Assessing the impact of a test and vaccinate or remove badger intervention project on bovine tuberculosis levels in cattle herds.

Bovine tuberculosis (bTB) is a chronic, zoonotic infection of domestic and wild animals caused mainly by Mycobacterium bovis. The Test and Vaccinate or Remove (TVR) project was a 5-year intervention (2014-2018) applied to Eurasian badgers (Meles meles) in a 100 km2 area of County Down, Northern Ireland. This observational study used routine bTB surveillance data of cattle to determine if the TVR intervention had any effect in reducing the infection at a herd level. The study design included the TVR treatment area (Banbridge) compared to the three adjacent 100 km2 areas (Dromore, Ballynahinch, and Castlewellan) which did not receive any badger intervention. Results showed that there were statistically lower bTB herd incidence rate ratios in the Banbridge TVR area compared to two of the other three comparison areas, but with bTB herd history and number of bTB infected cattle being the main explanatory variables along with Year. This finding is consistent with other study results conducted as part of the TVR project that suggested that the main transmission route for bTB in the area was cattle-to-cattle spread. This potentially makes any wildlife intervention in the TVR area of less relevance to bTB levels in cattle. It must also be noted that the scientific power of the TVR study (76%) was below the recommended 80%, meaning that results must be interpreted with caution. Even though statistical significance was achieved in two cattle-related risk factors, other potential risk factors may have also demonstrated significance in a larger study.

Implications of Organic Dairy Management on Herd Performance and Milk Fatty Acid Profiles and Interactions with Season.

Interest in organic cows' milk has increased due to the perceived superior nutritional quality and improved sustainability and animal welfare. However, there is a lack of simultaneous assessments on the influence of organic dairy practices and dietary and breed drivers on productivity, feed efficiency, health parameters, and nutritional milk quality at the herd level. This work aimed to assess the impact of organic vs. conventional management and month on milk yield and basic composition, herd feed efficiency, health parameters, and milk fatty acid (FA) composition. Milk samples (n = 800) were collected monthly from the bulk tanks of 67 dairy farms (26 organic and 41 conventional) between January and December 2019. Data on breed and feeding practices were gathered via farm questionnaires. The samples were analyzed for their basic composition and FA profile using Fourier transform infrared spectroscopy (FTIR) and gas chromatography (GC), respectively. The data were analyzed using a linear mixed model, repeated measures design and multivariate redundancy analysis (RDA). The conventional farms had higher yields (kg/cow per day) of milk (+7.3 kg), fat (+0.27 kg), and protein (+0.25 kg) and higher contents (g/kg milk) of protein, casein, lactose, and urea. The conventional farms produced more milk (+0.22 kg), fat (+8.6 g), and protein (+8.1 g) per kg offered dry matter (DM). The organic farms produced more milk per kg of offered non-grazing and concentrate DM offered, respectively (+0.5 kg and +1.23 kg), and fat (+20.1 g and +51 g) and protein (+17 g and +42 g). The organic milk had a higher concentration of saturated fatty acid (SFA; +14 g/kg total FA), polyunsaturated fatty acid (PUFA; +2.4 g/kg total FA), and nutritionally beneficial FA alpha linolenic acid (ALNA; +14 g/kg total FA), rumenic acid (RA; +14 g/kg total FA), and eicosapentaenoic acid (EPA; +14 g/kg total FA); the conventional milk had higher concentrations of monounsaturated FA (MUFA; +16 g/kg total FA). Although the conventional farms were more efficient in converting the overall diet into milk, fat, and protein, the organic farms showed better efficiency in converting conserved forages and concentrates into milk, fat, and protein as a result of reduced concentrate feeding. Considering the relatively small differences in the FA profiles between the systems, increased pasture intake can benefit farm sustainability without negatively impacting consumer nutrition and health.

"I don't have chronic back pain anymore": Patient Experiences in Pain Reprocessing Therapy for Chronic Back Pain.

In a recently published randomized controlled trial, two-thirds of the patients receiving a novel psychological treatment, pain reprocessing therapy (PRT), reported elimination or near-elimination of chronic back pain. The mechanisms of PRT and related treatments remain poorly understood but are hypothesized to center on pain reappraisal, fear reduction, and exposure-potentiated extinction. Here, we investigated treatment mechanisms from the participants' perspective. A sample of 32 adults with chronic back pain who received PRT completed semi-structured posttreatment interviews about their treatment experiences. The interviews were analyzed with multiphase thematic analysis. The analyses identified 3 major themes reflecting participants' understanding of how PRT led to pain relief: 1) reappraisal to reduce fear of pain, which included guiding participants to relate to pain as a helpful indicator, overcoming pain-related fear and avoidance, and reconceptualizing pain as a "sensation;" 2) the link between pain, emotions, and, stress, which included gaining insight into these connections and resolving difficult emotions; and 3) social connections, which included patient-provider alliance, therapist belief in the treatment model, and peer models of recovery from chronic pain. Our findings support the hypothesized mechanisms of PRT centered on pain reappraisal and fear reduction, but also highlight additional processes from the participants' perspective, including a focus on emotions and relationships. This study underscores the value of qualitative research methods in illuminating the mechanisms of novel pain therapies. PERSPECTIVE: This article presents participants' perspectives on their experience engaging in a novel psychotherapy for chronic pain, PRT. Through pain reappraisal, linking pain, emotions, and stress, and connecting with their therapist and peers, many participants reported an elimination or near-elimination of their chronic back pain with therapy.

Pre-Weaned Calf Rearing on Northern Irish Dairy Farms-Part 2: The Impact of Hygiene Practice on Bacterial Levels in Dairy Calf Rearing Environments.

Pre-weaned dairy calves are very susceptible to disease in the first months of life due to having a naïve immune system and because of the numerous physiological stressors they face. Hygiene management is a key element in minimizing enteric disease risk in calves by reducing their exposure to pathogens. Samples of milk, concentrate feed and drinking water, boot swabs of bedding and swabs of feed equipment were collected from 66 dairy farms as part of a survey of calf rearing practice and housing design. All the samples were cultured to determine total viable counts (TVC), total coliforms (TCC) and Escherichia coli as indicators of hygiene. Target ranges for levels of TVC, TCC and E. coli were defined from the literature and the sample results compared against them. The TVC targets in milk, MR and water were <4.0 log10 CFU/mL. TCC and E. coli targets of <1.1 log10 CFU/mL (the detection limit) were used for milk, MR, concentrate feed and feeding equipment. For water, the TCC and E. coli targets were <1.0 log10 CFU/100 mL. The targets used for bedding boot swabs were <6.3 log10 TVC CFU/mL and <5.7 log10 TCC or E. coli CFU/mL. Farm management factors were included as fixed effects in a generalized linear mixed model to determine the probability of samples being within each hygiene indicator target range. Milk replacer samples obtained from automatic feeders were more likely to be within the TVC target range (0.63 probability) than those prepared manually (0.34) or milk samples taken from the bulk tank (0.23). Concentrate feed samples taken from buckets in single-calf pens were more likely to have E. coli detected (0.89) than samples taken from group pen troughs (0.97). A very small proportion of water samples were within the indicator targets (TVC 9.8%, TCC 6.0%, E. coli 10.2%). Water from self-fill drinkers had a lower likelihood of being within the TVC target (0.03) than manually filled buckets (0.14), and water samples from single pens were more likely to be within TCC target ranges (0.12) than those from group pens (0.03). However, all self-fill drinkers were located in group pens so these results are likely confounded. Where milk feeders were cleaned after every feed, there was a greater likelihood of being within the TVC target range (0.47, compared with 0.23 when not cleaned after every feed). Detection of coliforms in milk replacer mixing utensils was linked with reduced probability of TVC (0.17, compared with 0.43 when coliforms were not detected) and TCC (0.38, compared with 0.62), which was within target in feeders. Key factors related to increased probability of bedding samples being within TCC target range were use of group calf pens (0.96) rather than single-calf pens (0.80), use of solid floors (0.96, compared with 0.76 for permeable floors) and increased space allowance of calves (0.94 for pens with ≥2 m2/calf, compared with 0.79 for pens with <2 m2/calf). Bedding TVC was more likely to be within the target range in group (0.84) rather than in single pens (0.66). The results show that hygiene levels in the calf rearing environment vary across farms and that management and housing design impact hygiene.

Performance of Dairy Cows Offered Grass Silage Produced within Either a Three- or Four-Harvest System When Supplemented with Concentrates on a Feed-to-Yield Basis.

More frequent harvesting of grass swards provides an opportunity to improve the nutritive value of grass silage. This study investigated the effect of offering silages produced within either a three- (3H) or four-harvest (4H) system on dairy cow performance when concentrate supplements were offered according to the individual cow's milk yield (feed-to-yield). Cows (n = 80) were allocated to either 3H or 4H at calving and remained on experiment for 25 weeks. Within both treatments, cows were offered silage from each harvest consecutively in proportion to the dry matter (DM) yield for each harvest. Silage was offered as a mixed ration with concentrate added at a rate of 8 kg/cow/day. Additional concentrates were offered on a feed-to-yield basis. Herbage yields were reduced in the 4H system, but 4H silage contained higher metabolisable energy and crude protein content compared to 3H. Cows offered the 4H silage had greater silage DM intake, milk yield and milk protein content, while milk fat content was greater in cows offered 3H silages. In conclusion, increasing harvesting frequency from three to four harvests per year can improve silage feed value, silage intakes and milk yields when concentrates are offered on a feed-to-yield basis.

Incidence and predictors of toxicity in the management of vulvar squamous cell carcinoma treated with radiation therapy.

Purpose/Objective: Given the rarity of vulvar cancer, data on the incidence of acute and late severe toxicity and patients' symptom burden from radiotherapy (RT) are lacking. Materials/Methods: This multi-center, single-institution study included patients with vulvar squamous cell carcinoma treated with curative intent RT between 2009 and 2020. Treatment-related acute and late grade ≥ 3 toxicities and late patient subjective symptoms (PSS) were recorded. Results: Forty-two patients with predominantly stage III/IV disease (n = 25, 59.5 %) were treated with either definitive (n = 25, 59.5 %) or adjuvant (n = 17, 40.5 %) external beam RT to a median dose of 64 Gy and 59.4 Gy, respectively. Five patients received a brachytherapy boost with a median total dose of 84.3 Gy in 2 Gy-equivalent dose (EQD2). Intensity-modulated RT was used in 37 (88.1 %) of patients, and 25 patients (59.5 %) received concurrent chemotherapy. Median follow-up was 27 months. Acute grade ≥ 3 toxicity occurred in 17 patients (40.5 %), including 13 (31.0 %) acute grade 3 skin events. No factors, including total RT dose (p = 0.951), were associated with acute skin toxicity. Eleven (27.5 %) patients developed late grade ≥ 3 toxicity events, including 10 (23.8 %) late grade ≥ 3 skin toxicity events. Patients with late grade ≥ 3 skin toxicity had a higher mean body-mass index (33.0 vs 28.2 kg/m2; p = 0.009). Common late PSS included vaginal pain (n = 15, 35.7 %), skin fibrosis (n = 10, 23.8 %), and requirement of long-term opiates (n = 12, 28.6 %). Conclusion: RT for vulvar cancer is associated with considerable rates of severe acute and late toxicity and PSS burden. Larger studies are needed to identify risk factors, explore toxicity mitigation strategies, and assess patient-reported outcomes.

The effect of naturally acquired rumen fluke infection on animal health and production in dairy and beef cattle in the UK.

The incidence of paramphistomosis, caused by the rumen fluke, Calicophoron daubneyi, has greatly increased within Europe in the last 15-20 years. However, the production impacts of this disease are poorly understood. This study firstly aimed to investigate the prevalence of rumen fluke in England and Northern Ireland (NI) by conducting an abattoir survey of dairy and beef cattle which also allowed the impact of rumen fluke on carcass weight, conformation and fat classification to be assessed. Secondly, an experiment aimed to assess the impact of C. daubneyi infection on diarrhea score, production loss and welfare in dairy heifers, while also evaluating the impacts of treating infected heifers with oxyclozanide. Rumen fluke prevalence was greater in NI than in England, with 53.8% (95% CI 51.9 - 55.9%) of the NI cattle carcases sampled being infected compared to 16.3% (95% CI 15.8 - 16.8%) and 17.9% (95% CI 17.4 - 18.4%) detected at the two abattoirs in England. However, there was no significant difference (P > 0.05) in the cold carcass weight between infected and non-infected cattle. Similarly, carcass conformation and fat classification were unaffected (P > 0.05) by the presence of rumen fluke. In the second experiment, daily live weight gain (DLWG), diarrhea score and welfare score were also unaffected (P > 0.05) by rumen fluke infection and by oxyclozanide treatment against rumen fluke. The farms in this experiment were managed to a high standard and animals had no intercurrent disease. Therefore, these findings suggest that on well-managed farms, production losses (growth rates) should not be compromised as a result of sub-clinical rumen fluke infection.

Milk Composition and Production Efficiency within Feed-To-Yield Systems on Commercial Dairy Farms in Northern Ireland.

This study examined the relationships between milk yield and diet composition, nutrient intakes, milk composition, and feed use efficiency when concentrates were offered using a feed-to-yield (FTY) approach. The study was conducted on 26 dairy farms in Northern Ireland. Cows (n = 3471) were fully housed and were offered concentrates on an FTY basis. Individual cow genetic information was obtained for 18 herds. Concentrate intakes of individual cows were either obtained from the farms or calculated, while milk yield and milk composition data were obtained from test-day milk recording. Mean test-day milk yields during months 2 to 5 post-calving were calculated for each cow, and cows within each lactation were placed into one of six equal-sized milk yield (kg/cow/day) groups. Diet effects and performance responses to milk yield groups were tested for linear and quadratic effects. Total dry matter intakes increased with increasing milk yield. Milk fat and milk protein concentration declined as milk yield increased, which could be attributed in part to genetics and diet. As milk yield increased, nitrogen and energy use efficiency was improved. However, concentrates offered per kg of energy-corrected milk also increased at higher milk yields, indicating an increased reliance on concentrates for these cows.

Performance and milk quality parameters of Jersey crossbreds in low-input dairy systems.

Previous work has demonstrated some benefit from alternative breeds in low-input dairying, although there has been no systematic analysis of the simultaneous effect of Jersey crossbreeding on productivity, health, fertility parameters or milk nutritional quality. This work aimed to understand the effects of, and interactions/interrelations between, dairy cow genotypes (Holstein-Friesian (HF), Holstein-Friesian × Jersey crossbreds (HF × J)) and season (spring, summer, autumn) on milk yield; basic composition; feed efficiency, health, and fertility parameters; and milk fatty acid (FA) profiles. Milk samples (n = 219) and breed/diet data were collected from 74 cows in four UK low-input dairy farms between March and October 2012. HF × J cows produced milk with more fat (+ 3.2 g/kg milk), protein (+ 2.9 g/kg milk) and casein (+ 2.7 g/kg milk); and showed higher feed, fat, and protein efficiency (expressed as milk, fat and protein outputs per kg DMI) than HF cows. Milk from HF × J cows contained more C4:0 (+ 2.6 g/kg FA), C6:0 (+ 1.9 g/kg FA), C8:0 (+ 1.3 g/kg FA), C10:0 (+ 3.0 g/kg FA), C12:0 (+ 3.7 g/kg FA), C14:0 (+ 4.6 g/kg FA) and saturated FA (SFA; + 27.3 g/kg milk) and less monounsaturated FA (MUFA; -23.7 g/kg milk) and polyunsaturated FA (- 22.3 g/kg milk). There was no significant difference for most health and fertility parameters, but HF × J cows had shorter calving interval (by 39 days). The superior feed, fat and protein efficiency of HF × J cows, as well as shorter calving interval can be considered beneficial for the financial sustainability of low-input dairy farms; and using such alternative breeds in crossbreeding schemes may be recommended. Although statistically significant, it is difficult to determine if differences observed between HF and HF × J cows in fat composition are likely to impact human health, considering average population dairy fat intakes and the relatively small difference. Thus, the HF × J cow could be used in low-input dairying to improve efficiency and productivity without impacting milk nutritional properties.

Impact of adopting non-antibiotic dry-cow therapy on the performance and udder health of dairy cows.

BACKGROUND: On dairy farms, the prophylactic use of antibiotics at drying-off is being increasingly challenged. The objective of this study was to examine the effect of antibiotic dry-cow therapy (DCT) or non-antibiotic DCT on dairy cow performance and udder health. METHODS: Holstein cows (n = 285) with low risk of intramammary infection (<200,000 cells/ml) were assigned to one of two treatments, either antibiotic DCT (A + TS; antibiotic treatment in combination with internal and external teat sealants) or non-antibiotic DCT (TS; internal and external teat sealant only). RESULTS: There was no statistically significant (p > 0.05) difference between treatments for mean cow milk yield, composition or energy corrected milk yield. Mean somatic cell count was 0.16 loge higher in the TS treatment (95% confidence interval [CI]: -0.00 loge to -0.33 loge ) compared to A + TS treatment (p = 0.047). A 50% increase in the number of mastitis cases was observed in the A + TS treatment compared to TS treatment (odds ratio = 1.5, 95% CI: 0.80%-3.01%), although this was not significant. There was no statistical evidence (p > 0.05) that treatment had any effect on colostrum quality and composition. CONCLUSION: Results indicate that non-antibiotic DCT can be adopted in 'low-risk' cows who were offered grass silage-based diets in cubicle accommodation, with low risk of adverse effects on performance or udder health.

Thirty-day Postoperative Adverse Events in Minimally Invasive versus Open Abdominal Radical Hysterectomy for Early-stage Cervical Cancer.

STUDY OBJECTIVE: To identify the incidence, type, and grade of postoperative adverse events in minimally invasive radical hysterectomy vs abdominal radical hysterectomy (ARH) for patients with early-stage cervical cancer and determine risk factors associated with these adverse events. DESIGN: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) was queried to identify patients with early-stage cervical cancer undergoing radical hysterectomy. Multivariable logistic regression was used to assess risk factors associated with adverse postoperative outcomes among patients undergoing radical hysterectomy. SETTING: ACS NSQIP participating institutions within the United States. PATIENTS: Patients were collected from the ACS NSQIP databases (2014-2017) undergoing radical hysterectomy for early-stage cervical cancer. INTERVENTIONS: N/A MEASUREMENTS AND MAIN RESULTS: ARH had a significantly increased incidence of any 30-day postoperative adverse event compared with minimally invasive radical hysterectomy (31.2% vs 19.9%, p <.001). There was a higher incidence of surgical site infection, both deep and superficial, and blood transfusions in ARH. On multivariable logistic regression, the abdominal surgical approach was the only risk factor significantly associated with any postoperative adverse event (odds ratio, 1.4; confidence interval, 1.1-1.9; p = .018; 95% CIs). CONCLUSIONS: In this study, the abdominal surgical approach for radical hysterectomy in early-stage cervical cancer was associated with a higher incidence of postoperative adverse events than the minimally invasive approach.

Evaluating the risk of bovine tuberculosis posed by standard inconclusive reactors identified at backward-traced herd tests in Northern Ireland that disclosed no reactors.

Bovine tuberculosis is a notifiable disease in Northern Ireland with the national eradication programme of compulsory testing and slaughter of reactor animals costing approximately £40 million per year. Backward tracing, known as Backward Check Tests (BCTs), of reactor animals is used to identify previous herds where the bTB positive animal has resided. The aim of this study was to quantify the bovine tuberculosis (bTB) risk posed by inconclusive reactors (ICs) at BCTs at both the individual animal and the herd level. ICs to the Comparative Intradermal Tuberculin Test (CITT) at a BCT, in which no reactors were found, were matched with CITT negative animals, based on age, sex, test ID and follow up period, in Northern Ireland between 1st January 2008 and 31st December 2017 (inclusive). A retrospective matched cohort study design was used with the outcome of interest being the bTB status of each animal and subsequent bTB herd breakdowns. After adjusting for herd size, IC animals at a BCT had 16 times the odds (95% confidence interval: 7.75 to 38.28, p < 0.001) of becoming bTB positive compared to CITT negative animals. The percentage population attributable risk was 0.0001%. The majority 75% (n = 71) of ICs that became bTB positive were identified at the 42 day retest. Of those that were not disclosed at the 42 day retest (n = 24), almost a third (29%) had moved to an unrestricted herd. However, after adjusting for herd size and type, herds that had ICs only identified at a BCT did not have an increased odds of a subsequent bTB herd breakdown compared to herds that had a CITT negative BCT. Given the increased risk posed by ICs at a BCT, it may be justifiable to remove them from the herd immediately or place them under lifetime movement restrictions to the herd where they were detected. However, further action regarding the herd of origin does not appear to be justified.

The Effect of Frequency of Fresh Pasture Allocation on the Feeding Behaviour of High Production Dairy Cows.

For ruminants, grazing and ruminating activities are essential in nutrient capture and ultimately animal performance however these activities can demand significant time and energy. This study evaluated the effect of three different pasture allocation frequencies (PAF's; 12, 24 and 36 h) on the feeding behaviour of grazing dairy cows. Eighty-seven spring calving dairy cows were divided into three treatments. Animals were rotationally grazed with fixed paddock sizes of 0.14 ha, 0.28 ha and 0.42 ha paddocks for the 12 h, 24 h and 36 h treatments, respectively. Animals (14 per treatment) were fitted with behaviour halters that monitored feeding activity. Diurnal feeding patterns were evident for all animals irrespective of PAF, concentrating the majority of grazing during daytime (90%) and ruminating activity during night (73%). Treatment significantly affected feeding behavior patterns. Peak grazing activity coincided with fresh pasture allocation in the 12 h and 24 h treatments. In the 36 h treatment, grazing was more evenly distributed over each 24 h period with peak grazing activity witnessed daily between 17:00 and 19:00 regardless of fresh pasture allocation, suggesting lack of anticipation of fresh feed delivery. In the 12 h treatment primiparous animals exhibited greater grazing and ruminating activity relative to multiparous animals in the 12 h treatment highlighting the impact of competition for resources within each feed on lower dominance animals.

Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain: A Randomized Clinical Trial.

Importance: Chronic back pain (CBP) is a leading cause of disability, and treatment is often ineffective. Approximately 85% of cases are primary CBP, for which peripheral etiology cannot be identified, and maintenance factors include fear, avoidance, and beliefs that pain indicates injury. Objective: To test whether a psychological treatment (pain reprocessing therapy [PRT]) aiming to shift patients' beliefs about the causes and threat value of pain provides substantial and durable pain relief from primary CBP and to investigate treatment mechanisms. Design, Setting, and Participants: This randomized clinical trial with longitudinal functional magnetic resonance imaging (fMRI) and 1-year follow-up assessment was conducted in a university research setting from November 2017 to August 2018, with 1-year follow-up completed by November 2019. Clinical and fMRI data were analyzed from January 2019 to August 2020. The study compared PRT with an open-label placebo treatment and with usual care in a community sample. Interventions: Participants randomized to PRT participated in 1 telehealth session with a physician and 8 psychological treatment sessions over 4 weeks. Treatment aimed to help patients reconceptualize their pain as due to nondangerous brain activity rather than peripheral tissue injury, using a combination of cognitive, somatic, and exposure-based techniques. Participants randomized to placebo received an open-label subcutaneous saline injection in the back; participants randomized to usual care continued their routine, ongoing care. Main Outcomes and Measures: One-week mean back pain intensity score (0 to 10) at posttreatment, pain beliefs, and fMRI measures of evoked pain and resting connectivity. Results: At baseline, 151 adults (54% female; mean [SD] age, 41.1 [15.6] years) reported mean (SD) pain of low to moderate severity (mean [SD] pain intensity, 4.10 [1.26] of 10; mean [SD] disability, 23.34 [10.12] of 100) and mean (SD) pain duration of 10.0 (8.9) years. Large group differences in pain were observed at posttreatment, with a mean (SD) pain score of 1.18 (1.24) in the PRT group, 2.84 (1.64) in the placebo group, and 3.13 (1.45) in the usual care group. Hedges g was -1.14 for PRT vs placebo and -1.74 for PRT vs usual care (P < .001). Of 151 total participants, 33 of 50 participants (66%) randomized to PRT were pain-free or nearly pain-free at posttreatment (reporting a pain intensity score of 0 or 1 of 10), compared with 10 of 51 participants (20%) randomized to placebo and 5 of 50 participants (10%) randomized to usual care. Treatment effects were maintained at 1-year follow-up, with a mean (SD) pain score of 1.51 (1.59) in the PRT group, 2.79 (1.78) in the placebo group, and 3.00 (1.77) in the usual care group. Hedges g was -0.70 for PRT vs placebo (P = .001) and -1.05 for PRT vs usual care (P < .001) at 1-year follow-up. Longitudinal fMRI showed (1) reduced responses to evoked back pain in the anterior midcingulate and the anterior prefrontal cortex for PRT vs placebo; (2) reduced responses in the anterior insula for PRT vs usual care; (3) increased resting connectivity from the anterior prefrontal cortex and the anterior insula to the primary somatosensory cortex for PRT vs both control groups; and (4) increased connectivity from the anterior midcingulate to the precuneus for PRT vs usual care. Conclusions and Relevance: Psychological treatment centered on changing patients' beliefs about the causes and threat value of pain may provide substantial and durable pain relief for people with CBP. Trial Registration: ClinicalTrials.gov Identifier: NCT03294148.

Revisiting the Relationships between Fat-to-Protein Ratio in Milk and Energy Balance in Dairy Cows of Different Parities, and at Different Stages of Lactation.

A statistical re-assessment of aggregated individual cow data was conducted to examine trends in fat-to-protein ratio in milk (FPR), and relationships between FPR and energy balance (EB, MJ of ME/day) in Holstein-Friesian dairy cows of different parities, and at different stages of lactation. The data were collected from 27 long-term production trials conducted between 1996 and 2016 at the Agri-Food and Biosciences Institute (AFBI) in Hillsborough, Northern Ireland. In total, 1321 lactations (1 to 20 weeks in milk; WIM), derived from 840 individual cows fed mainly grass silage-based diets, were included in the analysis. The energy balance was calculated daily and then averaged weekly for statistical analyses. Data were further split in 4 wk. intervals, namely, 1-4, 5-8, 9-12, 13-16, and 17-20 WIM, and both partial correlations and linear regressions (mixed models) established between the mean FPR and EB during these periods. Three FPR score categories ('Low' FPR, <1.0; 'Normal' FPR, 1.0-1.5; 'High' FPR, >1.5) were adopted and the performance and EB indicators within each category were compared. As expected, multiparous cows experienced a greater negative EB compared to primiparous cows, due to their higher milk production relative to DMI. Relatively minor differences in milk fat and protein content resulted in large differences in FPR curves. Second lactation cows displayed the lowest weekly FPR, and this trend was aligned with smaller BW losses and lower concentrations of non-esterified fatty acids (NEFA) until at least 8 WIM. Partial correlations between FPR and EB were negative, and 'greatest' in early lactation (1-4 WIM; r = -0.38 on average), and gradually decreased as lactation progressed across all parities (17-20 WIM; r = -0.14 on average). With increasing parity, daily EB values tended to become more negative per unit of FPR. In primiparous cows, regression slopes between FPR and EB differed between 1-4 and 5-8 WIM (-54.6 vs. -47.5 MJ of ME/day), while differences in second lactation cows tended towards significance (-57.2 vs. -64.4 MJ of ME/day). Irrespective of the lactation number, after 9-12 WIM, there was a consistent trend for the slope of the linear relationships between FPR and EB to decrease as lactation progressed, with this likely reflecting the decreasing milk nutrient demands of the growing calf. The incidence of 'High' FPR scores was greatest during 1-4 WIM, and decreased as lactation progressed. 'High' FPR scores were associated with increased energy-corrected milk (ECM) yields across all parities and stages of lactation, and with smaller BW gains and increasing concentrations (log transformed) of blood metabolites (non-esterified fatty acid, NEFA; beta-hydroxybutyrate, BHB) until 8 WIM. Results from the present study highlight the strong relationships between FPR in milk, physiological changes, and EB profiles during early lactation. However, while FPR can provide an indication of EB at a herd level, the large cow-to-cow variation indicates that FPR cannot be used as a robust indicator of EB at an individual cow level.

The regression of the bovine tuberculin reaction: Results from the Reactor Quality Assurance study in Northern Ireland.

Tuberculin skin tests remain widely used in the control of bovine tuberculosis (bTB) in cattle. Little is known about the rate of regression of tuberculin reactions after the comparative intradermal cervical test (CICT) in cattle. This study aimed to collect data to describe tuberculin regression in reactors following the CICT at 72 ± 4 h post injection. Reactors were also tested using the interferon gamma (IFN-γ) assay to establish if any pattern existed between these results and the CICT reaction regression. The data were derived from 108 herds, 112 herd-level CICTs and 1008 animals. A multivariable linear mixed model was built to explore the regression of the bovine tuberculin reaction over time and the influence of potential predictors. The results confirmed a proportional decline in the bovine tuberculin reaction occurred over time. The predictors in the final model demonstrated that regression of the tuberculin reaction differed between reactors according to their IFN-γ test results and whether visible lesions were present at slaughter. Follow-up measurement of tuberculin reactions and the serial use of the IFN-γ assay in large breakdowns has the potential to provide both a mechanism for quality assurance of the current CICT bTB surveillance and the identification of atypical breakdowns or reactors requiring further investigation.

Co-infection status of novel parvovirus's (PPV2 to 4) with porcine circovirus 2 in porcine respiratory disease complex and porcine circovirus-associated disease from 1997 to 2012.

As global pig health diseases, porcine respiratory disease complex (PRDC) and porcine circovirus-associated disease (PCVAD) generate substantial economic losses despite pigs been vaccinated against the primary causative virus, highlighting the importance of understanding virome interactions and specifically co-factor infections. Established primary endemic pathogens for PRDC include porcine circovirus 2 (PCV2), porcine reproductive and respiratory syndrome virus (PRRSv) and swine influenza virus (SIV), and PCV2 aetiology in interaction with other co-infecting viruses can result in PCVAD. Porcine parvovirus (PPV) 1 is a well-characterized virus with an available vaccine preventing reproductive failure in sows. However, whilst novel PPV 2 to 7 viruses have been identified since 2001, their viral pathogenic potential in clinical and subclinical disease remains to be determined. Therefore, this study has sought to develop a better understanding of their potential role as associated co-infections in PRDC and PCVAD by examining archival samples for the presence of PCV2 and the novel parvoviruses PPV2-4 from clinically diseased pigs across production age stages. Epidemiologically, the novel PPV2 was found to be the most prevalent within the fattener age group with PPV2-4 statistically associated with pig respiratory disease and enteric ulcers. Additionally, statistical modelling by latent class analysis (LCA) on veterinary pathology scored pigs found a clustering co-factor association between PPV2 and PCV2, suggesting the novel PPV may be involved in PRDC and PCVAD. Phylogenetic analysis of novel PPVs revealed the PPV2 capsid evolution to be diverged from the original strains with a low nucleotide homology of 88%-96% between two distinct clades. These findings determine that novel PPV 2-4 viruses are statistically associated as co-infectors in a diseased pig population, and significantly detected PPV2 clustering co-infection frequency with PCV2 in PRDC and PCVAD diseased pigs through LCA analysis.

Folate Receptor Alpha Is Preferentially Expressed in the Carcinoma Component of Endometrial Carcinosarcomas: A Potential Target for Adjuvant Therapy.

Carcinosarcomas (CSs) of the endometrium are biphasic malignancies, composed of high-grade carcinomatous and sarcomatous components. Surgical stage and pathologic characteristics are the most important prognostic findings, with a 5-yr survival of 15% to 30% in advance stage disease. Folate receptor alpha (FRA) overexpression has been observed in endometrial carcinomas and not yet studied in CSs. This study evaluates semiquantitative expression of FRA in both carcinomatous and sarcomatous components of CSs on whole tissue sections. Immunohistochemistry for FRA expression was performed and extent and intensity of staining were recorded for each case for both histologic components. A total of 46 cases were stained for FRA. The majority of these (40/46, 87%) showed FRA staining at variable intensity in the carcinomatous component, stronger in serous carcinomas and high-grade endometrioid, while only a small subset of tumors demonstrated weak staining in the sarcomatous component (2/46, 4.35%). CS is known to be associated with poor prognosis and adjuvant therapy is recommended even in low stage disease. Serous and high-grade endometrioid carcinomas are the most common carcinomatous components of CSs and are known to show consistently high FRA expression. Folate plays a role in tumor cell migration and loss of cellular adhesion, which are key steps in epithelial-mesenchymal transition, the process by which CS develops from carcinoma cells. Our study shows expression of FRA in the carcinomatous component of almost all CS cases (87%), further favoring FRA as a target for adjuvant treatment. While expression of FRA in the sarcomatous component was rarely observed, the carcinomatous component being associated with metastatic potential underscores the importance of anti-FRA therapy for systemic disease control.

The Effect of Frequency of Fresh Pasture Allocation on Pasture Utilisation and the Performance of High Yielding Dairy Cows.

Pasture allocation frequency (PAF) can influence pasture availability and grazing behaviour, which subsequently may impact on animal performance. Limited research to-date has investigated grazing management methods to improve the performance of high production dairy cows whilst also achieving high grass utilisation rates. This study evaluated the effect of three different PAF's (12, 24 and 36 h) on pasture utilisation, the performance of high yielding dairy cows and the interaction with parity. The experiment included two 60-day periods, 90 spring calving dairy cows (27 primiparous animals) in period one and 87 (24 primiparous animals) in period two. The average pre-grazing sward height (11.4 cm) was similar for all treatments in both periods. In period one, pasture utilisation rate was significantly higher (8%) in the 36 h compared to the 12 h treatment. In period two, milk energy output was significantly greater for primiparous animals in the 36 h treatment relative to the other treatments.