The impact of 10-valent pneumococcal vaccine introduction on invasive disease in Fiji.

BACKGROUND: In 2012, Fiji introduced the 10-valent pneumococcal conjugate vaccine (PCV10). We assessed the impact of PCV10 on invasive pneumococcal disease (IPD), probable bacterial or pneumococcal meningitis (PBPM), meningitis and sepsis 3-5 years post-introduction. METHODS: Laboratory-confirmed IPD and PBPM cases were extracted from national laboratory records. ICD-10-AM coded all-cause meningitis and sepsis cases were extracted from national hospitalisation records. Incidence rate ratios were used to compare outcomes pre/post-PCV10, stratified by age groups: 1-23m, 2-4y, 5-9y, 10-19y, 20-54y, ≥55y. To account for different detection and serotyping methods in the pre-and post-PCV10 period, a Bayesian inference model estimated serotype-specific changes in IPD, using pneumococcal carriage and surveillance data. FINDINGS: There were 423 IPD, 1,029 PBPM, 1,391 all-cause meningitis and 7,611 all-cause sepsis cases. Five years post-PCV10 introduction, IPD declined by 60% (95%CI: 37%, 76%) in children 1-23m months old, and in age groups 2-4y, 5-9y, 10-19y although confidence intervals spanned zero. PBPM declined by 36% (95%CI: 21%, 48%) among children 1-23 months old, and in all other age groups, although some confidence intervals spanned zero. Among children <5y of age, PCV10-type IPD declined by 83% (95%CI; 70%, 90%) and with no evidence of change in non-PCV10-type IPD (9%, 95%CI; -69, 43%). There was no change in all-cause meningitis or sepsis. Post-PCV10, the most common serotypes in vaccine age-eligible and non-age eligible people were serotypes 8 and 23B, and 3 and 7F, respectively. INTERPRETATIONS: Our study demonstrates the effectiveness of PCV10 against IPD in a country in the Asia-Pacific of which there is a paucity of data. FUNDING: This study was support by the Department of Foreign Affairs and Trade of the Australian Government and Fiji Health Sector Support Program (FHSSP). FHSSP is implemented by Abt JTA on behalf of the Australian Government.

Presence and prevalence of UV related genetic mutations in uveal melanoma: similarities with cutaneous melanoma.

Ultraviolet (UV) radiation is an accepted etiological factor in cutaneous melanoma (CM), however its role in uveal melanoma (UM) is controversial. Partly as a consequence, CM and UM are often considered to be separate conditions, and advances in the treatment of CM have not led to joint clinical trials or parallel improvements in survival of UM. This study hypothesized that a subset of UM tumors displays evidence of genetic changes consistent with UV-related damage similar to that shown in CM. Analysis of the Broad Institute's Firebrowse depository of 80 UM samples and 343 CM samples, together with the Sanger Institute's Catalogue of Somatic Mutations in Cancer depository of 995 UM and 12,447 CM samples was undertaken to identify the most frequently mutated genes, mutation types, and specific nucleotide variants (SNVs) in each condition. Somatic mutation data were cross-correlated and shared mutations assessed against known effects of UV radiation. The proportion of samples with C>T substitutions (a classic genetic marker of UV-related damage) was higher in UM than CM on both DNA strands (17.0% vs 13.1%, p=0.038). The most frequently encountered cross-correlated mutated genes between UM and CM were, in order, BRAF, NRAS, TP53, CDKN2A, TERT, PTEN, ARID2, and KMT2C, with multiple common BRAF point mutations. Each cross-correlated mutation, and each common point mutation in BRAF, was associated with UV-related mechanistic changes. These findings support the hypothesis that the etiology of a substantial minority of UMs may be more UV dependent than previously recognized.

Current Evidence for the Prevention of Endophthalmitis in Anti-VEGF Intravitreal Injections.

Intravitreal injection of a therapeutic substance is the most common procedure performed in ophthalmology. It has a low incidence of serious complications but is associated with a small chance of endophthalmitis. Although the rate of endophthalmitis is between 0.019% and 0.09%, the associated visual morbidity is often devastating. Procedural changes have evolved over the years to improve patient comfort and reduce injection-related injury and infection. Despite the availability of published evidence, there remains considerable variations and lack of consensus in practical clinical settings. In addition, emerging literature concerning the use of speculums, the use of prophylactic topical antibiotics, and the setting of injections continues to impact the ophthalmologist's injection practice. This article provides an up to date assessment of various aspects of the procedure such as the setting, ventilation, type of anaesthetic, and control of sterility during the procedure; including discussions on performing bilateral eye same-day injections and the use of antibiotics.

Systematic Assessment of Clinical Methods to Diagnose and Monitor Diabetic Retinal Neuropathy.

PURPOSE: Diabetic retinal neuropathy refers to retinal neural tissue damage occurring before the structural retinal changes of diabetic retinopathy and fulfils many of the criteria for causality for the subsequent vasculopathy. Developing reliable means of measuring neuronal damage in diabetes may be important in efforts to prevent retinopathy of a clinically significant and irreversible stage. This study aimed at systematically assessing current clinical measurements of diabetic retinal neuropathy so that future studies may utilise a consensual battery of tests in studying this poorly understood disease state between a healthy retina and one that is retinopathic. METHODS: A systematic search of the medical literature since 1984 was performed on PUBMED and EMBASE, and the evidence supporting each identified method as an indicator for clinically important diabetic retinal neuropathy was graded relatively as compelling, medium, or weak according to criteria assessing its relationship to subsequent diabetic retinopathy, quality of supporting studies, and published reproducibility. RESULTS: The systematic search yielded 6432 results. Subsequent assessment by two independent investigators identified 601 multiple subject studies in humans assessing clinical aspects of the retinal structure, function, or psychophysics in the prediabetic retina. The 933 separate instances of clinical methods assessed as being supported by relatively "compelling" evidence included colour vision changes, flash ERG b-wave latency, flash multifocal b-wave latency, scotopic b-wave and oscillatory potentials in ERG, and contrast sensitivity. CONCLUSION: The results showed moderately poor quality of extant evidence and indicate the best clinical methods for assessing diabetic retinal neuropathy that remain to be confirmed. This is the first systematic assessment of the medical literature aiming at assessing the breadth and validity of these methods and represents an early step in identifying and developing clinical endpoints for use in trials designed to identify at-risk patients or prevent diabetic retinopathy.

Assessing surface water flood risk and management strategies under future climate change: Insights from an Agent-Based Model.

Climate change and increasing urbanization are projected to result in an increase in surface water flooding and consequential damages in the future. In this paper, we present insights from a novel Agent Based Model (ABM), applied to a London case study of surface water flood risk, designed to assess the interplay between different adaptation options; how risk reduction could be achieved by homeowners and government; and the role of flood insurance and the new flood insurance pool, Flood Re, in the context of climate change. The analysis highlights that while combined investment in property-level flood protection and sustainable urban drainage systems reduce surface water flood risk, the benefits can be outweighed by continued development in high risk areas and the effects of climate change. In our simulations, Flood Re is beneficial in its function to provide affordable insurance, even under climate change. However, the scheme does face increasing financial pressure due to rising surface water flood damages. If the intended transition to risk-based pricing is to take place then a determined and coordinated strategy will be needed to manage flood risk, which utilises insurance incentives, limits new development, and supports resilience measures. Our modelling approach and findings are highly relevant for the ongoing regulatory and political approval process for Flood Re as well as for wider discussions on the potential of insurance schemes to incentivise flood risk management and climate adaptation in the UK and internationally.

A change in the trend in dosulepin usage following the introduction of a prescribing indicator but not after two national safety warnings.

WHAT IS KNOWN AND OBJECTIVE: The tricyclic antidepressant dosulepin has been associated with an increased risk of toxicity in overdose compared with other antidepressants. In the UK, the MHRA and NICE have issued advice on the prescribing of dosulepin, and a National Prescribing Indicator (NPI) to monitor usage was introduced in Wales in 2011. The aim of this study was to assess whether trends in dosulepin usage in Wales and NE England changed following the two pieces of safety guidance and the introduction of the National Prescribing Indicator in Wales. METHODS: Primary care dosulepin usage in the 12 months prior to and following MHRA safety advice (in 2007), NICE guideline CG90 (in 2009) and the introduction of the NPI (in 2011) was obtained. Usage was measured using defined daily doses (DDDs) per 1000 prescribing units (PUs). The trends in the 12 months prior to and following the introduction of prescribing advice and the NPI were compared using an autoregressive integrated moving average (ARIMA) model. RESULTS AND DISCUSSION: In Wales, the trend in dosulepin usage did not change significantly prior to and following the MHRA advice: -0·18 and -0·43 DDDs/1000PUs per month, respectively (P = 0·07), or prior to and following NICE CG90: -0·30 and -0·49 DDDs/1000PUs per month, respectively (P = 0·35). In the 12 months prior to and following the introduction of the NPI, the trend was -0·45 and -0·98 DDDs/1000PUs per month, respectively (P = 0·001). In NE England, the trend did not alter significantly following the NICE advice or the introduction of the NPI in Wales. WHAT IS NEW AND CONCLUSION: The trend in dosulepin usage in Wales altered significantly following the introduction of the NPI, but not after the other prescribing advice. This association, coupled with the absence of a significant change in NE England over the same period, provided some evidence of the effectiveness of the NPI in prompting a change in prescribing behaviour in Wales.

Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents.

BACKGROUND: In 2008 Fiji implemented a nationwide Human Papillomavirus (HPV) vaccine campaign targeting all girls aged 9-12 years through the existing school-based immunisation program. Parents of vaccine-eligible girls were asked to provide written consent for vaccination. The purpose of this study was to describe parents' knowledge, experiences and satisfaction with the campaign, the extent to which information needs for vaccine decision-making were met, and what factors were associated with vaccine consent. METHODS: Following vaccine introduction, a cross-sectional telephone survey was conducted with parents of vaccine-eligible girls from randomly selected schools, stratified by educational district. Factors related to vaccine consent were explored using Generalised Estimating Equations. RESULTS: There were 560 vaccine-eligible girls attending the participating 19 schools at the time of the campaign. Among these, 313 parents could be contacted, with 293 agreeing to participate (93.6%). Almost 80% of participants reported having consented to HPV vaccination (230/293, 78.5%). Reported knowledge of cervical cancer and HPV prior to the campaign was very low. Most respondents reported that they were satisfied with their access to information to make an informed decision about HPV vaccination (196/293, 66.9%). and this was very strongly associated with provision of consent. Despite their young age, the vaccine-eligible girls were often involved in the discussion and decision-making. Most consenting parents were satisfied with the campaign and their decision to vaccinate, with almost 90% indicating they would consent to future HPV vaccination. However, negative media reports about the vaccine campaign created confusion and concern. Local health staff were cited as a trusted source of information to guide decision-making. Just over half of the participants who withheld consent cited vaccine safety fears as the primary reason (23/44, 52.3%). CONCLUSION: This is the first reported experience of HPV introduction in a Pacific Island nation. In a challenging environment with limited community knowledge of HPV and cervical cancer, media controversy and a short lead-time for community education, Fiji has implemented an HPV vaccine campaign that was largely acceptable to the community and achieved a high level of participation. Community sensitisation and education is critical and should include a focus on the local health workforce and the vaccine target group.

Technical Note: Collection and preparation techniques change nutrient composition of masticate collected from esophageally fistulated cattle.

Two experiments determined effects of collection and preparation techniques on nutrient composition of masticate samples from esophageally fistulated cattle. In Exp. 1, 12 esophageally fistulated cattle were maintained on 2 precollection diets, high CP (24% CP; = 6) or low CP (7.7% CP; = 6), for 8 d. On d 9, the esophageal plug was removed, screen bottom bags were attached, and each cow was offered fresh grass. Immediately after fresh grass sample collection was complete, dry grass (hay) was offered and a sample was collected. Blood samples were collected and analyzed for serum urea nitrogen concentration. Masticate samples of both fresh and dry grass were divided and each was either squeezed by hand until no more saliva could be removed or remained unsqueezed. In Exp. 2, 10 esophageally fistulated cattle were fitted with either screen ( = 5) or solid ( = 5) bottom collection bags after removal of the esophageal plug and presented grass hay, fresh grass, alfalfa hay, or fresh alfalfa. In Exp. 1, the precollection diet did not affect ( = 0.49) CP content of masticate even though serum urea nitrogen tended to be greater ( = 0.08) for high- vs. low-CP precollection diets. Forage harvest type offered (fresh vs. hay) interacted ( = 0.01) with preparation technique (squeezed vs. unsqueezed) for CP, where CP decreased in squeezed fresh samples ( < 0.001) but not in squeezed grass hay samples ( = 0.98). In Exp. 2, ingestion greatly increased levels of ash ( < 0.001). Crude protein was greater ( < 0.004) before ingestion for all samples except grass hay ( = 0.43). Levels of NDF were similar before and after ingestion ( > 0.15) for all samples except fresh alfalfa, which was greater after ingestion ( = 0.002). Ingestion status did not affect in vitro OM disappearance (IVOMD; > 0.34) except for grass hay, which was greater after ingestion ( < 0.001). Bag type (screen vs. solid) did not affect ash and NDF ( > 0.31), except for fresh alfalfa, which were greater ( < 0.03) for solid bottom bags. Bag type did not affect alfalfa CP ( = 0.71) but did affect grass CP, which was lower ( = 0.02) for solid bottom bags. Bag type did not affect IVOMD ( > 0.33). More ( = 0.01) fresh forage than hay was recovered through the esophageal opening. Previous diet did not impact masticate samples but squeezing impacted CP levels of high-quality forage and therefore should not be performed. Nutrient values should be reported on an OM basis.

Effects of stocking rate on forage nutrient composition of Nebraska Sandhills upland range when grazed in early summer.

Twelve 2-ha, Nebraska Sandhills upland range paddocks were used in a 2-yr study to determine effects of stocking rate on grazed forage nutrient value in early summer. Paddocks contain a mixture of native cool- and warm-season grasses with forbs as a minor component. Stocking rates were 0 (control), 0.57 (light), and 0.85 (heavy) animal unit months per ha, respectively. Three esophageally fistulated cows collected diet samples on May 14 (d 0), May 21 (d 7), May 28 (d 14), and June 4 (d 21) in 2013 and 2014. Ten quadrats per paddock were clipped and separated into current or previous year growth on each diet sampling date. All samples were analyzed for CP, NDF, and in vitro OM disappearance, which was adjusted to an in vivo OM basis (). For diet samples, treatment interacted ( < 0.001) with sampling date for CP, NDF, and IVOMD. However, treatment and date did not interact ( ≥ 0.32) for clipped samples. Diets collected in control paddocks had greater ( < 0.05) IVOMD and CP and lower NDF compared with light and heavy stocking rate paddocks on d 7, 14, and 21 but light stocking rate paddocks did not differ ( ≥ 0.26) from heavy stocking rate paddocks on any sampling day except d 21 NDF ( = 0.03). In general, previous year growth IVOMD, CP, and NDF were not affected ( ≥ 0.11) by treatment. Generally, current year growth IVOMD and CP were not affected ( ≥ 0.22) by treatment. Current year growth NDF did not differ ( = 0.23) among stocking rates on d 0, but control paddock had lower ( = 0.02) NDF than light and heavy on d 7, 14, and 21. In stocked paddocks, diet samples had greater ( < 0.01) IVOMD and CP and lower NDF than current and previous year growth except IVOMD on d 0 where diet and current year growth did not differ ( = 0.34). Generally, in control paddocks, current year growth and diet samples had greater ( < 0.01) IVOMD and CP than previous year growth. Control paddocks had greater ( < 0.01) forage accumulation than stocked paddocks on d 7, 14, and 21; however, light and heavy stocked paddocks did not differ ( ≥ 0.29). On d 0 it was estimated that 96% of the diet was current year growth and only 4% previous year growth, whereas on d 21, 70% of the diet was current year growth vs. 30% previous year growth. Stocking pastures decrease current year growth forage mass and therefore diet nutritive value by forcing cattle to consume diets containing previous year growth in early summer.

Stearidonic and γ-linolenic acids in echium oil improves glucose disposal in insulin resistant monkeys.

Echium oil (EO) contains stearidonic acid (18:4), a n-3 polyunsaturated fatty acids (PUFAs), and gamma-linolenic acids (18:3), a n-6 PUFA that can be converted to long chain (LC)-PUFAs. We aimed to compare a safflower oil (SO)-enriched diet to EO- and fish oil (FO)-enriched diets on circulating and tissue PUFAs levels and glycemic, inflammatory, and cardiovascular health biomarkers in insulin resistant African green monkeys. In a Latin-square cross-over study, eight monkeys consumed matched diets for 6 weeks with 3-week washout periods. Monkeys consuming FO had significantly higher levels of n-3 LC-PUFAs and EO supplementation resulted in higher levels of circulating n-3 LC-PUFAs and a significant increase in dihomo-gamma linolenic acid (DGLA) in red blood cells and muscle. Glucose disposal was improved after EO consumption. These data suggest that PUFAs in EO supplementation have the capacity to alter circulating, RBC and muscle LC-PUFA levels and improve glucose tolerance in insulin-resistant monkeys.

Effects of 35% corn wet distillers grains plus solubles in steam-flaked and dry-rolled corn-based finishing diets on animal performance, carcass characteristics, beef fatty acid composition, and sensory attributes.

Fifty-four individually-fed Hereford-Angus cross steers (initial BW = 308 ± 9 kg) were used in an unbalanced randomized block design with a 2 × 2 factorial treatment arrangement to determine effects of corn processing method and corn wet distillers grains plus solubles (WDGS) inclusion in finishing diets on animal performance, carcass and beef characteristics, and sensory attributes. Dietary treatments included steam-flaked corn- (SFC) and dry-rolled corn (DRC)-based finishing diets containing 0 or 35% WDGS (DM basis; 0SFC and 35SFC, 0DRC and 35DRC, respectively). Yellow grease was used to equilibrate fat content of diets. Steers were fed 174 d, and were harvested on a single date when the mean ultrasound fat thickness was estimated to be 1.30 cm. No interactions between corn processing and WDGS were observed for performance or carcass characteristics (P ≥ 0.11). Final BW (556 ± 14 kg) and ADG (1.43 ± 0.06 kg) were not affected (P ≥ 0.25) by dietary treatment. Steers fed SFC-based diets consumed less feed, and were 10.6% more efficient (P < 0.01) than those fed DRC-based diets. Including WDGS in finishing diets improved feed efficiency of steers consuming both SFC- and DRC-based diets (P ≤ 0.04). Dietary treatment did not affect HCW, dressing percentage, fat thickness, or yield grade (P ≥ 0.27). Including WDGS in finishing diets decreased the concentration of 16:1cis-9, 18:1cis-9, and 18:1cis-11 fatty acids, and tended (P ≤ 0.10) to increase total fat concentration of steaks compared with diets without WDGS. A corn processing method by WDGS interaction was detected for 18:1trans-11 where steaks from 0DRC diets had decreased concentrations compared with other diets. There were no dietary effects on palatability attributes (P > 0.20). Livery-organy aromatics (P = 0.03) and sweet basic tastes (P = 0.01) in steaks from the 35SFC treatment were more intense than in other treatments, but were barely detectable. Thiobarbituric acid reactive substances tended to be greater in steaks from steers fed WDGS after 5 d of storage (P = 0.10), and were greater after 7 d. (P < 0.01). Inclusion of WDGS used in this experiment improved G:F with minimal impacts on carcass characteristics. Both WDGS inclusion and corn processing method impacted fatty acid composition. However, diet had minimal impacts on palatability attributes. When compared with diets fat-equilibrated with yellow grease, the primary concern with incorporating WDGS appears to be decreased shelf-life after 5 d of storage.

Effects of twenty percent corn wet distillers grains plus solubles in steam-flaked and dry-rolled corn-based finishing diets on heifer performance, carcass characteristics, and manure characteristics.

Two hundred sixty-four crossbred heifers (initial BW = 354 kg ± 0.5) were used to determine effects of corn processing method and wet distillers grains plus solubles (WDGS) inclusion in finishing diets on animal performance, carcass characteristics, and manure characteristics. The study was conducted as a randomized complete block with a 2 × 2 factorial arrangement of treatments. Dietary treatments included steam-flaked corn (SFC)- and dry-rolled corn (DRC)-based finishing diets containing 0 or 20% WDGS (0SFC, 20SFC, 0DRC, and 20DRC, respectively). Heifers averaged 154 d on feed and were marketed in 3 groups. There were no interactions between corn processing method and WDGS detected (P ≥ 0.29) for any performance or carcass response variables. Heifers fed diets containing WDGS tended to have greater final BW (P = 0.10) and increased G:F (P = 0.08) compared with heifers fed diets without WDGS. Heifers fed SFC-based diets consumed 7% less feed (P < 0.01) and were 9% more efficient (P < 0.01) than heifers fed DRC-based diets. Carcass characteristics were not affected by corn processing method or WDGS inclusion (P ≥ 0.16). Intakes of OM, N, P, and K were greater (P ≤ 0.05) for heifers fed DRC-based diets than those fed SFC-based diets, which resulted in greater net accumulation of the nutrients in the manure (P ≤ 0.04). Heifers fed diets containing WDGS had greater (P < 0.01) intakes of N, P, and K than heifers fed diets without WDGS. As a result, a greater net accumulation of P and K (P ≤ 0.03) and N (P = 0.10) were present in the manure from cattle fed diets containing WDGS compared with those fed diets without WDGS. There was no interaction (P ≥ 0.16) between corn processing and WDGS on N volatilization losses. Nitrogen volatilization losses from manure (expressed as a percentage of intake and g·heifer(-1)·d(-1)) were greater (P < 0.01) for heifers fed SFC-based diets than heifers fed DRC-based diets. Feeding DRC-based finishing diets to heifers resulted in increased manure production and nutrient excretion and decreased N volatilization. Both corn processing method and WDGS inclusion affected animal performance and manure characteristics.

Mucopolysaccharidosis type VI in a Miniature Poodle-type dog caused by a deletion in the arylsulphatase B gene.

AIM: To investigate and characterise an inborn error of metabolism in a dog with skeletal and ocular abnormalities. METHODS: A 2.5-year-old small male Miniature Poodle-like dog was presented with gross joint laxity and bilateral corneal opacities. Clinical examination was augmented by routine haematology, serum chemistry, radiographs, pathology, enzymology and molecular genetic studies. Euthanasia was requested when the dog was 3 years of age because of progressively decreasing quality of life. RESULTS: Radiology revealed generalised epiphyseal dysplasia, malformed vertebral bodies, luxation/subluxation of appendicular and lumbosacral joints with hypoplasia of the odontoid process and hyoid apparatus. These clinical and radiographic findings, together with a positive urinary Berry spot test for mucopolysaccharides, and metachromatic granules in leucocytes, were indicative of a mucopolysaccharidosis (MPS), a lysosomal storage disease. Histological lesions included vacuolation of stromal cells of the cornea, fibroblasts, chondrocytes, macrophages and renal cells. The brain was essentially normal except for moderate secondary Wallerian-type degeneration in motor and sensory tracts of the hind brain. Dermatan sulphate-uria was present and enzymology revealed negligible activity of N-acetylgalactosamine-4-sulphatase, also known as arylsulphatase B, in cultured fibroblasts and liver tissue. A novel homozygous 22 base pair (bp) deletion in exon 1 of this enzyme's gene was identified (c.103_124del), which caused aframe-shift and subsequent premature stop codon. The "Wisdom pure breed-mixed breed" test reported the dog as a cross between a Miniature and Toy Poodle. CONCLUSIONS: The clinicopathological features are similar to those of MPS type VI as previously described in dogs, cats and other species, and this clinical diagnosis was confirmed by enzymology and molecular genetic studies. This is an autosomal recessively inherited lysosomal storage disease. CLINICAL RELEVANCE: The prevalence of MPS VI in Miniature or Toy Poodles in New Zealand and elsewhere is currently unknown. Due to the congenital nature of the disorder, malformed pups may be subject to euthanasia without investigation and the potential genetic problem in the breed may not be fully recognised. The establishment of a molecular genetic test now permits screening for this mutation as a basis to an informed breeding policy.

Use of dried distillers grains throughout a beef production system: effects on stocker and finishing performance, carcass characteristics, and fatty acid composition of beef.

A 2-yr study was conducted using a 3 × 2 factorial arrangement of treatments to evaluate the effects of feeding dried distillers grains throughout a beef production system on performance, carcass characteristics, and fatty acid profile of beef. Factors were wheat pasture supplement [no supplement (CON), dry-rolled corn (DRC), and dried distillers grains (DDG)] fed at 0.5% BW daily and finishing diet [steam-flaked corn based diet containing 0 (SFC) or 35% (35DDG) DDG]. Each year, 60 preconditioned Hereford steers (initial BW = 198 kg ± 3) grazed winter wheat pasture with or without supplement. Body weight gain was 8% greater for steers consuming DDG supplement compared with CON and DRC steers (P < 0.01). After the grazing period, pastures within supplement treatment were randomly assigned to SFC or 35DDG. There was no supplement by finishing diet interaction for any performance or carcass variable of interest (P ≥ 0.41). Previous supplementation on winter wheat affected BW at feedlot entry and adjusted G:F (P ≤ 0.05) but had no effect on finishing ADG or carcass traits (P ≥ 0.12). On a carcass-adjusted basis, steers consuming 35DDG had reduced final BW, ADG, G:F, and total BW gain throughout the system (P ≤ 0.04) compared with SFC. Additionally, steers consuming 35DDG had reduced HCW, dressing percent, and fat thickness (P ≤ 0.03) compared with SFC. There was a supplement by finishing diet interaction (P = 0.02) for 18:0, in which cattle supplemented with DRC and fed the SFC finishing diet had the lowest concentration of 18:0 but DRC supplemented steers fed the 35DDG diet had the greatest concentration. The interaction was not significant (P ≥ 0.18) for other fatty acids. Main effects of supplement and finishing diet affected (P ≤ 0.05) several other fatty acids of interest, particularly 18:2, which is associated with reduced flavor-stability of beef. The use of DDG as a supplement to wheat pasture resulted in greater ADG during wheat grazing and heavier BW at feedlot entry, but final BW was not different from CON or DRC groups. Feeding DDG at 35% DM in steam-flaked corn-based finishing diets reduced ADG, G:F, and HCW, and affected the fatty acid composition of beef.

Wet distillers grains plus solubles concentration in steam-flaked-corn-based diets: Effects on feedlot cattle performance, carcass characteristics, nutrient digestibility, and ruminal fermentation characteristics.

Two experiments were conducted to determine the effects of wet distillers grain plus solubles (WDG; <15% sorghum grain) concentration in steam-flaked corn (SFC) diets on feedlot performance, carcass characteristics, ruminal fermentation, and diet digestibility. In Exp. 1, six hundred crossbred steers (364 ± 35 kg of BW) were used in a randomized complete block design with 8 replications/treatment. Dietary treatments consisted of a dry-rolled corn (DRC) control diet without WDG, a SFC control without WDG, and SFC with 4 WDG concentrations (15, 30, 45, 60% DM basis) replacing SFC, cottonseed meal, urea, and yellow grease. Final BW, ADG, G:F, HCW, and 12th-rib fat depth were greater (P ≤ 0.05) for SFC compared with DRC. Dry matter intake tended (P = 0.06) to be greater for DRC compared with SFC. Final BW, ADG, G:F, HCW, 12th-rib fat depth, and marbling score decreased linearly (P < 0.01) with increasing WDG concentration. In Exp. 2, six ruminally and duodenally cannulated crossbred steers (481 ± 18 kg of BW) were used in a 6 × 6 Latin square design using the same diets as Exp. 1. Ruminal, postruminal, and total tract OM and NDF digestibility were not different (P > 0.14) for DRC compared with SFC. Ruminal and total tract starch digestibility were greater (P < 0.01) for SFC compared with DRC. Dry matter and OM intake were not different (P ≥ 0.43) among WDG treatments. Ruminal and total tract OM digestibility decreased linearly (P < 0.01) with increasing WDG concentration. Intake, ruminal digestibility, and total tract digestibility of NDF increased linearly (P < 0.01) with increasing WDG concentration. Starch intake decreased linearly (P < 0.01) with increasing WDG concentration. Ruminal starch digestibility increased (P = 0.01) with increasing concentration of WDG. Total tract starch digestibility decreased quadratically (P < 0.01) with increasing concentration of WDG. Feeding SFC improved steer performance compared with DRC. The concentration of WDG and corn processing method influences nutrient digestibility and ruminal fermentation. The addition of WDG in SFC-based diets appears to negatively affect animal performance by diluting the energy density of the diet.

Evaluation of performance, carcass characteristics, and sensory attributes of beef from finishing steers fed field peas.

Whole field peas were fed at 0, 10, 20, and 30% of DM to 139 yearling steers (British cross; 409 ± 31 kg of initial BW) for a 119-d finishing period. Carcass data and Choice grade strip loins (n = 98) were collected from a commercial abattoir in Lexington, Nebraska. Consumer sensory and Warner-Bratzler shear force analyses were performed on 2.5-cm strip steaks. No differences (P ≥ 0.17) were observed in final BW, ADG, DMI, and G:F of steers. Likewise, no differences (P ≥ 0.23) were observed for HCW, LM area, fat thickness at the 12th rib, yield grade, and marbling scores. However, KPH responded quadratically to increasing dietary amount of field peas (P = 0.02). Regarding the sensorial analysis, feeding peas linearly increased subjective tenderness (P < 0.01) and led to a quadratic response of overall like ratings (P = 0.01) and flavor like ratings (P = 0.12). Feeding peas did not alter (P ≥ 0.64) juiciness, but decreased shear force values linearly when quantities were increased (P = 0.02). These data suggest that feeding peas does not affect steer performance or carcass characteristics differently from dry-rolled corn, but does improve objective and subjective tenderness, overall desirability, and flavor of beef. Field peas could be fed to cattle and give positive attributes to the quality of the meat up to 30% inclusion in the diet.

The role of surgical therapy for pulmonary vein atresia in childhood.

UNLABELLED: The outcome for children with pulmonary vein atresia has been historically poor. This report describes clinical outcomes after surgical treatment of primary and secondary pulmonary vein atresia. All patients undergoing surgery for pulmonary vein atresia at Children's Hospital Boston from 1 January 2005 to 1 January 2009 were identified. The data available for analysis included demographic characteristics, findings based on cardiac catheterization and other imaging, clinical information, operative surgical intervention, and pulmonary vein histology. The study-specific information included the calculated number of atretic pulmonary veins as well as surgical interventions performed during the study period. The study end points included successful relief of pulmonary vein atresia, recurrence of pulmonary atresia or stenosis, overall pulmonary vein disease progression, and patient survival. A total of 16 patients with one or more pulmonary vein atresias were identified in the cardiac surgery registry database. Of these 16 patients, 5 had primary pulmonary atresia, and 11 had secondary atresia after repair of anomalous pulmonary venous drainage. Surgical recanalization of atretic pulmonary veins was achieved for more than 80% of the patients. At the most recent follow-up assessment, 7 (44%) of the 16 patients had recurrence of atresia. Five of the patients had development of new atresia in other previously healthy pulmonary veins. The median follow-up period was 4 months for primary and 17 months for secondary pulmonary vein atresia. The three main predictors of pulmonary vein disease progression after surgery were the presence of underlying lung disease (P = 0.036), prematurity (P = 0.035), and a history of recurrent pulmonary vein atresia. The overall mortality rate for the patients with primary or secondary pulmonary vein atresia was 56% at the most recent follow-up assessment (100% for the patients with primary vein atresia and 36% for the patients with secondary vein atresia). CONCLUSIONS: Surgical recanalization of pulmonary vein atresia is possible, but prognosis remains poor. Recurrence of atresia can take place as early as a few months in the presence of underlying lung disease, prematurity, or history of recurrent pulmonary vein atresia. Further research is needed to identify mechanisms for attaining and sustaining pulmonary vein patency after surgery.