Cattle acclimate more substantially to repeated handling when confined individually in a pen than when assessed as a group.

Chute (CS) and exit (ES) scores are common subjective methods used to evaluate temperament in cattle production systems. A pen test, which allows behavior to be observed in a non-restrained setting, may also be an effective method to evaluate temperament by allowing more variation among animals to be expressed. The merit of pen scores in assisting producers in evaluating temperament is equivocal. The objectives of this study were to validate the usefulness of a pen score in delineating temperamental cattle and to determine whether these behavioral scores change under repeated and routine management. Over 3 consecutive years, a factorial design of two measurement protocols (frequent [F], infrequent [IN]) and three recording periods was used. The F measurements were collected over 3 consecutive days and IN measurements only on day 1 within a recording period. Each year, 20 mostly Angus commercial Bos taurus heifers were randomly assigned to each protocol. Behavior was measured using a CS, ES, and exit velocity. Body temperature and heart rate also were recorded. A fecal and blood sample were collected and analyzed for levels of various metabolites including glucose concentration and serum cortisol. Following routine handling, each heifers' response to 30 s of exposure to a human stressor was recorded both individually and in groups of four. An individual (IPS) and group (GPS) pen scores were assigned from 1 (docile) to 6 (aggressive). For all heifers, protocol, event, and their interaction, were compared on the first day of an event. For F heifers, event and day within event were instead used. Body weight was included as a covariate, with sire and year fitted as random effects. Reliability of IPS and GPS were determined using a kappa (K) coefficient. Both IPS and GPS were reliably assigned (K = 0.64 and 0.44 for IPS and GPS, respectively) and positively correlated with body temperature, heart rate, glucose, and serum cortisol (r = 0.28 to 0.37). Furthermore, F heifers acclimated to repeated handling in an individual pen setting (P < 0.05) while acclimation to handling within groups was not evident (P > 0.14). IPS provides a reliable evaluation of temperament in a non-restrained setting that is indicative of an animal's response to stress and may be useful when attempting to make phenotypic selection decisions. However, temperamental heifers became calmer with repeated gentle handling.

Chute and exit scores are common subjective methods used to evaluate temperament in cattle production systems. A pen test, which allows behavior to be observed in a non-restrained setting, may also be an effective method to evaluate temperament by allowing more variation among animals to be expressed. However, the merit of pen scores in assisting producers in evaluating temperament has yet to be discerned. Therefore, the objectives of this study were to validate the usefulness of pen scores in delineating temperamental cattle and to determine whether these behavioral scores change under repeated and routine management. Pen scores collected on heifers either individually or as a group could be assigned reliably and were indicative of an animal's response to stress during normal handling practices. Temperamental heifers, when handled more frequently, acclimated to repeated handling in an individual pen setting but not in a group. Therefore, regardless of method, when cattle are excitable during their first handling experience, more than one observation of temperament may be beneficial before assessing temperament.

Doravirine: A Return of the NNRTI Class?

Objective: To compare and contrast doravirine (DOR) with other agents in the nonnucleoside reverse transcriptase inhibitor (NNRTI) class, review safety and efficacy data from both completed and ongoing clinical trials, and outline the potential place in therapy of DOR. Data Sources: A literature search using the PubMed database (inception to June 2019) was conducted using the search terms HIV, doravirine, non-nucleoside reverse transcriptase inhibitor, NNRTI, and MK-1439. Study Selection and Data Extraction: Clinical data were limited to those published in the English language from phase 2 or 3 clinical trials. Ongoing trials were identified through ClinicalTrials.gov. Data Synthesis: DOR was approved by the US Food and Drug Administration on the strength of 2 phase 3 randomized, double-blind, noninferiority clinical trials with additional studies currently underway examining its utility in other clinical scenarios. Relevance to Patient Care and Clinical Practice: The role of NNRTIs as part of antiretroviral (ARV) therapy has diminished in recent years given the introduction of more tolerable individual ARV agents and regimens. Despite this, new agents are still needed in the therapeutic arena because treatment failure as well as intolerance can still occur with many first-line therapies. The optimal place in therapy of DOR remains to be defined. Conclusions: DOR is a new NNRTI that represents a potential treatment option for treatment-naïve patients, without many of the previously described untoward effects of the NNRTI class.

Susceptibility Provision Enhances Effective De-escalation (SPEED): utilizing rapid phenotypic susceptibility testing in Gram-negative bloodstream infections and its potential clinical impact.

Objectives: We evaluated the performance and time to result for pathogen identification (ID) and antimicrobial susceptibility testing (AST) of the Accelerate Pheno™ system (AXDX) compared with standard of care (SOC) methods. We also assessed the hypothetical improvement in antibiotic utilization if AXDX had been implemented. Methods: Clinical samples from patients with monomicrobial Gram-negative bacteraemia were tested and compared between AXDX and the SOC methods of the VERIGENE® and Bruker MALDI Biotyper® systems for ID and the VITEK® 2 system for AST. Additionally, charts were reviewed to calculate theoretical times to antibiotic de-escalation, escalation and active and optimal therapy. Results: ID mean time was 21 h for MALDI-TOF MS, 4.4 h for VERIGENE® and 3.7 h for AXDX. AST mean time was 35 h for VITEK® 2 and 9.0 h for AXDX. For ID, positive percentage agreement was 95.9% and negative percentage agreement was 99.9%. For AST, essential agreement was 94.5% and categorical agreement was 93.5%. If AXDX results had been available to inform patient care, 25% of patients could have been put on active therapy sooner, while 78% of patients who had therapy optimized during hospitalization could have had therapy optimized sooner. Additionally, AXDX could have reduced time to de-escalation (16 versus 31 h) and escalation (19 versus 31 h) compared with SOC. Conclusions: By providing fast and reliable ID and AST results, AXDX has the potential to improve antimicrobial utilization and enhance antimicrobial stewardship.