Effect of Calcium Hydroxide and Antioxidant Agents Filling the Pulp Chamber after Internal Bleaching.

To evaluate the effect of calcium hydroxide (CH), sodium ascorbate (SA) and sodium thiosulfate (ST) filling the pulp chamber on color stability and longevity of teeth after internal bleaching. Crowns of bovine incisors were submitted to internal bleaching and divided into groups according the material used in the pulp chamber: Control, CH, SA, ST. Each group was divided into two subgroups according to the time to perform restorative procedures (7 or 15 days). Color measurement was performed with a spectrophotometer at nine periods. The darkening (ΔE) values were calculated. The Mann-Whitney test was used to statistically analyze the data (p ⟨ 0.05). After bleaching, ΔE values were higher than 3.5, showing that the procedure was effective. After 24 hours, no difference was observed between groups. After 7 days, SA showed higher ΔE than the control group (p ⟨ 0.05). CH and TS did not differ from the control group. In restorations performed after 7/15 days, SA group showed higher values of darkening after 1 and 4 months than the control group (p ⟨ 0.05). SA induced perceptible darkening after bleaching and should not be used to fill the pulp chamber. ST and CH show color stability and longevity after 12 months.

Structural retrofitting of RC slabs using bamboo fibre laminate: Flexural performance and crack patterns.

Enhancing the durability of structural elements is a viable approach to promote sustainability in civil engineering. Research has shown that well-maintained slabs outperform degraded ones, which deteriorate rapidly due to insufficient upkeep. The occurrence of cracking and deformation in slabs subjected to sustained loads significantly impacts their functionality. However, the implementation of appropriate retrofitting techniques utilizing locally available materials can effectively minimize deflection and crack propagation while also improving flexural capacity. This particular study aimed to evaluate the flexural performance of slabs that were retrofitted using bamboo fibre laminate (BFL). Also, the study investigated two alternative replacement methods alongside the conventional mix; one involved replacing all fine aggregates with ceramic fine aggregate and the other involved a complete replacement of coarse aggregates with ceramic coarse aggregate. These mixes were represented in both the retrofitted and non-retrofitted samples. The retrofitting process included using the combined external bonding and near surface-mounted method. Twelve slab samples were made, with six being non-retrofitted and the other six retrofitted with BFL. Each of the samples had dimensions of 300 mm × 300 mm × 50 mm for reinforced concrete (RC) slabs. The slabs were tested employing the three point-bending system, and the retrofitted slabs with the conventional mix exhibited the highest ultimate failure load and flexural strength (62.1 kN), which compared to the non-retrofitted slabs of the same mix was a 60.76% increase. Additionally, the study did a thorough analysis of the presence of flexural and diagonal shear cracks, as well as the occurrence of debonding between BFL and the slabs. Non-destructive tests were also conducted on the slab samples to further confirm accurate results. These findings offer helpful insights into the development and application of a sustainable retrofitting material that can remarkably improve RC slabs.

Efficacy, safety and tolerability of high caloric diet in amyotrophic lateral sclerosis patients: A systematic review and meta-analysis.

BACKGROUND: Several randomized clinical trials were done to determine whether supplementation with a high caloric diet, either through carbohydrate or lipid supplementation, is safe, tolerable and improves survival. However, most of these trials are small and the results are conflicting. METHODS: Randomized prospective trials utilizing high caloric supplementation among patients with amyotrophic lateral sclerosis (ALS) were searched using the terms [("amyotrophic lateral sclerosis" or "motor neuron disease" or "ALS" or "MND") and ("high calorie" or "high fat" or "high protein" or "high carbohydrate" or "supplementation")] in Medline, Cochrane, Embase, Scopus, Prospero and Herdin by two independent neurologists. Journal articles deemed relevant were assessed for eligibility. MAIN RESULTS: There were 57 articles obtained from databases, 49 of which were excluded. Four articles were further excluded since all of them had different interventions. Overall, there were 311 ALS patients included in the study, 176 of them were from the intervention group while 135 were used as controls. Overall, high caloric supplementation in ALS was deemed safe and tolerable, and also when adverse events, tolerability and mortality are combined using meta-analysis. Although in most publications the efficacy of giving high caloric supplementation has been generally beneficial, some of the outcome parameters are not statistically different from controls when studies are combined using meta-analysis. CONCLUSIONS: Current evidence suggests that high calorie supplementation is generally safe and tolerable for patients with ALS. However, it has not been shown to be efficacious in improving weight and functional disability.

Machine learning dislocation density correlations and solute effects in Mg-based alloys.

Magnesium alloys, among the lightest structural materials, represent excellent candidates for lightweight applications. However, industrial applications remain limited due to relatively low strength and ductility. Solid solution alloying has been shown to enhance Mg ductility and formability at relatively low concentrations. Zn solutes are significantly cost effective and common. However, the intrinsic mechanisms by which the addition of solutes leads to ductility improvement remain controversial. Here, by using a high throughput analysis of intragranular characteristics through data science approaches, we study the evolution of dislocation density in polycrystalline Mg and also, Mg-Zn alloys. We apply machine learning techniques in comparing electron back-scatter diffraction (EBSD) images of the samples before/after alloying and before/after deformation to extract the strain history of individual grains, and to predict the dislocation density level after alloying and after deformation. Our results are promising given that moderate predictions (coefficient of determination [Formula: see text] ranging from 0.25 to 0.32) are achieved already with a relatively small dataset ([Formula: see text] 5000 sub-millimeter grains).

The Effect of Colloidal Silica and Glaze Coatings on the Adhesion of Zirconia with Various Ytrria Concentration.

PURPOSE: This study evaluated the effect of coating traditional and translucent Y-TZP with an industrial nanometric colloidal silica or glaze before or after sintering on the adhesion of zirconia with various ytrria concentration. MATERIALS AND METHODS: Specimens of Y-TZP with 3% and 5% yttria were subdivided into 5 groups (n=10), according to the coating applied and moment of application (before or after Y-TZP sintering): Control (no coating), Colloidal Silica/Sintering, Sintering/Colloidal Silica, Glaze/Sintering, Sintering/ Glaze. Lithium disilicate (LD) was used as positive control. Except for Y-TZP controls, groups were conditioned with silane before cementation with a self-adhesive resin cement. After 24 hours, the shear bond strength and failure analysis were performed. Also, analysis of specimens' surface was accomplished with SEM-EDX. Kruskal-Wallis and Dunn tests were applied to analyze differences between groups (p⟨0.05). RESULTS: Overall, the worst and best values of shear bond strength test were control and glaze after sintering groups. Different morphological and chemical aspects were observed in SEM-EDX analysis. CONCLUSIONS: Coating Y-TZP with colloidal silica showed unsatisfactory results. In 3Y-TZP, the surface treatment associated with the best adhesion values was the application of glaze after zirconia sintering. However, in 5Y-TZP, glaze application can be performed before or after the zirconia sintering to optimize clinical steps.

A network meta-analysis on the efficacy of different mycotoxin binders to reduce aflatoxin M1 in milk after aflatoxin B1 challenge in dairy cows.

The objective of this network meta-analysis was to determine the efficacy of different mycotoxin binders (MTB) to reduce aflatoxin M1 (AFM1) in milk. A literature search was conducted to identify in vivo research papers from different databases. Inclusion criteria were in vivo, dairy cows, description of the MTB used, doses of MTB, aflatoxin inclusion in the diet, and concentration of AFM1 in milk. Twenty-eight papers with 131 data points were selected. Binders used in the studies were hydrated sodium calcium aluminosilicate (HSCAS), yeast cell wall (YCW), bentonite, and mixes of several MTB (MX). The response variables were AFM1 concentration, AFM1 reduction in milk, total AFM1 excreted in milk, and transfer of aflatoxin from feed to AFM1 in milk. Data were analyzed with CINeMA and GLIMMIX procedures with the WEIGHT statement of SAS (SAS Inst. Inc.). The AFM1 concentration in milk decreased for bentonite (0.3 µg/L ± 0.05; mean ± SE) and HSCAS (0.4 µg/L ± 0.12), and tended to decrease for MX (0.6 µg/L ± 0.13) but was similar for YCW (0.6 µg/L ± 0.12), compared with control (0.7 µg/L ± 0.12). The percentage reduction of AFM1 in milk was similar for all MTB and different from control with a range of reduction from 25% for YCW to 40% for bentonite. The excretion of AFM1 in milk was lower in YCW (5.3 µg/L ± 2.37), HSCAS (13.8 µg/L ± 3.31), and MX (17.1 µg/L ± 5.64), and not affected by bentonite (16.8 µg/L ± 3.33) compared with control (22.1 µg/L ± 5.33). The transfer of aflatoxin B1 from feed into AFM1 in milk was lowest in bentonite (0.6% ± 0.12), MX (1.04% ± 0.27), and HSCAS (1.04% ± 0.21), and not affected in YCW (1.4% ± 0.10), compared with control (1.7% ± 0.35). The meta-analysis results indicate that all MTB reduced the AFM1 transfer into milk, where bentonite had the highest capacity and YCW the lowest.

A network meta-analysis of the impact of feed-grade and slow-release ureas on lactating dairy cattle.

A network meta-analysis was conducted to determine the effects of feeding feed-grade urea (FGU) or slow-release urea (SRU) as a replacement for true protein supplements (control; CTR) in high-producing dairy cattle diets. Research papers were selected (n = 44) from experiments published between 1971 and 2021 based on the following criteria: dairy breed, detailed description of the isonitrogenous diets fed, provision of FGU or SRU (or both), high-yielding cows (>25 kg/cow per day), and results that included at least milk yield and composition, but data on nutrient intake, digestibility, ruminal fermentation profile, and N utilization were also considered. Most studies compared only 2 treatments, and a network meta-analysis approach was adopted to compare the effects among CTR, FGU, and SRU. Data were analyzed using a generalized linear mixed model network meta-analysis. Forest plots of milk yield were used to visualize the estimated effect size of treatments. Cows included in the study produced 32.9 ± 5.7 L/d of milk, 3.46 ± 5.0% of fat, and 3.11 ± 0.2% of protein with an intake of 22.1 ± 3.45 kg of dry matter. Average diet composition was 1.65 ± 0.07 Mcal of net energy for lactation, 16.4 ± 1.45% CP, 30.8 ± 5.91% neutral detergent fiber, and 23.0 ± 4.62% starch. Average supply of FGU was 209 g/cow per day, whereas the average supply of SRU was 204 g/cow per day. With some exceptions, feeding FGU and SRU did not affect nutrient intake and digestibility, N utilization, and milk yield and composition. However, the FGU reduced the acetate proportion (61.6 vs. 59.7 mol/100 mol) and the SRU reduced the butyrate proportion (12.4 vs. 11.9 mol/100 mol) compared with CTR. Ruminal ammonia-N concentration increased from 8.47 to 11.5 and 9.3 mg/dL in CTR, FGU, and SRU, respectively. Urinary nitrogen excretion increased from 171 to 198 g/d in CTR versus the 2 urea treatments, respectively. The use of moderate doses of FGU in high-producing dairy cows may be justified based on its lower cost.

Modeling gait score of broiler chicken via production and behavioral data.

Lameness in broilers may be associated with pain and is considered a major broiler production and welfare concern. Manual gait score assessment in commercial broiler houses is discrete, time-consuming, and laborious. As such, automatic methods for broiler gait score assessment are urgently needed. The objective of this study was to identify the relation of broiler gait score with several productions and behavioral metrics (bird BW, age, activity, and distribution), and establish three gait score prediction models for automatic gait score estimations in broiler farms with automatic weighing systems, camera systems, or both. Sixteen pens were used to rear Cobb 500 and Ross 708 broilers for eight and nine weeks, respectively (eight pens/strain, 12 birds/pen). The gait scores of all birds were assessed weekly by trained assessors following a six-point (0-5) scoring protocol from the third week. The pen's average BW was measured weekly. Top-view cameras were installed to continuously record videos of broilers in all 16 pens. Images were extracted from video clips (10 min/hour) during a 16-hour light period to determine the activity index and distribution index through image processing. The gait score was positively correlated with BW (R2 = 0.97 for Cobb and R2 = 0.96 for Ross), while negatively correlated with activity (R2 = 0.78 for Cobb and R2 = 0.73 for Ross). The three models showed high accuracies in predicting broiler gait score based on variables of BW, age, activity index, and distribution index (R2 = 0.90-0.91, RMSE = 0.38-0.41). The findings of this study demonstrated the potential of estimating broiler gait score using bird BW, age, activity index, and distribution index. This information will assist in the development of automated gait score assessment systems in broiler production.

Meningitis neoplásica en tumores sólidos: revisión actualizada de diagnóstico, pronóstico, manejo terapéutico y direcciones futuras / Neoplastic meningitis in solid tumours: Updated review of diagnosis, prognosis, therapeutic management, and future directions

La meningitis neoplásica (MN) es una complicación metastásica relativamente frecuente en pacientes con cáncer, con alta morbilidad neurológica y en general pobre pronóstico. La prevalencia está en torno al 5-15% de los tumores sólidos, y los más frecuentes son el cáncer de mama, el de pulmón y el melanoma. La clínica se produce por afectación de hemisferios cerebrales, nervios craneales, médula y raíces nerviosas, siendo en muchos casos multifocal, y presenta a menudo síntomas y signos de hipertensión intracraneal. Las principales herramientas diagnósticas son la exploración neurológica, la resonancia magnética cerebral y medular con contraste, y el análisis y la citología del líquido cefalorraquídeo (LCR), aunque recientemente se están investigando técnicas como la detección de células tumorales y ADN circulante en el LCR, que aumentan la sensibilidad diagnóstica. Con las terapias disponibles en la actualidad el objetivo del tratamiento no es curativo, sino retrasar y disminuir los síntomas y preservar la calidad de vida de los pacientes, e implica un enfoque multimodal que puede incluir radioterapia, quimioterapia intratecal y/o sistémica y cirugía. El tratamiento debe ser individualizado y se basa principalmente en guías y opiniones de expertos. Actualmente se están llevando a cabo ensayos clínicos prometedores de fármacos contra dianas moleculares e inmunoterápicos. Este artículo es una revisión actualizada de la MN, e incluye epidemiologia, presentación clínica, diagnóstico, pronóstico, manejo y opciones terapéuticas; se dirige al neurólogo general, y en particular al neurólogo que ejerce su práctica en centros con pacientes oncológicos. (AU)

Neoplastic meningitis (NM) is a relatively frequent metastatic complication of cancer associated with high levels of neurological morbidity and generally poor prognosis. It appears in 5%-15% of patients with solid tumours, the most frequent being breast and lung cancer and melanoma. Symptoms are caused by involvement of the cerebral hemispheres, cranial nerves, spinal cord, and nerve roots, and are often multifocal or present with signs and symptoms of intracranial hypertension. The main diagnostic tools are the neurological examination, brain and spinal cord contrast-enhanced magnetic resonance imaging, and cerebrospinal fluid analysis including cytology, although studies have recently been conducted into the detection of tumour cells and DNA in the cerebrospinal fluid, which increases diagnostic sensitivity. With the currently available therapies, treatment aims not to cure the disease, but to delay and ameliorate the symptoms and to preserve quality of life. Treatment of NM involves a multimodal approach that may include radiotherapy, intrathecal and/or systemic chemotherapy, and surgery. Treatment should be individualised, and is based mainly on clinical practice guidelines and expert opinion. Promising clinical trials are currently being conducted to evaluate drugs with molecular and immunotherapeutic targets. This article is an updated review of NM epidemiology, clinical presentation, diagnosis, prognosis, management, and treatment; it is aimed at general neurologists and particularly at neurologists practicing in hospital settings with oncological patients. (AU)

Estudio tras intervención formativa del taller de: prevención, tratamiento y adherencia en la enfermedad osteoporótica desde la farmacia comunitaria / Study after training intervention of the workshop: prevention, treatment and adherence in osteoporotic disease from the community pharmacy

JUSTIFICACIÓN: debido a los cambios demográficos derivados del envejecimiento de la población y el aumento de pacientes con enfermedades crónicas en el mundo, la osteoporosis se ha convertido en una enfermedad prevalente y un problema de salud pública, con importantes repercusiones debido a la morbilidad y morbimortalidad que conlleva, y a los gastos directos e indirectos que genera. Si no se interviene desde la prevención, tratamiento precoz y adherencia al mismo en la práctica clínica, el número de pacientes que sufrirán osteoporosis y sus consecuencias irá en aumento. OBJETIVOS: formar al farmacéutico comunitario en educación sanitaria para la población de más de 50 años susceptible de sufrir enfermedad osteoporótica. Establecer un conjunto de recomendaciones basadas en la evidencia científica acerca de la atención farmacéutica en la enfermedad osteoporótica. MATERIAL Y MÉTODOS: estudio cuasiexperimental con intervención formativa y evaluación antes/después. Procedimiento. Se imparte el taller de forma presencial en quince ciudades con una duración de 45 minutos, eligiendo el farmacéutico horario de mañana o de tarde. Éste consta de una parte teórica y un caso práctico dividido en tres fases de seguimiento. Los asistentes responden a cinco preguntas de impacto antes y después de asistir al taller y se comparan las respuestas.RESULTADOS/ DISCUSIÓN: un 15% más de los asistentes conoce tras el taller que el problema fundamental de la enfermedad osteoporótica es la fractura por fragilidad. La mayoría de asistentes ya sabían antes del taller que se trata de una enfermedad más frecuente en mujeres (92,3%) y que el tratamiento farmacológico más habitual son los bifosfonatos (87,6%). Además, tras asistir al taller, el 14% de los asistentes mejoraron el conocimiento de los factores de riesgo más importantes y el 16% aprendió que la técnica validada para la fragilidad ósea es la densitometría central. (AU)

Neoplastic meningitis in solid tumours: updated review of diagnosis, prognosis, therapeutic management, and future directions.

Neoplastic meningitis (NM) is a relatively frequent metastatic complication of cancer associated with high levels of neurological morbidity and generally poor prognosis. It appears in 5%-15% of patients with solid tumours, the most frequent being breast and lung cancer and melanoma. Symptoms are caused by involvement of the cerebral hemispheres, cranial nerves, spinal cord, and nerve roots, and are often multifocal or present with signs and symptoms of intracranial hypertension. The main diagnostic tools are the neurological examination, brain and spinal cord contrast-enhanced magnetic resonance imaging, and cerebrospinal fluid analysis including cytology, although studies have recently been conducted into the detection of tumour cells and DNA in the cerebrospinal fluid, which increases diagnostic sensitivity. With the currently available therapies, treatment aims not to cure the disease, but to delay and ameliorate the symptoms and to preserve quality of life. Treatment of NM involves a multimodal approach that may include radiotherapy, intrathecal and/or systemic chemotherapy, and surgery. Treatment should be individualised, and is based mainly on clinical practice guidelines and expert opinion. Promising clinical trials are currently being conducted to evaluate drugs with molecular and immunotherapeutic targets. This article is an updated review of NM epidemiology, clinical presentation, diagnosis, prognosis, management, and treatment; it is aimed at general neurologists and particularly at neurologists practicing in hospital settings with oncological patients.

Resultados clínicos del tratamiento de la metatarsalgia mecánica sin afectación del primer metatarsiano / Clinical results of treatment of mechanical metatarsalgia without first metatarsal involvement

Resumen: Objetivo: Analizar los resultados clínicos de las metatarsalgias tratadas con osteotomías metafisarias metatarsales distales (DMMO) por vía percutánea. Material y métodos: Estudio prospectivo y continuo de 29 pacientes afectados de metatarsalgia mecánica aislada unilateral, intervenidas con una DMMO, con un seguimiento medio de 38 meses. La edad media de los pacientes fue 58 (rango: 50-67) años y sólo dos hombres. Utilizamos la escala AOFAS, anotamos la fórmula digital y metatarsiana sobre la radiografía. Registramos la valoración subjetiva del cirujano y del paciente al final del tratamiento. Resultados: La mejoría de la puntuación final superó los 80 puntos en todos los metatarsianos (p = 0.000), con una mejoría significativa del dolor (p = 0.000) y de las callosidades (p = 0.000), mejorando la estabilidad articular metatarso-falángica e interfalángica y la alineación de los metatarsianos. El tipo del calzado no cambió después de la cirugía, no encontramos variación de la movilidad, ni en las articulaciones metatarso-falángicas (p = 0.382), ni en las interfalángicas (p = 0.672). Después de la cirugía aumentaron los pies cuadrados (p = 0.027). La fórmula metatarsiana sufrió pocas modificaciones, 96% de los pacientes y de los cirujanos se mostraron «muy satisfechos¼ o «satisfechos¼. Conclusión: La DMMO consigue un alto grado de satisfacción en pacientes y también en el cirujano, elimina el dolor y la hiperqueratosis bajo la cabeza de los metatarsianos dolorosos que mejora significativamente la capacidad funcional de los pacientes.

Abstract: Objective: To analyze the clinical results of metatarsalgia treated with percutaneous distal metatarsal metaphyseal osteotomies (DMMO). Material and methods: Prospective and continuous study of 29 patients with isolated unilateral mechanical metatarsalgia, operated on with DMMO, with a mean follow-up of 38 months. The mean age of the patients was 58 (range: 50-67) years and only two men. We use the AOFAS score, we obtained the digital and metatarsal formulas on the X-rays. We record the subjective assessment of the surgeon and the patient at the end of the treatment. Results: The improvement in the final score exceeded 80 points in all cases (p = 0.000), with a significant improvement in pain (p = 0.000) and calluses (p = 0.000), improving metatarsal-phalangeal joint stability and interphalangeal and metatarsal alignment. The type of footwear did not change after surgery, we found no variation in mobility, neither in the metatarsophalangeal joints (p = 0.382), nor in the interphalangeal joints (p = 0.672). After surgery increased the square foot morphology (p = 0.027) but the metatarsal formula underwent few modifications. Patients and surgeons were in 96% of the cases «very satisfied¼ or «satisfied¼. Conclusion: DMMO achieves a high degree of satisfaction in patients and in the surgeon, pain and hyperkeratosis under the head of the painful metatarsals disappear and that significantly improves the functional capacity of patients.

Analgesia no farmacológica durante la realización del cribado metabólico. Aplicación en otros procedimientos dolorosos / Non-pharmacological analgesia during the heel lance procedure in newborns. Application in other painful procedures

INTRODUCCIÓN: uno de los primeros estímulos dolorosos al que es sometido un recién nacido sano es el cribado neonatal, mediante punción en el talón y extracción de muestra sanguínea. Tradicionalmente se ha tendido a menospreciar la sensibilidad al dolor neonatal y no se ha visto la necesidad de aplicar técnicas de analgesia para evitarlo. MATERIAL Y MÉTODOS: se diseñó un estudio experimental con una muestra de 106 recién nacidos en el Hospital San Pedro de Logroño (España) durante el año 2018. Se dividió la muestra en tres grupos en función de la analgesia recibida durante el procedimiento y se evaluó la respuesta al dolor mediante una escala validada. RESULTADOS: el dolor producido fue significativamente mayor en el grupo de no intervención frente a los grupos de suero glucosado o lactancia materna (p <0,001). Sin embargo, no se encontraron diferencias estadísticamente significativas entre ambos procedimientos analgésicos (p = 0,851). CONCLUSIONES: a la vista de los resultados, proponemos la implementación de estas intervenciones en otros procedimientos dolorosos. Los profesionales sanitarios han de tomar conciencia de la percepción del dolor en los procedimientos llevados a cabo tanto en el ámbito hospitalario como en Atención Primaria

INTRODUCTION: neonatal screening is one of the first painful stimuli in newborns. It consists in the extraction of a capillary blood sample by puncturing the heel. Neonatal pain is often underestimated and also the need to apply analgesia in these cases has not always been taken into account. PATIENTS AND METHODS: an experimental study was conducted on a sample of 106 newborns in the San Pedro Hospital in Logroño during 2018. Depending on the analgesia received during the heal lance, the population sample was divided into three groups. Pain response was evaluated using a validated scale. RESULTS: pain was significantly higher in the non-intervention group compared to the groups treated with glucose or breastfeeding (p <0.001). However, no statistically significant differences were found between both the analgesic procedures (p = 0.851). CONCLUSIONS: we propose the implementation of these interventions in other painful procedures. Health professionals must be aware of the perception of pain in the procedures carried out in Hospitals or Primary Care Centers

Prepartum behavior changes in dry Holstein cows at risk of postpartum diseases.

The objective of this study was to identify changes in prepartum behavior associated with the incidence of postpartum diseases in dairy cows. Multiparous Holstein cows (n = 489) were monitored with accelerometers for 3 wk prepartum. Accelerometers measured steps, time at the feed bunk, frequency of meals, lying bouts, and lying time. Postpartum health was monitored from 0 to 30 d in milk and cases of metritis, mastitis, retained placenta, displaced abomasum (DA), ketosis, and hypocalcemia were recorded. A multivariate linear mixed model was used to assess differences in behavior between diseased and not diagnosed diseased cows. A multivariate logistic regression was used to predict the occurrence of diseases. Predictors were selected using a manual backward stepwise selection process of variables until all remaining predictors had a P < 0.10. Models were submitted to a leave-one-out cross-validation process, and sensitivity, specificity, false discovery rate, and false omission rate were calculated. On average, over the 3-wk prepartum period, cows not diagnosed diseased (n = 345) took 1,613 ± 38 steps, spent 181 ± 7.1 min at the feed bunk, had 8.3 ± 0.17 meals, had 9.8 ± 0.32 lying bouts, and spent 742 ± 11.3 min lying per day. Behavior of diseased cows (n = 144) did not differ from those not diagnosed diseased. However, differences for specific diseases were observed, being significant in the week prepartum. When considering changes in behavior for only the week before calving, cows with metritis had more lying bouts (+21%), cows with DA had fewer meals (-24%) and tended to take fewer steps (-18%), and cows with ketosis had fewer meals (-22%) and spent less time at the feed bunk (-40%). Prediction models with the best outcomes were found for DA and ketosis using data of the prepartum week only. The model for DA included time at the feed bunk. Cross-validation resulted in a 80% sensitivity, 58.1% specificity, 59.2% accuracy, 91.2% false discovery rate, and 1.7% false omission rate. The model for ketosis included time at the feed bunk and number of meals. Cross-validation resulted in 64.3% sensitivity, 59.3% specificity, 59.5% accuracy, 93.0% false discovery rate, and 2.8% false omission rate. Prepartum behavior of cows affected with metritis, DA, and ketosis was different from that of cows not diagnosed with diseases. Prediction equations were able to classify cows at high or low risk of ketosis and DA and can be used in taking management decisions, but the high false discovery rates requires further refinement.

[Clinical results of treatment of mechanical metatarsalgia without first metatarsal involvement]. / Resultados clínicos del tratamiento de la metatarsalgia mecánica sin afectación del primer metatarsiano.

OBJECTIVE: To analyze the clinical results of metatarsalgia treated with percutaneous distal metatarsal metaphyseal osteotomies (DMMO). MATERIAL AND METHODS: Prospective and continuous study of 29 patients with isolated unilateral mechanical metatarsalgia, operated on with DMMO, with a mean follow-up of 38 months. The mean age of the patients was 58 (range: 50-67) years and only two men. We use the AOFAS score, we obtained the digital and metatarsal formulas on the X-rays. We record the subjective assessment of the surgeon and the patient at the end of the treatment. RESULTS: The improvement in the final score exceeded 80 points in all cases (p = 0.000), with a significant improvement in pain (p = 0.000) and calluses (p = 0.000), improving metatarsal-phalangeal joint stability and interphalangeal and metatarsal alignment. The type of footwear did not change after surgery, we found no variation in mobility, neither in the metatarsophalangeal joints (p = 0.382), nor in the interphalangeal joints (p = 0.672). After surgery increased the square foot morphology (p = 0.027) but the metatarsal formula underwent few modifications. Patients and surgeons were in 96% of the cases "very satisfied" or "satisfied". CONCLUSION: DMMO achieves a high degree of satisfaction in patients and in the surgeon, pain and hyperkeratosis under the head of the painful metatarsals disappear and that significantly improves the functional capacity of patients.

OBJETIVO: Analizar los resultados clínicos de las metatarsalgias tratadas con osteotomías metafisarias metatarsales distales (DMMO) por vía percutánea. MATERIAL Y MÉTODOS: Estudio prospectivo y continuo de 29 pacientes afectados de metatarsalgia mecánica aislada unilateral, intervenidas con una DMMO, con un seguimiento medio de 38 meses. La edad media de los pacientes fue 58 (rango: 50-67) años y sólo dos hombres. Utilizamos la escala AOFAS, anotamos la fórmula digital y metatarsiana sobre la radiografía. Registramos la valoración subjetiva del cirujano y del paciente al final del tratamiento. RESULTADOS: La mejoría de la puntuación final superó los 80 puntos en todos los metatarsianos (p = 0.000), con una mejoría significativa del dolor (p = 0.000) y de las callosidades (p = 0.000), mejorando la estabilidad articular metatarso-falángica e interfalángica y la alineación de los metatarsianos. El tipo del calzado no cambió después de la cirugía, no encontramos variación de la movilidad, ni en las articulaciones metatarso-falángicas (p = 0.382), ni en las interfalángicas (p = 0.672). Después de la cirugía aumentaron los pies cuadrados (p = 0.027). La fórmula metatarsiana sufrió pocas modificaciones, 96% de los pacientes y de los cirujanos se mostraron "muy satisfechos" o "satisfechos". CONCLUSIÓN: La DMMO consigue un alto grado de satisfacción en pacientes y también en el cirujano, elimina el dolor y la hiperqueratosis bajo la cabeza de los metatarsianos dolorosos que mejora significativamente la capacidad funcional de los pacientes.

Influence of milk feeding levels and calf housing on subsequent performance of Holstein heifers.

The purpose of this study was to investigate the effects of increased milk feeding levels or social housing during the preweaning stage of Holstein dairy heifers on subsequent weight gain, health, and reproductive parameters over time. A total of 210 heifers were grouped by calving date in groups of 10 and randomly assigned to one of 3 treatments: low-milk individual housing (LMI; 4 L of milk/d), high-milk individual housing (HMI; 8 L of milk/d), or low-milk social housing (LMS; 4 L of milk/d). Data collected included passive transfer status, disease events, weight gain at different time periods, age at first calving, calving intervals, and milk yield over the first 3 lactations. Passive transfer was successful in 189 calves, and, overall, disease events were low in this herd. The average daily gain for heifers in the HMI group (0.79 ± 0.05 kg/d) was significantly higher (F 2, 9 = 4.76) during the preweaning treatment period compared with the other groups (LMI: 0.59 ± 0.05 kg/d; LMS: 0.68 ± 0.04 kg/d). Although treatment groups did not differ with respect to age at first calving, the LMS and HMI heifers calved (22 and 15 d, respectively) earlier than the LMI heifers. Milk yield over 3 lactations was similar among the treatment groups. This suggests that both nutrition and social dynamics can influence performance of preweaned calves. Further investigation is needed to understand the mechanisms driving increased weight gain in socially housed calves.

Relative bioavailability of 3 rumen-undegradable methionine sources in dairy cows using the area under the curve technique.

The objective of this study was to evaluate the relative bioavailability of two 2-hydroxy-4-(methylthio)butanoic isopropyl esters (HMBi) obtained through different production processes and an encapsulated rumen-protected Met using the area under the curve (AUC) method. The new HMBi product (Kessent MF Liquid, Kemin Animal Nutrition and Health) was compared with an existing HMBi product (Metasmart, Adisseo SAS) and a pH-sensitive coated Met (Smartamine, Adisseo SAS). Nine multiparous lactating cows (30 kg of milk/d and 227 d in milk) fed a 45:55 forage:concentrate diet were randomly assigned within square to a triplicate 3 × 3 Latin square design. Each period consisted of a 3-d sampling period and a 3-d washout period. Treatments were dosed on d 1 of each period, and blood samples were collected from the coccygeal vein at 0, 1, 2, 3, 4, 6, 9, 12, 24, 30, and 48 h thereafter. The daily dose was 50 g of Met equivalent of each treatment. The HMBi treatments were administered directly into the cow's mouth, whereas Smartamine was fed mixed with 0.5 kg of concentrate and fully consumed within 15 min. Nonlinear models were fitted to raw data, and the basal concentration at time 0 h, time at peak (Tmax), concentration at peak, and AUC of plasma Met were determined. The Met basal concentration at t = 0 h (26.7 ± 7.67 µM) and concentration at peak (210 ± 22.2 µM) were similar among treatments, but the Tmax (11.3 vs. 1.4 h) was delayed and the AUC was 1.8-fold larger (3,457 vs. 1,868 arbitrary units) in Smartamine compared with HMBi. Results of this study indicate that the 2 HMBi products have similar plasma kinetics and bioavailability. Smartamine had different kinetics compared with HMBi products, with delayed Tmax and larger AUC and relative bioavailability.

A Genomic Snapshot of the SARS-CoV-2 Pandemic in the Balearic Islands.

Objective: To analyze the SARS-CoV-2 genomic epidemiology in the Balearic Islands, a unique setting in which the course of the pandemic has been influenced by a complex interplay between insularity, severe social restrictions and tourism travels. Methods: Since the onset of the pandemic, more than 2,700 SARS-CoV-2 positive respiratory samples have been randomly selected and sequenced in the Balearic Islands. Genetic diversity of circulating variants was assessed by lineage assignment of consensus whole genome sequences with PANGOLIN and investigation of additional spike mutations. Results: Consensus sequences were assigned to 46 different PANGO lineages and 75% of genomes were classified within a VOC, VUI, or VUM variant according to the WHO definitions. Highest genetic diversity was documented in the island of Majorca (42 different lineages detected). Globally, lineages B.1.1.7 and B.1.617.2/AY.X were identified as the 2 major lineages circulating in the Balearic Islands during the pandemic, distantly followed by lineages B.1.177/B.1.177.X. However, in Ibiza/Formentera lineage distribution was slightly different and lineage B.1.221 was the third most prevalent. Temporal distribution analysis showed that B.1 and B.1.5 lineages dominated the first epidemic wave, lineage B.1.177 dominated the second and third, and lineage B.1.617.2 the fourth. Of note, lineage B.1.1.7 became the most prevalent circulating lineage during first half of 2021; however, it was not associated with an increased in COVID-19 cases likely due to severe social restrictions and limited travels. Additional spike mutations were rarely documented with the exception of mutation S:Q613H which has been detected in several genomes (n = 25) since July 2021. Conclusion: Virus evolution, mainly driven by the acquisition and selection of spike substitutions conferring biological advantages, social restrictions, and size population are apparently key factors for explaining the epidemic patterns registered in the Balearic Islands.