Impact of prepartum administration of a vaccine against infectious calf diarrhea on nonspecific colostral immunoglobulin concentrations of dairy cows.

Passive transfer of colostral immunoglobulins from the cow to the calf is essential for calf health. The objective of this study was to determine if prepartum administration of a vaccine stimulates increased concentrations of colostral immunoglobulins of dairy cows beyond what is explained by vaccine-specific immunoglobulins. A prospective cohort study was conducted on a spring-calving commercial dairy farm that had a policy of only vaccinating cows with even ear tag numbers with a calf diarrhea vaccine, whereas cows with odd ear tag numbers were left unvaccinated. Cows in the vaccinated group (even ear tag numbers, n = 204) received a sensitizer and booster vaccination with a vaccine against bovine rotavirus (serotypes G6 and G10), bovine coronavirus, and E. coli having the K99 pili adherence factor. A sensitizer was given because the study vaccine was different from the vaccine previously used. Cows in the control group (odd ear tag numbers, n = 194) received a 2-mL subcutaneous sterile saline solution. Both groups received two treatments at a 3-wk interval, completing the treatments approximately 2 wk prior to the planned start of calving. During the calving period, technicians separated calves from cows immediately after parturition and prior to suckling, and cows were completely milked out within 6 h of parturition. Vaccine-specific, total, and nonvaccine-specific (total minus vaccine-specific) concentrations of immunoglobulin classes A, G1, G2a, and M (IgA, IgG1, IgG2a, and IgM, respectively) were quantified by mass spectrometry for 20 colostrum samples from each treatment group. Predicted mean non-vaccine-specific colostral IgM concentrations were 8.76 (95% CI = 7.18-10.67) and 5.78 (95% CI = 4.74-7.05) mg/mL for vaccinated and control cows, respectively (P = 0.005). Predicted mean non-vaccine-specific colostral IgG1 concentrations were 106.08 (95% CI = 92.07-120.08) and 95.30 (95% CI = 81.30-109.31) mg/mL among vaccinated and control cows, respectively; however, these means were not significantly different (P = 0.278). It is thus possible that the vaccine, in addition to specifically managing infectious calf diarrhea, may also have non-specific benefits by improving colostrum quality through increased non-vaccine-specific colostrum IgM concentrations. Further research is necessary to determine the mechanism for these preliminary findings, whether the effect may occur in other immunoglobulin classes, and what impacts it may have on calf health outcomes.

Unlike human babies, calves do not receive protective immune proteins (immunoglobulins) from the mother before birth, so a sufficient volume of immunoglobulin-rich colostrum of adequate quality must be consumed within hours of birth. It can be a challenge to meet this requirement for all dairy calves. Prior to calving, cows can be vaccinated with a vaccine against specific infectious causes of calf diarrhea to stimulate elevated concentrations of specific immunoglobulins in their colostrum, which is consumed by their calves to protect them until their own immune systems develop. We enrolled cows that were either vaccinated or not with a calf diarrhea vaccine and, using novel laboratory techniques, measured concentrations of immunoglobulin classes A, G, and M in their colostrum. As expected, vaccinated cows had elevated concentrations of vaccine-specific immunoglobulins in their colostrum. However, they also had elevated non-vaccine-specific concentrations of immunoglobulin M. The vaccine may therefore have stimulated a nonspecific increase in colostral immunoglobulin M concentrations. Further research is necessary to confirm the preliminary findings of the present study and determine the mechanism for this apparent nonspecific increase in colostral immunoglobulin M concentrations, whether it may occur in other immunoglobulin classes, and whether it may benefit calf health and growth.

The length of the receiver operating characteristic curve and the two cutoff Youden index within a robust framework for discovery, evaluation, and cutoff estimation in biomarker studies involving improper receiver operating characteristic curves.

During the early stage of biomarker discovery, high throughput technologies allow for simultaneous input of thousands of biomarkers that attempt to discriminate between healthy and diseased subjects. In such cases, proper ranking of biomarkers is highly important. Common measures, such as the area under the receiver operating characteristic (ROC) curve (AUC), as well as affordable sensitivity and specificity levels, are often taken into consideration. Strictly speaking, such measures are appropriate under a stochastic ordering assumption, which implies, without loss of generality, that higher measurements are more indicative for the disease. Such an assumption is not always plausible and may lead to rejection of extremely useful biomarkers at this early discovery stage. We explore the length of a smooth ROC curve as a measure for biomarker ranking, which is not subject to directionality. We show that the length corresponds to a ϕ divergence, is identical to the corresponding length of the optimal (likelihood ratio) ROC curve, and is an appropriate measure for ranking biomarkers. We explore the relationship between the length measure and the AUC of the optimal ROC curve. We then provide a complete framework for the evaluation of a biomarker in terms of sensitivity and specificity through a proposed ROC analogue for use in improper settings. In the absence of any clinical insight regarding the appropriate cutoffs, we estimate the sensitivity and specificity under a two-cutoff extension of the Youden index and we further take into account the implied costs. We apply our approaches on two biomarker studies that relate to pancreatic and esophageal cancer.

Marital Status Disruptions and Internalizing Disorders of Children.

Marital disruption (i.e., separation or divorce) impacts an estimated 40-50% of married couples. Previous research has shown that marital disruption results in negative health outcomes for children and adolescents. Our study aims to investigate the relationship between marital disruptions and internalizing disorders of children in a prospective cohort. Comparisons between marital status groups at each time point showed a significant difference in CBCL score between children in married and unmarried families at 3 years of age, with children in unmarried families having a 0.10 higher standardized CBCL score (95% CI: 0.09-0.12; p<.0001). Differences in CBCL score by marital status were not significant at 5 and 9 years after adjusting for confounders. Parental marital status is associated with an increased CBCL internalizing behavior score at 3 years of age, but the association disappears at later time points.

Interracial couples and breastfeeding initiation in the United States.

In the past decade, the prevalence of interracial couples has steadily increased. Recent reports state that nearly one in five marriages are between spouses of different races. Interracial couples receive less social support and are more likely to separate. As a result, children born to these couples may be at an increased risk of poor health outcomes. This study aims to investigate the relationship between interracial couples and breastfeeding initiation. Data from the 2014 Vital Statistics Natality Birth database were analyzed. Data were restricted to singleton births and infants with no congenital malformations. Racial composition of parents was categorized as non-Hispanic (NH) white, NH black; Hispanic; NH white/NH black; NH white/Hispanic; and NH black/Hispanic. Breastfeeding initiation (yes; no) was categorized according to information from the child's birth certificate file. Multiple logistic regression was used to generate crude and adjusted odds ratios and 99% confidence intervals. After adjusting for confounders, all interracial couples with at least one Hispanic parent had increased odds of breastfeeding initiation. Interracial white and black parents had 18% lower odds of breastfeeding initiation. The lowest odds of breastfeeding initiation were observed among intraracial black parents, who had 43% lower odds of breastfeeding initiation compared to intraracial white parents. Breastfeeding non-initiation continues to pose the greatest risk for infants with at least one black parent. Nurses, midwives, physicians, and other medical staff should discuss potential barriers that may be unique to interracial couples and provide additional breastfeeding education and support.

Discordance in Couples Pregnancy Intentions and Breastfeeding Duration: Results from the National Survey of Family Growth 2011-2013.

BACKGROUND: Parental disagreement in pregnancy intention elevates the risk of adverse health events for mother and child. However, research surrounding parental pregnancy intention discrepancies and breastfeeding duration is limited. This study aims to examine the relationship between couple's discordant pregnancy intention and breastfeeding duration. METHODS: Data from the 2011-2013 National Survey of Family Growth was analyzed. Parental pregnancy intention was categorized as "intended by both parents," "unintended by both parents," "father intended and mother unintended," and "father unintended and mother intended." Breastfeeding duration was categorized as "never breastfed," "breastfed less than six months," and "breastfed at least six months." Multinomial logistic regression, odds ratios, and 95% confidence intervals were calculated. RESULTS: Couples with a concordant unintended pregnancy were more likely to have a child who was never breastfed or breastfed less than six months compared to couples with a concordant intended pregnancy. Similarly, couples with a discordant pregnancy were more likely to have a child who was never breastfed or breastfed less than six months. CONCLUSIONS: Findings from this study show a relationship between couples' pregnancy intentions and subsequent breastfeeding behaviors. Healthcare professionals should be cognizant of parents' differing opinions surrounding pregnancy intention and the implications on breastfeeding outcomes.

The Role of Paternity Acknowledgment in Breastfeeding Noninitiation.

BACKGROUND: In the United States, less than a quarter of mothers breastfeed in accordance with national recommendations. To date, researchers have demonstrated that paternal support directly influences breastfeeding outcomes; however, healthcare practitioners may not be able to quantify a lack of support in the immediate postpartum period. Research aim: The aim is to investigate the relationship between breastfeeding noninitiation and paternity acknowledgment, a factor that can be easily identified in the immediate postpartum period. METHODS: Data from the 2014 Vital Statistics Natality Birth database were analyzed. Analysis included primiparous singleton births with no health complications ( N = 1,127,861). Based on the birth certificate data, paternity acknowledgment was categorized as married with paternity acknowledged, unmarried with paternity acknowledged, and unmarried without paternity acknowledged. Breastfeeding initiation was dichotomized (yes or no). Multiple logistic regression analyses were conducted to obtain crude and adjusted odds ratios and 99% confidence intervals (α = .01). RESULTS: Approximately one in seven births had no paternity acknowledgment on their birth certificate. After adjusting for confounders, mothers who were not married but the paternity of the infant was acknowledged had 50% higher odds of breastfeeding noninitiation compared with mothers who were married and their infants' paternity was acknowledged (adjusted odds ratio = 1.50, 99% confidence interval [1.47, 1.53]). Furthermore, women who were unmarried and without paternity acknowledgment had 135% higher odds of breastfeeding noninitiation compared with married women with paternity acknowledgment (adjusted odds ratio = 2.35, 99% confidence interval [2.30, 2.41]). CONCLUSION: Women whose births were not acknowledged by the fathers may need additional breastfeeding support from healthcare practitioners.

Associations of Partner Age Gap at Sexual Debut with Teenage Parenthood and Lifetime Number of Partners.

CONTEXT: Age at sexual debut and age gap between partners at debut are modifiable characteristics that may be related to risky sexual behaviors. Understanding any such relationships is a necessary first step toward strengthening risk interventions. METHODS: Age at sexual debut and partner age gap were examined for 3,154 female and 2,713 male respondents to the 2011-2013 National Survey of Family Growth who first had intercourse before age 18. Multivariable logistic regression was used to assess associations between these measures and teenage parenthood and reporting a high lifetime number of partners (i.e., a number above the sample median). RESULTS: Females' odds of teenage parenthood were elevated if sexual debut occurred at ages 15-17 and involved a partner age gap of 3-4 years (odds ratio, 1.8) or more (2.0); they were reduced if debut occurred before age 15 and the gap was 3-4 years (0.8). Females' likelihood of reporting a high lifetime number of partners was negatively associated with age gap (0.4-0.7, depending on age at debut and length of age gap). Males' likelihood of reporting a large number of partners was positively associated with age gap if sexual debut was before age 15 and the gap was five or more years (1.7) or if debut was at ages 15-17 and involved a 3-4-year gap (2.0). CONCLUSION: Identifying the mechanisms underlying these associations could inform program design and implementation.

Treatment of afibrinogenemia in a chihuahua.

This report discusses the diagnosis and treatment of afibrinogenemia in a Chihuahua. Prolongations of prothrombin time (PT), activated partial thromboplastin time (aPTT), and thrombin clotting time (TCT) together with fibrinogen assay results of either no or trace amounts of fibrinogen support a diagnosis of afibrinogenemia. Differential diagnoses include common coagulopathies, liver failure, and disseminated intravascular coagulation (DIC). Either aggressive cryoprecipitate or plasma transfusions are required to treat afibrinogenemia. The current guidelines for treatment of coagulopathies include plasma transfusions (either 15-30 mL/kg or until both PT and aPTT are normalized). This report describes a case in which bleeding persisted 2 days after standard plasma transfusion levels were administered and PT and aPTT levels had normalized. In this case, the bleeding was stabilized for up to 2 mo after administering > 54 mL/kg plasma. In human medicine, either cryoprecipitate or fibrinogen concentrate is used to increase blood fibrinogen levels to 100 mg/dL for minor bleeding and 200 mg/dL for major bleeding. Further studies are needed; however, the author of this report suggests that aggressive transfusions and monitoring are needed in veterinary afibrinogenemia cases.