Effect of pyloroplasty on clinical outcomes following esophagectomy.

INTRODUCTION: The role of concurrent pyloroplasty with esophagectomy is unclear. Available literature on the impact of pyloroplasty during esophagectomy on complications and weight loss is varied. Data on the need for further pyloric intervention are scarce. Our study compares the clinical outcomes after esophagectomy with or without pyloroplasty and investigates the role of post-operative pyloric dilatation. METHODS: Consecutive patients (n = 207) undergoing Ivor Lewis esophagectomy performed by two surgeons at our institution were included. Data on patient demographics, mortality rate, anastomotic leak, respiratory complications (Clavien-Dindo grade ≥ 3), anastomotic stricture rate, and percentage weight loss at 1 and 2 year post-operatively were evaluated. For weight analysis at 1 and 2 year post-operatively, patients were excluded if they had been diagnosed with recurrence or died prior to the 1 or 2 year timepoints. RESULTS: Ninety-two patients did not have a pyloroplasty, and 115 patients had a pyloroplasty. There were no complications resulting from pyloroplasty. There was no significant demographic difference between the groups except for age. Mortality rate, anastomotic leak, respiratory complications, anastomotic stricture rate, and percentage weight loss at 1 and 2 years were statistically similar between the two groups. However, 14.1% of patients without pyloroplasty required post-operative endoscopic pyloric balloon dilatation to treat respiratory complications or gastroparesis. Subgroup analysis of patients without pyloroplasty indicated that patients requiring dilatation had greater weight loss at 1 year (15.8% vs 9.4%, p = 0.02) and higher respiratory complications rate (27.3% vs 4.7%, p = 0.038). CONCLUSIONS: Overall results from our study that pyloroplasty during Ivor Lewis esophagectomy is safe and useful to prevent the need for post-operative pyloric dilatation.

Associations of High BMI and Excessive Gestational Weight Gain With Pregnancy Outcomes in Women With Type 1 Diabetes: A Systematic Review and Meta-analysis.

BACKGROUND: The increased risk of pregnancy complications in type 1 diabetes is mainly attributed to maternal hyperglycemia. However, it is unclear whether other potentially modifiable factors also contribute to risk in this population. PURPOSE: We sought to assess whether high BMI and excessive gestational weight gain (GWG) are associated with perinatal complications in type 1 diabetes. DATA SOURCES: We searched Medline, Embase, PubMed, Scopus, Web of Science, and Cochrane databases to January 2024. STUDY SELECTION: Studies examining associations between periconception BMI or GWG and perinatal complications in type 1 diabetes were included. DATA EXTRACTION: We used a predesigned data extraction template to extract study data including year, country, sample size, participants' characteristics, exposure, and outcomes. DATA SYNTHESIS: We included 29 studies (18,965 pregnancies; 1978-2019) in the meta-analysis. A 1 kg/m2/1 kg increase in preconception BMI or GWG was associated with a 3% and 11% increase, respectively, in perinatal complications (BMI odds ratio [OR] 1.03 [95% CI 1.01-1.06]; GWG OR 1.11 [95% CI 1.04-1.18]). Preconception BMI ≥ 25 kg/m2 or excessive GWG was associated with a 22% and 50% increase, respectively, in perinatal complications (BMI OR 1.22 [95% CI 1.11-1.34]; GWG OR 1.50 [95% CI 1.31-1.73]). BMI was associated with congenital malformation, preeclampsia, and neonatal intensive care unit admission. Excessive GWG was associated with preeclampsia, cesarean delivery, large for gestational age, and macrosomia. LIMITATIONS: Limitations included retrospective study design, variable measurement for exposures and outcomes, small number of studies for some outcomes, and no data from Asia and Africa. CONCLUSIONS: Addressing maternal BMI prepregnancy and preventing excessive GWG should be key clinical priorities to improve outcomes in pregnant women with type 1 diabetes.

Risk factors for and treatment of anastomotic strictures after Ivor Lewis esophagectomy.

INTRODUCTION: Anastomotic strictures following esophagectomy occur frequently and impact on nutrition and quality of life. Although strictures are often attributed to ischemia and anastomotic leaks, the role of anastomosis size and pyloroplasty is not well evaluated. Our study aims to assess the rate of and risk factors for anastomotic stricture following esophagectomy, and the impact of treatment with regular endoscopic balloon dilatations. METHODS: Consecutive patients (n = 207) undergoing Ivor Lewis esophagectomy performed by two surgeons at our institution were included. Data on patient demographics, surgical outcomes and anastomotic strictures were recorded. Relationship of anastomotic strictures with circular stapler size, pyloroplasty and anastomotic leak was analyzed. Treatment of strictures with endoscopic balloon dilatation was reviewed and percentage weight loss at 1 year was evaluated. RESULTS: Anastomotic strictures occurred in 17.4% of patients. Patient demographics between those with and without stricture were similar. Stricture rate was similar in patients with or without pyloroplasty (13.9% vs 21.7%, respectively, p = 0.14) and in those with or without an anastomotic leak (25.0% vs 16.6%, respectively, p = 0.345). Stricture risk increased with smaller sized stapler (25 mm = 33.3%, 28 mm = 15.3%, 31 mm = 4.8%; p = 0.027). The median number of dilatations required to fully treat strictures was 2 (IQR: 1-3). The median length of time from surgery to first dilatation was 2.9 months (IQR: 2.0-4.7) and to last dilatation was 6.1 months (IQR: 4.8-10.0). Median maximum dilatation diameter was 20 mm (IQR: 18.0-20.0). There were no complications from dilatations. Percentage weight loss at 1 year in patients with strictures was similar to those without strictures (8.7% vs 11.1%, respectively, p = 0.090). CONCLUSIONS: Post-esophagectomy anastomotic strictures are common and not necessarily related to anastomotic leaks or absence of pyloroplasty. Smaller anastomosis size was strongly linked with stricture formation. A driven approach with regular endoscopic balloon dilation is safe and effective in treating these strictures with no excess weight loss at 1 year once treated.

How well do connectivity tools agree over the full life cycle? A case study of Irish Sea plaice Pleuronectes platessa Linnaeus, 1758.

Adult plaice in the Irish Sea have distinct traits that reflect the spawning locations that could suggest a number of different populations. However, do connectivity pathways support this concept? Different tools are directed at measuring exchange or connectivity between different life-history stages, and the challenge is to integrate the signals to obtain full life-cycle estimates. Collectively, the different methods reveal stable connectivity between known spawning and nursery grounds, with sufficient exchange to maintain a single population with weak genetic structure.

The Effect of an Exercise Paddock on Dairy Cow Behavior, Health, and Nutrient Digestion during the Transition from Pregnancy to Lactation.

Providing an exercise paddock may improve the behavior and health of cows in their dry period. We compared a control group of cows in a shed with no exercise paddock and an experimental group in the same shed but with access to an exercise paddock. Both groups had ad libitum total mixed ration (TMR) indoors combined with access to a paddock (Group EX). The other group was just offered TMR indoors (Group IN). Total lying time was longer for cows without the exercise paddock (859 min/d) than for those with the paddock (733 min/d) (p = 0.012). Lying bouts were shorter, there were more allogrooming bouts, and drinking time was longer if an exercise paddock was provided. Cows with the paddock spent on average 76 min/d in paddock activity. Non-esterified fatty acids in the blood were increased by providing the exercise paddock. No significant differences in postpartum milk yield and calf weight of dry cows with or without access to exercise paddock were observed. However, crude protein and neutral detergent fiber digestibility were increased by providing the exercise paddock. The results suggest that providing an exercise paddock for cows in their dry period increased activity, including allogrooming, reduced lying, and improved digestibility of some major nutrients in the feed.

Behavioural Responses of Beef Cattle to Hot Conditions.

Cattle are increasingly exposed to hot temperatures as a result of climate change, and a better understanding of behavioural responses could be beneficial for the diagnosis of heat loads. The changes in the positioning of key body parts, feeding behaviour, body maintenance, and respiratory dynamics were assessed in 24 Black Angus steers individually exposed to hot conditions and fed a finisher diet based on cereal grain or a substituted diet (8% of the grain replaced by an isoenergetic amount of lucerne hay). Increased respiration rate during the heat load period, compared to the recovery period, was associated with increased stepping, especially by left limbs. Cattle also reduced eating, grooming, and scratching during the heat load period. The lowered head, backward ear, vertical or raised tail, and increased respiration rate and panting persisted in cattle during the heat load period. Cattle on the cereal grain diet stood for longer and were more likely to hold their ears backward and tail vertical than those on the substituted diet. We conclude that these behaviours could be used to detect animals that are most affected and that changing from a cereal-based diet to a substituted diet containing a higher amount of fibre, such as lucerne hay, can reduce hyperthermic behavioural responses to a heat load.

Idelalisib-Induced Pneumonitis in Chronic Lymphocytic Leukemia.

Idelalisib, a phosphoinositide 3-kinase delta (PI3Kδ) inhibitor, effectively treats relapsed chronic lymphocytic leukemia (CLL). While this targeted approach offers a therapeutic edge, particularly in B-cell malignancies, it is associated with complications such as pneumonitis. This report details idelalisib-induced pneumonitis, highlighting the importance of early diagnosis and tailored treatment in achieving a favorable patient outcome.

Single nuclei RNA-seq reveals a medium spiny neuron glutamate excitotoxicity signature prior to the onset of neuronal death in an ovine Huntington's disease model.

Huntington's disease (HD) is a neurodegenerative genetic disorder caused by an expansion in the CAG repeat tract of the huntingtin (HTT) gene resulting in behavioural, cognitive, and motor defects. Current knowledge of disease pathogenesis remains incomplete, and no disease course-modifying interventions are in clinical use. We have previously reported the development and characterisation of the OVT73 transgenic sheep model of HD. The 73 polyglutamine repeat is somatically stable and therefore likely captures a prodromal phase of the disease with an absence of motor symptomatology even at 5-years of age and no detectable striatal cell loss. To better understand the disease-initiating events we have undertaken a single nuclei transcriptome study of the striatum of an extensively studied cohort of 5-year-old OVT73 HD sheep and age matched wild-type controls. We have identified transcriptional upregulation of genes encoding N-methyl-D-aspartate (NMDA), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and kainate receptors in medium spiny neurons, the cell type preferentially lost early in HD. Further, we observed an upregulation of astrocytic glutamate uptake transporters and medium spiny neuron GABAA receptors, which may maintain glutamate homeostasis. Taken together, these observations support the glutamate excitotoxicity hypothesis as an early neurodegeneration cascade-initiating process but the threshold of toxicity may be regulated by several protective mechanisms. Addressing this biochemical defect early may prevent neuronal loss and avoid the more complex secondary consequences precipitated by cell death.

Effects of Transport Duration and Pre-Transport Fasting on Blood Biochemistry in Dorper × Mongolian Sheep.

Transport is a high-risk time for sheep, especially if the distances are long and sheep are fasted for a long time beforehand. Two experiments were conducted to compare transport durations of 1 hour (1 h) and 3 hours (3 h) and the effects of feeding before transport using Dorper × Mongolian sheep, which are typical of the region and may be tolerant of the high temperatures in the Inner Mongolian summer. Thirty 4-month-old male sheep were randomly divided into two treatment groups, with 15 sheep/treatment in each experiment, to evaluate the effects on blood biochemical indicators, stress hormone levels, rectal temperatures, and antioxidant status of lambs in summer. In Experiment 1, the levels of triglycerides and free fatty acids after 3 h transport were significantly lower than after 1 h transport (p < 0.05). The levels of thyroxine and malondialdehyde in blood were greater after 3 h transport than 1 h transport (p < 0.05). Creatine kinase levels after 3 h transport tended to be lower than after 1 h transport (p = 0.051). In Experiment 2, the levels of urea and superoxide dismutase in the group fasted pre-transport was significantly lower than those of the group fed pre-transport (p < 0.05). The serum cortisol level in the pre-transport fed group was higher compared to the group fed pre-transport (p = 0.04). Total antioxidant capacity in the pre-transport fasted group tended to be lower compared to that in the pre-transport fed group (p < 0.0001). We conclude that the reduction in nutritional status of sheep transported for longer and without feed pre-transport suggests that transporting sheep in hot conditions in northern China after fasting for a long period should be restricted. However, a decrease in the stress induced by transport following fasting is worthy of further study.

Farm Animal Welfare-From the Farmers' Perspective.

Improvements in the welfare of animals in the intensive production industries are increasingly being demanded by the public. Scientific methods of welfare improvement have been developed and are beginning to be used on farms, including those provided by precision livestock farming. The number of welfare challenges that animals are facing in the livestock production industries is growing rapidly, and farmers are a key component in attempts to improve welfare because their livelihood is at stake. The challenges include climate change, which not only exposes animals to heat stress but also potentially reduces forage and water availability for livestock production systems. Heat-stressed animals have reduced welfare, and it is important to farmers that they convert feed to products for human consumption less efficiently, their immune system is compromised, and both the quality of the products and the animals' reproduction are adversely affected. Livestock farmers are also facing escalating feed and fertiliser costs, both of which may jeopardise feed availability for the animals. The availability of skilled labour to work in livestock industries is increasingly limited, with rural migration to cities and the succession of older farmers uncertain. In future, high-energy and protein feeds are unlikely to be available in large quantities when required for the expanding human population. It is expected that livestock farming will increasingly be confined to marginal land offering low-quality pasture, which will favour ruminant livestock, at the expense of pigs and poultry unable to readily digest coarse fibre in plants. Farmers also face disease challenges to their animals' welfare, as the development of antibiotic resistance in microbes has heralded an era when we can no longer rely on antibiotics to control disease or improve the feed conversion efficiency of livestock. Farmers can use medicinal plants, pro-, pre- and synbiotics and good husbandry to help maintain a high standard of health in their animals. Loss of biodiversity in livestock breeds reduces the availability of less productive genotypes that survive better on nutrient-poor diets than animals selected for high productivity. Farmers have a range of options to help address these challenges, including changing to less intensive diets, diversification from livestock farming to other enterprises, such as cereal and pseudocereal crops, silvopastoral systems and using less highly selected breeds. These options may not always produce good animal welfare, but they will help to give farm animals a better life.

The Effects of Occupation, Education and Dwelling Place on Attitudes towards Animal Welfare in China.

Attitudes to animal welfare are not understood well in China, the country with the highest output of farm animals in the world. We surveyed attitudes of the public around China using a team of researchers to conduct individual interviews, with 1301 respondents in total. Contrary to results obtained in several other countries, high school leavers were more concerned about animal welfare than those who had obtained a university degree. We speculate that this may reflect the labour market currently existing in China, with limited opportunities for graduates. Scientists were less supportive, and artists more supportive, of good animal welfare. Urban dwellers were more concerned about animal welfare than rural residents, with village residents in the middle, which confirmed our theory that such a difference prevails in developing countries, where a large proportion of the rural population are involved in agriculture. It is concluded that education level, occupation and living place all have pronounced influences on attitudes to animal welfare in China, some of which follow international trends.

Delayed Presentation of Malignancy-Associated Pseudoachalasia of the Gastric Cardia.

Pseudoachalasia is a condition in which symptoms, manometry, and imaging findings highly resemble primary achalasia but has a secondary etiology. The majority of patients with pseudoachalasia have the condition as the result of a malignancy, most often at the gastroesophageal junction. There may be issues with timely identification of this malignancy as symptoms are often obscure with diagnostic testing yielding nonspecific results. We describe a case of a 65-year-old diabetic female smoker with a four-month history of intractable vomiting, abdominal pain, and weight loss who was belatedly found to have an adenocarcinoma at the gastric cardia necessitating a total gastrectomy and chemotherapy administration. The case educates clinicians on the clinical alarm symptoms related to malignant pseudoachalasia and stresses the paramount importance of performing a timely esophagogastroduodenoscopy in all cases of achalasia, even with seemingly normal imaging, to rule out pseudoachalasia related to malignancy.

The Effects of Housing on Growth, Immune Function and Antioxidant Status of Young Female Lambs in Cold Conditions.

Cold conditions in northern China during winter may reduce sheep growth and affect their health, especially if they are young, unless housing is provided. We allocated 45 two-month-old female lambs to be housed in an enclosed building, a polytunnel, or kept outdoors, for 28 days. The daily weight gain and scalp and ear skin temperature of outdoor lambs were less than those of lambs that were housed in either a house or polytunnel; however, rectal temperature was unaffected by treatment. There was a progressive change in blood composition over time, and by the end of the experiment, outdoor lambs had reduced total antioxidant capacity (T-AOC), catalase (CAT), glutathione peroxidase (GSH-Px) and total superoxide dismutase (T-SOD) and increased malondialdehyde compared to those in the house or polytunnel. In relation to immune responses in the lambs' serum, in the polytunnel, immunoglobulin A (IgA), tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) were higher and immunoglobulin G (IgG) lower compared with the concentrations in lambs that were outdoors. Over the course of the experiment, genes expressing heat shock proteins and antioxidant enzymes increased in lambs in the outdoor treatment, whereas they decreased in lambs in the indoor treatments. It is concluded that although there were no treatment effects on core body temperature, the trends for progressive changes in blood composition and gene expression indicate that the outdoor lambs were not physiologically stable; hence, they should not be kept outdoors in these environmental conditions for long periods.

Somatic CAG Repeat Stability in a Transgenic Sheep Model of Huntington's Disease.

Somatic instability of the huntingtin (HTT) CAG repeat mutation modifies age-at-onset of Huntington's disease (HD). Understanding the mechanism and pathogenic consequences of instability may reveal therapeutic targets. Using small-pool PCR we analyzed CAG instability in the OVT73 sheep model which expresses a full-length human cDNA HTT transgene. Analyses of five- and ten-year old sheep revealed the transgene (CAG)69 repeat was remarkably stable in liver, striatum, and other brain tissues. As OVT73 sheep at ten years old have minimal cell death and behavioral changes, our findings support instability of the HTT expanded-CAG repeat as being required for the progression of HD.

Humans can identify reward-related call types of chickens.

Humans can decode emotional information from vocalizations of animals. However, little is known if these interpretations relate to the ability of humans to identify if calls were made in a rewarded or non-rewarded context. We tested whether humans could identify calls made by chickens (Gallus gallus) in these contexts, and whether demographic factors or experience with chickens affected their correct identification context and the ratings of perceived positive and negative emotions (valence) and excitement (arousal) of chickens. Participants (n = 194) listened to eight calls when chickens were anticipating a reward, and eight calls in non-rewarded contexts, and indicated whether the vocalizing chicken was experiencing pleasure/displeasure, and high/low excitement, using visual analogue scales. Sixty-nine per cent of participants correctly assigned reward and non-reward calls to their respective categories. Participants performed better at categorizing reward-related calls, with 71% of reward calls classified correctly, compared with 67% of non-reward calls. Older people were less accurate in context identification. Older people's ratings of the excitement or arousal levels of reward-related calls were higher than younger people's ratings, while older people rated non-reward calls as representing higher positive emotions or pleasure (higher valence) compared to ratings made by younger people. Our study strengthens evidence that humans perceive emotions across different taxa, and that specific acoustic cues may embody a homologous signalling system among vertebrates. Importantly, humans could identify reward-related calls, and this ability could enhance the management of farmed chickens to improve their welfare.

BridgePRS leverages shared genetic effects across ancestries to increase polygenic risk score portability.

Here we present BridgePRS, a novel Bayesian polygenic risk score (PRS) method that leverages shared genetic effects across ancestries to increase PRS portability. We evaluate BridgePRS via simulations and real UK Biobank data across 19 traits in individuals of African, South Asian and East Asian ancestry, using both UK Biobank and Biobank Japan genome-wide association study summary statistics; out-of-cohort validation is performed in the Mount Sinai (New York) BioMe biobank. BridgePRS is compared with the leading alternative, PRS-CSx, and two other PRS methods. Simulations suggest that the performance of BridgePRS relative to PRS-CSx increases as uncertainty increases: with lower trait heritability, higher polygenicity and greater between-population genetic diversity; and when causal variants are not present in the data. In real data, BridgePRS has a 61% larger average R2 than PRS-CSx in out-of-cohort prediction of African ancestry samples in BioMe (P = 6 × 10-5). BridgePRS is a computationally efficient, user-friendly and powerful approach for PRS analyses in non-European ancestries.

The effects of replacing wheat and soyabean meal with duckweed (Lemna minor) and including enzymes in the diet of laying hens on the yield and quality of eggs, biochemical parameters, and their antioxidant status.

Duckweed is a rapidly growing aquatic plant, which could be used in the diet of laying hens to enhance carbon capture and improve land use efficiency. Digestion may be improved by supplementation with exogenous enzymes. We replaced soyabean meal and wheat with duckweed in a 10-week study with 432, 60-week-old Hy-Line W-36 layers, divided into six isocaloric and isonitrogenous dietary treatments, each with eight replicates. Two factors were investigated: first, duckweed substituted for wheat gluten meal and soyabean meal at 0, 7.5 and 15% of the diet, and second, with and without a multi-enzyme supplement (500 mg/kg). Duckweed did not affect egg output or weight, but it improved yolk color (P = 0.01) and reduced the liver enzymes aspartate aminotransferase (P = 0.04) and alanine aminotransferase (P = 0.02) in serum, suggesting hepatoprotective effects. Enzyme addition did not alter the effects of including duckweed in the diet, but it increased feed intake (P = 0.03). It is concluded that, as well as offering the potential to increase land productivity, inclusion of duckweed in the diet of laying hens enhances egg yolk color and hepatoprotection, without detrimental effects on performance.

Nutrients as Risk Factors and Treatments for Gestational Diabetes.

Gestational diabetes (GDM), traditionally defined as any form of glucose intolerance first detected in pregnancy [...].

Farmers' Perspectives of the Benefits and Risks in Precision Livestock Farming in the EU Pig and Poultry Sectors.

More efficient livestock production systems are necessary, considering that only 41% of global meat demand will be met by 2050. Moreover, the COVID-19 pandemic crisis has clearly illustrated the necessity of building sustainable and stable agri-food systems. Precision Livestock Farming (PLF) offers the continuous capacity of agriculture to contribute to overall human and animal welfare by providing sufficient goods and services through the application of technical innovations like digitalization. However, adopting new technologies is a challenging issue for farmers, extension services, agri-business and policymakers. We present a review of operational concepts and technological solutions in the pig and poultry sectors, as reflected in 41 and 16 European projects from the last decade, respectively. The European trend of increasing broiler-meat production, which is soon to outpace pork, stresses the need for more outstanding research efforts in the poultry industry. We further present a review of farmers' attitudes and obstacles to the acceptance of technological solutions in the pig and poultry sectors using examples and lessons learned from recent European projects. Despite the low resonance at the research level, the investigation of farmers' attitudes and concerns regarding the acceptance of technological solutions in the livestock sector should be incorporated into any technological development.