Salmonella enterica subspecies enterica serovar Choleraesuis in a Swedish gilt-producing herd, a case report.

BACKGROUND: When Salmonella enterica subspecies enterica serovar Choleraesuis (S. Choleraesuis) was detected in faecal samples collected within the Swedish Salmonella surveillance program from a gilt multiplying herd in September 2020, S. Choleraesuis had not been detected in domestic pigs or wild boar in Sweden for over 40 years. This report describes the subsequent investigation, identification of possible entry routes and measures undertaken to eliminate the pathogen from the herd. CASE PRESENTATION: In accordance with Swedish regulations, pig movements to and from the farm were restricted, internal biosecurity measures were enhanced, and a test-and-remove strategy was implemented. Testing included repeated faecal sampling, tissue samplings from all dead or euthanized pigs, and serological sampling of replacement gilts. Epidemiological investigations included scrutinising of production records, employee interviews, analysing feed and environmental samples, faecal samples from the herd's purebred gilt supplier, and tissue and faecal samples from wild boars in the adjacent area. Testing of in-contact herds receiving gilts (n = 15) or 30-kg pigs (n = 7) from the multiplier included whole-herd faecal sampling and tissue cultures from pigs that died with signs of septicaemia. In total, S. Choleraesuis was detected in 12/4200 faecal and 5/1350 tissue samples from the herd, and the corresponding groups of pigs were euthanized. All feed and environmental samples as well as samples from the gilt supplier were negative. Testing of contact herds resulted in the identification and culling of one group of S. Choleraesuis-positive gilts. Replacement gilts introduced to the herd from January until May 2021 remained serologically negative during a surveillance-period of five months. CONCLUSION: Although speculative, the epidemiological investigation identified indirect transmission from wild boar as possible source of introduction to the herd. Whole-genome sequencing of S. Choleraesuis isolates from wild boar in the area showed that they clustered with isolates from the herd. Repeated testing of the herd indicated that the test-and-remove strategy was successful. In August 2021, all restrictions were removed, and the herd was re-instated as a gilt producing herd. Compensation from the Swedish state to the farmer for production losses, culled animals and extra costs associated with the elimination cost totalled SEK 7 992 234.

Substance Use Disorder among Hospitalized Adolescents in North Carolina.

OBJECTIVES: Individuals who began using alcohol or other drugs before the age of 15 are 7 times more likely to develop a substance use disorder (SUD) in adulthood. This study sought to determine the common characteristics of SUD-related hospitalizations and patterns of discharge diagnoses among adolescents in North Carolina. METHODS: Using the 2014 State Inpatient Database (SID), discharge records associated with the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes for SUD were identified. Adolescents between the ages of 13 and 19 years were included. SUD and non-SUD groups were compared using the Student t test for continuous variables and the χ2 test for categorical variables. A total of 1.1 million hospital discharges were analyzed. A uniform and standardized coding system called Clinical Classifications Software was used to identify cases. The Clinical Classifications Software collapses the ICD-9-CM codes into 679 clinically meaningful categories. A cluster of 3900 ICD-9-CM procedure codes also was used to identify clinically relevant groups of procedures performed during hospitalization. RESULTS: An estimated 3276 adolescents associated with SUD were discharged from North Carolina hospitals during the study year. Discharged patients with a SUD spent a total of 21,242 inpatient days, at a cost of $62 million. Among the adolescents with a SUD, 53% were boys, 62% were White, 24% were Black, 8% were Hispanic (8%), and 6% were of other races. Compared with patients without a SUD, those with a SUD had longer mean hospital stays (6.5 days vs 4.7 days; P < 0.0001) and lower mean hospital charge per hospitalization ($18,932 vs 24,532; P < 0.0001). Adolescents with a SUD also were diagnosed primarily as having mood disorders (44.78%), followed by schizophrenia and other psychological disorders, upon discharge. Approximately 37% of the SUD-related discharges occurred in areas, denoted in this study using ZIP code designations, with mean household annual incomes <$38,999. A large proportion of the SUD-related hospitalizations (44%) were billed to Medicaid. Frequently observed diagnoses associated with adolescents with a SUD were mood disorders (45%), schizophrenia (7%), and poisoning by other medications and drugs (4%). In 16% of hospitalized adolescents with a SUD, there were at least 2 procedures performed. There was a statistically significant mean hospital charge difference of $5600 between SUD and non-SUD teens. CONCLUSIONS: The literature reflects the connection between adolescent use and the propensity for diagnosis with a SUD in adulthood; it is evident that this is a growing public health crisis. This study identified patterns of adolescent substance use that, based on the current literature, are indicative of problematic futures for these individuals. The concerning data and literature identify a significant need to address prevention, treatment, and recovery services for adolescents, not only in North Carolina but throughout the United States. The need for focused interventions, access to care, and funding of substance-specific adolescent education and services is greatly needed to change the trajectory of these adolescents' lives.

Discriminating the Interaction Anisotropy in Polymorphs Using Powder Brillouin Light Scattering.

Drug product performance is polymorph specific, and it is imperative that solid phase stability be monitored throughout the manufacturing process to ensure final product quality and performance. PXRD remains the gold standard for polymorph identification, but due to a growing interest in continuous manufacturing, a need has emerged for alternative process analytical technologies (PATs) that can provide fast, reliable, and non-destructive polymorph discrimination amenable to in situ process monitoring. Herein we demonstrate an original application of powder Brillouin light scattering (p-BLS) for the discrimination of polymorphic molecular solids. We hypothesize that the anisotropic sound velocities directly reflect the strength and orientation of the intermolecular forces in molecular solids. Redistributing these forces upon polymorphic conversion should thus clearly be reflected in the sound frequency distributions obtained by p-BLS. To test this hypothesis, three model compounds - resorcinol, sulfamerazine and furosemide - were selected. Distinct, polymorph-specific, acoustic frequency distributions were observed, and these p-BLS spectra were interpreted using a hydrogen-bond analysis and energy frameworks calculated from CrystalExplorer. In conclusion, this study clearly demonstrates that the sound frequencies measured in p-BLS are sensitive to the interaction forces in molecular solids, and p-BLS is a novel optical technique capable of reliably discriminating polymorphs. Extending this study further, we fully expect that many pharmaceutically relevant processes - e.g., hydrate formation, co-crystallization, or amorphous instability - could potentially be monitored using p-BLS.

Temporal trends in rates of opioid misuse among delivery-related hospitalizations in North Carolina from 2000 to 2014.

Opioid misuse during pregnancy is increasing at an alarming rate across the United States. To determine the prevalence, temporal trends, and resource usage of delivery-related hospitalizations of women who misuse opioids in North Carolina from 2000 to 2014. A retrospective, cross-sectional study was conducted using the State Inpatient Databases. Annual prevalence was calculated, and linear trends were assessed using logistic regression. Temporal trends in hospital charges and length of stay (LOS) were analyzed using ordinary least squares regression with a loge-transformed response. Of 1,937,455 delivery-related hospitalizations in NC, 6,084 were associated with opioid misuse, a prevalence of 3.14 cases per 1,000 delivery-related discharges. During the study period, the prevalence of opioid misuse during pregnancy in NC increased 955%, from 0.9 cases per 1,000 discharges in 2000 to 9.5 cases per 1,000 discharges in 2014, an average annual rate increase of 1.18 cases (95% CI, 1.16-1.21; P < 0.0001). Median LOS for women who misuse opioids remained stable at three days, whereas the median charge per delivery-related hospitalization significantly increased from $6,311 in 2000 to $9,019 in 2010 (annual average change [AAC], 282.2; 95% CI, 182.9-381.5; P < 0.0001) and from $8,908 in 2011 to $10,864 in 2014 (AAC, 667.5; 95% CI, 275.2-1059.9; P < 0.0001). Health care providers and policymakers in NC are advised to introduce system-wide public health responses focused on prevention and increased access to evidence-based treatment that improves the health of the mothers and neonates who are exposed to opioids.

Patient and Hospital Characteristics of Newborns with Neonatal Withdrawal Syndrome.

OBJECTIVES: We sought to evaluate hospital resource usage patterns and determine risk factors for neonatal withdrawal syndrome (NWS) in the United States. METHODS: Using the 2016 Kids' Inpatient Database (KID), we conducted a retrospective cross-sectional analysis of a nationally representative sample of neonates with NWS. The KID is the largest publicly available pediatric (20 years of age and younger) inpatient care database in the United States. We analyzed a stratified probability sampling of 3.1 million pediatric hospital discharges weighted to 6.3 million national discharges. Descriptive statistics for hospital and patient characteristics were identified and binary variables were analyzed using the Student t test. Multivariate regression was performed to assess the predictors of NWS. We excluded discharges if total cost or hospital length of stay (LOS) exceeded mean values by >3 standard deviations. Hospitalizations with NWS diagnosis were identified using the International Classification of Diseases, 10th Revision, Clinical Modification code P96.1 in any 1 of 30 discharge diagnostic fields. RESULTS: We estimated that 25,394 pediatric discharges were associated with an NWS diagnosis, totaling 403,127 inpatient days at a cost of $1.8 billion. Compared with non-NWS newborns, neonates with NWS had higher mean hospital charges ($71,540 vs $15,765), longer mean hospital stays (16 days vs 3 days), and a significantly higher proportion of low birth weight (7.2% vs 1.9%), feeding problems (19.0% vs 3.5%), respiratory diagnoses (5.6% vs 2.5%), and seizure (0.3% vs 0.1%). Among newborns with NWS, 53% were boys, 80.0% were white, 7.2% were black, 7.4% were Hispanic, and 5.3% were of other races. Hispanic neonates had the highest mean hospital charges and LOS of any other ethnic group ($123,749, 21 days). The largest proportion (83.0%) of NWS-related hospital stays were billed to Medicaid, followed by private insurance (10.3%) and self-pay (4.8%). More than one-third of NWS-related discharges (39.3%) occurred in areas with the lowest mean household annual income (≤$42,999) compared with 28.4% of neonates without NWS. Most NWS cases (53%) had ≥5 diagnoses, compared with 11% of non-NWS neonates. In the multivariate analysis, neonates with a birth weight <2500 g, feeding problems, respiratory diagnoses, seizure, >4 diagnoses, LOS >5 days, rural hospitals, Medicaid, and low-income households were significantly associated with NWS. There was a statistically significant mean hospital charge difference of $55,775 between NWS and non-NWS neonates. CONCLUSIONS: Since 2000, the number of infants treated for NWS in the US neonatal intensive care units has increased fivefold, accounting for an estimated $1.5 billion in annual hospital expenditures. The high hospital resource usage among NWS neonates raises the possibility that care for expectant mothers who use opiates and their newborns may be able to be delivered in a more efficient and effective manner. Because the majority of the study population was covered by Medicaid programs, state policy makers should be mindful of the impact the opioid crises continue to have on expectant mothers and their infants.

Opioid use disorder among pregnant women in the 2000-2014 North Carolina state inpatient database.

Background: The opioid epidemic's impact reached an increasing portion of the United States population, including pregnant women.Objectives: We sought to determine the prevalence and factors associated with opioid use disorders during pregnancy in North Carolina.Study Design: Using North Carolina's State Inpatient Sample, a retrospective study was conducted to identify pregnancy-related discharges between 2000 and 2014. Hospital discharge records associated with ICD-9-CM diagnoses codes for the use of opioids for all eligible pregnancy-related discharges were extracted. Logistic regression models were used to estimate unadjusted and adjusted bivariate and multivariate relationships.Results: Of 1,937,455 pregnancy-related hospitalization in North Carolina, 6,084 were associated with opioid use, a prevalence of 3.14 cases per 1,000 discharge. Maternal opioid use was associated with an increased odds of early onset delivery, threatened preterm labor, premature rupture of membranes, postpartum depression, stillbirth and poor fetal growth. Women who used opioids during pregnancy had prolonged hospital stays (>5 days) and were 2 times as likely to have more than 4 procedures performed during hospitalization. Compared to other racial groups, non-Hispanic whites had a notably higher prevalence of opioid use disorders (5.8/1,000 pregnancy-related discharges) (P < 0.05 for all).Conclusions: Very few health issues have garnered the attention of such diverse sectors of our society as the opioid epidemic. As the first state-level analysis of opioid use disorders among delivery hospitalizations, these findings suggest the need for a system-wide public health response such as improved funding for Medicaid and child welfare systems to improve the health of the opioid-exposed mother-infant dyad.

Understanding the Tabletability Differences between Indomethacin Polymorphs Using Powder Brillouin Light Scattering.

PURPOSE: The unconventional tabletability of the indomethacin polymorphs - α and γ - are investigated from a topological and mechanical perspective using powder Brillouin light scattering (p-BLS) to identify the specific structure-performance relationship in these materials. METHOD: Indomethacin (γ-form) was purchased and used to prepare the α polymorph. Powder X-ray diffraction was used to confirm phase identity, while p-BLS was used to obtain the mechanical properties. Energy frameworks were determined with Crystal Explorer to visualize the interaction topologies. Using a Carver press and a stress-strain analyzer, the tableting performance of each polymorph was determined. RESULTS: Polymorph-specific acoustic frequency distributions were observed with distinct, zero-porosity, aggregate elastic moduli determined. The p-BLS spectra for α-indomethacin display a population of low-velocity shear modes, indicating a direction of facilitated shear. This improves slip-mediated plasticity and tabletability. Our p-BLS spectra experimentally indicates that a low-energy slip system is available to α-indomethacin which supports ours and previous energy framework calculations. Despite a 2d-layered crystal motif favorable for shear deformation, the γ-form displays a higher shear modulus that is supported by our hydrogen-bonding analysis of γ-indomethacin. CONCLUSION: Our experimental, mechanical data is consistent with the predicted interaction topologies and these two inputs combined permit a comprehensive, molecular understanding of polymorph-specific tabletability.

Quantification of Cefepime, Meropenem, Piperacillin, and Tazobactam in Human Plasma Using a Sensitive and Robust Liquid Chromatography-Tandem Mass Spectrometry Method, Part 2: Stability Evaluation.

Although the stability of ß-lactam antibiotics is a known issue, none of the previously reported bioanalytical methods had an adequate evaluation of the stability of these drugs. In the current study, the stability of cefepime, meropenem, piperacillin, and tazobactam under various conditions was comprehensively evaluated. The evaluated parameters included stock solution stability, short-term stability, long-term stability, freeze-thaw stability, processed sample stability, and whole-blood stability. When stored at -20°C, the stock solution of meropenem in methanol was stable for up to 3 weeks, and the stock solutions of cefepime, piperacillin, and tazobactam were stable for up to 6 weeks. All four antibiotics were stable in human plasma for up to 3 months when stored at -80°C and were stable in whole blood for up to 4 h at room temperature. Short-term stability results indicated that all four ß-lactams were stable at room temperature for 2 h, but substantial degradation was observed when the plasma samples were stored at room temperature for 24 h, with the degradation rates for cefepime, meropenem, piperacillin, and tazobactam being 30.1%, 75.6%, 49.0%, and 37.7%, respectively. Because the stability information is method independent, our stability results can be used as a reference by other research groups that work with these antibiotics.

Quantification of Cefepime, Meropenem, Piperacillin, and Tazobactam in Human Plasma Using a Sensitive and Robust Liquid Chromatography-Tandem Mass Spectrometry Method, Part 1: Assay Development and Validation.

The highly variable pharmacokinetics of ß-lactam antibiotics and ß-lactamase inhibitors poses a significant challenge to clinicians in ensuring appropriate antibiotic doses in critically ill patients. Therefore, routine monitoring of plasma concentrations is important for individualization of antimicrobial therapy. Accordingly, a simple and robust analytical method for the simultaneous measurement of multiple ß-lactam antibiotics and ß-lactamase inhibitors is highly desirable to ensure quick decisions on dose adjustments. In this study, a sensitive, simple, and robust method for the simultaneous quantification of cefepime, meropenem, piperacillin, and tazobactam in human plasma was developed and rigorously validated according to FDA guidance. Sample extraction was accomplished by simple protein precipitation. Chromatographic separation of analytes was achieved using stepwise gradient elution. Analytes were monitored using tandem mass spectrometry (MS/MS) with a turbo ion spray source in positive multiple-reaction-monitoring mode. The calibration curve ranged from 0.5 to 150 µg/ml for cefepime, 0.1 to 150 µg/ml for meropenem and piperacillin, and 0.25 to 150 µg/ml for tazobactam. Inter- and intraday precision and accuracy, sensitivity, selectivity, dilution integrity, matrix effect, extraction recovery, and hemolysis effect were investigated for all four analytes, and the results met the acceptance criteria. Compared to other reported methods, our method is more robust because of the combination of the following features: (i) a simple sample extraction procedure, (ii) a short sample run time, (iii) a wide dynamic range, and (iv) the small plasma sample volume needed. Since our method already covers ß-lactams and a ß-lactamase inhibitor with highly heterogeneous physicochemical properties, further antibiotic candidates may easily be incorporated into this multianalyte method.

Association between the genetic similarity of the open reading frame 5 sequence of Porcine reproductive and respiratory syndrome virus and the similarity in clinical signs of Porcine reproductive and respiratory syndrome in Ontario swine herds.

A study of Ontario swine farms positive for Porcine reproductive and respiratory syndrome virus (PRRSV) tested the association between genetic similarity of the virus and similarity of clinical signs reported by the herd owner. Herds were included if a positive result of polymerase chain reaction for PRRSV at the Animal Health Laboratory at the University of Guelph, Guelph, Ontario, was found between September 2004 and August 2007. Nucleotide-sequence similarity and clinical similarity, as determined from a telephone survey, were calculated for all pairs of herds. The Mantel test indicated that clinical similarity and sequence similarity were weakly correlated for most clinical signs. The generalized additive model indicated that virus homology with 2 vaccine viruses affected the association between sequence similarity and clinical similarity. When the data for herds with vaccine-like virus were removed from the dataset there was a significant association between virus similarity and similarity of the reported presence of abortion, stillbirth, preweaning mortality, and sow/boar mortality. Ownership similarity was also found to be associated with virus similarity and with similarity of the reported presence of sows being off-feed, nursery respiratory disease, nursery mortality, finisher respiratory disease, and finisher mortality. These results indicate that clinical signs of PRRS are associated with PRRSV genotype and that herd ownership is associated with both of these.

Une étude effectuée sur des fermes porcines ontariennes positives pour le virus du SRRP a testé l'association entre la similarité génétique des virus SRRP et la similarité des signes cliniques rapportés par le propriétaire des animaux. Les élevages pouvaient être inclus si un résultat positif par PCR pour le virus du SRRP avait été obtenu du Animal Health Laboratory de l'Université de Guelph entre les mois de septembre 2004 et août 2007. Les similarités des séquences virales et les similarités cliniques notées suite à une enquête ont été calculées pour chaque paire de troupeaux. Le test de Mantel indiquait que les similarités cliniques et les similarités virales étaient faiblement corrélées pour la plupart des signes cliniques. Le modèle additif généralisé indiquait que des virus homologues à deux virus vaccinaux affectaient l'association entre les similarités virales et les similarités cliniques. Lorsque les troupeaux avec les virus similaires aux vaccins furent retirés des données, il y avait une association significative entre les similarités virales et des similarités pour les avortements, les mort-nés, la mortalité pré-sevrage et la mortalité des truies et verrats. Les similarités de propriété ont également été déterminées comme étant associées avec les similarités virales et les similarités cliniques suivantes : truies sans appétit, maladies respiratoires en pouponnière, mortalité en pouponnière, maladies respiratoires chez les porcs en finition, et mortalités chez les porcs en finition. Ces résultats indiquent que les signes cliniques de SRRP sont associés avec le génotype du virus du SRRP et que la propriété du troupeau est associée avec ces deux éléments.(Traduit par Docteur Serge Messier).

Spatial and temporal patterns of porcine reproductive and respiratory syndrome virus (PRRSV) genotypes in Ontario, Canada, 2004-2007.

BACKGROUND: The spread of PRRSV among pig herds has been investigated experimentally, but few observational studies have investigated this subject. Because PRRSV is endemic and live modified vaccines are used in Ontario, the spatial and temporal distributions of 6 PRRSV genotypes were investigated in the province during the period from 2004-2007. The purpose was to find evidence of spread of PRRSV genotypes and determine if spread could be attributed to supplier or ownership connections between herds. Sequence information from PRRSV ORF5 and related source-herd demographic information were obtained from diagnostic submissions to the Animal Health Laboratory, University of Guelph. RESULTS: A spatial cluster that could not be attributed to supplier or ownership connections among herds in the cluster was detected for RFLP type 1-3-4. Because of genetic dissimilarity among members of the cluster, it was considered to be a result of past spread of the RFLP type. A spatio-temporal cluster detected for RFLP type 1-18-4 was attributed to a shared gilt supplier among the herds in the cluster. Significant spatio-temporal patterns detected for RFLP type 2-5-2, which is considered to be a vaccine-type virus were most likely due to grouping of herds in an ownership that used the corresponding vaccine. Clustering within herd-ownership was a risk factor for presence of five of the six genotypes investigated in the present study. CONCLUSIONS: Although the literature indicates that PRRSV can spread via aerosol between pig herds, the present study found no strong evidence of this occurring in Ontario. The evidence pointed toward transmission of PRRSV occurring in this population by common sources of animals or similarity of herd ownership, which is a proxy measure for other connections between herds. It is also apparent that the recognition and testing of these connections between herds is a necessary part of interpreting spatio-temporal patterns of PRRSV genotypes.

Dive behaviour impacts the ability of heart rate to predict oxygen consumption in Steller sea lions (Eumetopias jubatus) foraging at depth.

The predictive relationship between heart rate (f(H)) and oxygen consumption (VO2) has been derived for several species of marine mammals swimming horizontally or diving in tanks to shallow depths. However, it is unclear how dive activity affects the f(H):VO2 relationship and whether the existing equations apply to animals diving to deeper depths. We investigated these questions by simultaneously measuring the f(H) and VO2 of Steller sea lions (Eumetopias jubatus) under different activity states (surface resting or diving), types of dives (single dives or dive bouts), and depths (10 or 40 m). We examined the relationship over dives only and also over dive cycles (dive + surface interval). We found that f(H) could only predict VO2 over a complete single dive cycle or dive bout cycle (i.e. surface intervals had to be included). The predictive equation derived for sea lions resting on the surface did not differ from that for single dive cycles. However, the equation derived over dive bout cycles (multiple dives + surface intervals) differed from those for single dive cycles or surface resting, with similar f(H) for multiple dive bout equations yielding higher predicted VO2 than that for single dive bout cycles (or resting). The f(H):VO2 relationships were not significantly affected by dive duration, dive depth, water temperature or cumulative food consumed under the conditions tested. Ultimately, our results demonstrate that f(H) can be used to predict activity-specific metabolic rates of diving Steller sea lions, but only over complete dive cycles that include a post-dive surface recovery period.

Environment and feeding change the ability of heart rate to predict metabolism in resting Steller sea lions (Eumetopias jubatus).

The ability to use heart rate (fh) to predict oxygen consumption rates ([Formula: see text]) in Steller sea lions and other pinnipeds has been investigated in fasting animals. However, it is unknown whether established fh:[Formula: see text] relationships hold under more complex physiological situations, such as when animals are feeding or digesting. We assessed whether fh could accurately predict [Formula: see text] in trained Steller sea lions while fasting and after being fed. Using linear mixed-effects models, we derived unique equations to describe the fh:[Formula: see text] relationship for fasted sea lions resting on land and in water. Feeding did not significantly change the fh:[Formula: see text] relationship on land. However, Steller sea lions in water displayed a different fh:[Formula: see text] relationship after consuming a 4-kg meal compared with the fasting condition. Incorporating comparable published fh:[Formula: see text] data from Steller sea lions showed a distinct effect of feeding after a 6-kg meal. Ultimately, our study illustrated that both feeding and physical environment are statistically relevant when deriving [Formula: see text] from telemetered fh, but that only environment affects the practical ability to predict metabolism from fh. Updating current bioenergetic models with data gathered using these predictive fh:[Formula: see text] equations will yield more accurate estimates of metabolic rates of free-ranging Steller sea lions under a variety of physiological, behavioral, and environmental states.

Spread of porcine circovirus associated disease (PCVAD) in Ontario (Canada) swine herds: Part II. Matched case-control study.

BACKGROUND: The emergence of porcine circovirus associated disease (PCVAD) was associated with high mortality in swine populations worldwide. Studies performed in different regions identified spatial, temporal, and spatio-temporal trends as factors contributing to patterns of the disease spread. Patterns consistent with spatial trend and spatio-temporal clustering were already identified in this dataset. On the basis of these results, we have further investigated the nature of local spread in this report. The primary objective of this study was to evaluate risk factors for incidence cases of reported PCVAD. RESULTS: A time-matched case-control study was used as a study design approach, and conditional logistic regression as the analytical method. The main exposure of interest was local spread, which was defined as an unidentified mechanism of PCVAD spread between premises located within 3 kilometers of the Euclidean distance. Various modifications of variables indicative of local spread were also evaluated. The dataset contained 278 swine herds from Ontario originally sampled either from diagnostic laboratory submissions or directly from the target population. A PCVAD case was defined on the basis of the producer's recall. Existence of apparent local spread over the entire study period was confirmed (OR = 2.26, 95% CI: 1.06, 4.83), and was further identified to be time-varying in nature - herds experiencing outbreaks in the later part of the epidemic were more likely than control herds to be exposed to neighboring herds experiencing recent PCVAD outbreaks. More importantly, the pattern of local spread was driven by concurrent occurrence of PCVAD on premises under the same ownership (OREXACTwithin ownership = 25.6, 95% CI: 3.4, +inf; OREXACToutside ownership = 1.3, 95% CI: 0.45, 3.3). Other significant factors included PRRSv status of a herd (OREXACT = 1.9, 95% CI: 1.0, 3.9), after adjusting for geographical location by including the binary effect of the easting coordinate (Easting > 600 km = 1; OREXACT = 1.8, 95% CI: 0.5, 5.6). CONCLUSIONS: These results preclude any conclusion regarding the existence of a mechanism of local spread through airborne transmission or indirectly through contaminated fomites or vectors, as simultaneous emergence of PCVAD could also be a result of concurrent change in contributing factors due to other mechanisms within ownerships.

Spread of porcine circovirus associated disease (PCVAD) in Ontario (Canada) swine herds: Part I. Exploratory spatial analysis.

BACKGROUND: The systemic form of porcine circovirus associated disease (PCVAD), also known as postweaning multisystemic wasting syndrome (PMWS) was initially detected in the early 1990s. Starting in 2004, the Canadian swine industry experienced considerable losses due to PCVAD, concurrent with a shift in genotype of porcine circovirus type 2 (PCV2). Objectives of the current study were to explore spatial characteristics of self-reported PCVAD distribution in Ontario between 2004 and 2008, and to investigate the existence and nature of local spread. RESULTS: The study included 278 swine herds from a large disease-monitoring project that included porcine reproductive and respiratory syndrome (PRRS) virus-positive herds identified by the diagnostic laboratory, and PRRS virus-negative herds directly from the target population. Herds were included if they had growing pigs present on-site and available geographical coordinates for the sampling site. Furthermore, herds were defined as PCVAD-positive if a producer reported an outbreak of circovirus associated disease, or as PCVAD-negative if no outbreak was noted. Spatial trend was investigated using generalized additive models and time to PCVAD outbreak in a herd using Cox's proportional hazard model; spatial and spatio-temporal clustering was explored using K-functions; and location of most likely spatial and spatio-temporal clusters was investigated using scan statistics. Over the study period, the risk of reporting a PCVAD-positive herd tended to be higher in the eastern part of the province after adjustment for herd PRRS status (P = 0.05). This was partly confirmed for spread (Partial P < 0.01). Local spread also appeared to exist, as suggested by the tentative (P = 0.06) existence of spatio-temporal clustering of PCVAD and detection of a spatio-temporal cluster (P = 0.04). CONCLUSIONS: In Ontario, PCVAD has shown a general trend, spreading from east-to-west. We interpret the existence of spatio-temporal clustering as evidence of spatio-temporal aggregation of PCVAD-positive cases above expectations and, together with the existence of spatio-temporal and spatial clusters, as suggestive of apparent local spread of PCVAD. Clustering was detected at small spatial and temporal scales. Other patterns of spread could not be detected; however, survival rates in discrete Ontario zones, as well as a lack of a clear spatial pattern in the most likely spatio-temporal clusters, suggest other between-herd transmission mechanisms.

Clinical signs and their association with herd demographics and porcine reproductive and respiratory syndrome (PRRS) control strategies in PRRS PCR-positive swine herds in Ontario.

The purposes of this study were to describe the clinical signs observed in PRRS positive herds during a porcine reproductive and respiratory syndrome (PRRS) outbreak in Ontario and to determine associations between these clinical signs and herd demographics and PRRS control strategies. All PRRS polymerase chain reaction-(PCR)-positive submissions to a diagnostic laboratory between September 1, 2004 and August 31, 2007 were identified (n = 1864). After meeting eligibility requirements and agreeing to voluntary study participation, producers from 455 of these submissions were surveyed for information on clinical signs observed in their herds, herd demographics, and PRRS control strategies used in their herds at the time that the PCR-positive samples were taken. Larger herd size was associated with an increased risk of reporting abortion, weakborn piglets, off-feed sows, and sow mortality in sow herds, and with an increased risk of reporting mortality in finishing herds. When disease control strategies were examined, use of a commercial PRRS vaccine in sows and gilts was associated with a decreased risk of reporting weakborn pigs and high pre-weaning mortality, while the use of serum inoculation in breeding animals was associated with an increased risk of reporting off-feed sows and sow mortality. Providing biofeedback of stillborn/mummified piglets, placenta or feces to gilts was associated with an increased risk of reporting respiratory disease and mortality in finishing pigs while all-in/all-out flow in farrowing rooms was associated with an increased risk of reporting sow mortality and weakborn piglets.

Distribution of genotypes of porcine reproductive and respiratory syndrome virus in Ontario during 2004-2007 and the association between genotype and clinical signs of disease.

Restriction fragment length polymorphism (RFLP) was first proposed to classify porcine reproductive and respiratory syndrome virus (PRRSV) in 1998. The primary objective of this study was to identify associations between different PRRSV RFLP types in swine herds in southern Ontario and clinical signs of disease in those herds. Herds included in the study submitted samples to the Animal Health Laboratory at the University of Guelph between September 2004 and August 2007. Each farm owner was surveyed to describe the clinical disease in the herd and the RFLP pattern of an isolate of PRRSV was obtained from a diagnostic sample. The most frequent isolates were RFLP types 1_4 (25.1%), 252 (14.7%), 134 (12%), and 1_2 (7.7%). The distribution of RFLP types in this study was found to be different from a previous investigation in Ontario. Those RFLP types most associated with clinical disease in the farrowing phase of production were 1_4, 1_2, and 134. The only virus type to be significantly associated with disease in the finisher phase was RFLP type 262. During the study period RFLP type 184 emerged in the population in November 2005.

Management factors associated with farrowing rate in commercial sow herds in Ontario.

The objectives of this study were to determine associations between low farrowing rate and various management factors in sow herds. In 30 sow herds, a management survey, breeding observations, semen evaluation, and semen storage temperature monitoring were completed. Herds with an average farrowing rate of < 85% were classified as low farrowing rate herds while those with an average farrowing rate of > or = 85% were classified as good farrowing rate herds. Low farrowing rate herds were more likely than good farrowing rate herds to move boars into gilt pens for estrus detection, breed a high proportion of sows by artificial insemination (AI) only, start heat detection 3 d post-weaning, wipe the vulva prior to breeding, and use "hands-free" AI devices.

PACAP expression in explant cultured mouse major pelvic ganglia.

The major pelvic ganglia (MPG) contain both parasympathetic and sympathetic postganglionic neurons and provide much of the autonomic innervation to urogenital organs and components of the lower bowel. Whereas many parasympathetic neurons were found to express vasoactive intestinal polypeptide (VIP), no MPG neurons exhibited immunoreactivity for pituitary adenylate cyclase-activating polypeptide (PACAP). However, in 3-day cultured MPGs, numerous PACAP-IR cells and nerve fibers were present, and transcript levels for PACAP increased significantly. In 3-day cultured MPGs, PACAP immunoreactivity was seen in cells that were also immunoreactive for VIP or neuronal nitric oxide synthase, but not tyrosine hydroxylase, indicating that PACAP expression occurred preferentially in MPG parasympathetic postganglionic neurons. Transcript levels for the VPAC2, but not VPAC1 or PAC1 receptor, also increased significantly following 3 days in culture. Transcript levels of activating transcription factor 3 (ATF-3), a marker of cellular injury, were increased 64-fold in 3-day explants, and ATF-3-IR nuclei were evident in both TH-IR and nNOS-IR neurons as well as in non-neuronal cells. In sum, these results demonstrate that, although only the parasympathetic neurons in explant cultured MPGs increase expression of PACAP, both sympathetic and parasympathetic postganglionic neurons in the cultured MPG whole-mount increase expression of ATF-3.

Reducing the incidence of denture stomatitis: are denture cleansers sufficient?

PURPOSE: Candida albicans is the predominant oral yeast associated with denture stomatitis. With an increasing population of denture wearers, the incidence of denture stomatitis is increasing. Effective management of these patients will alleviate the morbidity associated with this disease. The aim of this study was to examine the capacity of four denture cleansers to efficiently decontaminate and sterilize surfaces covered by C. albicans biofilms. MATERIALS AND METHODS: Sixteen C. albicans strains isolated from denture stomatitis patients and strain ATCC 90028 were grown as mature confluent biofilms on a 96-well format and immersed in Dentural, Medical Interporous, Steradent Active Plus, and Boots Smile denture cleansers according to the manufacturers' instructions or overnight. The metabolic activity and biomass of the biofilms were then quantified, and scanning electron microscopy (SEM) used to examine treated biofilms. RESULTS: Dentural was the most effective denture cleanser, reducing the biomass by greater than 90% after 20 minutes. Steradent Active plus was significantly more effective following 10-minute immersion than overnight (p < 0.001). All cleansers reduced the metabolic activity by greater than 80% following overnight immersion; however, Boots Smile exhibited significantly reduced metabolic activity following only a 15-minute immersion (p < 0.001). SEM revealed residual C. albicans material following Dentural treatment. CONCLUSIONS: This study showed that denture cleansers exhibit effective anti-C. albicans biofilm activity, both in terms of removal and disinfection; however, residual biofilm retention that could lead to regrowth and denture colonization was observed. Therefore, alternative mechanical disruptive methods are required to enhance biofilm removal.