Seasonal variations of physiological responses, milk production, and fatty acid profile of local crossbred cows in Tunisia.

The study investigates the seasonal variations of physiological responses, milk yield, milk composition, and milk fatty acid profile of local crossbred cows (Friesian × Brown Atlas) in northwestern Tunisia. A total of 80 multiparous cows from smallholder farmers were sampled between 2018 and 2019. The cows were feed the same diet ad libitum and exposed to the same Mediterranean climatic conditions. Weekly rectal temperature (RT; °C), respiratory rate (RR; rpm), and heart rate (HR; bpm) were measured per cow in each season. Individual milk yield and samples were recorded bi-weekly and collected in duplicate for chemical analyses. Milk fatty acids (FAs) were analyzed using gas chromatography-mass spectrometry (GC-MS). Results showed an increase (P < 0.05) in RT (+ 1.3%), RR (+ 12.1%), and HR (+ 9.9%) when the temperature-humidity index (THI) increased from winter (53.6) to summer (74.4) in response to heat stress. Milk yield did not vary significantly between seasons (8.3 L/day on average). Summer milk contained more fat (+ 7.8%) and log SCC (+ 13.7%). The proportion of the monounsaturated (31.2 vs. 27.2%) and polyunsaturated (4.29 vs. 3.86%) FAs decreased (P < 0.05) between winter and summer. Saturated FAs (64.5 vs. 67.7%) were higher (P < 0.05) in summer than in winter. Winter milk fat contained higher levels of C18:2cis-9 trans-11 (CLA) (0.73 vs. 0.56%) and ω-3 FA (0.83 vs. 0.63%), but a lower ω-6/ω-3 ratio (4.07 vs. 6.17%) compared to summer. As the cows were fed the same diet throughout the two seasons, the performances obtained were mainly due to the resistance of the local crossbred cow to the hot conditions. It is concluded that the local crossbred cow maintains its productivity and tolerate the hot Mediterranean climate.

Responses to melatonin of 2 breeds of dairy ewes in early lactation under autumn photoperiod conditions.

A total of 72 dairy ewes of 2 breeds (MN, Manchega, 72.4 ± 1.9 kg of body weight, n = 36; LC, Lacaune, 77.7 ± 2.3 kg of body weight; n = 36) were used to evaluate the lactational effects of melatonin implants in early lactation and under the short-day photoperiod conditions of autumn (experiment was centered on the winter solstice). Ewes lambed in autumn and were penned indoors in 12 balanced groups of 6 ewes by breed, body weight, age, and number of lambs, and randomly assigned to a 2 × 2 × 3 factorial design (treatment × breed × replicate). Ewes suckled their lambs for 28 d. Treatments were (1) melatonin (MEL), which received 1 subcutaneous implant of melatonin (18 mg/ewe) in the ear base at 35 ± 1 d (1 wk after lamb weaning), and (2) control, which did not receive any treatment. Ewes were fed ad libitum a total mixed ration (forage:concentrate, 60:40) and machine milked twice daily. Daily milk yield was automatically recorded from d 29 to 105 of lactation and sampled every 2 wk for composition. Jugular blood was sampled for plasma hormone analyses at 30, 50, 80, 110, and 124 d of lactation. Body reserves were assessed every 2 wk. Feed intake was measured by pen during 3 separated periods after the start of the treatments (wk 2 to 3, wk 6 to 7, and wk 10 to 11). Feed intake, and milk yield and composition varied by breed, but no MEL effects were detected on dry matter intake, milk yield, milk composition, or fat and protein standardized milk in either breed. As a result of the unique composition of the implants and the variable body weights of the ewes, the MEL treatment dose (on average, 0.24 mg/kg of body weight) was 6.8% greater in the MN (lighter) than in the LC (heavier) ewes. Plasmatic melatonin markedly increased in the MEL-treated ewes (on average, 111%), but despite the amount of MEL used, the MN responded greatly compared with the LC ewes (150 vs. 63%, respectively). No differences in basal plasmatic melatonin were detected between breeds (6.4 ± 1.1 pg/mL, on average), indicating the greater responsiveness to the implants of the lighter MN ewes. Plasmatic prolactin tended to decrease in the MEL-treated ewes (-35%, on average), but the effect was significant only in the MN ewes (-54%), in agreement with their greater response to MEL. No effects of MEL treatment were detected on plasmatic IGF-I in either breed. Moreover, body reserves did not vary by effect of MEL treatment or breed throughout the experiment. In conclusion, the use of exogenous melatonin as MEL implants, together with the endogenous melatonin naturally produced under short-day photoperiod conditions, had no effects on the early-lactation performances of dairy sheep, despite their breed and level of production.

Efficacy of marine cyanobacterium Oxynema thaianum ALU PBC5 against multi drug resistant Gram negative pathogens.

AIM: Emergence of extended antibiotic resistance among several human bacterial pathogens often leads to the failure of existing antibiotics to treat bacterial infections worldwide. Hence, the present study is aimed to explore antibacterial activity of marine cyanobacterium against MDR pathogens. METHODS AND RESULTS: The cyanobacterial samples were collected and isolated from Thondi Palk Strait region. The isolate was subjected to polarity based solvent extraction and checked for their antibacterial activity against test bacterial pathogens. The active principles from chloroform extract of Oxynema thaianum (CEOT) were partially purified through thin layer chromatography (TLC). The active principle with highest activity was further characterized by FTIR, high performance liquid chromatography (HPLC) and gas chromatography mass spectrometry (GC-MS) analysis. Among the eight extracts tested, CEOT showed effective zone of clearance against ESBL producing Escherichia coli and Klebsiella pneumoniae in disc diffusion method. In TLC, all the purified five fractions were eluted and tested for their antibacterial activity against test pathogens. The third fraction showing maximum activity was subjected to HPLC analysis for checking its purity. In GC-MS analysis, 9-octadecenoic acid, methyl ester and hexadecanoic acid were identified as the major chemical compounds. CONCLUSION: Hence, the present study was concluded that O. thaianum ALU PBC5 is a promising agent to treat ESBL producing MDR bacterial pathogens. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the pioneer study on screening and isolation of bioactive compounds from the marine cyanobacteria against MDR pathogens such as E. coli and K. pneumoniae. Here, 9-octadecenoic acid, methyl ester and hexadecanoic acid were identified as the major chemical compounds through TLC, FTIR, HPLC and GC-MS. From this screen, we identified the bioactive compounds against ESBL producing multidrug resistant pathogens such as E. coli and K. pneumoniae.

Polycyclic aromatic hydrocarbons, antibiotic resistance genes, toxicity in the exposed to anthropogenic pressure soils of the Southern Russia.

The influence of anthropogenic pollution, particularly with polycyclic aromatic hydrocarbons (PAHs) on soil toxicity and spread of antibiotic resistance genes (ARGs) is extremely important nowadays. We studied 20 soil samples from a technogenically polluted site, municipal solid wastes (MSW) landfills, and rural settlements in the southwestern part of the Rostov Region of Russia. A close correlation was established between the results of biosensor testing for integral toxicity, the content of genes for the biodegradation of hydrocarbons, and the concentration of PAHs in soils. The relation between the quantitative content of ARGs and the qualitative and quantitative composition of PAHs has not been registered. Soils subjected to different types of the anthropogenic pressure differed in PAHs composition. The technogenic soils are the most polluted ones. These soils are enriched with 5 ring PAHs and carry the maximum variety of assayed ARGs, despite the fact that they do not receive household or medical waste.

Introduction of an interactive tool (the Dental Trauma Guide) in the undergraduate dental teaching to manage traumatic dental injuries.

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are complex problems where lack of proper care may result in serious complications. The need to improve the management of TDI is a frequently addressed concern. Methods of improvement in their diagnosis and management are continuously evolving. The interactive Internet tool, the Dental Trauma Guide (DTG), helps to simplify diagnostic and management dilemmas. However, it is not a freely available tool. The aim of the current study was to assess the knowledge and diagnostic skills of undergraduate dental students with access to the DTG compared with students without such access, in order to validate and promote this tool in dental education. MATERIALS AND METHODS: Two groups of students were randomly selected where one group of final year dental undergraduate students were exposed to lectures, demonstrations, discussions and tutorials on the management of TDI according to the standard undergraduate curriculum in Sri Lanka. Another test group of 21 students were provided with access to DTG during their training in paediatric dentistry. At the end of the study period, students were assessed on their knowledge of TDI using MCQs (Multiple Choice Questions) and OSCEs (Objective Structured Clinical Examination), based on the DTG. RESULTS: The students with access to the DTG were more knowledgeable in providing the correct answers to three out of the seven OSCE questions. Evaluation based on the MCQs did not reveal a significant difference (p = .913). However, users of the DTG showed a statistically significant difference with better overall knowledge based on their answers (p = .028). Following this period of evaluation, all of the students were provided with access to the DTG to supplement their learning experience. CONCLUSION: The Dental Trauma Guide is a useful supplementary tool for undergraduate students to arrive at a correct diagnosis and treatment plan for TDI.

Suppression of prolactin and reduction of milk secretion by effect of cabergoline in lactating dairy ewes.

The effects of cabergoline, an ergot derivative and dopamine receptor agonist, were investigated in 30 ewes of 2 dairy breeds (Manchega; MN, n = 15; Lacaune; LC, n = 15). Ewes were in a similar late-lactation stage, but differed in milk yield according to breed (MN vs. LC, 1.02 ± 0.03 vs. 2.27 ± 0.05 kg/d). Treatments consisted of a single intramuscular injection of cabergoline at different doses per ewe. Cabergoline doses (per ewe) were: low (0.56 mg), high (1.12 mg), and control (CON; 0 mg; 1 mL of saline). Milk yield was recorded daily (d -14 to 25), milk and blood were sampled, and udder traits were measured from d -2 to 14 after injection. No local reaction at the injection site, nor behavior and metabolic indicators of the ewes were detected after the cabergoline injection, but milk yield fell rapidly in both breeds (MN vs. LC, -54% vs. -27%) when compared with CON ewes. Cabergoline effects progressively disappeared after d 5, and no milk yield differences between treatments were detected from d 8 to 25 after injection. Milk fat and protein contents increased similarly (22% and 23%; respectively) in both breeds and at both cabergoline doses until d 5, and the effects disappeared thereafter. Plasma prolactin (PRL) decreased dramatically in the low- and high-treated ewes the day after injection when compared with the CON ewes, and reached values below the detection limit of the assay between d 1 and 5, increasing similarly thereafter. On d 14, PRL values were 58% greater in the low- and high-treated than in the CON ewes, showing that PRL concentrations rebounded when the cabergoline effects ceased. Total udder volume correlated with milk accumulated in the udder (r = 0.77) of all groups of ewes throughout the experiment, suggesting its use as a noninvasive method for the estimation of milk stored in the udder. Udder volume was similar for the low and high ewes, but both values were lower than those of the CON ewes from d 1 to 14 after injection. No other effects on udder size were detected. Cabergoline dramatically inhibited PRL secretion and decreased milk yield and udder volume of lactating dairy ewes. The low dose of cabergoline was as effective as the high dose in the 2 breeds of dairy ewes. These results suggest the use of cabergoline to facilitate the decrease of milk production in dairy ewes (e.g., dry-off, illness care), although further research in pregnant dairy ewes and during the following lactation is still needed.

Differentiation malignant from benign pericardial effusion with diffusion-weighted MRI.

AIM: To differentiate malignant from benign pericardial effusion with diffusion-weighted magnetic resonance imaging (MRI). MATERIAL AND METHODS: Retrospective analysis of diffusion-weighted MRI of 41 patients (29 men and 12 women; mean 39 years) with pericardial effusion. Apparent diffusion coefficient (ADC) of pericardial fluid, and associated pericardial mass or pleural effusion was calculated. ADC of pericardial fluid was calculated by two observers and correlated with cytological analysis. Receiver operating characteristic curves and Bland-Altman plots were used. RESULTS: There was significant differences in the ADCs between benign and malignant pericardial effusions (p=0.001) by both observers. Mean ADC of malignant pericardial effusions was (2.92±0.29 and 2.86±0.33×10-3 mm2/s) and of benign effusions was (3.36±0.31 and 3.28±0.28×10-3 mm2/s) for both observers, respectively. The cut-off values of the ADC used for differentiating malignant from benign pericardial effusion were 3.25 and 3.05×10-3 mm2/s with areas under curve of 0.839 and 0.791, sensitivities of 88.2% and 70.6%, specificities of 69.6% and 73.9%, and accuracies of 78% and 72.5% for both observers, respectively. The overall interobserver agreement of the ADC value of pericardial effusion by both observers was significant (r=0.808, p=0.001). The interobserver agreement of malignant effusion (r=0.861, p=0.001) and benign effusion was significant (r=0.659, p=0.001). The ADC of pleural effusion is well correlated with ADC of pericardial effusion (r=0.088, p=0.001). CONCLUSION: The ADC value is a non-invasive imaging parameter that can be used for differentiation of malignant from benign pericardial fluid.

Enhanced supply of methionine or arginine alters mechanistic target of rapamycin signaling proteins, messenger RNA, and microRNA abundance in heat-stressed bovine mammary epithelial cells in vitro.

Heat stress (HS) causes reductions in milk production, but it is unclear whether this effect is due to reduced number or functional capacity (or both) of mammary cells. Methionine supplementation improves milk protein, whereas Arg is taken up in excess by mammary cells to produce energy and nonessential AA that can be incorporated into milk protein. To evaluate molecular mechanisms by which mammary functional capacity is affected by HS and Met or Arg, mammary alveolar (MAC-T) cells were incubated at thermal-neutral (37°C) or HS (42°C) temperatures. Treatments were optimal AA profiles (control; Lys:Met = 2.9:1.0; Lys:Arg = 2.1:1.0), control plus Met (Lys:Met = 2.5:1.0), or control plus Arg (Lys:Arg = 1.0:1.0). After incubation for 6 h, cells were harvested and RNA and protein were extracted for quantitative real-time PCR and Western blotting. Protein abundance of mechanistic target of rapamycin (MTOR), eukaryotic initiation factor 2a, serine-threonine protein kinase (AKT), 4E binding protein 1 (EIF4EBP1), and phosphorylated EIF4EBP1 was lower during HS. The lower phosphorylated EIF4EBP1 with HS would diminish translation initiation and reduce protein synthesis. Both Met and Arg had no effect on MTOR proteins, but the phosphorylated EIF4EBP1 decreased by AA, especially Arg. Additionally, Met but not Arg decreased the abundance of phosphorylated eukaryotic elongation factor 2, which could be positive for protein synthesis. Although HS upregulated the heat shock protein HSPA1A, the apoptotic gene BAX, and the translation inhibitor EIF4EBP1, the mRNA abundance of PPARG, FASN, ACACA (lipogenesis), and BCL2L1 (antiapoptotic) decreased. Greater supply of Met or Arg reversed most of the effects of HS occurring at the mRNA level and upregulated the abundance of HSPA1A. In addition, compared with the control, supply of Met or Arg upregulated genes related to transcription and translation (MAPK1, MTOR, SREBF1, RPS6KB1, JAK2), insulin signaling (AKT2, IRS1), AA transport (SLC1A5, SLC7A1), and cell proliferation (MKI67). Upregulation of microRNA related to cell growth arrest and apoptosis (miR-34a, miR-92a, miR-99, and miR-184) and oxidative stress (miR-141 and miR-200a) coupled with downregulation of fat synthesis-related microRNA (miR-27ab and miR-221) were detected with HS. Results suggest that HS has a direct negative effect on synthesis of protein and fat, mediated in part by coordinated changes in mRNA, microRNA, and protein abundance of key networks. The positive responses with Met and Arg raise the possibility that supplementation with these AA during HS might have a positive effect on mammary metabolism.

Effects of shearing 2 breeds of dairy ewes during lactation under mild winter conditions.

The lactational effects of shearing (CO, control unshorn; SH, shorn) were investigated in 48 dairy ewes of 2 breeds (Lacaune, LC, n = 24; Manchega, MN, n = 24) having a similar stage of lactation (120 ± 6 d in milk) and body frame (65.1 ± 1.5 kg of body weight and 2.4 ± 0.1 body condition score), but differing in fleece and milk production. Ewes were penned indoors, adapted to the diet (alfalfa hay ad libitum and fixed amount of concentrate), and allocated for 30 d in 8 balanced groups to which the experimental treatments were applied. All ewes were sheared on the same day. Feed intake by pen and milk yield by ewe were recorded daily. Individual samples of milk (d -3, 3, 5, 7, and 15) and blood (d -7, 3, 7, and 15) were collected, as well as body weight and body condition score measured (d -15, 0, and 15), related to shearing. Pooled milk samples per pen were also collected before and after shearing for milk fatty acid analysis (d -3 and 15). Average temperatures in the barn before (12.6 ± 0.7°C) and after (13.7 ± 0.4°C) shearing were mild. Fleece was heavier in MN than in LC (1.04 ± 0.10 vs. 0.75 ± 0.09 kg/ewe) and tended to cover more body surface in MN than in LC ewes. Responses to shearing varied according to breed, the rectal temperature after shearing only decreasing significantly in the MN (-0.36 ± 0.09°C). Feed intake increased in the LC-SH (5%), when compared with LC-CO, but did not vary in the MN ewes. Ingestibility of the alfalfa hay, expressed as filling units for sheep and monitored in 2 groups of 6 dry and unshorn ewes of each breed (73.0 ± 2.5 kg of body weight and 3.1 ± 0.2 body condition score), was constant throughout the experiment (0.99 ± 0.03 filling units for sheep/kg of dry matter). Regarding milk production, LC-SH ewes yielded 10% more milk (1.38 ± 0.06 vs. 1.52 ± 0.05 kg/d) than LC-CO ewes, but no differences were detected in MN ewes (0.74 ± 0.03 kg/d, on average). No differences in the concentration of major milk components by effect of the shearing treatment were detected in either breed, but LC-SH ewes yielded 9% more milk protein than did LC-CO ewes. No relevant effects of shearing were detected on milk fatty acid profiles, although MN ewes showed lower C4:0, C6:0, C14:0, trans-11 and trans-12 C18:1 contents than did LC ewes. Moreover, no changes by effect of shearing were detected in plasma glucose, nonesterified fatty acids, cortisol, or insulin values in either breed, or in body weight or body condition score. In conclusion, shearing dairy ewes during lactation under mild winter conditions is a suitable management option that may increase feed intake and milk production, without deleterious effects on milk composition.

Isolation, diversity, and biotechnological potential of rhizo- and endophytic bacteria associated with mangrove plants from Saudi Arabia.

Marine bacteria have been exceptional sources of halotolerant enzymes since decades. The aim of the present study was to isolate bacteria producing hydrolytic enzymes from seven different mangroves collected from the coastal area of Thuwal, Jeddah, Saudi Arabia, and to further screen them for other enzymatic and antifungal activities. We have isolated 46 different rhizo- and endophytic bacteria from the soil, roots, and leaves of the mangroves using different enzymatic media. These bacterial strains were capable of producing industrially important enzymes (cellulase, protease, lipase, and amylase). The bacteria were screened further for antagonistic activity against fungal pathogens. Finally, these bacterial strains were identified on the basis of the16S rDNA sequence. Taxonomic and phylogenetic analysis revealed 95.9-100% sequence identity to type strains of related species. The dominant phylum was Gammaproteobacteria (γ-Proteobacteria), which comprised 10 different genera - Erwinia, Vibrio, Psychrobacter, Aidingimonas, Marinobacter, Chromohalobacter, Halomonas, Microbulbifer, and Alteromonas. Firmicutes was the second dominant phylum, which contained only the genus Bacillus. Similarly, only Isoptericola belonged to Actinobacteria. Further these enzyme-producing bacteria were tested for the production of other enzymes. Most of the active strains showed cellulytic and lipolytic activities. Several were also active against fungal pathogens. Our results demonstrated that the mangroves represent an important source of potentially active bacteria producing enzymes and antifungal metabolites (bioactive products). These bacteria are a source of novel halophilic enzymes and antibiotics that can find industrial and medicinal use.

Four-factor prothrombin complex concentrates in paediatric patients - a retrospective case series.

BACKGROUND: Four-factor prothrombin complex concentrates (PCCs) are human plasma-derived products containing coagulation factors II, VII, IX and X as well as proteins C and S. They are licensed in many countries for treatment of bleeding or urgent periprocedural prophylaxis in patients with acquired deficiency of prothrombin complex coagulation factors, typically in the setting of vitamin K antagonist (VKA) usage. Efficacy and safety have been established in the adult population, but there is little information in the literature regarding their use for these indications in the paediatric population. We report on our institution's experience with these products in paediatric patients over a five-year period. METHOD: A retrospective case series study was performed, whereby any patient aged 0-16 years who had received PCCs between 2009 and 2013 was identified. Details regarding patient demographics, indications, dose, relevant bloodwork, additional blood products used, adverse effects and general outcomes were obtained through chart and blood bank reviews. RESULTS: A total of sixteen patients were included in our study, fourteen of whom received PCCs in a perioperative setting. Eleven received product for VKA reversal. Significant improvements in PT INRs were observed in those patients who had timely bloodwork drawn. Five others received product for reasons not related to VKA use. One thrombotic event was detected a day following PCC infusion, but causation is uncertain. CONCLUSION: Within study limitations, when used for rapid reversal of VKAs, efficacy and safety of these products in a paediatric population appear to be similar to those reported in adults.

Characteristics of severe acute respiratory infectionassociated hospitalization in Yemen, 2014/15.

This study aims to describe etiological agents, demographic details of patients, seasonality and underlying conditions among patients hospitalized due to viral severe acute respiratory infection (SARI) in Yemen. We carried out a retrospective descriptive analysis of data from January 2014 to December 2015. Nasopharyngeal swabs were taken from each patient for laboratory testing. A total of 1346 diagnostic specimens were tested, of which 733 (54%) were positive for influenza viruses. Influenza A(H3) and A(H1N1) pdm09 predominated. Respiratory syncytial virus (RSV) was reported predominantly among children (41%). Males (61%) were more affected than females. The median age was 1 year (range 0.5-94.0). The median length of hospitalization was 6 days. Chronic cardiovascular disease was the most commonly reported underlying condition, but 67% had no documented underlying disease. Respiratory viruses, particularly RSV, adenovirus and influenza, were commonly associated with hospitalization for SARI.

Using wireless rumen sensors for evaluating the effects of diet and ambient temperature in nonlactating dairy goats.

Sixteen Murciano-Granadina dairy goats, provided with wireless rumen sensors for pH and temperature, were used to assess the rumen environment variations produced by extreme forage to concentrate diets (experiment 1) and climatic conditions (experiment 2). To avoid the interference of feed intake, goats were fed at maintenance level. Rumen sensors were inserted by surgery and programmed to collect and store rumen pH and temperature every 30min. In experiment 1, 8 dry goats (38.6±2.3kg of body weight) in tiestalls were divided into 2 groups and fed at maintenance level with 2 diets varying in forage-to-concentrate ratio [high forage (HF) 70:30; low forage (LF) 30:70] according to a crossover design. Diets were offered once daily for 4h and tap water (4 L, 9.8±0.4°C) was offered for only 30min at 6h after feeding. Rectal temperatures were recorded 3 times during the day. Rumen pH fell immediately after feeding, reaching a nadir depending on the diet (HF=6.35±0.07 at 11h after feeding; LF=6.07±0.07 at 6h after feeding) and being on average greater (0.31±0.06) in HF than LF goats. No diet effects were detected in rectal (38.2±0.1°C) and ruminal (38.9±0.1°C) mean temperatures, which were positively correlated. Rumen temperature dramatically changed by feeding (1.4±0.1°C) and drinking (-3.4±0.1°C), and 2h were necessary to return to the fasting value (38.2±0.1°C). In experiment 2, 8 dry goats (43.9±1.0kg of body weight) were kept in metabolic cages, fed a 50:50 diet and exposed to 2 climatic conditions following a crossover design. Conditions were thermoneutral (TN; 20 to 23°C day-night) and heat stress (HS; 12-h day at 37°C and 12-h night at 30°C). Humidity (40±5%) and photoperiod (light-dark, 12-12h) were similar. Goats were fed at maintenance level, the feed being offered once daily and water at ambient temperature was freely available. Intake, rectal temperature, and respiratory rate were recorded 3 times daily. Despite no differing in dry matter intake, rumen pH was lower in HS than in TN goats (-0.12±0.04). On the contrary, rumen temperature (0.3±0.1°C), rectal temperature (0.4±0.1°C), respiratory rate (77±5 breaths/min), and water intake (3.2±0.7 L/d) had a greater increase in HS than TN, which might indicate an altered microbial fermentation under high temperature conditions. In conclusion, wireless bolus sensors proved to be a useful tool to monitor rumen pH and temperature as affected by different feeding and climatic conditions.

Barriers to the delivery of optimal antidiabetic therapy in the Middle East and Africa.

BACKGROUND: The prevalence of type 2 diabetes is increasing worldwide, but developing nations will bear a disproportionate share of this burden. Countries in the Middle East and Africa are in a state of transition, where marked disparities of income and access to education and healthcare exist, and where the relatively young populations are being exposed increasingly to processes of urbanisation and adverse changes in diet that are fuelling the diabetes epidemic. Optimising diabetes care in these nations is crucial, to minimise the future burden of complications of diabetes. METHODS: We have reviewed the barriers to effective diabetes care with special relevance to countries in this region. RESULTS: The effects of antidiabetic treatments themselves are unlikely to differ importantly in the region compared with elsewhere, but economic inequalities within countries restrict access to newer treatments, in particular. Values relating to family life and religion are important modifiers of the physician-patient interaction. Also, a lack of understanding of diabetes and its treatments by both physicians and patients requires more and better diabetes education, delivered by suitably qualified health educators. Finally, sub-optimal processes for delivery of care have contributed to a lack of proper provision of testing and follow-up of patients in many countries. CONCLUSION: Important barriers to the delivery of optimal diabetes care exist in the Middle East and Africa.

Implementing electronic identification for performance recording in sheep: I. Manual versus semiautomatic and automatic recording systems in dairy and meat farms.

With the aim of assessing the secondary benefits of using electronic identification (e-ID) in sheep farms, we compared the use of manual (M), semiautomatic (SA), and automatic (AU) data-collection systems for performance recording (i.e., milk, lambing, and weight) in 3 experiments. Ewes were identified with visual ear tags and electronic rumen boluses. The M system consisted of visual ear tags, on-paper data recording, and manual data uploading to a computer; the use of a personal digital assistant (PDA) for data recording and data uploading was also done in M. The SA system used a handheld reader (HHR) for e-ID, data recording, and uploading. Both PDA and HHR used Bluetooth for uploading. The AU system was only used for body weight recording and consisted of e-ID, data recording in an electronic scale, and data uploading. In experiment 1, M and SA milk-recording systems were compared in a flock of 48 dairy ewes. Ewes were milked once- (×1, n=24) or twice- (×2, n=24) daily in a 2 × 12 milking parlor and processed in groups of 24. Milk yield (1.21 ± 0.04 L/d, on average) was 36% lower in ×1 than ×2 ewes and milk recording time correlated positively with milk yield (R(2)=0.71). Data transfer was markedly faster for PDA and HHR than for M. As a result, overall milk recording time was faster in SA (×1=12.1 ± 0.6 min/24 ewes; ×2=22.1 ± 0.9 min/24 ewes) than M (×1=14.9 ± 0.6 min/24 ewes; ×2=27.9 ± 1.0 min/24 ewes). No differences between PDA and HHR were detected. Time savings, with regard to M, were greater for ×2 than for ×1 (5.6 ± 0.2 vs. 2.8 ± 0.1 min per 24 ewes, respectively), but similar for PDA and HHR. Data transfer errors averaged 3.6% in M, whereas no errors were found in either SA system. In experiment 2, 73 dairy and 80 meat ewes were monitored at lambing using M and SA. Overall time for lambing recording was greater in M than SA in dairy (1.67 ± 0.06 vs. 0.87 ± 0.04 min/ewe) and meat (1.30 ± 0.03 vs. 0.73 ± 0.03 min/ewe) ewes. Recording errors were greater in dairy (9.6%) than in meat (1.9%) ewes. Data uploading errors only occurred in M (4.9%). In experiment 3, 120 dairy and 120 meat ewes were weighed using M and AU systems. In both flocks, mean BW recording and data uploading times, as well as overall BW recording time (0.63 ± 0.02 and 0.25 ± 0.01 min/ewe, respectively) were greater in M than in AU, and uploading errors only occurred in M (8.8%). In conclusion, HHR and PDA systems were time-effective for performance recording, both saving time and improving data accuracy. Working load and time for ewe identification were faster in HHR but it did not affect the performance recording time. The PDA was the fastest device for data download. Further research will evaluate the costs of implementing e-ID for performance recording and other uses in sheep farms.

Implementing electronic identification for performance recording in sheep: II. Cost-benefit analysis in meat and dairy farms.

Costs and secondary benefits of implementing electronic identification (e-ID) for performance recording (i.e., lambing, body weight, inventory, and milk yield) in dairy and meat ewes were assessed by using the results from a previous study in which manual (M), semiautomatic (SA), and automatic (AU) data collection systems were compared. Ewes were identified with visual ear tags and electronic rumen boluses. The M system used visual identification, on-paper data recording, and manual data uploading to a computer. The SA system used e-ID with a handheld reader in which performances were typed and automatic uploaded to a computer. The use of a personal digital assistant (PDA) for recording and automatic data uploading, which transformed M in a SA system, was also considered. The AU system was only used for BW recording and consisted of e-ID, automatic data recording in an electronic scale, and uploading to a computer. The cost-benefit study was applied to 2 reference sheep farms of 700 meat ewes, under extensive or intensive production systems, and of 400 dairy ewes, practicing once- or twice-a-day machine milkings. Sensitivity analyses under voluntary and mandatory e-ID scenarios were also included. Benefits of using e-ID for SA or AU performance recording mainly depended on sheep farm purpose, number of test days per year, handheld reader and PDA prices, and flock size. Implementing e-ID for SA and AU performance recording saved approximately 50% of the time required by the M system, and increased the reliability of the data collected. Use of e-ID increased the cost of performance recording in a voluntary e-ID scenario, paying only partially the investment made (15 to 70%). For the mandatory e-ID scenario, in which the cost of e-ID devices was not included, savings paid 100% of the extra costs needed for using e-ID in all farm types and conditions. In both scenarios, the reader price was the most important extra cost (40 to 90%) for implementing e-ID in sheep farms. Calculated extra costs of using the PDA covered more than 100% of the implementation costs in all type of sheep farms, indicating that this device was cost-effective for sheep-performance recording.

Thermographic variation of the udder of dairy ewes in early lactation and following an Escherichia coli endotoxin intramammary challenge in late lactation.

A total of 83 lactating dairy ewes (Manchega, n=48; Lacaune, n=35) were used in 2 consecutive experiments for assessing the ability of infrared thermography (IRT) to detect intramammary infections (IMI) by measuring udder skin temperatures (UST). In experiment 1, ewes were milked twice daily and IRT pictures of the udder were taken before and after milking at 46 and 56d in milk (DIM). Milk yield was 1.46 ± 0.04 L/d, on average. Detection of IMI was done using standard bacterial culture by udder half at 15, 34, and 64 DIM. Twenty-two ewes were classified as having IMI in at least one udder half, the others being healthy (142 healthy and 24 IMI halves, respectively). Four IMI halves had clinical mastitis. No UST differences were detected by IMI and udder side, being 32.94 ± 0.04°C on average. Nevertheless, differences in UST were detected for breed (Lacaune - Manchega=0.35 ± 0.08°C), milking process moment (after - before=0.13 ± 0.11°C), and milking schedule (p.m. - a.m.=0.79 ± 0.07°C). The UST increased linearly with ambient temperature (r=0.88). In experiment 2, the UST response to an Escherichia coli O55:B5 endotoxin challenge (5 µg/udder half) was studied in 9 healthy Lacaune ewes milked once daily in late lactation (0.58 ± 0.03 L/d; 155 ± 26 DIM). Ewes were allocated into 3 balanced groups of 3 ewes to which treatments were applied by udder half after milking. Treatments were (1) control (C00, both udder halves untreated), (2) half udder treated (T10 and C01, one udder half infused with endotoxin and the other untreated, respectively), and (3) treated udder halves (T11, both udder halves infused with endotoxin). Body (vaginal) temperature and UST, milk yield, and milk composition changes were monitored by udder half at different time intervals (2 to 72 h). First local and systemic signs of IMI were observed at 4 and 6h postchallenge, respectively. For all treatments, UST increased after the challenge, peaking at 6h in T 0055 (which differed from that in C00, C01, and T10), and decreased thereafter without differences by treatment. Vaginal temperature and milk somatic cell count increased by 6h postchallenge, whereas lactose content decreased, in the endotoxin-infused udder halves. Effects of endotoxin on lactose and somatic cell count values were detectable in the infused udder halves until 72 h. In conclusion, despite the accuracy of the camera (± 0.15°C) and the moderate standard errors of the mean obtained for UST measures (± 0.05 to 0.24°C), we were unable to discriminate between healthy and infected (subclinically or clinically) udder halves in dairy ewes.

Identifying the major bacteria causing intramammary infections in individual milk samples of sheep and goats using traditional bacteria culturing and real-time polymerase chain reaction.

Use of DNA-based methods, such as real-time PCR, has increased the sensitivity and shortened the time for bacterial identification, compared with traditional bacteriology; however, results should be interpreted carefully because a positive PCR result does not necessarily mean that an infection exists. One hundred eight lactating dairy ewes (56 Manchega and 52 Lacaune) and 24 Murciano-Granadina dairy goats were used for identifying the main bacteria causing intramammary infections (IMI) using traditional bacterial culturing and real-time PCR and their effects on milk performance. Udder-half milk samples were taken for bacterial culturing and somatic cell count (SCC) 3 times throughout lactation. Intramammary infections were assessed based on bacteria isolated in ≥2 samplings accompanied by increased SCC. Prevalence of subclinical IMI was 42.9% in Manchega and 50.0% in Lacaune ewes and 41.7% in goats, with the estimated milk yield loss being 13.1, 17.9, and 18.0%, respectively. According to bacteriology results, 87% of the identified single bacteria species (with more than 3 colonies/plate) or culture-negative growth were identical throughout samplings, which agreed 98.9% with the PCR results. Nevertheless, the study emphasized that 1 sampling may not be sufficient to determine IMI and, therefore, other inflammatory responses such as increased SCC should be monitored to identify true infections. Moreover, when PCR methodology is used, aseptic and precise milk sampling procedures are key for avoiding false-positive amplifications. In conclusion, both PCR and bacterial culture methods proved to have similar accuracy for identifying infective bacteria in sheep and goats. The final choice will depend on their response time and cost analysis, according to the requirements and farm management strategy.

Association between FTO, MC4R, SLC30A8, and KCNQ1 gene variants and type 2 diabetes in Saudi population.

Recent genome wide association studies identified many loci in several genes that have been consistently associated with type 2 diabetes mellitus in various ethnic populations. Among the genes that were most strongly associated with diabetes were fat mass- and obesity-associated, melanocortin 4 receptor, solute carrier family 30 member 8 (SLC30A8), and a member of the potassium voltage-gated channels. In the present study, we examined the association between variants in fat mass- and obesity-associated [rs9939609 (A/T)], melanocortin 4 receptor [rs17782313 (C/T), and rs12970134 (A/G)], SLC30A8 [rs13266634 (C/T)], and a member of the potassium voltage-gated channels [rs2237892(C/T)] genes in diabetes patients from Saudi Arabia. Genotypes were determined using the TaqMan single-nucleotide polymorphism genotype analysis technique. Minor allele frequency of the 4 variants tested was comparable between type 2 diabetes cases and controls. We observed an association between allele variants of SLC30A8 [rs13266634 (C/T)] and type 2-diabetes (P = 0.04). The other single-nucleotide polymorphisms examined in this study showed moderate or no correlation with diabetes in Saudis. Our data indicate that the SLC30A8 polymorphisms are associated with type 2 diabetes in the Saudi population. There is no evidence supporting an association between variants in the fat mass- and obesity-associated and melanocortin 4 receptor, and a member of the potassium voltage-gated channels genes and type 2 diabetes in the Saudi population.

Emerging artificial intelligence-aided diagnosis and management methods for ischemic strokes and vascular occlusions: A comprehensive review.

Large-vessel occlusion (LVO) stroke is a promising field for the use of AI, especially machine learning (ML) because optimal results are highly dependent on timely diagnosis, communication, and treatment. In order to better understand the current state of artificial intelligence (AI) in relation to LVO strokes, its efficacy, and potential future applications, we searched relevant literature to perform a comprehensive evaluation of the topic. The databases PubMed, Embase, and Scopus were extensively searched for this review. Studies were then screened using title and abstract criteria and duplicate studies were excluded. By using pre-established inclusion and exclusion criteria, it was decided whether or not to include full-text papers in the final analysis. The studies were analyzed, and the relevant information was retrieved. In recognizing LVO on computed tomography, ML approaches were very accurate. There is a shortage of AI applications for thrombectomy patient selection, despite the fact that certain research accurately evaluates individual patient eligibility for endovascular therapy. Machine learning algorithms may reasonably predict clinical and angiographic outcomes as well as associated factors. AI has shown promise in the diagnosis and treatment of people who have just suffered a stroke. However, the usefulness of AI in management and forecasting remains restricted, necessitating more studies into machine learning applications that can guide decision making in the future.