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The prepartum diet as well as individual metabolic status of the cow influences colostrum parameters. The objectives of this study were to 1) investigate the effect of increasing prepartum dietary MP supply on colostrum yield, composition, and immunoglobulin G (IgG) concentration, and 2) identify prepartum metabolic indicators associated with these outcomes. Multiparous Holstein cows (n = 96) were blocked by expected calving date and randomly assigned to 1 of 2 prepartum diets formulated to contain a control (CON; 85 g of MP/kg DM; 1,175 g of MP/d) or high (HI; 113 g of MP/kg DM; 1,603 g of MP/d) level of MP starting at 28 d before expected calving. Both prepartum diets were formulated to supply Met and Lys at an equal amount of 1.24 and 3.84 g/Mcal of metabolizable energy (ME), respectively. Metabolic indicators were determined in serum (albumin, glutamate dehydrogenase, cholesterol, aspartate transaminase, total protein, total bilirubin, and IgG) or plasma (Ca, glucose, fatty acids, BHB, and urea nitrogen) twice weekly in a subset of cows (n = 60). Colostrum was harvested at 3.6 ± 2.4 h from calving and yield as well as concentrations of IgG, fat, protein, and Ca were determined. Cows were retrospectively grouped based on the typical volume of colostrum needed for 2 colostrum meals (<6 or ≥ 6 kg), IgG concentration (<100 or ≥ 100 g/L), as well as the median concentrations of fat (<4.4 or ≥ 4.4%), protein (<16.5 or ≥ 16.5%), Ca (<0.21 or ≥ 0.21%), and total colostrum ME (<8.65 or ≥ 8.65 Mcal). Data were analyzed using mixed effects ANOVA, with repeated measures where applicable. Feeding HI tended to increase colostrum yield in cows entering parity 2 (9.4 vs. 7.2 ± 0.9 kg), but treatment did not affect yield from cows entering parity ≥3 (5.1 vs. 6.4 ± 1.0 kg). Supply of MP did not affect concentrations of IgG, fat, protein, or Ca. Cows that produced ≥ 6 kg vs. those producing <6 kg of colostrum had lower plasma concentrations of glucose. Metabolic indicators were not associated with IgG group. Colostrum fat ≥4.4% was associated with cows having lower prepartum concentrations of glucose, total protein, albumin, and aspartate transaminase activity. Colostrum protein ≥ 16.5% was associated with lower circulating serum IgG and elevated cholesterol. Elevated glucose as well as lower cholesterol and BHB concentrations were associated with colostrum Ca ≥ 0.21%. Further, higher albumin and fatty acids as well as lower glucose concentrations were associated with a greater colostrum energy output. In conclusion, increasing prepartum MP supply tended to increase colostrum yield in cows entering parity 2, but did not affect the composition or IgG concentration. The observed associations between metabolic indicators and colostrum parameters suggest that slight adjustment in metabolism during late gestation might be necessary to support colostrogenesis, but the causality of these relationships should be considered.
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Importance: Chronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Objective: To evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection-like index illness. Design, Setting, and Participants: This prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 years with acute symptoms suggestive of SARS-CoV-2 infection who received a US Food and Drug Administration-approved SARS-CoV-2 test at the time of illness and did not die or withdraw from the study by 3 months. Follow-up surveys were collected through February 28, 2023. Exposure: COVID-19 status (positive vs negative) at enrollment. Main Outcome and Measures: The main outcome was the weighted proportion of participants with ME/CFS-like illness based on the 2015 Institute of Medicine clinical case definition using self-reported symptoms. Results: A total of 4378 participants were included in the study. Most were female (3226 [68.1%]). Mean (SD) age was 37.8 (11.8) years. The survey completion rates ranged from 38.7% (3613 of 4738 participants) to 76.3% (1835 of 4738) and decreased over time. The weighted proportion of participants identified with ME/CFS-like illness did not change significantly at 3 through 12 months of follow-up and was similar in the COVID-19-positive (range, 2.8%-3.7%) and COVID-19-negative (range, 3.1%-4.5%) groups. Adjusted analyses revealed no significant difference in the odds of ME/CFS-like illness at any time point between COVID-19-positive and COVID-19-negative individuals (marginal odds ratio range, 0.84 [95% CI, 0.42-1.67] to 1.18 [95% CI, 0.55-2.51]). Conclusions and Relevance: In this prospective cohort study, there was no evidence that the proportion of participants with ME/CFS-like illness differed between those infected with SARS-CoV-2 vs those without SARS-CoV-2 infection up to 12 months after infection. A 3% to 4% prevalence of ME/CFS-like illness after an acute infection-like index illness would impose a high societal burden given the millions of persons infected with SARS-CoV-2.
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COVID-19 , Síndrome de Fatiga Crónica , SARS-CoV-2 , Humanos , Síndrome de Fatiga Crónica/epidemiología , COVID-19/epidemiología , COVID-19/complicaciones , Femenino , Adulto , Masculino , Estudios Prospectivos , Persona de Mediana Edad , Estudios Longitudinales , Prevalencia , Adulto Joven , Estados Unidos/epidemiología , AdolescenteRESUMEN
Scintillator-based ZnS:Ag/6LiF neutron detectors have been under development at ISIS for more than three decades. Continuous research and development aim to improve detector capabilities, achieve better performance and meet the increasingly demanding requirements set by neutron instruments. As part of this program, a high-efficiency 2D position-sensitive scintillator detector with wavelength-shifting fibres has been developed for neutron-diffraction applications. The detector consists of a double scintillator-fibre layer to improve detection efficiency. Each layer is made up of two orthogonal fibre planes placed between two ZnS:Ag/6LiF scintillator screens. Thin reflective foils are attached to the front and back scintillators of each layer to minimize light cross-talk between layers. The detector has an active area of 192 × 192â mm with a square pixel size of 3 × 3â mm. As part of the development process of the double-layer detector, a single-layer detector was built, together with a prototype detector in which the two layers of the detector could be read out separately. Efficiency calculations and measurements of all three detectors are discussed. The novel double-layer detector has been installed and tested on the SXD diffractometer at ISIS. The detector performance is compared with the current scintillator detectors employed on SXD by studying reference crystal samples. More than a factor of 3 improvement in efficiency is achieved with the double-layer wavelength-shifting-fibre detector. Software routines for further optimizations in spatial resolution and uniformity of response have been implemented and tested for 2D detectors. The methods and results are discussed in this manuscript.
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Background: One of the goals of the Multi-site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM) study was to evaluate whether clinicians experienced in diagnosing and caring for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) recognized the same clinical entity. Methods: We enrolled participants from seven specialty clinics in the United States. We used baseline data (n = 465) on standardized questions measuring general clinical characteristics, functional impairment, post-exertional malaise, fatigue, sleep, neurocognitive/autonomic symptoms, pain, and other symptoms to evaluate whether patient characteristics differed by clinic. Results: We found few statistically significant and no clinically significant differences between clinics in their patients' standardized measures of ME/CFS symptoms and function. Strikingly, patients in each clinic sample and overall showed a wide distribution in all scores and measures. Conclusions: Illness heterogeneity may be an inherent feature of ME/CFS. Presenting research data in scatter plots or histograms will help clarify the challenge. Relying on case-control study designs without subgrouping or stratification of ME/CFS illness characteristics may limit the reproducibility of research findings and could obscure underlying mechanisms.
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BACKGROUND: Altered gait patterns and reduced walking speed are commonly reported in adults with Down syndrome (DS). Research on the effects of DS-specific exercise programmes on adults with DS is lacking. The purpose of this quasi-experimental study was to evaluate the changes in gait deviations and walking speed in adults with DS after a DS-specific exercise programme. METHODS: Twenty participants underwent a 12-week, DS-specific exercise programme in a telehealth format. Before and after the intervention, gait deviations were assessed with the Ranchos Los Amigos Observational Gait Analysis form, and comfortable walking speed was evaluated with the 4-m walk test. RESULTS: We observed increased comfortable walking speed and reduced gait deviations in the whole gait cycle in adults with DS after the intervention. There were fewer gait deviations during single-leg stance and swing-limb advancement and at the hip, knee and ankle joints after the 12-week exercise programme. CONCLUSIONS: Gait speed and observable gait impairments in adults with DS significantly improved following a 12-week telehealth exercise programme.
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Síndrome de Down , Terapia por Ejercicio , Velocidad al Caminar , Humanos , Síndrome de Down/fisiopatología , Síndrome de Down/rehabilitación , Síndrome de Down/complicaciones , Masculino , Femenino , Adulto , Velocidad al Caminar/fisiología , Terapia por Ejercicio/métodos , Adulto Joven , Telemedicina/métodos , Trastornos Neurológicos de la Marcha/rehabilitación , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/etiología , Persona de Mediana Edad , Evaluación de Resultado en la Atención de SaludRESUMEN
Colostrum is a rich source of nutritional and non-nutritional components and is recognized as essential to transfer passive immunity to newborn calves. Because of the individual and seasonal variability in colostrum yield and composition, maintaining an adequate supply of high-quality colostrum year-round remains a challenge for commercial dairy producers. In this narrative review, we described the individual, seasonal, and herd-level variability of colostrum production and summarized the association between individual animal factors such as parity, sex of the calf, calf birth weight, as well as indicators of the cow's metabolic status and the yield and composition of colostrum. Further, we reviewed the current knowledge on the influence of prepartum nutrition and management strategies on colostrum production. Research on the metabolizable energy and protein supplied in the prepartum diet as well as on the inclusion and source of vitamins, minerals, and feed additives suggests prepartum nutrition influences the yield, quality, and composition of colostrum. Furthermore, the prepartum environment and dry period length remain influential factors in the production of colostrum. However, additional research is needed to understand the mechanisms by which prepartum nutrition and management affect colostrum production. Finally, time from calving to colostrum harvest and oxytocin administration as well as the current knowledge on the effect of heat treatment and colostrum storage strategies on colostral components were discussed. To conclude, we identify critical gaps in knowledge for future focus of investigation in colostrum research.
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Calostro , Dieta , Calostro/química , Animales , Bovinos , Femenino , Dieta/veterinaria , Embarazo , Lactancia , Alimentación Animal , Animales Recién NacidosRESUMEN
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex, multisystem illness characterized by activity-limiting fatigue, worsening of symptoms after activity, and other symptoms (1). It affects all age, sex, and racial and ethnic groups and costs the U.S. economy about $18-$51 billion annually (2-5). This report describes the percentage of adults who had ME/CFS at the time of interview by selected demographic and geographic characteristics based on data from the 2021-2022 National Health Interview Survey (NHIS).
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Síndrome de Fatiga Crónica , Adulto , Humanos , Estados Unidos/epidemiología , Síndrome de Fatiga Crónica/epidemiología , Síndrome de Fatiga Crónica/diagnóstico , Encuestas y CuestionariosRESUMEN
While most individuals who contract COVID-19 feel better within a few weeks, others have new, returning, or ongoing symptoms that they did not have before COVID-19, which is often referred to as Long COVID (1). This report describes the percentage of children ages 0-17 years who ever had Long COVID or had Long COVID at the time of interview (currently have Long COVID) based on parent-reported data from the 2022 National Health Interview Survey (NHIS). Long COVID was defined as the presence of symptoms for at least 3 months after having COVID-19 among those who received either a positive test or a doctor's diagnosis of COVID-19.
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BACKGROUND: The clinical burden of Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other post-infectious fatiguing illnesses (PIFI) is increasing. There is a critical need to advance understanding of the effectiveness and sustainability of innovative approaches to clinical care of patients having these conditions. METHODS: We aim to assess the effectiveness of a Long COVID and Fatiguing Illness Recovery Program (LC&FIRP) in a two-arm, single-blind, pragmatic, quality improvement, professional cluster, randomized controlled trial in which 20 consenting clinicians across primary care clinics in a Federally Qualified Health Center system in San Diego, CA, will be randomized at a ratio of 1:1 to either participate in (1) weekly multi-disciplinary team-based case consultation and peer-to-peer sharing of emerging best practices (i.e., teleECHO (Extension for Community Healthcare Outcomes)) with monthly interactive webinars and quarterly short courses or (2) monthly interactive webinars and quarterly short courses alone (a control group); 856 patients will be assigned to participating clinicians (42 patients per clinician). Patient outcomes will be evaluated according to the study arm of their respective clinicians. Quantitative and qualitative outcomes will be measured at 3- and 6-months post-baseline for clinicians and every 3-months post assignment to a participating clinician for patients. The primary patient outcome is change in physical function measured using the Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Analyses of differences in outcomes at both the patient and clinician levels will include a linear mixed model to compare change in outcomes from baseline to each post-baseline assessment between the randomized study arms. A concurrent prospective cohort study will compare the LC&FIRP patient population to the population enrolled in a university health system. Longitudinal data analysis approaches will allow us to examine differences in outcomes between cohorts. DISCUSSION: We hypothesize that weekly teleECHO sessions with monthly interactive webinars and quarterly short courses will significantly improve clinician- and patient-level outcomes compared to the control group. This study will provide much needed evidence on the effectiveness of a technology-enabled multi-disciplinary team-based care model for the management of Long COVID, ME/CFS, and other PIFI within a federally qualified health center. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05167227 . Registered on December 22, 2021.
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COVID-19 , Síndrome de Fatiga Crónica , Humanos , SARS-CoV-2 , Síndrome Post Agudo de COVID-19 , Síndrome de Fatiga Crónica/diagnóstico , Síndrome de Fatiga Crónica/terapia , Estudios Prospectivos , Fatiga Muscular , Mejoramiento de la Calidad , Método Simple Ciego , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Colostrum yield and quality are influenced by prepartum nutrition and the metabolic status of the cow; however, data considering these associations on multiple dairy farms are limited. Our objective was to identify cow-level prepartum metabolic indicators, as well as farm-level nutritional strategies associated with colostrum yield and the indicator of colostrum quality, Brix %. A convenience sample of 19 New York Holstein dairies (median: 1,325 cows; range: 620 to 4,600 cows) were enrolled in this observational study. Records for individual colostrum yield and Brix % were collected by farm personnel between October 2019 and February 2021. Farms were visited 4 times, approximately 3 mo apart, to obtain feed samples of the prepartum diets, collect blood samples from 24 pre- and postpartum cows, respectively, and determine prepartum body condition score. Feed samples were submitted for analysis of chemical composition, and particle size was determined on-farm using a particle separator. Prepartum serum samples (n = 762) were analyzed for glucose and nonesterified fatty acid concentrations. Whole blood from postpartum cows was analyzed for herd prevalence of hyperketonemia (proportion of samples with ß-hydroxybutyrate ≥1.2 mmol/L). A cohort of primiparous (PP; n = 1,337) and multiparous (MPS; n = 3,059) cows calving ± 14 d of each farm visit were included in the statistical analysis. Animals calving in this period were assigned results for the close-up diet composition and herd prevalence of hyperketonemia collected from the respective farm visit. Greatest colostrum yield from PP and MPS cows was associated with moderate starch [18.6-22.5% of dry matter (DM)] and a moderate herd prevalence of hyperketonemia (10.1-15.0%). Greatest colostrum yield from MPS cows was associated with moderate crude protein (13.6-15.5% of DM) and a less severe negative dietary cation-anion difference (DCAD; >-8 mEq/100 g), whereas greatest colostrum yield from PP cows was associated with low crude protein (≤13.5% of DM). In addition, a moderate proportion of the diet with particle length ≥19 mm (15.3-19.1%) was associated with lowest colostrum yield from PP and MPS cows. Highest colostrum Brix % was associated with prepartum dietary factors of low neutral detergent fiber (≤39.0% of DM) and high proportion of the diet with particle length ≥19 mm (>19.1%). In addition, low starch (≤18.5% of DM) and low and moderate DCAD level (≥-15.9 mEq/100 g) were associated with greatest Brix % from PP cows, whereas moderate DCAD (-15.9 to -8.0 mEq/100 g) was associated with greatest Brix % from MPS cows. Prepartum serum nonesterified fatty acid concentration ≥290 µEq/L was associated with increased colostrum yield, but prepartum serum glucose concentration and body condition score were not associated with colostrum yield or Brix %. These data provide nutritional and metabolic variables to consider when troubleshooting colostrum production on farms.
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Lactancia , Leche , Animales , Bovinos , Femenino , Embarazo , Alimentación Animal/análisis , Calostro , Dieta/veterinaria , Ácidos Grasos/metabolismo , Leche/metabolismo , New York , Periodo Posparto/metabolismoRESUMEN
The objectives of this study were to evaluate the abundance and viability of leukocytes, the abundance of microRNA, and the activity of the complement pathway in (1) colostrum following heat-treatment or freezing, and (2) colostrum, transition milk, and mature milk. In experiment 1, composite colostrum samples were harvested from individual cows (n = 14) on a commercial dairy farm in NY and split into 3 aliquots using single-use colostrum bags. One aliquot was immediately cooled on ice following harvest (RAW) and stored at 4°C overnight, one was heat-treated for 60 min at 60°C (HT) before being cooled on ice and stored at 4°C overnight, and one was frozen at -20°C overnight (FR). The following morning, all samples were warmed to 40°C before further processing. In experiment 2, cows were sampled in a longitudinal study where composite samples were collected from colostrum (first milking, n = 23), transition milk (3 to 4 d postpartum, n = 13), and mature milk (6 to 7 d postpartum, n = 13). In both experiments colostrum was harvested from the first milking within 8 h of calving and samples were processed within 14 h of collection. Colostral leukocytes were isolated before viability was determined by trypan blue exclusion and manual differential cell counts were performed. Extracellular vesicles were isolated from whey by ultracentrifugation to isolate and quantify microRNA. Activity of the alternative complement pathway was determined in casein-depleted whey by semi-solid phase hemolysis assay. Somatic cell counts were determined for all raw samples. Macrophages and neutrophils made up the greatest proportion of leukocytes in colostrum followed by lymphocytes. Lymphocyte proportion increased as colostrum transitioned to mature milk, but overall somatic cell numbers declined concurrently. Viable cells were not isolated from HT or FR samples. Abundance of microRNA isolated from transition and mature milk was decreased compared with colostrum, did not differ between HT and RAW, but was increased in FR compared with RAW. Alternative complement pathway activity was decreased in HT, but not FR compared with RAW, and was not measurable in transition or mature milk. Postharvest heat-treatment and freezing of colostrum eliminated viable colostral leukocytes and affected microRNA abundance and complement activity. Leukocyte proportions, microRNA abundance, and complement activity changed as colostrum transitioned to mature milk. Although there were clear changes in the colostral components under study in relation to treatment and transition to mature milk, the biological significance of the described treatment effects and temporal changes were not investigated here.
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MicroARNs , Leche , Embarazo , Femenino , Bovinos , Animales , Calostro , Calor , Congelación , Hielo , Estudios Longitudinales , Leucocitos , LactanciaRESUMEN
BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multisystem illness characterized by substantial reduction in function accompanied by profound unexplained fatigue not significantly relieved by rest, post-exertional malaise, and other symptoms. Reduced natural killer (NK) cell count and cytotoxicity has been investigated as a biomarker for ME/CFS, but few clinical laboratories offer the test and multi-site verification studies have not been conducted. METHODS: We determined NK cell counts and cytotoxicity in 174 (65%) ME/CFS, 86 (32%) healthy control (HC) and 10 (3.7%) participants with other fatigue associated conditions (ill control [IC]) from the Multi-Site Clinical Assessment of ME/CFS (MCAM) study using an assay validated for samples shipped overnight instead of testing on day of venipuncture. RESULTS: We found a large variation in percent cytotoxicity [mean and (IQR) for ME/CFS and HC respectively, 34.1% (IQR 22.4-44.3%) and 33.6% (IQR 22.9-43.7%)] and no statistically significant differences between patients with ME/CFS and HC (p-value = 0.79). Analysis stratified on illness domain measured with standardized questionnaires did not identify an association of NK cytotoxicity with domain scores. Among all participants, NK cytotoxicity was not associated with survey results of physical and mental well-being, or health factors such as history of infection, obesity, smoking, and co-morbid conditions. CONCLUSION: These results indicate this assay is not ready for clinical implementation and studies are needed to further explore immune parameters that may be involved in the pathophysiology of ME/CFS.
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Síndrome de Fatiga Crónica , Canales Catiónicos TRPM , Humanos , Células Asesinas Naturales , Antígeno CD146RESUMEN
Hypocalcemia induced by immune activation is a conserved response across mammalian species; however, administration of Ca is discouraged in other species as it is associated with increased morbidity and mortality. Early postpartum cows experience a decrease in circulating Ca concentration following acute inflammation. Corrective Ca therapy during the transition period, particularly in dairy cows experiencing acute disease, is common practice. However, the effect of Ca administration on the inflammatory response during acute immune activation is unknown. Our objective was to compare the clinical, inflammatory, and metabolic response to an intravenous (IV) lipopolysaccharide (LPS) challenge between postpartum cows infused, or not, with IV Ca to maintain eucalcemia. Cows (n = 14, 8 ± 1 d in milk) were enrolled in a matched-pair randomized controlled design to receive IV Ca (IVCa) or sterile 0.9% NaCl (CTRL) during an IV LPS challenge (0.040 or 0.045 µg of LPS/kg of body weight over 1 h). Ionized Ca (iCa) was monitored cow-side, and IV Ca infusion was adjusted in a eucalcemic clamp for 12 h following the start of LPS infusion. Cows were monitored during the 24 h following challenge and serial blood samples were collected to quantify concentrations of glucose, ß-hydroxybutyrate, nonesterified fatty acids, urea nitrogen, cytokines, acute-phase proteins, and cortisol. Blood iCa concentration decreased to 0.87 ± 0.03 mM in CTRL during challenge, and by design, iCa concentration was maintained within 3% of baseline in IVCa. Body temperature, heart rate, and respiratory rate were monitored for 24 h following the start of challenge and did not differ between groups. A treatment × time interaction was identified such that serum cortisol concentrations increased in both groups at 2 h but decreased to a greater extent at 6 h in IVCa compared with CTRL. Rumination time (min/h) over the first 12 h following challenge was greater in IVCa, but total rumination time in the 24 h following challenge did not differ from CTRL. Serum glucose and nonesterified fatty acid concentrations decreased, and ß-hydroxybutyrate and urea nitrogen concentrations increased over time, but did not differ between groups. Acute leukopenia occurred in both groups at 4 h before leukocytosis was observed at 24 h with total white blood cell counts returning to baseline within 72 h. Plasma concentrations of tumor necrosis factor (TNF) and interleukin-10 (IL-10) increased within 1 h following the start of challenge and did not differ between groups. Serum haptoglobin and serum amyloid A concentrations increased within the 24 h following challenge and were elevated through 72 h but did not differ between groups. Eucalcemia during the acute systemic inflammatory response did not alter the TNF or IL-10 cytokine response, or the acute-phase protein SAA and haptoglobin response in this LPS challenge model; however, eucalcemia was associated with a more rapid decline in cortisol response and greater rumination time in the first 12 h following challenge. We did not find evidence that eucalcemia exacerbated the inflammatory response in early postpartum cows, but Ca administration may alter the clinical response to acute systemic inflammation.
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Enfermedades de los Bovinos , Inflamación , Lactancia , Femenino , Bovinos , Animales , Lipopolisacáridos/farmacología , Interleucina-10/metabolismo , Hidrocortisona , Ácido 3-Hidroxibutírico , Haptoglobinas/metabolismo , Periodo Posparto , Leche/metabolismo , Glucosa/metabolismo , Inflamación/metabolismo , Inflamación/veterinaria , Citocinas/metabolismo , Proteínas de Fase Aguda/metabolismo , Proteína Amiloide A Sérica/metabolismo , Urea/metabolismo , Ácidos Grasos no Esterificados , Mamíferos , Enfermedades de los Bovinos/metabolismoRESUMEN
Hypocalcemia induced by immune activation is a conserved response among mammals. Early postpartum cows will experience decreased circulating Ca concentrations following acute immune activation; however, the cause for decreased Ca concentration is unknown. Our objectives were to (1) describe Ca dynamics following an intravenous (IV) LPS challenge in early postpartum cows, and (2) compare inflammatory-induced changes in Ca dynamics between IV Ca-treated cows and control cows. Cows (n = 14, 8 ± 1 d in milk) were enrolled in a matched-pair randomized controlled design to receive IV Ca (IVCa) in a eucalcemic clamp for 12 h, or 0.9% NaCl (CTRL) following an IV LPS infusion (0.040 or 0.045 µg of LPS/kg of body weight over 1 h). During the 24 h following LPS infusion, circulating concentrations of parathyroid hormone and serotonin were measured, serum and urine samples were collected to calculate urinary fractional excretion of Ca (FECa), and fecal samples were collected to calculate Ca apparent digestibility (ADCa) using amylase-treated and ash-corrected undigested neutral detergent fiber after 240 h (uNDFom240) as an internal marker. Changes in Ca intake and milk Ca secretion were also quantified and compared with baseline values. Cows were fasted during challenge and dry matter intake was 20 ± 5% less than baseline values on the day of challenge and did not differ between groups. On the day of challenge, milk Ca concentration increased, but milk yield decreased such that total Ca secreted in milk did not change from baseline. Urine FECa was low overall, but an interaction of treatment and time was identified such that FECa increased in IVCa but decreased in CTRL. Concentrations of parathyroid hormone increased and serotonin decreased following challenge. Fecal dry matter decreased from baseline, but did not differ between 6, 12, and 24 h, and did not differ between groups. An interaction of treatment and time was identified for ADCa and apparent digestibility of dry matter such that digestibility was decreased in CTRL but not IVCa at 6 h. Acute immune activation induced hypocalcemia in CTRL, and although urinary Ca excretion was not a primary cause, it is unclear to what degree hypocalcemia was due to altered ADCa. Eucalcemia appeared to alter adaptations in Ca homeostasis during immune activation as FECa was increased in IVCa animals.
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Enfermedades de los Bovinos , Hipocalcemia , Femenino , Bovinos , Animales , Calcio , Lipopolisacáridos/efectos adversos , Hipocalcemia/veterinaria , Serotonina , Periodo Posparto , Lactancia/fisiología , Leche , Calcio de la Dieta , Hormona Paratiroidea , Dieta/veterinaria , Mamíferos , Enfermedades de los Bovinos/inducido químicamenteRESUMEN
BACKGROUND: Many patients fail to receive adjuvant chemotherapy following pancreatic cancer surgery. This study implemented a multimodal, multidisciplinary approach to improving recovery after pancreatoduodenectomy (the 'Fast Recovery' programme) and measured its impact on adjuvant chemotherapy uptake and nutritional decline. The predictive accuracies of a bundle of frailty and physical performance assessments, with respect to the recipient of adjuvant chemotherapy, were also evaluated. RESULTS: The N = 44 patients treated after the introduction of the 'Fast Recovery' programme were not found to have a significantly higher adjuvant chemotherapy uptake than the N = 409 treated before the pathway change (80.5 vs. 74.3%, p = 0.452), but did have a significantly lower average weight loss at six weeks post-operatively (mean: 4.3 vs. 6.9 kg, p = 0.013). Of the pre-operative frailty and physical performance assessments tested, the 6-min walk test was found to be the strongest predictor of the receipt of adjuvant chemotherapy (area under the ROC curve: 0.91, p = 0.001); all patients achieving distances ≥ 360 m went on to receive adjuvant chemotherapy, compared to 33% of those walking < 360 m. CONCLUSIONS: The multimodal 'Fast Recovery' programme was not found to significantly improve access to adjuvant chemotherapy, but did appear to have benefits in reducing nutritional decline. Pre-operative assessments were found to be useful in identifying patients at risk of non-receipt of adjuvant therapies, with markers of physical performance appearing to be the best predictors. As such, these markers could be useful in targeting pre- and post-habilitation measures, such as physiotherapy and improved dietetic support.
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Fragilidad , Neoplasias Pancreáticas , Humanos , Terapia Combinada , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/cirugía , Quimioterapia Adyuvante/métodosRESUMEN
Adequate supply of high-quality colostrum is essential for calf health. Colostrum production, at first milking, varies between animals and seasons, but herd-level and management associations with colostrum production have not been well described. Our objectives were to (1) describe colostrum production and colostrum handling practices and (2) to identify individual cow, herd management, and environmental factors associated with colostrum production. A convenience sample of 19 New York Holstein dairy farms (620 to 4,600 cows) were enrolled in this observational study to describe colostrum production and to evaluate cow, management, and prepartum environmental factors associated with colostrum yield and Brix %. Herd owners or managers were given a colostrum management questionnaire, and farm personnel recorded individual colostrum yield and Brix % for primiparous (PP; n = 5,978) and multiparous (MPS; n = 13,228) cows between October 2019 and February 2021. Temperature, relative humidity, and light intensity were measured by sensors placed in each farm's close-up dry cow pens for the entire length of the study. Median colostrum yield for each farm ranged from 2.5 to 7.6 kg for PP and 4.0 to 7.7 kg for MPS cows. Mean Brix % from each farm ranged from 22.2 to 27.9% for PP and 22.0 to 28.8% for MPS cows. Lowest colostrum yield from PP animals was associated with calf sex (female) and colostrum Brix % (≤22%). Greatest colostrum yield from MPS cows was associated with colostrum Brix % (≤22%), calf sex (twin), dry period length (>67 d), gestation length (283-293 d), an alive calf, second parity, previous lactation length (>344 d) and previous lactation 305-d mature equivalent milk yield (>13,091 kg), heat and humidity exposure area under the curve (AUC) 7 d before calving (>69.2 average temperature-humidity index per 30-min interval), and light intensity AUC 14 d before calving (>154.2 average lux per 15-min interval). Greatest colostrum Brix % from PP animals was associated with calf sex (male), an alive calf, and light intensity AUC 14 d before calving (≤64.0 average lux per 15-min interval). Greatest colostrum Brix % from MPS cows was associated with dry period length (>67 d), an alive calf, 305-d mature equivalent milk yield of previous lactation (≤15,862 kg), gestation length (274-282 d), colostrum yield (<6 kg), fifth or greater parity, and heat and humidity exposure AUC 7 d before calving (≤50.1 average temperature-humidity index per 30-min interval). Dairy producers can use this information to recognize the variation in colostrum production and alter colostrum management programs in anticipation of periods of low production or quality.