Dietary replacement of soybean meal with heat-treated grain soybean in diets of feedlot-finished beef cattle: impacts on intake, digestibility, and ruminal parameters.

The objective of this study was to assess the impact of increasing levels of heat-treated soybean in the diet of crossbred cattle during the finishing phase on nutrient intake and digestibility, ruminal parameters, digesta passage rate, nitrogen balance, and microbial protein synthesis. Five steers, crossbred 7/8 Jersey x Zebu, fitted with rumen cannulas and with an average weight of 350 ± 50 kg, were utilized. The experimental treatments consisted of 0, 7, 14, 21, and 28% inclusion of heat-treated soybean in the total diet dry matter. The animals were randomly allocated in a 5 × 5 Latin square design. Evaluation of the animals took place over five experimental periods, each lasting 20 days. During each experimental period, the first 15 days were allocated for animal adaptation to the experimental diets, followed by five days of data collection. No significant differences were observed among the diets in terms of dry matter intake (average of 6.57 kg day-1; P = 0.615) and organic matter intake (average of 6.23 kg day-1; P = 0.832). However, heat-treated soybean had a significant impact on the digestibility of dry matter (P = 0.02), organic matter (P = 0.01), crude protein (P < 0.01), and neutral detergent fiber (P < 0.01). There was no observed change on microbial protein synthesis (average of 409.6 g day-1) in animals with the inclusion of heat-treated soybean in the diets. With each 1% inclusion of heat-treated soybean in the cattle diet, there was an increase of 0.00754 units in ruminal pH values and a reduction of 0.75839 mg dL-1 in ruminal ammoniacal nitrogen values. This study suggests that heat-treated soybean can be included in up to 15% of the dry matter in diets for finishing feedlot cattle.

Longitudinal follow-up after telephone disclosure in the randomized COGENT study.

PURPOSE: To better understand the longitudinal risks and benefits of telephone disclosure of genetic test results in the era of multigene panel testing. METHODS: Adults who were proceeding with germline cancer genetic testing were randomized to telephone disclosure (TD) with a genetic counselor or in-person disclosure (IPD) (i.e., usual care) of test results. All participants who received TD were recommended to return to meet with a physician to discuss medical management recommendations. RESULTS: Four hundred seventy-three participants were randomized to TD and 497 to IPD. There were no differences between arms for any cognitive, affective, or behavioral outcomes at 6 and 12 months. Only 50% of participants in the TD arm returned for the medical follow-up appointment. Returning was associated with site (p < 0.0001), being female (p = 0.047), and not having a true negative result (p < 0.002). Mammography was lower at 12 months among those who had TD and did not return for medical follow-up (70%) compared with those who had TD and returned (86%) and those who had IPD (87%, adjusted p < 0.01). CONCLUSION: Telephone disclosure of genetic test results is a reasonable alternative to in-person disclosure, but attention to medical follow-up may remain important for optimizing appropriate use of genetic results.

Preferences for in-person disclosure: Patients declining telephone disclosure characteristics and outcomes in the multicenter Communication Of GENetic Test Results by Telephone study.

Telephone disclosure of cancer genetic test results is noninferior to in-person disclosure. However, how patients who prefer in-person communication of results differ from those who agree to telephone disclosure is unclear but important when considering delivery models for genetic medicine. Patients undergoing cancer genetic testing were recruited to a multicenter, randomized, noninferiority trial (NCT01736345) comparing telephone to in-person disclosure of genetic test results. We evaluated preferences for in-person disclosure, factors associated with this preference and outcomes compared to those who agreed to randomization. Among 1178 enrolled patients, 208 (18%) declined randomization, largely given a preference for in-person disclosure. These patients were more likely to be older (P = 0.007) and to have had multigene panel testing (P < 0.001). General anxiety (P = 0.007), state anxiety (P = 0.008), depression (P = 0.011), cancer-specific distress (P = 0.021) and uncertainty (P = 0.03) were higher after pretest counseling. After disclosure of results, they also had higher general anxiety (P = 0.003), depression (P = 0.002) and cancer-specific distress (P = 0.043). While telephone disclosure is a reasonable alternative to in-person disclosure in most patients, some patients have a strong preference for in-person communication. Patient age, distress and complexity of testing are important factors to consider and requests for in-person disclosure should be honored when possible.

Randomized Noninferiority Trial of Telephone vs In-Person Disclosure of Germline Cancer Genetic Test Results.

Background: Germline genetic testing is standard practice in oncology. Outcomes of telephone disclosure of a wide range of cancer genetic test results, including multigene panel testing (MGPT) are unknown. Methods: Patients undergoing cancer genetic testing were recruited to a multicenter, randomized, noninferiority trial (NCT01736345) comparing telephone disclosure (TD) of genetic test results with usual care, in-person disclosure (IPD) after tiered-binned in-person pretest counseling. Primary noninferiority outcomes included change in knowledge, state anxiety, and general anxiety. Secondary outcomes included cancer-specific distress, depression, uncertainty, satisfaction, and screening and risk-reducing surgery intentions. To declare noninferiority, we calculated the 98.3% one-sided confidence interval of the standardized effect; t tests were used for secondary subgroup analyses. Only noninferiority tests were one-sided, others were two-sided. Results: A total of 1178 patients enrolled in the study. Two hundred eight (17.7%) participants declined random assignment due to a preference for in-person disclosure; 473 participants were randomly assigned to TD and 497 to IPD; 291 (30.0%) had MGPT. TD was noninferior to IPD for general and state anxiety and all secondary outcomes immediately postdisclosure. TD did not meet the noninferiority threshold for knowledge in the primary analysis, but it did meet the threshold in the multiple imputation analysis. In secondary analyses, there were no statistically significant differences between arms in screening and risk-reducing surgery intentions, and no statistically significant differences in outcomes by arm among those who had MGPT. In subgroup analyses, patients with a positive result had statistically significantly greater decreases in general anxiety with telephone disclosure (TD -0.37 vs IPD +0.87, P = .02). Conclusions: Even in the era of multigene panel testing, these data suggest that telephone disclosure of cancer genetic test results is as an alternative to in-person disclosure for interested patients after in-person pretest counseling with a genetic counselor.

Use and Patient-Reported Outcomes of Clinical Multigene Panel Testing for Cancer Susceptibility in the Multicenter Communication of Genetic Test Results by Telephone Study.

PURPOSE: Multigene panels (MGPs) are increasingly being used despite questions regarding their clinical utility and no standard approach to genetic counseling. How frequently genetic providers use MGP testing and how patient-reported outcomes (PROs) differ from targeted testing (eg, BRCA1/2 only) are unknown. METHODS: We evaluated use of MGP testing and PROs in participants undergoing cancer genetic testing in the multicenter Communication of Genetic Test Results by Telephone study (ClinicalTrials.gov identifier: ), a randomized study of telephone versus in-person disclosure of genetic test results. PROs included genetic knowledge, general and state anxiety, depression, cancer-specific distress, uncertainty, and satisfaction. Genetic providers offered targeted or MGP testing based on clinical assessment. RESULTS: Since the inclusion of MGP testing in 2014, 395 patients (66%) were offered MGP testing. MGP testing increased over time from 57% in 2014 to 66% in 2015 (P = .02) and varied by site (46% to 78%; P < .01). Being offered MGP testing was significantly associated with not having Ashkenazi Jewish ancestry, having a history of cancer, not having a mutation in the family, not having made a treatment decision, and study site. After demographic adjustment, patients offered MGP testing had lower general anxiety (P = .04), state anxiety (P = .03), depression (P = .04), and uncertainty (P = .05) pre-disclosure compared with patients offered targeted testing. State anxiety (P = .05) and cancer-specific distress (P = .05) were lower at disclosure in the MGP group. There was a greater increase in change in uncertainty (P = .04) among patients who underwent MGP testing. CONCLUSION: MGP testing was more frequently offered to patients with lower anxiety, depression, and uncertainty and was associated with favorable outcomes, with the exception of a greater increase in uncertainty compared with patients who had targeted testing. Addressing uncertainty may be important as MGP testing is increasingly adopted.

Residual frying oil in the diets of sheep: intake, digestibility, nitrogen balance and ruminal parameters.

OBJECTIVE: The objective of this study was to evaluate the intake and nutrient digestibility, nitrogen balance and ruminal ammonia nitrogen in lambs of diets containing different levels of residual frying oil. METHODS: Levels of 0, 20, 40, 60, and 80 g/kg dry matter (DM) base of residual frying oil in the diets of lambs were evaluated. Five castrated lambs with initial body weights of 36.8±3.3 kg, distributed in a Latin square (5×5) design, were used. RESULTS: There was a decreasing linear effect on the intake of DM, organic matter (OM), crude protein (CP), neutral detergent fiber (NDF), total carbohydrates (TCH), and nonfibrous carbohydrates (NFC). There was an increased linear intake of ether extract (EE). The apparent digestibility of DM, OM, CP, NDF, TCH, and NFC, as well as urine nitrogen excretion, nitrogen balance and ruminal parameters, were not influenced by different levels of residual frying oil in the diet. EE digestibility presented a crescent linear effect. CONCLUSION: It can be concluded that the addition of residual frying oil to the diets of sheep can affect nutrient intake without affecting the digestibility of most nutrients (with the exception of EE), nitrogen balance and ruminal ammonia nitrogen concentration.