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1.
Nature ; 620(7973): 336-343, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37558848

RESUMO

Anthropogenic climate change is predicted to severely impact the global hydrological cycle1, particularly in tropical regions where agriculture-based economies depend on monsoon rainfall2. In the Horn of Africa, more frequent drought conditions in recent decades3,4 contrast with climate models projecting precipitation to increase with rising temperature5. Here we use organic geochemical climate-proxy data from the sediment record of Lake Chala (Kenya and Tanzania) to probe the stability of the link between hydroclimate and temperature over approximately the past 75,000 years, hence encompassing a sufficiently wide range of temperatures to test the 'dry gets drier, wet gets wetter' paradigm6 of anthropogenic climate change in the time domain. We show that the positive relationship between effective moisture and temperature in easternmost Africa during the cooler last glacial period shifted to negative around the onset of the Holocene 11,700 years ago, when the atmospheric carbon dioxide concentration exceeded 250 parts per million and mean annual temperature approached modern-day values. Thus, at that time, the budget between monsoonal precipitation and continental evaporation7 crossed a tipping point such that the positive influence of temperature on evaporation became greater than its positive influence on precipitation. Our results imply that under continued anthropogenic warming, the Horn of Africa will probably experience further drying, and they highlight the need for improved simulation of both dynamic and thermodynamic processes in the tropical hydrological cycle.


Assuntos
Mudança Climática , Modelos Climáticos , Secas , Chuva , Temperatura , Ciclo Hidrológico , Água , Atmosfera/química , Dióxido de Carbono/análise , Mudança Climática/história , Secas/estatística & dados numéricos , Sedimentos Geológicos/química , História Antiga , Umidade , Quênia , Lagos/química , Tanzânia , Termodinâmica , Clima Tropical , Volatilização , Água/análise
2.
PLoS Med ; 21(4): e1004369, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38607977

RESUMO

BACKGROUND: Older adults with diabetes are at high risk of severe hypoglycemia (SH). Many machine-learning (ML) models predict short-term hypoglycemia are not specific for older adults and show poor precision-recall. We aimed to develop a multidimensional, electronic health record (EHR)-based ML model to predict one-year risk of SH requiring hospitalization in older adults with diabetes. METHODS AND FINDINGS: We adopted a case-control design for a retrospective territory-wide cohort of 1,456,618 records from 364,863 unique older adults (age ≥65 years) with diabetes and at least 1 Hong Kong Hospital Authority attendance from 2013 to 2018. We used 258 predictors including demographics, admissions, diagnoses, medications, and routine laboratory tests in a one-year period to predict SH events requiring hospitalization in the following 12 months. The cohort was randomly split into training, testing, and internal validation sets in a 7:2:1 ratio. Six ML algorithms were evaluated including logistic-regression, random forest, gradient boost machine, deep neural network (DNN), XGBoost, and Rulefit. We tested our model in a temporal validation cohort in the Hong Kong Diabetes Register with predictors defined in 2018 and outcome events defined in 2019. Predictive performance was assessed using area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC) statistics, and positive predictive value (PPV). We identified 11,128 SH events requiring hospitalization during the observation periods. The XGBoost model yielded the best performance (AUROC = 0.978 [95% CI 0.972 to 0.984]; AUPRC = 0.670 [95% CI 0.652 to 0.688]; PPV = 0.721 [95% CI 0.703 to 0.739]). This was superior to an 11-variable conventional logistic-regression model comprised of age, sex, history of SH, hypertension, blood glucose, kidney function measurements, and use of oral glucose-lowering drugs (GLDs) (AUROC = 0.906; AUPRC = 0.085; PPV = 0.468). Top impactful predictors included non-use of lipid-regulating drugs, in-patient admission, urgent emergency triage, insulin use, and history of SH. External validation in the HKDR cohort yielded AUROC of 0.856 [95% CI 0.838 to 0.873]. Main limitations of this study included limited transportability of the model and lack of geographically independent validation. CONCLUSIONS: Our novel-ML model demonstrated good discrimination and high precision in predicting one-year risk of SH requiring hospitalization. This may be integrated into EHR decision support systems for preemptive intervention in older adults at highest risk.


Assuntos
Diabetes Mellitus , Hipoglicemia , Humanos , Idoso , Registros Eletrônicos de Saúde , Estudos Retrospectivos , Hipoglicemia/diagnóstico , Hipoglicemia/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Hospitalização , Aprendizado de Máquina
3.
Clin Radiol ; 77(5): e346-e355, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35289292

RESUMO

AIM: To provide an updated systematic review concerning the impact of endoscopic ultrasound (EUS) in the modern era of oesophageal cancer staging. MATERIALS AND METHODS: To update the previous systematic review, databases including MEDLINE and EMBASE were searched and studies published from 2005 onwards were selected. Studies reporting primary data in patients with oesophageal or gastro-oesophageal junction cancer who underwent radiological staging and treatment, regardless of intent, were included. The primary outcome was the reported change in management after EUS. Secondary outcomes were recurrence rate and overall survival. Two reviewers extracted data from included articles. This study was registered with PROSPERO (CRD42021231852). RESULTS: Eighteen studies with 11,836 patients were included comprising 2,805 patients (23.7%) who underwent EUS compared to 9,031 (76.3%) without EUS examination. Reported change of management varied widely from 0% to 56%. When used, EUS fine-needle aspiration precluded curative treatment in 37.5%-71.4%. Overall survival improvements ranged between 121 and 639 days following EUS intervention compared to patients without EUS. Smaller effect sizes were observed in a randomised controlled trial, compared to larger differences reported in observational studies. CONCLUSION: Current evidence for the effectiveness of EUS in oesophageal cancer pathways is conflicting and of limited quality. In particular, the extent to which EUS adds value to contemporary cross-sectional imaging techniques is unclear and requires formal re-evaluation.


Assuntos
Neoplasias Esofágicas , Neoplasias Gástricas , Endossonografia/métodos , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/terapia , Junção Esofagogástrica/patologia , Humanos , Estadiamento de Neoplasias , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Gástricas/patologia
4.
Clin Radiol ; 76(6): 458-464, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33752881

RESUMO

AIM: To evaluate variation in the pre-pandemic use of endoscopic ultrasound (EUS) for oesophageal cancer diagnosis and treatment planning up to 2019, and which factors contributed to this. MATERIALS AND METHODS: A UK-wide online survey of oesophagogastric multidisciplinary team lead clinicians was undertaken to determine perceptions towards, and the use of, EUS to aid staging and treatment planning in oesophageal cancer. RESULTS: Thirty-five responses were received, representing 97 UK National Health Service Trusts/Health Boards. A majority of centres (n=21, 60%) did not have formal written guidance for EUS use. Although all respondents had access to EUS, a perceived lack of utility (n=7) and concerns about delaying treatment start dates (n=8) each restricted EUS use for a fifth of respondents. For most centres (n=24, 68.6%), EUS use is case-specific, whereas for 10 (28.6%) EUS is used for all patients with potentially curable disease. A majority of centres use diagnostic positron-emission tomography for radiotherapy target volume delineation (TVD), whereas 22 (62.9%) use EUS. The factors contributing to decisions to use EUS for staging, TVD and surgical planning varied between centres. The proportion of centre respondents who would request EUS in each of six clinical scenarios varied considerably. CONCLUSION: There were substantial differences in the patient and disease characteristics that are perceived to be indications for EUS use for both staging and treatment planning. Research to clarify in which patients with oesophageal cancer EUS affords benefit is required, as is urgent standardisation of its role in the diagnostic pathway.


Assuntos
Endossonografia/métodos , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/terapia , Pesquisas sobre Atenção à Saúde/métodos , Estudos Transversais , Esôfago/diagnóstico por imagem , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Humanos , Reino Unido
5.
J Dairy Sci ; 103(5): 4838-4845, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32197853

RESUMO

Successful passive transfer of antibodies in neonatal calves can be achieved by feeding an adequate quantity and quality of maternal colostrum (MC) or colostrum replacer (CR). An alternative could be feeding low-quality maternal colostrum (LMC) with added IgG from a CR. The objective of this study was to determine if a commercial whey-based CR product containing low levels of casein (Premolac PLUS Bovine IgG; Zinpro Corporation, Eden Prairie, MN) fed to replace MC or supplement LMC could lead to adequate serum IgG levels and apparent efficiency of absorption (AEA) in neonatal dairy calves. Holstein calves (n = 20 per treatment) were separated from their dam after birth and randomly assigned to be fed 3.79 L of MC (106 g/L of IgG; 401 g of IgG fed), LMC (30 g/L IgG) supplemented with CR (41 g/L IgG; 154 g of IgG total fed; LMC-CR), or 1.3 L of 1 of 2 levels of CR (110 or 150 g of IgG fed; CR-110 or CR-150) within 1.5 h of birth. Colostrum was obtained from the first (MC) or second and third milkings (LMC) of cows from Pennsylvania State University dairy and pooled by source into large batches. Blood samples were taken from calves before colostrum feeding and 24 h after birth and were analyzed for serum total protein, total IgG, hematocrit, and Brix percentage. Calves fed MC had higher 24-h IgG values (means ± SEM) than calves fed LMC-CR (27.04 ± 1.07 vs. 22.33 ± 1.08 mg/mL, respectively). Feeding 150 g of IgG from CR led to higher 24-h serum IgG values than feeding 110 g of IgG (16.90 ± 1.09 vs. 12.79 ± 1.08 mg/mL). Serum IgG levels were different between the CR-fed calves and the calves fed LMC-CR and MC, but all had average values >10 mg/mL IgG. Calves fed LMC-CR had greater AEA than calves fed MC (54.58 ± 2.39 vs. 24.38 ± 2.36%, respectively). Among calves fed CR-110 or CR-150, AEA did not differ. Serum total protein and Brix percentage had strong correlations with actual IgG values across the entire study. We found no differences in average daily gain or health variables measured, and no differences in final hip width, withers height, or body weight for calves fed MC, LMC-CR, CR-150, or CR-110. These results indicate that CR can be fed successfully as an alternative to MC or as a supplement to colostrum with low IgG.


Assuntos
Ração Animal , Bovinos/imunologia , Colostro , Imunoglobulina G/sangue , Soro do Leite , Animais , Animais Recém-Nascidos , Peso Corporal , Suplementos Nutricionais , Feminino , Masculino , Substitutos do Leite/farmacologia , Pennsylvania , Gravidez
6.
J Dairy Sci ; 103(7): 6190-6199, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32331899

RESUMO

The objective was to determine the effects of converting calves from a component-fed ration to a total mixed ration (TMR) at 8, 10, or 12 wk of age on intake, growth, and nutrient digestibility. Holstein calves (n = 40) were randomly assigned to 1 of 4 groups (no TMR, TMR conversion at 8, 10 or 12 wk; T0, T8, T10, and T12, respectively). Calves were weaned at 6 wk of age, housed individually, and studied from 7 to 14 wk of age. Rations, consisting of a 20% crude protein texturized starter and grass hay, were offered ad libitum as separate components or as a TMR with 85% starter and 15% grass hay on a dry matter (DM) basis. Intakes and body weights (BW) were measured weekly. Component intake for TMR was calculated from the proportion of grass hay and starter contained in the TMR. Fecal grab samples were collected every 9 h over 3 d for a total of 8 samples that formed a composite at 9, 11, and 13 wk of age from the same 4 calves per group. Rumen fluid samples were collected via esophageal tube at -1, 0, 3, and 7 d relative to conversion from component to TMR. Feed and feces were evaluated for DM, neutral detergent fiber, acid detergent fiber, and acid detergent lignin (internal flow marker) to estimate digestibility. Average daily gain and final BW tended to be least for T8. Empty BW gain was significantly less for T8 than for T0 but not different from T10 or T12 (T0 = 1.07, T8 = 0.93, T10 = 1.02, T12 = 1.04 kg/d). Hip growth tended to be least for T8 and resulted in lower final hip width (T0 = 25.9, T8 = 25.2, T10 = 25.6, T12 = 25.8 cm). Intake tended to be reduced for calves converted to TMR earlier. Throughout the study, calves fed TMR ate more hay and less starter than component-fed calves. Metabolizable energy intake was less for T8 versus T0 but not different from T10 or T12 (T0 = 8.46, T8 = 7.55, T10 = 8.01, T12 = 8.23 Mcal/d). We observed no differences in feed efficiency for the duration of the study. Differences in DM digestibility were not observed, but fiber digestibility was greater for calves fed TMR at 9, 11, and 13 wk of age. Conversion to TMR increased rumen pH. These results indicate that TMR conversion increased hay consumption and subsequently decreased starter and total DM intake. This led to reduced weight and structural growth; however, calves that were converted to TMR as early as 8 wk still achieved adequate growth. The increase in rumen pH and subsequent increase in fiber digestibility allowed for calves to be converted to a 15% grass hay TMR as early as 8 wk and still achieve desirable growth goals.


Assuntos
Ração Animal/análise , Dieta/veterinária , Fenômenos Fisiológicos da Nutrição Animal , Animais , Peso Corporal , Bovinos , Fibras na Dieta/metabolismo , Digestão/efeitos dos fármacos , Fezes , Feminino , Nutrientes , Rúmen/metabolismo
7.
J Dairy Sci ; 103(8): 7535-7539, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32534921

RESUMO

Serum IgG concentrations in dairy calves change throughout their first weeks of life, peaking at 24 h and then steadily decreasing until calves begin to produce endogenous IgG. The objective of this study was to observe serum IgG dynamics from birth until 16 wk of life in calves fed either maternal colostrum (MC) or colostrum replacer (CR). A total of 44 Holstein calves were randomly assigned to 1 of the 4 colostrum treatments and followed throughout the study. Treatments consisted of feeding high-quality MC, low-quality MC supplemented with CR, or 1 of 2 distinct levels of IgG concentration from CR. Overall, the interaction between type of colostrum fed and sampling time was significant. Individual differences for this effect were found at d 1, 7, 14, 21, 28, and 98, while the other time points were not different.


Assuntos
Ração Animal , Bovinos/imunologia , Colostro , Imunoglobulina G/sangue , Envelhecimento/sangue , Envelhecimento/imunologia , Animais , Animais Recém-Nascidos/sangue , Animais Recém-Nascidos/imunologia , Bovinos/sangue , Suplementos Nutricionais , Feminino , Masculino
8.
J Dairy Sci ; 103(6): 5694-5699, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31785867

RESUMO

Multistate dairy management research project NC-2042, which is part of the National Institute of Food and Agriculture, has devoted an ongoing objective to calf and heifer nutrition and management. Within this objective, colostrum research has been a priority due to continued opportunities to improve this area on US dairy farms. Research has focused on heating colostrum to reduce bacterial populations and pathogens while increasing IgG absorption. Research also identified other proteins that are reduced when heating colostrum. Studies indicated an apparent upper limit to IgG absorption from colostrum fed to calves. Additional studies have shed light on absorption of IgG from colostrum replacers and evaluated the use of lactoferrin and sodium bicarbonate in both maternal colostrum and colostrum replacers. Milk replacer formulation, feeding strategies, and the effect of calfhood nutrition on future performance have also been researched. Finally, water quality and its effect on calves and heifers have been studied. This review focuses on research done by multistate research project NC-2042 member states in the area of colostrum and calf nutrition and management.


Assuntos
Ração Animal/análise , Bovinos/fisiologia , Indústria de Laticínios/economia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Estado Nutricional
9.
J Dairy Sci ; 102(4): 3654-3660, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30799103

RESUMO

The objective of this study was to compare the effects of feeding preweaning dairy calves pasteurized milk once or twice a day with or without a combination of yeast-derived products. Holstein heifer calves (n = 48) from The Pennsylvania State University dairy herd were fed 3.8 L of colostrum in 1 feeding and randomly assigned to 1 of 4 treatments (once-a-day milk feeding with or without live yeast culture and mannan-rich fraction and twice-a-day milk feeding with or without live yeast culture and mannan-rich fraction). All calves were fed 6 L of milk daily. Weekly growth measurements and blood samples were taken 3 h after the morning milk feeding for all animals. Growth measurement included body weight, hip width, and withers height. Calf starter refusal was recorded weekly, and a sample was taken to determine dry matter intake. Daily health scores were recorded for each calf using a standard scoring system. Intake, growth measurements, haptoglobin, and health scores data were analyzed using repeated measures analysis with calf included as a random variable. Preweaning average daily gain was 553.4 and 512.1 g/d for calves fed milk once and twice a day, respectively, and we found no difference between treatments. Preweaning calf starter intake was 242.3 and 198.7 g/d for calves fed milk once and twice a day, respectively, and we found no treatment differences. Preweaning calf starter intake was 224.3 and 216.6 g/d for calves fed yeast and without yeast, respectively. Withers height and hip width were similar in calves fed milk either once or twice a day; however, calves fed yeast tended to have greater withers height and hip width than control calves. Haptoglobin concentration as a measure of stress had least squares means of 4.0 and 9.5 ± 3.5 µg/mL for calves fed milk once or twice a day, respectively, and we found no difference among treatments. Scours score and total daily score were similar for calves fed milk once or twice a day. These results suggest that feeding milk once a day can be successfully applied to a calf feeding system and that yeast products may improve structural growth.


Assuntos
Ração Animal , Bovinos/crescimento & desenvolvimento , Dieta/veterinária , Leite , Saccharomyces , Animais , Animais Recém-Nascidos/crescimento & desenvolvimento , Peso Corporal , Colostro , Indústria de Laticínios/métodos , Suplementos Nutricionais , Feminino , Pasteurização , Gravidez , Desmame
10.
J Dairy Sci ; 102(3): 2068-2074, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30660413

RESUMO

The objective of this study was to determine the effect of different durations of heat treatment on passive transfer of IgG from high-, medium- and low-quality colostrum. Colostrum was collected from The Pennsylvania State University dairy herd and divided by quality (high, medium, or low) based on colostrometer measurements. Colostrum was pooled by quality to create 3 unique batches. Each batch was further divided in thirds as follows: frozen to be fed without heat treatment, heated at 60°C for 30 min, or heated at 60°C for 60 min. Colostrum samples from each treatment were collected and analyzed for standard plate count, gram-negative noncoliforms, coliforms, and total IgG concentration. Serum samples were collected from 108 Holstein calves before feeding colostrum and 24 h after birth. Blood samples were analyzed for total protein, total IgG, and hematocrit. Colostrum quality (high, medium, or low), heat treatment (unheated, 60°C for 30 min or, 60°C for 60 min), and their interaction were analyzed as fixed effects, with calf sex included as a random block effect. Colostrum IgG was different between quality groups (92.5, 59.4, and 48.1 mg/mL of IgG). Heating colostrum reduced IgG concentration compared with the control by 9% when heated for 30 min and by 12% when heated for 60 min. Colostrum heated for 60 min had a lower standard plate count than colostrum heated for 30 min or not heated (1.8, 2.0, and 3.6 log cfu/mL, respectively). Serum IgG concentration at 24 h increased as colostrum quality increased (18.0, 22.2, and 24.8 mg/mL) and tended to increase as heat treatment time increased (19.7, 20.3, and 25.0 mg/mL of IgG). Apparent efficiency of IgG absorption was greater in calves that received medium-quality colostrum compared with calves fed high-quality colostrum (38.1 and 25.0%, respectively). These results suggest an upper limit may exist to the amount of IgG absorption in a given time period and that medium- or high-quality colostrum yields similar blood IgG concentration given the same volume of intake.


Assuntos
Animais Recém-Nascidos/fisiologia , Bovinos/fisiologia , Colostro/fisiologia , Imunoglobulina G/metabolismo , Animais , Indústria de Laticínios , Feminino , Calefação , Distribuição Aleatória , Fatores de Tempo
11.
Community Dent Health ; 36(1): 22-26, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30779499

RESUMO

OBJECTIVE: To describe child dental attendance (DA) by 1 year of age in England and its relationship with area deprivation. BASIC RESEARCH DESIGN: Analysis of National Health Service data for the 12 months to June 2017. Deprivation was measured by Index of Multiple Deprivation Rank of Average Score (2015) for upper-tier and unitary local authorities in England (LAs, n=151). DA rates were calculated for children under 1 year (⟨1yr) and children aged 1 year and under (⟨1yr). A Spearman's test assessed strength of association with deprivation. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) explored equity. CLINICAL SETTING: Upper-tier and unitary LAs in England. MAIN OUTCOME MEASURE: Attending an NHS primary care dental service. RESULTS: DA rates ranged from 0 to 12.3% (Median:2; IQR:1.4,3.9) in children ⟨1yr and from 3.7 to 37.6% (Median:10; IQR:7.4,17) in children ≤1yr. DA rates decreased as deprivation decreased (Spearman=-0.25, p=0.0019 in children ⟨1yr; Spearman=-0.21, p=0.0104 in children ≤1yr). The SII suggested a 2 percentage point difference in DA rate across the deprivation distribution in children ⟨1yr (SII=-0.02, 95% CI=-0.01,-0.04; p=⟨0.001); and a 5 point difference in children ≤1yr (SII=-0.05, 95% CI=-0.02,-0.09; p=0.003). The DA rate in the most deprived LA was 2.1 higher than the least deprived LA (RII=2.1, 95% CI=1.4,3.2; p=⟨0.001) in children ⟨1yr and 1.5 higher (RII=1.5, 95% CI=1.2,2; p=0.004) in children ≤1yr. CONCLUSIONS: DA rates were low for all LAs and only partially explained by deprivation. More deprived LAs were, unexpectedly, more likely to report higher DA rates.


Assuntos
Assistência Odontológica , Governo Local , Atenção Primária à Saúde , Criança , Inglaterra , Disparidades nos Níveis de Saúde , Humanos , Lactente , Fatores Socioeconômicos
12.
Ann Oncol ; 28(9): 2272-2277, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28637287

RESUMO

BACKGROUND: Following the functional and physicochemical characterization of a proposed biosimilar, comparative clinical studies help to confirm biosimilarity by demonstrating similar safety and efficacy to the reference product in a sensitive patient population. PATIENTS AND METHODS: LA-EP2006 is a proposed biosimilar that has been developed for pegfilgrastim, a long-acting form of granulocyte colony-stimulating factor for the prevention of neutropenia. The current analysis reports data pooled from two independent, multinational, prospective, randomized, controlled, double-blind phase III studies of similar design comparing the safety and efficacy of reference pegfilgrastim with LA-EP2006 in patients with breast cancer receiving myelotoxic (neo)adjuvant TAC (docetaxel, doxorubicin, and cyclophosphamide) chemotherapy and requiring granulocyte colony-stimulating factor. RESULTS: A total of 624 patients were randomized in the PROTECT-1 and PROTECT-2 studies (NCT01735175; NCT01516736) (LA-EP2006: n = 314; reference: n = 310). Baseline characteristics of patients were well balanced across treatment groups. The primary end point, mean duration of severe neutropenia in the first chemotherapy cycle was similar in both the LA-EP2006 and reference groups (1.05 ± 1.055 days versus 1.01 ± 0.958 days), with a treatment difference of - 0.04 days [95% confidence interval (CI): -0.19 to 0.11] that met the equivalence criteria (the 95% CI were within the defined margin of ±1 day). Secondary end points, such as the nadir of absolute neutrophil count and the incidence of febrile neutropenia, were also similar between LA-EP2006 and reference pegfilgrastim. The safety and tolerability profile of LA-EP2006 was similar to that observed with reference pegfilgrastim, and there were no reports of neutralizing antibodies. CONCLUSIONS: This pooled analysis confirms, as a part of totality of evidence approach, that the proposed biosimilar pegfilgrastim LA-EP2006 has a comparable efficacy and safety profile to reference pegfilgrastim in patients with breast cancer receiving TAC chemotherapy. CLINICAL TRIAL NUMBERS: NCT01735175 and NCT01516736.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Medicamentos Biossimilares/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Filgrastim/uso terapêutico , Neutropenia/tratamento farmacológico , Polietilenoglicóis/uso terapêutico , Adulto , Medicamentos Biossimilares/efeitos adversos , Método Duplo-Cego , Feminino , Filgrastim/efeitos adversos , Humanos , Neutropenia/induzido quimicamente , Polietilenoglicóis/efeitos adversos , Estudos Prospectivos , Resultado do Tratamento
13.
Hum Reprod ; 32(4): 868-875, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-28184441

RESUMO

Study question: What is the relationship between children's thoughts and feelings about their donor and their security of attachment to their solo mothers in middle childhood? Summary answer: Children with higher levels of secure-autonomous attachment to their mothers were more likely to have positive perceptions of the donor, and those with higher levels of insecure-disorganized attachment to their mothers were more likely to perceive him negatively. What is known already: There is limited understanding of the factors that contribute to children's thoughts and feelings about their donor in solo mother families. In adolescence, an association was found between adolescents' curiosity about donor conception and their security of attachment to their mothers. Study design size, duration: 19 children were administered the Friends and Family Interview and Donor Conception Interview between December 2015 and March 2016 as part of the second phase of a longitudinal, multi-method, multi-informant study of solo mother families. Participants/materials setting methods: All children were aged between 7 and 13 years and had been conceived by donor insemination to solo mothers. Interviews were conducted in participants' homes. The Friends and Family Interview was rated according to a standardized coding scheme designed to measure security of attachment in terms of secure-autonomous, insecure-dismissing, insecure-preoccupied and insecure-disorganized attachment patterns. Quantitative analyses of the Donor Conception Interview yielded two factors: interest in the donor and perceptions of the donor. Qualitative analyses of the Donor Conception Interview were conducted using qualitative content analysis and thematic analysis. Main results and the role of chance: Statistically significant associations were found between the perception of the donor scale and the secure-autonomous and insecure-disorganized attachment ratings. Children with higher levels of secure-autonomous attachment to their mothers were more likely to have positive perceptions of the donor (r = 0.549, P = 0.015), and those with higher levels of insecure-disorganized attachment to their mothers were more likely to perceive him negatively (r = -0.632, P = 0.004). Children's narratives about the donor depicted him as a stranger (n = 8), a biological father (n = 4), a social parent (n = 3), or in ambivalent terms (n = 4). Limitations, reasons for caution: Findings are limited by the wide age range of children within a small overall sample size. Participants were those willing and able to take part in research on donor conception families. The statistical significance of correlation coefficients was not corrected for multiple comparisons. Wider implications of the findings: Findings highlight the importance of situating children's ideas about the donor within family contexts. It is recommended that those working with donor conception families consider this when advising parents about whether, what and how to tell children about donor conception. Study funding/competing interest(s): This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.


Assuntos
Inseminação Artificial Heteróloga/psicologia , Doadores de Tecidos/psicologia , Adolescente , Criança , Revelação , Emoções , Feminino , Humanos , Estudos Longitudinais , Masculino , Mães/psicologia , Psicologia da Criança , Pais Solteiros/psicologia , Espermatozoides
14.
J Dairy Sci ; 100(12): 10173-10188, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29153161

RESUMO

The years 1917 to 2017 saw many advances in research related to the dairy heifer, and the Journal of Dairy Science currently publishes more than 20 articles per year focused on heifers. In general, nutrition and management changes made in rearing the dairy heifer have been tremendous in the past century. The earliest literature on the growing heifer identified costs of feeding and implications of growth on future productivity as major concepts requiring further study to improve the overall sustainability of the dairy herd. Research into growth rates and standards for body size and stature have been instrumental in developing rearing programs that provide heifers with adequate nutrients to support growth and improve milk production in first lactation. Nutrient requirements, most notably for protein but also for energy, minerals, and vitamins, have been researched extensively. Scientific evaluation of heifer programs also encouraged a dramatic shift toward a lower average age at first calving over the past 30 yr. Calving at 22 to 24 mo best balances the cost of growing heifers with their production and lifetime income potential. Increasingly, farms have become more progressive in adopting management practices based on the physiology and nutrient needs of the heifer while refining key economic strategies to be successful. Research published in the Journal of Dairy Science has an integral role in the progress of dairy heifer programs around the world.


Assuntos
Bovinos , Indústria de Laticínios/história , Pesquisa/história , Animais , Feminino , História do Século XX , História do Século XXI , Lactação
15.
J Dairy Sci ; 100(10): 8451-8454, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28822548

RESUMO

The estimation of Holstein heifer body weight (BW) from heart girth measurements is needed, as many farms do not have animal scales to make the management decisions that require BW. The correlation between heart girth and BW is known to vary with differing animal conformation. The previous equation to correlate the 2 measures for Holstein dairy heifers was done 25 yr ago. Data were derived from 6 US experiment stations that are part of Regional Research Project NC-2042: Management Systems to Improve the Economic and Environmental Sustainability of Dairy Enterprises. After deriving a new equation from a data set of observations and using a second validation data set, it was determined that the equation developed in 1992 was still valid and further equation development was not needed at this time.


Assuntos
Algoritmos , Peso Corporal , Coração/anatomia & histologia , Animais , Bovinos , Feminino , Tamanho do Órgão , Especificidade da Espécie
16.
Community Dent Health ; 34(3): 157-162, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28872810

RESUMO

OBJECTIVE: We report the findings from and comment on the surveys of the oral health of 5-year-old children undertaken in Scotland (2013-14), Wales (2014-15) and England (2014-15). This was the fourteenth survey in Scotland since 1988. In England and Wales it is the third survey since 2007 when changes were required in consent arrangements. METHOD: Representative samples were drawn within Health Boards across Scotland and local authorities across England and Wales. Consent was sought via opt-out parental consent in Scotland and opt-in parental consent in England and Wales. Children examined were those aged five in England and those in Primary 1 (school year aged 5 to 6) in Scotland and Wales. Examinations were conducted in schools by trained and calibrated examiners. Caries was visually diagnosed at the dentinal threshold. RESULTS: There is a continuing decline in d3mft in all three countries. d3mft was 1.27 (opt-out consent) for Scotland, 0.84 for England (opt-in consent) and 1.29 for Wales (opt-in consent). Tooth decay levels remain higher in more deprived areas across Great Britain, with clear inequalities gradients demonstrated across all geographies. Attempts to measure changes in dental health inequalities across the three countries show no conclusive trends. CONCLUSION: Inter-country comparisons provide further oral health intelligence despite differences in approach and timing. The third surveys in England and Wales using the new consent arrangements have enabled trend analysis. Dental health inequalities gradients were shown across all geographies and all of the indicators of inequality.


Assuntos
Cárie Dentária/epidemiologia , Saúde Bucal , Criança , Estudos Transversais , Índice CPO , Inglaterra , Humanos , Prevalência , Escócia , Reino Unido , País de Gales
17.
J Fish Biol ; 90(2): 492-504, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27325371

RESUMO

Classification method performance was evaluated using otolith chemistry of juvenile Atlantic menhaden Brevoortia tyrannus when assumptions of data normality were met and were violated. Four methods were tested [linear discriminant function analysis (LDFA), quadratic discriminant function analysis (QDFA), random forest (RF) and artificial neural networks (ANN)] using computer simulation to determine their performance when variable-group means ranged from small to large and their performance under conditions of typical skewness to double the amount of skewness typically observed. Using the kappa index, the parametric methods performed best after applying appropriate data transformation, gaining 2% better performance with LDFA performing slightly better than QDFA. RF performed as well as QDFA and showed no difference in performance between raw and transformed data while the performance of ANN was the poorest and worse with raw data. All methods performed well when group differences were large, but parametric methods outperformed machine-learning methods. When data were skewed the performance of all methods declined and worsened with greater skewness, but RF performed consistently as well or better than the other methods in the presence of skewness. The parametric methods were found to be more powerful when assumptions of normality can be met and can be used confidently when skewness and kurtosis are minimized. When these assumptions cannot be minimized, then machine-algorithm methods should also be tried.


Assuntos
Membrana dos Otólitos/química , Algoritmos , Distribuição Animal , Animais , Simulação por Computador , Análise Discriminante , Peixes/classificação , Redes Neurais de Computação
18.
J Dairy Sci ; 99(8): 6206-6214, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27209128

RESUMO

Several studies and a 2013 meta-analysis have proposed that increased feeding of milk or milk replacer to neonatal calves may improve subsequent milk production. However, data from individual studies are conflicting, and the meta-analysis was unable to assess the influence of calf starter intake. The objective of the current meta-analysis was to review newly published data and evaluate the effects of preweaning diet (including calf starter intake) and growth rate on first-lactation milk, fat, and protein yield. Data from 9 studies representing 21 treatment groups were included in the analysis. We created separate models for each outcome variable using regression methods in SAS (version 9.4, SAS Institute Inc., Cary, NC) to determine the effects of intake and growth rate. We then selected the best-fitting models using Akaike's information criterion. The effect of study explained 98, 85, and 96% of the variance in 305-d milk, fat, and protein yield in first lactation, respectively, indicating that other aspects of management are more important for determining first-lactation production than preweaning intake and growth rate. However, we found a synergistic relationship between preweaning liquid and starter dry matter intake for improving milk, fat, and protein production, and a positive relationship between first-lactation performance and preweaning average daily gain. These data indicate that provision of adequate nutrients from liquid and solid feeds and maintaining average daily gain above 0.5kg/d can enhance the first-lactation performance of heifers when combined with proper postweaning practices.


Assuntos
Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Dieta/veterinária , Desmame , Animais , Bovinos , Gorduras na Dieta/análise , Feminino , Lactação , Leite/química , Leite/metabolismo , Proteínas do Leite/análise , Estado Nutricional
19.
J Dairy Sci ; 99(1): 341-53, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26601592

RESUMO

Two trials were conducted to determine effects of straw particle size in calf starter on rumen fermentation and development in calves. Holstein calves (n=17 in trial 1; n=25 in trial 2) were housed in individual pens; bedding (wood shavings) was covered with landscape fabric to completely avoid consumption of bedding. Milk replacer was fed at 12% of birth body weight per day and water offered free choice. Calves were randomly assigned to 4 treatments differing in geometric mean particle length (Xgm) of straw comprising 5% of starter dry matter. Straw was provided within the pellet at manufacture (PS; 0.82 mm Xgm) or mixed with the pellet at time of feeding at Xgm of 3.04 (SS), 7.10 (MS), or 12.7 (LS) mm. Calves (n=12; 3/treatment) in trial 1 were fitted with a rumen cannula by wk 2 of age. A fixed amount of starter that was adjusted with age and orts were fed through the cannula in cannulated calves. Calves were euthanized 6 wk after starter was offered (9 and 7 wk of age for trials 1 and 2, respectively). Rumen digesta pH linearly decreased with age, whereas volatile fatty acid concentration increased with age. Overall pH had a cubic trend with SS lower than that of PS and MS. Molar proportion of acetate decreased with age whereas propionate proportion increased. Overall molar proportions of volatile fatty acids were not affected by diet. Fecal Xgm was not different in spite of changes in diet particle size and rumen digesta of PS being greater than SS, MS, and LS at slaughter. Fecal pH and starch concentration were not affected by diet; however, pH decreased whereas starch content increased with age. Weight of stomach compartments, rumen papillae length and width, and rumen wall thickness did not differ between diets. Omasum weight as a percentage of body weight at harvest linearly decreased as straw particle size increased. Under the conditions of this study, modifying straw particle length in starter grain resulted in minimal rumen fermentation parameter changes and no changes in rumen development. Rumen pH and fermentation changes with age were likely effects of increasing starter intake.


Assuntos
Ração Animal/análise , Bovinos/fisiologia , Dieta/veterinária , Tamanho da Partícula , Rúmen/metabolismo , Animais , Peso Corporal , Sistema Digestório/metabolismo , Grão Comestível , Ácidos Graxos Voláteis/análise , Fezes/química , Fermentação , Concentração de Íons de Hidrogênio , Leite/metabolismo , Propionatos/análise , Amido/análise
20.
J Dairy Sci ; 98(7): 4640-5, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25935243

RESUMO

Improved IgG absorption in calves fed heat-treated colostrum has been attributed to the reduced bacteria content in colostrum after heat treatment. However, at least one study reported that colostrum bacteria content did not affect IgG absorption. The main objective of the current study was a more conclusive test of the combined effects of colostrum bacteria content and heat treatment on IgG absorption. Comparison of conclusions from plasma IgG as measured by radial immunodiffusion and ELISA and comparison of health scores in the first week of life were secondary and tertiary objectives. Colostrum from individual cows was pooled, divided, either heat treated or unheated, and allowed to incubate for bacterial growth or not. The 4 treatments were unheated, low bacteria; unheated, high bacteria; heat-treated, low bacteria; and heat-treated, high bacteria. Plasma samples were collected from bull calves (n=25-27 per treatment) before and 48h after colostrum feeding for IgG and total protein analysis. Fecal, respiratory, and general health scores were assigned daily for the first 7 d. Plasma IgG, total protein, apparent efficiency of IgG absorption, and frequency of illness were analyzed using the MIXED and FREQ procedures in SAS (SAS Institute Inc., Cary, NC). Plasma IgG values from ELISA were lower than radial immunodiffusion; however, conclusions were similar. Greater colostrum bacteria content reduced total protein, plasma IgG, and efficiency of IgG absorption. Heat treatment tended to improve 48-h plasma IgG as measured by ELISA. Respiratory scores were not affected by colostrum treatment, but calves fed heat-treated, low-bacteria colostrum tended to experience fewer scour days. These results provide conclusive evidence for the benefits of minimizing bacterial contamination in colostrum for feeding calves.


Assuntos
Animais Recém-Nascidos , Colostro/química , Colostro/microbiologia , Temperatura Alta , Imunoglobulina G/sangue , Animais , Bovinos , Ensaio de Imunoadsorção Enzimática , Feminino , Imunodifusão , Masculino
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