Comparison of water-based foam and carbon dioxide gas emergency depopulation methods of turkeys.

Recommended response strategies for outbreaks of avian influenza and other highly contagious poultry diseases include surveillance, quarantine, depopulation, disposal, and decontamination. The best methods of emergency mass depopulation should maximize human health and safety while minimizing disease spread and animal welfare concerns. The goal of this project was to evaluate the effectiveness of 2 mass depopulation methods on adult tom turkeys. The methods tested were carbon dioxide gassing and water-based foam. The time to unconsciousness, motion cessation, brain death, and altered terminal cardiac activity were recorded for each bird through the use of an electroencephalogram, accelerometer, and electrocardiogram. Critical times for physiological events were extracted from sensor data and compiled in a spreadsheet for statistical analysis. A statistically significant difference was observed in time to brain death, with water-based foam resulting in faster brain death (µ = 190 s) than CO2 gas (µ = 242 s). Though not statistically significant, differences were found comparing the time to unconsciousness (foam: µ = 64 s; CO2 gas: µ = 90 s), motion cessation (foam: µ = 182 s; CO2 gas: µ = 153 s), and altered terminal cardiac activity (foam: µ = 208 s; CO2 gas µ = 242 s) between foam and CO2 depopulation treatments. The results of this study demonstrate that water-based foam can be used to effectively depopulate market size male turkeys.

Electroencephalogram-based methodology for determining unconsciousness during depopulation.

When an avian influenza or virulent Newcastle disease outbreak occurs within commercial poultry, key steps involved in managing a fast-moving poultry disease can include: education; biosecurity; diagnostics and surveillance; quarantine; elimination of infected poultry through depopulation or culling, disposal, and disinfection; and decreasing host susceptibility. Available mass emergency depopulation procedures include whole-house gassing, partial-house gassing, containerized gassing, and water-based foam. To evaluate potential depopulation methods, it is often necessary to determine the time to the loss of consciousness (LOC) in poultry. Many current approaches to evaluating LOC are qualitative and require visual observation of the birds. This study outlines an electroencephalogram (EEG) frequency domain-based approach for determining the point at which a bird loses consciousness. In this study, commercial broilers were used to develop the methodology, and the methodology was validated with layer hens. In total, 42 data sets from 13 broilers aged 5-10 wk and 12 data sets from four spent hens (age greater than 1 yr) were collected and analyzed. A wireless EEG transmitter was surgically implanted, and each bird was monitored during individual treatment with isoflurane anesthesia. EEG data were evaluated using a frequency-based approach. The alpha/delta (A/D, alpha: 8-12 Hz, delta: 0.5-4 Hz) ratio and loss of posture (LOP) were used to determine the point at which the birds became unconscious. Unconsciousness, regardless of the method of induction, causes suppression in alpha and a rise in the delta frequency component, and this change is used to determine unconsciousness. There was no statistically significant difference between time to unconsciousness as measured by A/D ratio or LOP, and the A/D values were correlated at the times of unconsciousness. The correlation between LOP and A/D ratio indicates that the methodology is appropriate for determining unconsciousness. The A/D ratio approach is suitable for monitoring during anesthesia, during depopulation, and in situations where birds cannot be readily viewed.

Mass emergency water-based foam depopulation of poultry.

When an avian influenza or virulent Newcastle disease outbreak occurs within commercial poultry, a large number of birds that are infected or suspected of infection must be destroyed on site to prevent the rapid spread of disease. The choice of mass emergency depopulation procedures is limited, and all options have limitations. Water-based foam mass emergency depopulation of poultry was developed in 2006 and conditionally approved by the U.S. Department of Agriculture and American Veterinary Medical Association. Water-based foam causes mechanical hypoxia and can be used for broilers, layers, turkeys, and ducks. The time to physiologic states was evaluated for broilers, layer hens, turkeys, and ducks, comparing water-based foam and CO2 gas using electroencephalogram (unconsciousness and brain death), electrocardiogram (altered terminal cardiac activity), and accelerometer (motion cessation). In broilers, turkeys, and layer hens, water-based foam results in equivalent times to unconsciousness, terminal convulsions, and altered terminal cardiac activity. With Pekin ducks, however, CO2 gas resulted in shorter times to key physiologic states, in particular unconsciousness, altered terminal cardiac activity, motion cessation, and brain death.

High-dose femtosecond-scale gamma-ray beams for radiobiological applications.

Objective. In the irradiation of living tissue, the fundamental physical processes involved in radical production typically occur on a timescale of a few femtoseconds. A detailed understanding of these phenomena has thus far been limited by the relatively long duration of the radiation sources employed, extending well beyond the timescales for radical generation and evolution.Approach. Here, we propose a femtosecond-scale photon source, based on inverse Compton scattering of laser-plasma accelerated electron beams in the field of a second scattering laser pulse.Main results. Detailed numerical modelling indicates that existing laser facilities can provide ultra-short and high-flux MeV-scale photon beams, able to deposit doses tuneable from a fraction of Gy up to a few Gy per pulse, resulting in dose rates exceeding 1013Gy/s.Significance. We envisage that such a source will represent a unique tool for time-resolved radiobiological experiments, with the prospect of further advancing radio-therapeutic techniques.

Enhanced thromboprophylaxis in critically ill patients with COVID-19 infection.

Background: Patients with severe SARS-CoV-2 infection have been shown to have abnormal coagulation parameters and are at increased risk of thromboembolism. The optimal thromboprophylaxis regimen that minimizes thrombosis without increased risk of serious bleeding is uncertain. Objectives: To describe the efficacy and safety of increased intensity (enhanced) thromboprophylaxis in patients with COVID-19 admitted to the medical intensive care unit (MICU). Methods: This is a retrospective cohort analysis of patients with a diagnosis of COVID-19 admitted to the MICU of an urban safety net hospital. With the exception of patients being supported with extracorporeal membrane oxygenation or on chronic anticoagulation who received therapeutic dosing of anticoagulation, thromboprophylaxis was given as either enoxaparin or unfractionated heparin in doses higher than those recommended for standard prophylaxis, but lower than those used for therapeutic anticoagulation. Main results: Of the 120 patients managed with an enhanced thromboprophylaxis protocol, 6 (5%) experienced thromboembolism as a result of their COVID-19 disease (1 pulmonary embolus, 4 deep vein thromboses, and 1 arterial embolism). Four patients experienced major bleeding while receiving therapeutic anticoagulation. Conclusions: In critically ill patients with COVID-19, increased intensity (enhanced) thromboprophylaxis appears to be effective at preventing clinically significant thromboembolic events without an increased risk of serious bleeding.

Comparison of water-based foam and inert-gas mass emergency depopulation methods.

Current control strategies for avian influenza (AI) and other highly contagious poultry diseases include surveillance, quarantine, depopulation, disposal, and decontamination. Selection of the best method of emergency mass depopulation involves maximizing human health and safety while minimizing disease spread and animal welfare concerns. Proper selection must ensure that the method is compatible with the species, age, housing type, and disposal options. No one single method is appropriate for all situations. Gassing is one of the accepted methods for euthanatizing poultry. Whole-house, partial-house, or containerized gassing procedures are currently used. The use of water-based foam was developed for emergency mass depopulation and was conditionally approved by the United States Department of Agriculture in 2006. Research has been done comparing these different methods; parameters such as time to brain death, consistency of time to brain death, and pretreatment and posttreatment corticosterone stress levels were considered. In Europe, the use of foam with carbon dioxide is preferred over conventional water-based foam. A recent experiment comparing CO2 gas, foam with CO2 gas, and foam without CO2 gas depopulation methods was conducted with the use of electroencephalometry results. Foam was as consistent as CO2 gassing and more consistent than argon-CO2 gassing. There were no statistically significant differences between foam methods.

Postoutbreak disinfection of mobile equipment.

Current control strategies for avian influenza virus, exotic Newcastle disease, and other highly contagious poultry diseases include surveillance, quarantine, depopulation, disposal, and decontamination. Skid steer loaders and other mobile equipment are extensively used during depopulation and disposal. Movement of contaminated equipment has been implicated in the spread of disease in previous outbreaks. One approach to equipment decontamination is to power wash the equipment, treat with a liquid disinfectant, change any removable filters, and let it sit idle for several days. In this project, multiple disinfectant strategies were individually evaluated for their effectiveness at inactivating Newcastle disease virus (NDV) on mechanical equipment seeded with the virus. A small gasoline engine was used to simulate typical mechanical equipment. A high titer of LaSota strain, NDV was applied and dried onto a series of metal coupons. The coupons were then placed on both interior and exterior surfaces of the engine. Liquid disinfectants that had been effective in the laboratory were not as effective at disinfecting the engine under field conditions. Indirect thermal fog showed a decrease in overall virus titer or strength. Direct thermal fog was more effective than liquid spray application or indirect thermal fog application.

The Gly/Arg-rich (GAR) domain of Xenopus nucleolin facilitates in vitro nucleic acid binding and in vivo nucleolar localization.

Epitope-tagged Xenopus nucleolin was expressed in Escherichia coli cells and in Xenopus oocytes either as a full-length wild-type protein or as a truncation that lacked the distinctive carboxy glycine/arginine-rich (GAR) domain. Both full-length and truncated versions of nucleolin were tagged at their amino termini with five tandem human c-myc epitopes. Whether produced in E. coli or in Xenopus, epitope-tagged full-length nucleolin bound nucleic acid probes in in vitro filter binding assays. Conversely, the E. coli-expressed GAR truncation failed to bind the nucleic acid probes, whereas the Xenopus-expressed truncation maintained slight binding activity. Indirect immunofluorescence staining showed that myc-tagged full-length nucleolin properly localized to the dense fibrillar regions within the multiple nucleoli of Xenopus oocyte nuclei. The epitope-tagged GAR truncation also translocated to the oocyte nuclei, but it failed to efficiently localize to the nucleoli. Our results show that the carboxy GAR domain must be present for nucleolin to efficiently bind nucleic acids in vitro and to associate with nucleoli in vivo.

The influence of time of day on the foraging behavior of the honeybee, Apis mellifera.

The honeybee time sense, or Zeitgedächtnis, is highly adaptive, allowing bees to synchronize their foraging behavior with the peak time of daily floral nectar rhythms. Each foraging group within the honeybee colony shows a high degree of fidelity to one species of flower. Across the day, the temporal accuracy of foraging visits to experimental feeding times varies considerably, being nearly exact for morning-trained foraging groups but becoming less so for foraging groups trained later in the day. The evidence gained in this study suggests that the diel change in accuracy exhibited by foraging groups, which persists after the removal of many potential environmental time cues, is an endogenously driven behavior pattern. Furthermore, it appears that individual bees are continuously and accurately aware of the time of day, but are programmed to forage with greater anticipation to late-day food sources. Therefore, two separate processes contributing to the honeybee time sense are implicated. The first varies with time of day and determines the amount of anticipatory activity directed toward the food source. The second process is invariant across the day and is involved with the individual forager's continuous, accurate awareness of time.

Donor nutritional status--a determinant of liver preservation injury.

In liver transplantation, the quality of the liver is determined by a number of factors including donor nutritional status. Livers from fasted donors appear to tolerate long-term preservation better than livers from fed donors. In this study we repeated earlier results and obtained 31% (4/13) survival after 40-hr preservation of livers from fed donor Brown Norway rats and 67% (8/12) survivors with donor livers from 4-day-fasted rats (P = 0.154). The explanation for this improvement is not known but may be due to inactivation of Kupffer cells due to nutritional depletion of the liver. Kupffer cell activation has been one explanation advanced to explain how cold storage injuries livers during reperfusion (transplantation). In this study, we have measured how donor fasting affects Kupffer cell function (phagocytosis of colloidal carbon) after preservation of the rat liver. In addition, we measured how enhancing liver glycogen by feeding glucose to the rat donors affected outcome and liver functions tested by isolated perfusion after 24- and 40-hr cold storage of the liver. Preservation did not cause inactivation or activation of Kupffer cell phagocytosis of colloidal carbon. In livers with 0-hr preservation, colloidal carbon uptake was 3.1 +/- 0.2 mg/g/hr, after 40-hr preservation uptake was 3.8 mg/g/hr (P < 0.05 vs. 0 hr) (fed) and 2.7 +/- 0.3 mg/g/hr (fasted, P, 0.05 vs. 0-hr and 40-hr-fed). Thus, the improved survival obtained with livers from fasted donors does not appear related to inactivation of Kupffer cell phagocytosis. Although livers from fasted donors showed improved survival, there was extensive hepatocellular injury as indicated by large LDH release from the livers after 40-hr cold storage as tested by isolated perfusion. LDH released into the perfusate increased from 35.8 +/- 10.1 U/L (fed, 40-hr CS) to 301 +/- 65 U/L (fasted, 40-hr CS) after 1-hr reperfusion. AST release showed a similar pattern and bile production was suppressed more in livers from fasted donors than fed donors. Feeding rats glucose elevated liver glycogen and significantly reduced hepatocellular injury as measured by LDH release and AST release in the isolated perfused liver after 40-hr cold storage. Feeding rats glucose (40% in drinking water for 4 days) also improved survival: fed+glucose = 85% survival versus 31% survival with no glucose and fasted+glucose = 92% survival versus 67% survival with no glucose. These results show that both extensive donor fasting and glucose feeding enhanced outcome in orthotopic liver transplantation. This dilemma (both fasting and feeding improved survival) are discussed in terms of how the interactions between Kupffer cells and hepatocytes affect liver viability. Donor fasting is probably impractical clinically as a method to improve the donor liver, but elevating liver glycogen by glucose supplementation is possible and may lead to improved preservation and outcome in liver transplantation.

Prolongation of canine intestinal allograft survival with RS-61443, cyclosporine, and prednisone.

The efficacy of RS-61443 and cyclosporine utilized either alone or in combination was assessed in both a segmental heterotopic and total orthotopic canine intestinal transplant model. Twenty-eight dogs underwent segmental (150-cm) heterotopic intestinal transplants and five dogs total orthotopic transplants. Five heterotopic groups were compared: group 1, no immunosuppression; group 2, cyclosporine and prednisone; group 3, RS-61443, cyclosporine and prednisone; group 4, RS-61443 and prednisone; and group 5, RS-61443 and subtherapeutic cyclosporine. Group 3 animals achieved a median survival of 136 days, while the median survivals of groups 1, 2, 4, and 5 were < or = 10 days (P < .001). Twenty deaths in groups 1 through 5 were secondary to allograft rejection, two were due to infection, and two were unexplained. Four animals in group 3 were sacrificed, one at 83 days due to diarrhea and weight loss and three at the termination of the study. The median survival of five dogs undergoing total orthotopic transplantation (group 6) was 27.0 days and was significantly longer than groups 1, 4, and 5 (P < .01). No dog in this group had intestinal rejection--however, four were sacrificed due to weight loss and one died of malnutrition. The combination of RS-61443 and cyclosporine significantly prolonged intestinal allograft survival in both the heterotopic and orthotopic transplant models. Clinically, this combination may be promising for both combined liver-intestinal and isolated intestinal transplantation.

Randomized comparative study of ampicillin/sulbactam vs. ceftriaxone for treatment of soft tissue and skeletal infections in children.

In a prospective study 105 children hospitalized with soft tissue infection, 11 children with suppurative arthritis and 9 children with osteomyelitis were treated with either parenterally administered ampicillin/sulbactam or ceftriaxone. Treatment was randomized using a computer-generated table in a 2:1 fashion: 84 patients received ampicillin/sulbactam and 41 patients received ceftriaxone. Organisms isolated from wound site or blood cultures included Staphylococcus aureus (33), Streptococcus pyogenes (19), Haemophilus influenzae (9) including 4 beta-lactamase-positive organisms, Streptococcus pneumoniae (5), Neisseria gonorrhoeae (3) and 9 other organisms. Clinical and bacteriologic response was satisfactory in 100% of the ampicillin/sulbactam-treated patients and in 93% of the ceftriaxone-treated patients. Two patients with S. aureus infections treated with ceftriaxone had a delayed response and required change in therapy to parenterally administered oxacillin. Ampicillin/sulbactam represents a potentially useful single agent for the treatment of cellulitis and bone or joint infections in pediatric patients.

Tryptophan depletion in SSRI-recovered depressed outpatients.

RATIONALE: Recently, a number of studies have challenged the finding that acute tryptophan depletion (TD) increases depressive symptoms in medicated, formerly depressed patients. The present study examined the effects of acute nutritional TD on remitted depressed patients currently treated with selective serotonin reuptake inhibitors. In an attempt to clarify conflicting earlier findings, the effects of a number of clinical variables on outcome were also investigated. METHODS: Ten patients underwent TD in a double-blind, controlled, balanced crossover fashion. The control session followed the procedure of Krahn et al. (1996 Neuropsychopharmacology 15:325-328). Sessions were 5-8 days apart. RESULTS: TD was significantly related to increased scores on clinician-rated depression and anxiety scales, and on self-rated depression, anxiety, and somatic symptoms. The control challenge had no effect, despite the fact that the reductions in plasma tryptophan during the control session were unexpectedly high. Some evidence was found for a threshold in the relationship between reduction of plasma tryptophan and mood response. CONCLUSIONS: The mood effect of TD in medicated, formerly depressed patients was confirmed. A threshold may exist for mood effects following TD, implying that recent negative findings may have been caused by insufficient depletion. No other predicting or mediating factors were identified, although the variable "history of response pattern to medication" deserves further study.

Wing dimorphism in Gryllus rubens: genetic basis of morph determination and fertility differences between morphs.

The genetic basis of wing morph determination and fertility differences between wing morphs were studied in the wing-dimorphic cricket, Gryllus rubens. Using pair corsses, a significant effect of genotype on morph determination was documented in F3 progeny of field-collected crickets. The effect of genotype was significantly stronger in females than in males. Results are consistent with an earlier study (Zera and Tiebel 1988) showing that wing development is more strongly buffered from environmental variation in females. Segregation patterns were consistent with a polygenic mode of inheritance and provided no evidence for the existence of genes of major effect, maternal effects, or sex linkage. Only a weak morph x sex association was observed. These results contrast those of Walker (1987) where sex-linked loci of major effect on morph determination were identified in crosses between long-wing and short-wing-selected strains of G. rubens. Short-winged female G. rubens began ovipositing earlier and oviposited significantly more eggs than long-winged females during the first 24 days after adult eclosion. The greater reproductive output of the short-winged morph was due entirely to greater oviposition during the first two weeks after adult eclosion. Preliminary results indicate that flight may further accentuate the reduced reproductive output of long-winged versus short-winged females. These data provide the foundation for investigating the endocrine basis of morph-associated fertility variation in G. rubens and its mechanistic relationship with morph determination.

Immunological and feeding studies on antigens derived from the biting fly, Stomoxys calcitrans.

Pairs of rabbits were immunised with three antigenic preparations derived from Stomoxys calcitrans gut, abdominal section and whole flies. Immunoblotting studies demonstrated that a humoral response was mounted against eight antigens from the gut preparation and 12 each from the abdominal and whole fly preparations. In vitro feeding experiments showed higher mortality between Days 4 and 7 in the group of flies which had fed upon blood from rabbits inoculated with the gut derived antigen. This group also produced the lowest percentage of viable eggs (15.5%).

Anxiety disorders in plastic surgery.

Surgery is a stressful event, with the potential for profound disturbance to the patient's psychological and physiologic homeostasis. Cosmetic surgery is a particularly intense psychological experience because, in addition to the usual concerns about surgical side effects, cosmetic patients bring their hopes and expectations for improved self-image, putting them at risk for the added anxiety of disappointment. High levels of anxiety coupled with the perception of vulnerability or threat to self can cause significant psychological reactions complicating care for the plastic surgical patient. This paper outlines the diagnostic features of the common types of anxiety disorders seen in plastic surgical patients, and it offers treatment strategies for the practitioner, delineating when referral to a mental health expert is advised. Specific clinical case studies of panic attack, posttraumatic stress disorder, and acute stress disorder are presented to illustrate the variety of abnormal anxiety responses that may be encountered in the perioperative setting. Interventions for the anxious patient are part science and part art. Careful questioning and psychosocial assessment can identify those patients who are at greater risk for psychological problems after surgery. However, some patients may mask or keep secret their concerns, which can be manifested with resulting anger and hostility. Plastic surgeons must use appropriate indicators of psychological anxiety and measure a specific patient's reactions to surgery to make the diagnosis of abnormal anxiety. Close follow-up by the plastic surgical team is an essential part of the anxiety disorder patient's psychological treatment, but it is imperative that these problematic patients be referred promptly to a qualified mental health professional to limit their adverse experience and promote their well-being. Patients who are less anxious during the perioperative period report less emotional distress and fewer defensive behaviors and are likely to be more satisfied with the outcome of their surgery.

Psychological complications in 281 plastic surgery practices.

Surgery is a high-stakes stressor with possible consequences that include death, pain, disfigurement, economic losses, and alterations in social roles. Often, the most disturbing complications to surgeons and patients are psychological rather than physical. Ineffective management of psychological complications of surgery can have profound consequences, resulting in delayed recuperative times, delayed return to work, poor patient compliance, dissatisfaction with the surgical outcome, hostility toward surgeons, and anxiety. The purpose of this study was to investigate in a large randomized group of plastic surgery practices the relative incidence of negative psychological outcomes and to compare these with the incidence of adverse physical outcomes to gain a greater appreciation of the relative magnitude of each type of perioperative complication. The study design was a descriptive, correlational survey that assessed psychological complications reported by plastic surgeons. The Plastic Surgery Questionnaire was sent to 702 randomly selected board-certified plastic surgeons. The sample consisted of 281 board-certified plastic surgeons (40 percent response rate). The study instrument was found to be highly reliable, with inter-item Cronbach's alpha r = 0.85. The demographics were representative of the specialty as a whole. It was found in general that psychological complications were much more prevalent than physical problems such as hematoma or infection. Anxiety reactions were commonly encountered by 95.4 percent of surgeons; disappointment (96.8 percent), depression (95.0 percent), nonspecific physical complaints (92.2 percent), and sleep disorders (88.5 percent) were the next most commonly reported complications. Most surgeons (75.8 percent) reported that screening for depression was important, but only 18.8 percent identified screening for post-traumatic stress disorder as important, even though 86 percent had diagnosed post-traumatic stress disorder in their postoperative patients. Psychological complications occur at rates equal to or greater than those of physical complications in the plastic surgery practice. Patients who experience physical complications are much more likely to simultaneously experience psychological complications. Patients with preexisting psychological conditions are more at risk for postoperative psychological complications. Disappointment, anxiety, and depression were the most frequently seen psychological complications. Nursing personnel are perceived by plastic surgeons to have the primary role in screening patients for pertinent psychological history. Directed research should be undertaken to determine which treatment regimens are most effective in reducing preoperative psychological complications. Controlled clinical trials of pharmaceuticals and alternative therapies must be designed and carried out in a prospective manner to establish the optimum treatment for alleviation of adverse emotional consequences of surgery. The next frontier for the specialty is to actively and consciously investigate and improve our patients' emotional and psychological results from surgery.

Reevaluating the need for routine drainage in reduction mammaplasty.

The incidence of complications after reduction mammaplasty without drains was reviewed by analysis of 50 bilateral reduction mammaplasty procedures. Patients ranged in age from 14 to 65 years; the average combined volume removed was 953 g. Eighty-four percent of the patients underwent a Pitanguy technique, and the remaining patients underwent an inferior pedicle or amputative technique with free nipple grafts. Three patients had six complications; one of these patients had three of the complications. Complications included two cases of fat necrosis and one case of wound disruption. One patient had a hematoma with wound disruption and partial nipple loss. There were no cases of infection. The purpose of this study was to determine the rate of complications in reduction mammaplasty performed without drains. Incidentally, statistical analysis using the chi-squared test revealed that this series without drains compared favorably with previously published data for reduction mammaplasty using drains. It is concluded that routine closed suction drainage after reduction mammaplasty is unnecessary and should be reconsidered.

National plastic surgery survey: face lift techniques and complications.

The purpose of this study was to assess trends in technique and philosophy of face lifting, associated procedures, and the incidence and management of complications. Surveys were sent to 3800 members of the American Society of Plastic and Reconstructive Surgeons (ASPRS); 570 surveys (15 percent) were returned. Numerous very specific technique and philosophy questions were asked. Details of demographics, techniques, incidence of complications, management of complications, and basic philosophy are presented. Three basic conclusions can be gleaned from this study: (1) Surgeons perform more tried and true methods of aesthetic surgery, rather than the many new methods that seem to get the most attention in the media and at the meetings. (2) It seems that less-experienced surgeons tend to be generally more conservative in their approach to aesthetic surgery. (3) Complication rates reported by the plastic surgery community at large coincide with previous complication rates, as outlined in other nonsurvey studies. The authors expect to report additional data from the survey--on brow surgery (part II) and facility and ancillary procedures (part III)--in forthcoming publications.