A survey of calf management practices and farmer perceptions of calf housing in UK dairy herds.

Adoption of optimal management techniques for rearing dairy calves has significant effects on their health, welfare, and productivity. Despite much published literature on best practice, calf morbidity and mortality rates remain high. This survey aimed to establish current calf management practices in the United Kingdom, along with farmer perceptions surrounding different housing types. A survey containing 48 questions was distributed online to UK farmers via social media, online forums, and a convenience sample of veterinary practices and was completed by 216 participants. A descriptive analysis with frequency distributions was calculated, with chi-squared tests, linear regression and multinomial regression performed to assess associations between variables. There was a low level of regular veterinary involvement in day-to-day health decision making for calves (3/216, 1.4%), highlighting the need for appropriate staff training and standard operating procedures to ensure prudent antimicrobial usage. Restricted calf milk feeding remains highly prevalent in the United Kingdom, with most calves fed milk replacer (114/216, 52.8%), twice daily (189/216, 87.5%), initially given milk at 4 L/d (66/216, 30.6%) or 6 L/d (47/216, 21.8%). There was, however, a small number of farmers initially feeding only 2 to 3 L/d (28/216, 13.0%). Euthanasia of bull calves (5/216, 2.3%) and feeding antimicrobial waste milk to calves (8/216, 3.7%) both occurred on some farms. With regard to housing, use of individual calf pens has reduced from around 60% in 2010 to 38.4% in this study (83/216), with this reduction being partly driven by the policy of UK milk buyers. Farmer perceptions indicated that individual housing was thought to help to improve calf health and feed monitoring of calves, suggesting that successful use of group housing requires a higher level of stockmanship. The majority of farmers did not provide fresh bedding to calves on a daily basis (141/216, 65.3%), and relatively few disinfected both the calf housing (38.0%) and ground (47.7%) between calves, suggesting that hygiene practices may require additional attention in farm management protocols.

Assessing the impact of tailored biosecurity advice on farmer behaviour and pathogen presence in beef herds in England and Wales.

The term 'biosecurity' encompasses many measures farmers can take to reduce the risk of pathogen incursion or spread. As the best strategy will vary between settings, veterinarians play an important role in assessing risk and providing advice, but effectiveness requires farmer acceptance and implementation. The aim of this study was to assess the effectiveness of specifically-tailored biosecurity advice packages in reducing endemic pathogen presence on UK beef suckler farms. One hundred and sixteen farms recruited by 10 veterinary practices were followed for three years. Farms were randomly allocated to intervention (receiving specifically-tailored advice, with veterinarians and farmers collaborating to develop an improved biosecurity strategy) or control (receiving general advice) groups. A spreadsheet-based tool was used annually to attribute a score to each farm reflecting risk of entry or spread of bovine viral diarrhoea virus (BVDV), bovine herpesvirus-1 (BHV1), Mycobacterium avium subsp. paratuberculosis (MAP), Leptospira interrogans serovar hardjo (L. hardjo) and Mycobacterium bovis (M. bovis). Objectives of these analyses were to identify evidence of reduction in risk behaviours during the study, as well as evidence of reductions in pathogen presence, as indications of effectiveness. Risk behaviours and pathogen prevalences were examined across study years, and on intervention compared with control farms, using descriptive statistics and multilevel regression. There were significant reductions in risk scores for all five pathogens, regardless of intervention status, in every study year compared with the outset. Animals on intervention farms were significantly less likely than those on control farms to be seropositive for BVDV in years 2 and 3 and for L. hardjo in year 3 of the study. Variations by study year in animal-level odds of seropositivity to BHV1 or MAP were not associated with farm intervention status. All farms had significantly reduced odds of BHV1 seropositivity in year 2 than at the outset. Variations in farm-level MAP seropositivity were not associated with intervention status. There were increased odds of M. bovis on intervention farms compared with control farms at the end of the study. Results suggest a structured annual risk assessment process, conducted as a collaboration between veterinarian and farmer, is valuable in encouraging improved biosecurity practices. There were some indications, but not conclusive evidence, that tailored biosecurity advice packages have potential to reduce pathogen presence. These findings will inform development of a collaborative approach to biosecurity between veterinarians and farmers, including adoption of cost-effective strategies effective across pathogens.

Alternative lengthening of telomeres in cancer stem cells in vivo.

Chromosome ends are protected by telomeres that prevent DNA damage response and degradation. Telomerase expression extends telomeres and inhibits DNA damage response. Telomeres are also maintained by the recombination-based alternative lengthening pathway. Telomerase is believed to be the sole mechanism for telomere maintenance in the epidermis. We show that basal cells in the epidermis maintain telomeres both by telomerase and alternative lengthening of telomere (ALT) mechanisms in vivo. ALT was detected in epidermal stem cells in Terc(-/-) mice, and normal human epidermal keratinocytes are also ALT-positive. The ALT pathway is suppressed in primary, but not metastatic, epidermal squamous cell carcinomas (SCC) in Terc(+/+) mice. The ALT pathway is expressed in stem cells and basal cells in epidermal SCC in Terc(-/-) mice, and in some telomerase-positive human SCC lines. Telomeres shorten markedly in stem cells and basal cells in epidermal SCC in vivo. Telomere shortening is associated with telomeric DNA damage response and apoptosis in stem cells and basal cells. Stem cells were transformed in both primary and metastatic epidermal SCC. Genetic ablation of this small cell population resulted in significant tumor regression in vivo. We concluded that alternative lengthening of telomeres is important in epidermal homeostasis and tumorigenesis in vivo.

Gender differences between predictors of HIV status among PWID in Ukraine.

BACKGROUND: The HIV epidemic in Ukraine is among the largest in Europe. While traditionally the epidemic has spread through injection risk behavior, sexual transmission is becoming more common. Previous research has found that women in Ukraine have higher rates of HIV and engage in more HIV risk behavior than men. This study extended that work by identifying risk factors that differentially predict men and women's HIV status among people who inject drugs (PWID) in Ukraine. METHODS: From July 2010 to July 2013, 2480 sexually active PWID with unknown HIV status were recruited from three cities in Ukraine through street outreach. The average age was 31 years old. RESULTS: Women, who made up twenty-eight percent of the sample, had higher safe sex self-efficacy (p<.01) and HIV knowledge (p<.001) than men, but scored higher on both the risky injection (p<.001) and risky sex (p<.001) composite scores than men. Risky sex behaviors were associated with women's HIV status more than men's. We also report results identifying predictors of risky injection and sex behaviors. CONCLUSIONS: Gender-specific interventions could address problem of HIV risk among women who inject drugs in a country with a growing HIV epidemic. Our findings suggest specific ways in which intervention efforts might focus on groups and individuals who are at the highest risk of contracting HIV (or who are already HIV positive) to halt the spread of HIV in Ukraine.

Monitoring the bulk milk antibody response to BVDV: the effects of vaccination and herd infection status.

Bovine Viral Diarrhoea Virus (BVDV) is a pestivirus in the flaviviridae family which affects cattle worldwide. Bulk milk (BM) antibody testing is frequently used as a relatively quick method of assessing herd BVDV exposure; however, an understanding of the effects of vaccination and historic infection is essential for test interpretation. This study investigated the trends exhibited by monthly BM antibody analysis in 14 herds split into three categories. Category 1 herds (vaccinating/no persistently infected (PI) animals) began the study with mid-positive BM antibody titres and experienced an estimated increase of 0.007 optical density (OD) units per month (equating to a rise of 0.35 OD units in 50 months). Category 2 herds (not vaccinating/no PI animals) began the study with mid-positive BM antibody titres and experienced an estimated decrease of 0.005 OD units per month with antibody levels in one category 2 herd taking 1290 days to decrease from mid-positive to negative. Category 3 herds (vaccinating/PI animals present) began the study with high BM antibody titres which plateaued within this range throughout the 50-month observation period. Vaccination was observed to cause transient increases in BM antibody in a number of herds in categories 1 and 3.

Establishing a pilot bovine viral diarrhoea virus eradication scheme in Somerset.

Beginning in April 2006, 41 farms were recruited onto a pilot Bovine viral diarrhoea virus (BVDV) eradication programme across the south of England with the majority of study herds concentrated in Somerset. Each herd was assessed and where relevant cleared of persistently infected (PI) animals. Seven farms dropped out before whole herd screening could be performed. Of the remaining 34 farms, 20 (59 per cent) were classified as infected although two of these were initially misclassified as BVDV-free. Over the course of three years, 61 PIs were identified across 16 of the 20 infected farms. 72 per cent of PIs indentified on the first herd test were below two years of age. PI prevalence ranged from 0.2 to 3.1 per cent of infected herds and was highest in herds that did not vaccinate. By the end of 2009, 24/34 (71 per cent) of study farms were BVDV-free while 10 (29 per cent) remained infected.

Evidence for essential histidines in human pituitary glutaminyl cyclase.

Glutaminyl cyclase (QC, EC 2.3.2.5) catalyzes the formation of the pyroglutamyl residue present at the amino terminus of numerous secretory peptides and proteins. Treatment with diethyl pyrocarbonate inactivated recombinant human QC with the apparent modification of three essential histidine residues. Comparisons of the protein sequences of QC from a variety of eukaryotic species show four completely conserved histidine residues. Mutation of each of these residues to glutamine resulted in two mutant enzymes that were inactive (H140Q and H330Q), suggesting a role in catalysis, and two that exhibited increased Km values (H307Q and H319Q), suggesting a role in substrate binding. Consistent with these results is the prediction that QC possesses a zinc aminopeptidase domain in which the four histidines identified here are present in the active site. Mammalian glutaminyl cyclases may, therefore, have structural and catalytic similarities to a family of bacterial zinc aminopeptidases.

Differences among out-of-treatment drug injectors who use stimulants only, opiates only or both: implications for treatment entry.

The goal of this study was to compare drug and alcohol use, psychological symptoms and substance abuse treatment entry among 583 street-recruited, out-of-treatment injection drug users (IDUs) who used stimulants only, opiates only or both stimulant and opiate. Data analyzed from structured interviews indicated that stimulant-only users had the most severe alcohol problems and the highest psychological symptom scores for hostility, paranoia and psychoticism. In the 2 months following their interview only 3% of the stimulant-only users entered substance abuse treatment, as compared to nearly half of the participants in the other two groups. Even after controlling for variables that differed among the groups by logistic regression analysis, stimulant only users were still 24-25 times less likely than opiate only or both stimulant and opiate users to enter treatment. Researchers and clinicians are challenged to better understand and address the unique needs of stimulant users, including potential psychological problems and alcohol abuse, in order to attract them to treatment and serve them through a comprehensive treatment approach.

Methadone maintenance as HIV risk reduction with street-recruited injecting drug users.

OBJECTIVE: To compare changes in HIV risk behaviors between street-recruited opiate injectors who entered and remained in methadone maintenance treatment and those who did not. METHODS: Three hundred sixteen participants were interviewed at baseline, received outreach interventions, and were interviewed again 6 months later. RESULTS: Significant (p <.001) reductions in HIV-related risk behaviors, including frequency of injecting, injecting with used (dirty) needles, and sharing injection paraphernalia, were demonstrated. Participants (31%) who entered and remained in methadone maintenance treatment for at least 90 days before follow-up showed a significantly greater reduction in heroin injections than those who did not. They did not show a greater reduction in using dirty needles or sharing other injection paraphernalia. CONCLUSIONS: These findings suggest that although methadone maintenance may reduce injection frequency, it does not reduce other HIV-related risk behaviors above and beyond what can be accomplished through outreach interventions. Treatment facilities and outreach intervention programs should collaborate to provide a comprehensive approach to reducing HIV risk behaviors among drug injectors both in and out of drug treatment.

The effects of offering free treatment to street-recruited opioid injectors.

AIMS: The goal of this investigation was to assess the treatment entry impact of offering free treatment to street-recruited injecting opioid users, and to determine which variables differentiated subjects who entered treatment when it was free, compared to those who entered when they had to pay for treatment. DESIGN: Three hundred and sixty-two out-of-treatment opioid injectors, recruited through street outreach, were randomly assigned to receive or not receive a coupon for 90 days of free substance abuse treatment. Demographics, desire for treatment, drug use and HIV risk behaviors were assessed prior to assignment. FINDINGS: Subjects were characterized by frequent and long-term drug use, numerous arrests, a variety of behaviors that placed them at risk for HIV, and ambivalence about entering substance abuse treatment. Offering free treatment led to significantly greater treatment entry (53% vs. 33%) and retention (155 days vs. 83 days). Entry into free treatment was particularly high, compared to those who had to pay for treatment, among subjects who had never been in treatment (43% vs. 23%) and those who reported that they did not want to enter treatment (24% vs. 6%). Subjects who entered free treatment were significantly less likely to have family problems than those who paid for their treatment. CONCLUSIONS: Opioid addicts recruited on the street and offered free methadone maintenance treatment are likely to enter and remain in treatment, even if they have never been in treatment before or claim not to want treatment. Different treatment approaches may be necessary if such subjects are motivated more by the removal of financial obstacles than other factors, such as family problems.

Sex related HIV risk behaviors: differential risks among injection drug users, crack smokers, and injection drug users who smoke crack.

This study was designed to assess differences in sex-related risk behaviors between drug injectors who did not smoke crack cocaine, crack smokers who did not inject drugs, and drug users who both injected drugs and smoked crack. Current drug users (i.e. used within the past 30 days) from 22 cities were recruited and assessed. The sample (n = 26,982) included 28% who injected only, 42% who smoked crack only, and 30% who both injected and smoked crack. Results showed that active drug users were at risk of HIV infection through sexual transmission: in the 30 day period prior to their interview, 28% reported sex with two or more individuals, 23% had an IDU sex partner, and 24% had exchanged sex for drugs or money. In addition, more than 80% did not use a condom during sex. Crack only smokers and crack smoking injectors were more likely than injectors only to report multiple sex partners and exchanging sex. Because of these high risk behaviors, condom use was of particular importance. The number of days of alcohol use and having an IDU sex partner were independently associated with not using a condom. Crack smoking injectors reported the highest average number of days of alcohol consumption and were the most likely to have had an IDU sex partner.

Extensor mechanism allografts in total knee arthroplasty.

Forty knees in 40 patients who had a chronic extensor mechanism disruption after knee arthroplasty underwent extensor mechanism allograft placement to restore extensor function. Thirteen knees were infected previously and 11 knees did not respond to previous attempts at direct extensor repair or reconstruction. Two patients died and two patients underwent above the knee amputation because of recurrent infection. The final group of 36 patients was studied for a mean followup of 3.6 years (range, 2-10 years). Clinical evaluations were performed using a modified Knee Society scoring system. The average range of motion in the entire group of patients was 1.4 degrees extension to 98 degrees flexion. The average extensor lag was 13 degrees in 15 of 36 patients. There were eight extensor allograft ruptures, which were treated by repeat extensor allograft placement. The average knee scores for function improved from 37 points preoperatively to 68 points postoperatively. Despite these initial ruptures, 34 of 36 patients had a successful clinical result. These results support the use of this technique for complete extensor mechanism loss after knee arthroplasty when direct repair is unfavorable.

Arthroscopic treatment of patellar clunk.

Excellent results have been reported with posterior stabilized total knee arthroplasty. A common complication relating to patellofemoral articulation is patellar clunk syndrome. Patellar clunk syndrome occurs when a fibrous nodule develops just proximal to the patellar button. At approximately 30 degrees to 45 degrees from full extension, the nodule catches the anterior flange of the femoral prosthesis, resulting in the clunk and a painful range of motion. The present study examines the use of arthroscopic debridement for this disorder. Thirty consecutive patients (32 knees) with the diagnosis of patellar clunk syndrome were evaluated at 1 year after arthroscopic debridement. All patients were evaluated clinically and radiographically according to the Knee Society score. In addition, patients were questioned specifically regarding anterior knee pain and patellofemoral symptoms. Radiographs were evaluated further regarding patella and component position. Patients were diagnosed with patellar clunk at an average of 12 months after their latest knee arthroplasty, with a range of 3 to 47 months. All patients complained of anterior knee pain and the clunk. All patients had a hypertrophic nodule at the junction of the proximal pole of the patella and quadriceps tendon and underwent arthroscopic debridement through a superolateral portal. All patients were free of patellar clunk postoperatively; one patient reported persistent anterior knee pain. Knee Society scores increased from an average of 64 points preoperative to 93 points postoperative. Radiographs showed patella alta in eight knees, patella baja in two. Four femoral components were in 5 degrees flexion. The present study represents the largest collection of data regarding patellar clunk syndrome. The data appear to support arthroscopic debridement as a successful treatment of patellar clunk syndrome.

Health-related service utilization and HIV risk behaviors among HIV infected injection drug users and crack smokers.

This study was designed to assess utilization of health-related services and HIV risk related behaviors by HIV infected drug users one year prior to and two years following the availability of Ryan White Title I funding. Using a cross-sectional design, a total of 777 drug injectors and crack smokers from five US cities were surveyed, over three waves of data collection, about their use of drug treatment, medical services, housing, mental health, and case management and about their sex and drug-related risk behaviors. For all service categories and in each wave, including the year prior to Title I funding, HIV risk behaviors were lower among those who used health-related services, with the exception of housing. Use of services did not increase significantly following the disbursement of Title I funds except for housing and case management. These findings suggest that it may be necessary to increase the attractiveness of health-related services, not just funding for services, for HIV infected substance abusers.