, postsynaptic excitability, and perisynaptic Schwann cells are discussed as avenues to improve neuromuscular transmission and maintain muscle strength. Finally, we discuss the challenges and opportunities in translating these mechanistic insights into clinical therapies and highlight how novel human neuromuscular organoid models and advanced molecular profiling can bridge this gap. Together, these insights establish the NMJ as a critical, modifiable target for preserving motor function across neuromuscular diseases and aging.

ABSTRACT Introduction The present research aims to better understand the meal preparation strategies and food security of unaccompanied Latino migrant farmworker (LMFW) youth in Georgia and Florida. This unfolded in two studies. Methods In Study 1, we explored the day-to-day meal preparation experiences and strategies of N = 20 migrant youths aged 15–20 years (50% from Mexico under the H-2A agricultural visa program working in Georgia; 50% from Guatemala, undocumented minors working in Florida). In Study 2, using a different sample, we examined the levels of food security among N = 36 unaccompanied LMFW youths aged 15–20 years and working in Florida. Results In Study 1, thematic analysis highlighted three shared themes among LMFW youth related to meal preparation strategies: (1) “I do it myself”, (2) “We try to help each other”, and (3) “Sometimes I don’t even have time to eat.” In Study 2, findings showed that 81% (29) of LMFW youths cooked alone while 19% (7) cooked in groups. Most (72%) lacked food security. Out of the 29 LMFW youths who cooked alone, 83% lacked food security compared to 29% of the 7 LMFW youths who cooked in groups. Additionally, among LMFW youths who cooked alone, those who were minors lacked food security (86%) more commonly than those who were non-minors (80%). Conclusion Together, these studies provide insight into meal preparation strategies, and food security status among unaccompanied LMFW youth, specifically that solitude in meal preparation is associated with a lack of food security among these youth in U.S. agriculture.