Yr Of Age Research Articles

Severely obese 14-year-old boy with central sleep apnea several years after head trauma

Severely obese 14-year-old boy with central sleep apnea several years after head trauma

Clinical outcomes of rhabdomyolysis & validation of McMahon Score for risk prediction.

Rhabdomyolysis in tropics has a unique aetiology and clinical profile. The objective of this study was to determine the aetiology and clinical outcomes of rhabdomyolysis and validate the McMahon risk prediction score in affected individuals from south India. A retrospective study of affected individuals with rhabdomyolysis admitted to a tertiary care hospital in south India, between January 2015 and June 2020, was undertaken. In-patients who were ≥15 yr in age and had creatinine phosphokinase ≥5000 U/l were included in the study. Cardiac, stroke, chronic muscular diseases and chronic kidney disease on maintenance haemodialysis were excluded. The incidence of acute kidney injury (AKI) in this group was calculated. Other clinical outcomes determined were 28-day mortality, proportion of individuals who required renal replacement therapy (RRT), intensive care unit (ICU) admission, vasopressors, mechanical ventilation (MV), number of days on mechanical ventilator and length of stay in ICU and hospital. Validation of McMahon risk prediction score for the requirement of RRT and mortality was performed. Major aetiologies identified in the 75 study participants included were infections, trauma and seizures. Twenty eight-day mortality was 24 per cent (n=18). AKI incidence was 68 per cent, out of which 43.1 per cent had RRT. AKI in all survivors became dialysis independent. Vasopressors, MV and ICU requirement were 30.7, 32 and 77.3 per cent, respectively. Receiver operator characteristic curve for RRT and mortality risk prediction based on the McMahon Score showed a sensitivity of 71.4 per cent and specificity of 77.8 per cent for a cut-off ≥7.8. Rhabdomyolysis in tropics is associated with significant organ dysfunction and mortality. Although the incidence of AKI and RRT is high, the overall renal outcome is good among survivors. The wide confidence intervals for the area under curve for McMahon Score limit its predictability for RRT and mortality.

62 The Impact of Hair Coat Color on Body Temperature in Beef Cattle

Abstract Ambient temperature has a fundamental role in animal health and performance. Selecting for coat color may improve animal productivity and welfare through management and breeding decisions. The thermoneutral zone of cattle, 0°C - 25°C, is characterized as the range in ambient temperature that does not require cattle to expend energy to maintain core body temperature. When the ambient temperature is above or below these values, cattle must expend energy to keep their body temperature in homeostasis resulting in a reduction in efficiency. A proper herd management plan to mitigate heat stress can increase efficiency and decrease mortality in serious cases. Registered Hereford and commercial black cows (n = 39; average 4 yr of age) were placed in a 23-ha pasture, to determine if coat color affects internal body temperature. Cattle were on a typical fescue dominated pasture located in Mountain Grove, MO, with areas of shade and one pond centralized in the pasture. Cattle were divided into treatments based on hair coat color: black (n =13) or red (n = 26). Using temperature data loggers, vaginal temperatures were recorded in 5-min intervals during a 14-d period in Mid-July 2022, and combined into 6-hour timing intervals, A = 0400-1000 h, B = 1001-1600 h, C = 1601-2200 h, and D = 2201-0359 h. Environmental temperature data loggers were suspended in two locations of partial sun to record ambient temperature. In addition, the Mountain Grove weather station operated by the University of Missouri Extension provided a daily data archive that recorded wind speed, total precipitation, maximum and minimum air temperature. Throughout the study, the mean environmental temperature was 34.4°C and ranged from 19.5°C to 40.2°C. Temperature data were evaluated using the Glimmix procedure of SAS and pairwise comparisons between timepoints were determined utilizing the GLM procedure of SAS. Differences were considered significant at P = 0.05. Black-haired cattle were warmer at all intervals (P ≤ 0.04) with temperature differences between the treatments of 0.07, 0.10, 0.03, and 0.09°C for timepoints A, B, C and D, respectively (Table 1). Based on our results black-hided cattle get warmer earlier in the day and take longer to dissipate heat than those with red hair coats.

Glutaraldehyde-based desensitizers’ influence on bonding performances and dentin enzymatic activity of universal adhesives

ObjectivesTo evaluate the influence of two glutaraldehyde-based desensitizers (L: GLUMA Desensitizer, Heraeus Kulzer and G: GLUMA Desensitizer PowerGel) prior to the adhesive procedures on microtensile bond strength (µTBS) to dentin and endogenous enzymatic activity. MethodsNoncarious human third molars (N = 48) were cut to expose middle coronal dentin. Six experimental groups were formed according to the dentin pre-treatment (L or G) and the universal adhesives (IBU - iBond universal, Kulzer or AU - Adhese Universal, Ivoclar Vivadent) used in the self-etch mode (n = 8): 1) L/IBU; 2) G/IBU; 3) IBU; 4) L/AU; 5) G/AU; 6) AU. Specimens were cut into sticks and stressed until failure after 24 h (T0) or 1 yr of aging (T12). Additional 4 teeth were used for in situ zymography evaluation and data were statistically analyzed (α = 0.05). ResultsDentin pre-treatment, adhesive and aging statistically influenced bond strength and enzymatic activity (P<0.001). AU demonstrated higher bond strength values than IBU (P<0.001). The L resulted in higher bond strength compared to the G and control groups (P<0.001). aging statistically influenced bonding performance, especially when no dentin pre-treatment was performed (P<0.001). In situ zymography revealed that at baseline the control groups exhibited lower interfacial fluorescence compared to the experimental groups, irrespective of the adhesive used (P<0,001). However, after 1 yr of artificial storage, no differences were found among the groups (P>0.05). Conclusions: Glutharldeadeyde-based products increased bond strength and determined a stabilization of the adhesive interface over time apparently not related to the MMPs inhibition. Clinical SignificanceThe results of this in vitro study suggest that the application of glutaraldehyde-based desensitizers prior to the adhesive procedures when associated with universal adhesives could result in increased bond strength and stabilization of the adhesive interface over time.

Examining sex differences in the association between sedentary behavior and cognitive function in bariatric surgery patients

BackgroundObesity is associated with cognitive impairment. A potential contributor to these deficits is sedentary behavior (SB), which is linked to poorer cognitive functioning in other populations. Little is known about the association between SB and cognitive function in bariatric surgery populations. ObjectivesThis cross-sectional study examined the association between SB and cognitive function in preoperative bariatric surgery patients, as well as possible sex differences in this relationship. SettingData were collected at 2 health centers in the United States. MethodsA total of 121 participants (43.2 ± 10.3 yr of age) scheduled for Roux-en-Y gastric bypass or sleeve gastrectomy completed the National Institute of Health (NIH) Toolbox for the Assessment of Neurological and Behavioral Function Cognition Domain, a computerized neuropsychological assessment battery. Participants wore a waist-mounted accelerometer for 7 consecutive days to measure SB and light-intensity physical activity (LPA). ResultsPearson and partial correlations found no significant relationships between cognitive function and SB or LPA in the full sample. However, partial correlations controlling for LPA found that greater SB was associated with poorer performance on List Sorting Working Memory Test in women (r = −.28; P = .006), whereas there was a positive relationship between SB and Dimensional Change Card Sort for men (r = .51; P = .015; 95% CI [.25, .73]). ConclusionsThese results showed that greater SB, independent of LPA, is associated with poorer working memory in women and better set shifting ability in men. Future studies should examine the possibility of domain-specific cognitive effects associated with SB in bariatric surgery samples and clarify possible sex differences.

Maternal Western-style diet in nonhuman primates leads to offspring islet adaptations including altered gene expression and insulin hypersecretion.

Maternal overnutrition is associated with increased susceptibility to type 2 diabetes in the offspring. Rodent models have shown that maternal overnutrition influences islet function in offspring. To determine whether maternal Western-style diet (WSD) alters prejuvenile islet function in a model that approximates that of human offspring, we utilized a well-characterized Japanese macaque model. We compared islet function from offspring exposed to WSD throughout pregnancy and lactation and weaned to WSD (WSD/WSD) compared with islets from offspring exposed only to postweaning WSD (CD/WSD) at 1 yr of age. WSD/WSD offspring islets showed increased basal insulin secretion and an exaggerated increase in glucose-stimulated insulin secretion, as assessed by dynamic ex vivo perifusion assays, relative to CD/WSD-exposed offspring. We probed potential mechanisms underlying insulin hypersecretion using transmission electron microscopy to evaluate β-cell ultrastructure, qRT-PCR to quantify candidate gene expression, and Seahorse assay to assess mitochondrial function. Insulin granule density, mitochondrial density, and mitochondrial DNA ratio were similar between groups. However, islets from WSD/WSD male and female offspring had increased expression of transcripts known to facilitate stimulus-secretion coupling and changes in the expression of cell stress genes. Seahorse assay revealed increased spare respiratory capacity in islets from WSD/WSD male offspring. Overall, these results show that maternal WSD feeding confers changes to genes governing insulin secretory coupling and results in insulin hypersecretion as early as the postweaning period. The results suggest a maternal diet leads to early adaptation and developmental programming in offspring islet genes that may underlie future β-cell dysfunction.NEW & NOTEWORTHY Programed adaptations in islets in response to maternal WSD exposure may alter β-cell response to metabolic stress in offspring. We show that islets from maternal WSD-exposed offspring hypersecrete insulin, possibly due to increased components of stimulus-secretion coupling. These findings suggest that islet hyperfunction is programed by maternal diet, and changes can be detected as early as the postweaning period in nonhuman primate offspring.

EVALUATING THE EFFICACY OF NONINVASIVE FECAL SAMPLING FOR PREGNANCY DETECTION IN ELK (CERVUS CANADENSIS).

Elk (Cervus canadensis) were reintroduced to Tennessee, USA in the early 2000s, with limited reproductive monitoring since initial release. We assessed the efficacy of noninvasive sampling for determining pregnancy using invasive (capture) and noninvasive (fecal collection in the field) techniques at the North Cumberland Wildlife Management Area (NCWMA), Tennessee. We captured 20 female elk 2019-2020, used pregnancy-specific protein B (PSPB) in blood to determine pregnancy and compared results to fecal progesterone metabolite (FPM) concentrations using two commercially available enzyme immunoassay (EIA) kits. Based on PSPB concentrations, 8/11 and 3/4 of captured adult elk (≥2.5 yr of age) were pregnant in 2019 and 2020, respectively; no 1.5-yr-old elk were pregnant (n=5). Using the progesterone EIA kit, FPM concentrations were x̄=192.84±38.63 ng/g (95% CI, 96.48-289.20) for nonpregnant and x̄=536.17±74.98 ng/g (95% CI, 375.97-696.36) for pregnant captured females. For the progesterone metabolite kit, FPM concentrations were x̄=188.16±43.39 ng/g (95% confidence interval [CI], 76.63-299.69) for nonpregnant and x̄=693.52±126.52 ng/g (95% CI, 407.31-979.72) for pregnant captured females. From February to May 2019, we collected 357 fecal samples in 65 areas across 489.62 km2 of the NCWMA. Using extracted DNA and analysis of 15 microsatellites, we identified 62 unique individuals from 128 female fecal samples collected on the landscape. We categorized females from landscape-collected feces as nonpregnant (35.5-40.3%; Metabolite-EIA kits), undetermined (1.6-6.5%; Metabolite-EIA kits), or pregnant (62.9-53.2%; Metabolite-EIA kits) based on a 95% CI of captured female FPM concentrations, giving an overall pregnancy rate of 53.2% using the recommended EIA kit. The pregnancy rate in sexually mature females may be higher, as it was not possible to distinguish age classes of landscape-collected fecal samples; therefore, some may have been from younger age classes not expected to be pregnant. Analysis of FPM may be useful at a population level to detect pregnancy.

SURVIVAL OF SPLIT SKIN GRAFT IN DIABETIC ULCER VERSUS NON - DIABETIC ULCER

Introduction:Chronic ulceration of the lower leg and foot is a frequent condition and wide in distribution they may be associated with a number of Medical, Surgical &amp; Dermatological condition the patient suffering is very immense, commonly seen in most of the surgical wards and OPD Material &amp; Method: Present prospective cohort study was conducted among the patients with foot ulcers presenting to department of General Surgery, AVMCH and were posted for elective surgeries during a period of 2 years. The patients posted for split skin graft were admitted a day prior to surgery. A detailed history including the identication detail of the patient, presenting complaints, were obtained. General Examination and detailed clinical examination was done. The outcome among the patients were analysed as graft uptake and any complications noted between the groups. Result: In present study, total of 170 patients fullling inclusion criteria were included with mean age of 51.4±13.2yr of age. On assessment of the 1st acceptance of graft, it was signicantly higher in group B (78.8%) compared to the group A(60.3%).(p&lt;0.05) On assessment of different post operative day the percentage of acceptance was signicantly higher in group B compared to the group A patients.(p&lt;0.05) On assessment of complications, there is no signicant complication documented in group B compared to the group Apatient. Conclusion: The study documented the improvement in the graft acceptance in both the group, of which the non-diabetic group had signicantly early healing compared to the diabetic foot ulcer.

FATAL GASTRIC DILATATION AND VOLVULUS IN THREE CAPTIVE JUVENILE LINNAEUS'S TWO-TOED SLOTHS (CHOLOEPUS DIDACTYLUS).

Linnaeus's two-toed sloth (Choloepus didactylus) is one of two extant neotropical species of the family Megalonychidae. Despite their being commonly kept under managed care, the digestive physiology of sloths remains poorly understood. Gastrointestinal disease has been reported as a primary or contributing cause of morbidity and mortality in captive two-toed and three-toed (Bradypus spp.) sloths. Gastric dilatation due to gas accumulation ("bloat") has been reported in sloths; however, a literature search failed to yield any published mention of gastric volvulus in any sloth species. Following an inquiry sent to the electronic mailing lists of the American Association of Zoo Veterinarians, the European Association of Zoo and Wildlife Veterinarians, and the LatinVets community, three cases of fatal gastric dilatation and volvulus (GDV) were identified in one male and two female Linnaeus's two-toed sloths from institutions in the United States, Canada, and Germany. All cases occurred in juvenile sloths <1 yr of age. Two animals were primarily hand reared, whereas one was reared primarily by its dam. Two animals were found dead with no overt premonitory signs, whereas one animal died following a 3-wk course of waxing and waning clinical signs consistent with gastric gas accumulation. In all cases, GDV was diagnosed on postmortem examination. Similar to other species, the condition is likely subsequent to a combination of host- and husbandry-related contributing factors. Further research into sloth husbandry is required in order to take an evidence-based approach to their management.

Sperm mobility is predictive of the relative genetic contribution among competing mating geese, as determined by microsatellite genotype identification of potential sires

The low reproductive efficiency (RE) of geese limits their production in the poultry industry. To select ganders with high breeding potential, the effect of 3 sperm mobility ranks (SMRs; high-, medium-, and low-SMR) on the RE of naturally mating geese was determined. To exclude the confounding effect of social rank (SR) on RE in naturally mating flocks, a 2-factor nested experimental design was used to differentiate the effects of SMR and SR on RE. Twenty-seven ganders and 135 geese (Zi geese, Anser cygnoides L.) at approximately 1 yr of age were divided into 3 flocks, each of which included the 3 SMR groups. Each SMR group included 3 ganders and 15 female geese. Relative genetic contribution (RGC) is defined as the number of offspring sired by 1 male as a percentage of the entire goslings in each flock, and it was used to compare the differences in RE among ganders. The frequency of agonistic behavioral interactions (ABIs) among the ganders was video recorded in each SMR group, and the SR of each gander was determined. In total, 1,026 eggs were incubated, and 609 goslings hatched. Parent-offspring relationships among 771 individuals from the 2 generations were identified using 20 microsatellite markers, and the RGC was calculated. Results showed that the SMR and SR had significant effects on RGC in naturally mating geese (P=0.001 and P=0.000, respectively). Significant differences in RGC were observed among the high- and medium- and low-SMR groups, with average RGCs of 14.3, 10.6, and 8.4%, respectively. The high-SMR group had the highest RGCs in each flock, and the ganders with high SR had the highest RGCs among the 3 SMRs. The study showed that in a naturally mating geese population, selecting for the sperm mobility traits of a gander can effectively improve the RE.

Cochlear Implantation Outcomes in Adults With Single-Sided Deafness: A Systematic Review and Meta-analysis.

To assess spatial hearing, tinnitus, and quality-of-life outcomes in adults with single-sided deafness (SSD) who underwent cochlear implantation. PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from January 2008 to September 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting spatial hearing, tinnitus, and quality-of-life outcomes in adult cochlear implant (CI) recipients (≥18 yr old) with SSD were evaluated. Study characteristics, demographic data, spatial hearing (speech recognition in noise, sound source localization), tinnitus (severity, loudness), and quality-of-life outcomes were collected. From an initial search of 1,147 articles, 36 studies that evaluated CI use in 796 unique adults with SSD (51.3 ± 12.4 yr of age at time of implantation) were included. The mean duration of deafness was 6.2 ± 9.6 years. There was evidence of improvement for speech recognition in noise using different target-to-masker spatial configurations, with the largest benefit observed for target-to-masker configurations assessing head shadow (mean, 1.87-6.2 dB signal-to-noise ratio). Sound source localization, quantified as root-mean-squared error, improved with CI use (mean difference [MD], -25.3 degrees; 95% confidence interval [95% CI], -35.9 to -14.6 degrees; p < 0.001). Also, CI users reported a significant reduction in tinnitus severity as measured with the Tinnitus Handicap Inventory (MD, -29.97; 95% CI, -43.9 to -16.1; p < 0.001) and an improvement in spatial hearing abilities as measured with the Spatial, Speech, and Qualities of Hearing questionnaire (MD, 2.3; 95% CI, 1.7 to 2.8; p < 0.001). Cochlear implantation and CI use consistently offer improvements in speech recognition in noise, sound source localization, tinnitus, and perceived quality of life in adults with SSD.

Congenital hypothyroidism and thyroid function in a Japanese birth cohort: data from The Japan Environment and Children's Study.

The most common hormonal and metabolic disease in early childhood is congenital hypothyroidism (CH). This study aimed to describe CH in large-scale birth cohort data and summarize the results of serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels in 2-yr-old children. Data were obtained from the Japan Environment and Children's Study (JECS), and we identified 171 children with CH detected in newborn screenings or medical records (170.5 per 100,000 population). Infants with CH are at higher risk of developing congenital diseases than those without CH. Of 171 children with CH, 20 (11.7%) were diagnosed with congenital heart defects, 33 (19.3%) had chromosomal or other congenital abnormalities, and 23 (13.5%) had Down syndrome. At the age of 2 yr old, the median and 95% reference range values for TSH and fT4 were 2.13 (0.78-5.52) μIU/mL and 1.2 (1.0-1.5) ng/dL, respectively. Moreover, boys had slightly higher TSH and fT4 levels than did girls. Data on the distribution of TSH and fT4 in 2-yr-old children should be useful for decreasing the misclassification of thyroid disorders in the pediatric population. Trial-off treatment and re-evaluation of thyroid function are needed to classify permanent congenital hypothyroidism and transient congenital hypothyroidism after 3 yr of age.

Estimating body weight and body condition score of mature beef cows using depth images.

Obtaining accurate body weight (BW) is crucial for management decisions yet can be a challenge for cow-calf producers. Fast-evolving technologies such as depth sensing have been identified as low-cost sensors for agricultural applications but have not been widely validated for U.S. beef cattle. This study aimed to (1) estimate the body volume of mature beef cows from depth images, (2) quantify BW and metabolic weight (MBW) from image-projected body volume, and (3) classify body condition scores (BCS) from image-obtained measurements using a machine-learning-based approach. Fifty-eight crossbred cows with a mean BW of 410.0 ± 60.3 kg and were between 4 and 6 yr of age were used for data collection between May and December 2021. A low-cost, commercially available depth sensor was used to collect top-view depth images. Images were processed to obtain cattle biometric measurements, including MBW, body length, average height, maximum body width, dorsal area, and projected body volume. The dataset was partitioned into training and testing datasets using an 80%:20% ratio. Using the training dataset, linear regression models were developed between image-projected body volume and BW measurements. Results were used to test BW predictions for the testing dataset. A machine-learning-based multivariate analysis was performed with 29 algorithms from eight classifiers to classify BCS using multiple inputs conveniently obtained from the cows and the depth images. A feature selection algorithm was performed to rank the relevance of each input to the BCS. Results demonstrated a strong positive correlation between the image-projected cow body volume and the measured BW (r = 0.9166). The regression between the cow body volume and the measured BW had a co-efficient of determination (R2) of 0.83 and a 19.2 ± 13.50 kg mean absolute error (MAE) of prediction. When applying the regression to the testing dataset, an increase in the MAE of the predicted BW (22.7 ± 13.44 kg) but a slightly improved R2 (0.8661) was noted. Among all algorithms, the Bagged Tree model in the Ensemble class had the best performance and was used to classify BCS. Classification results demonstrate the model failed to predict any BCS lower than 4.5, while it accurately classified the BCS with a true prediction rate of 60%, 63.6%, and 50% for BCS between 4.75 and 5, 5.25 and 5.5, and 5.75 and 6, respectively. This study validated using depth imaging to accurately predict BW and classify BCS of U.S. beef cow herds.

Costs of parthenogenesis on growth and longevity in ex situ zebra sharks Stegostoma tigrinum

The zebra shark Stegostoma tigrinum, a popular aquarium fish, is an endangered species that is known to readily reproduce both sexually and through facultative parthenogenesis while in human care. Artificial insemination trials that took place between 2011 and 2013 resulted in the hatching of 2 sexually produced (herein heterozygotes) and 10 parthenogenetic sharks that allowed for a retrospective comparison of growth, feeding and longevity between offspring produced from 2 distinct reproductive modes. Parthenogenetic offspring were generally smaller at hatch than their heterozygous counterparts and, after the first several months post-hatch, failed to increase in mass and length at the same rate as heterozygotes. Parthenogenetic offspring exhibited non-normal swimming behaviors such as spiraling, spy hopping and head standing, which may have been correlated with a gradual decline in the ability of some sharks to properly suction feed. Median lifespan for the parthenotes was 1.05 yr (range: 0.27-6.64 yr); one of the heterozygotes lived to 2.37 yr of age, and the other was alive at the time of this writing in August 2022 and had reached reproductive maturity. By contrast, the 2 longest surviving parthenotes perished just prior to reaching sexual maturity (~5.5 and ~6.5 yr). Parthenogenesis has been documented among ex situ S. tigrinum maintained in aquariums across the globe, and this study demonstrates substantial negative costs to fitness in parthenogenetic offspring compared with their heterozygous siblings. The reduced fitness of parthenotes has implications for managing populations in human care as well as for in situ conservation efforts.

Comparison of three maternal composite sheep breeds managed under pasture lambing and purebred or terminal mating systems: ewe body weight, reproductive efficiency, and longevity.

Extensive sheep systems have lower inputs (e.g., feed, labor, infrastructure) but, generally, lower outputs per ewe than intensively managed flocks. Average ewe prolificacy is low (< 1.1 lambs per ewe) across the United States and traditional expectation is that costs required to support larger litters will not be recovered due to greater lamb mortality. The Composite-IV (C-IV) is a 50% Romanov, 25% Katahdin, and 25% White Dorper hair sheep developed and selected for enhanced reproductive efficiency at the U.S. Meat Animal Research Center. Objectives of the current study were to compare productivity of C-IV ewes (N = 404) to Katahdin (N = 342) and Polypay (N = 390), two popular maternal composite breeds, in a lower-input system. Experimental ewes were exposed to either rams of their own breed or Texel rams for the first time at 7 mo of age and remained in the same mating system for up to 4 yr. Ewes lambed on pasture from May to June and were expected to rear their lambs in the absence of supplemental feed and with minimal intervention. The ewe age × breed interaction effect impacted all annually recorded traits (P < 0.01) including number and total weight of lamb marketed at 25 wk per ewe exposed to mating (LS25 and LW25, respectively). Within all ages, LS25 of C-IV was greater (1.2 to 1.63 lambs; P < 0.01) than Katahdin (0.71 to 1.17 lambs) and Polypay (0.68 to 1.26 lambs) which were similar. At 1, 2, and 3-yr of age, C-IV ewes had, on average, 12 to 17 kg greater LW25 (P ≤ 0.01) than other breeds. Polypay LW25 was similar to Katahdin at 1 yr of age, but 8 to 13 kg greater (P < 0.01) at older ages. At 4 yr of age, LW25 was similar for C-IV and Polypay (63 and 62 kg, respectively). Overall, Texel mating improved LW25 by 3 kg compared to purebred mating (P < 0.01). Twin litters were most common within mature ewes (> 1 yr) of all breeds (52% to 65%); however, the proportion of triplet litters was numerically greater for C-IV (13%) than Katahdin (1%) or Polypay (4%). The frequency of mature ewes that gave birth to and reared twins (75% to 82%) was high for all breeds. Most triplet-bearing mature C-IV ewes reared twins (43%) though many reared triplets (39%). Ewe reproductive efficiency can be enhanced in lower-input systems by utilizing additive breed effects and heterosis in a complimentary crossbreeding program. More research is needed to identify indicator traits associated with lamb survival and to derive appropriate levels of prolificacy to fit specific management constraints.

Relapse Is the Most Common Treatment Failure Post HSCT in Children with ALL below 4 Years of Age Given a Chemo-Based Conditioning Regimen. Results from the Prospective Multinational Forum-Trial

Background: Relapse and non-relapse mortality (NRM) are the major causes of treatment failure in infants and young children with high-risk ALL undergoing HSCT. Conditioning regimens for this high-risk population usually omit total body irradiation (TBI) to avoid acute and long-term side effects that are more pronounced in this age group. The optimal chemotherapeutic approach aiming improved event-free survival (EFS) and low NRM is not yet defined. Methods: The prospective FORUM trial used two myeloablative chemo-conditioning regimens for children <4 years (yrs) of age: fludarabine (FLU), thiotepa (THIO) and either intravenous busulfan (BU) or treosulfan (TREO) as described previously (Peters et al., JCO 2021). This report includes 194/202 patients (pts) (107 male, 87 female) from 26 countries enrolled in FORUM who received HSCT (5 pts received TBI-based conditioning and 3 pts with unknown conditioning were excluded). Median age at HSCT was 2.2 yrs (6 months - 4 yrs; 38 pts 0-1yrs (20%), 53 pts 1-2yrs (27%), 53 pts 2-3yrs (27%), 50 pts 3-4yrs (26%)). Stem cell source was bone marrow in 132 (68%) pts, peripheral blood stem cells in 37 (19%), and cord blood in 24 (13%). Donors were HLA-matched siblings (MSD) in 39 (20%) pts and 9 or 10/10 HLA allele-matched unrelated donors (MUD) in 155 (80%) pts.Clonal genetic abnormalities reported at diagnosis included 9 pts with BCR-ABL, 13 pts with TEL-AML, and 53 pts with KMT2A r-rearrangements; all pts underwent HSCT in complete morphological remission (CR) (142 pts CR1; 50 pts CR2, 2 pts CR3). FLU/THIO/BU and FLU/THIO/TREO were used in 101, and 93 HSCTs, respectively. Graft-versus-host-disease (GvHD)-prophylaxis was Cyclosporin-A-based in 90%; recipients of MUD-grafts also received ATG and 3 doses of methotrexate. At data cut-off, median follow-up (FU) was 3 yrs (range, 3 months - 7.2 yrs). Results: 3-yrs OS was 0.69±0.04, 3-yrs EFS was 0.52±0.04; 3-yrs Cumulative incidence of relapse (CIR) was 0.44+0.04, and 3-yrs NRM was 0.05 ± 0.02. OS and EFS did not differ between pts < 2 and 2-4 yrs of age at HSCT (Table 1). Pts transplanted in CR 1 had significantly better EFS (0.58±0.04) as compared to >CR1pts (0.36±0.07, p=0.01); due to a higher CIR. OS was worse for the 53 pts with KMT2A-rearrangements (3-yrs OS 0.56±0.08 vs. 0.73±0.04, p=0.040). EFS for pts < 1 yr of age at diagnosis was significantly inferior as compared to older pts (3-yrs EFS 0.40±0.05 vs. 0.63±0.05, p=0.002). OS/EFS were not significantly different when donor type, stem cell source, and immunophenotype were compared (Table 1). At 3-yrs, OS was 0.63±0.05 and 0.76±0.05 and EFS was 0.52±0.05 and 0.51±0.06 (p=0.794) for the FLU/THIO/BU and FLU/THIO/TREO-group, respectively (p=0.075) with no significant difference in CIR and TRM. However, pts who relapsed post-HSCT had a better 3-yr post-relapse OS after FLU/THIO/TREO compared to FLU/THIO/BU (0.38±0.11; 0.16±0.07. p = 0.012) respectively. Most relapses occurred prior to 1 yr after HSCT. Acute GVHD occurred in 32 pts (20 pts experienced grade III/IV) with no significant difference between the two conditioning regimen). The 3-yr incidence of chronic GVHD (cGVHD) was comparable between the BU- and -TREO-group (p = 0.943). cGVHD/relapse-free survival at 3 yrs for FLU/THIO/BU was 0.44±0.05 and for FLU/THIO/TREO 0.41±0.06 (p=0.943). In multivariate analysis, remission > CR1 and the presence of KMT2A, negatively influence OS while EFS was worse for patients who underwent HSCT > CR1 or had ALL-diagnosis below 1 yr of age. Donor type, stem cell source, age between 1 and 4 yrs at HSCT, conditioning regimen, and PCR-MRD positivity pre-HSCT did not significantly influence outcome. 1-yr TRM was low for both conditioning regimens (0.06±0.02 for FLU/THIO/BU and 0.03±0.02 after FLU/THIO/TREO (n.s.) Conclusion: Within the FORUM-trial, infants and young children receiving HSCT after conditioning with either BU- or TREO containing regimens have a lower OS and EFS as compared to children above the age of 4 yrs due to a higher CIR. Because of decreased NRM, these results represent an improvement as compared to previously reported series; however, KMT2A-rearrangement continues to be an obstacle to successful HSCT. Pre- and post-transplant immunotherapeutic strategies aimed at reducing relapse-incidence without increasing chemotherapy-associated complications are needed. Figure 1: 3-yrs OS according to Conditioning Flu: fludarabine, Thio: thiotepa, Treo: treosulfan, Bu: busulfan Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Effects of different feeding levels during a 14-week preweaning phase in dairy heifer calves on telomere length and mitochondrial DNA copy number in blood.

Telomeres cap the ends of eukaryotic chromosomes, and the telomere length (TL) is related to cellular age. The mitochondrial DNA copy number (mtDNAcn) reflects the abundance of mitochondria in a cell. In addition to generating energy, mitochondria are also the main producers of reactive oxygen species, which in turn can accelerate TL attrition and impair mitochondrial function. Nutrition in early life could influence mtDNAcn and TL in later life. In the present study, we investigated the effects of feeding different levels of milk replacer (MR) on TL shortening and energetic status by examining mtDNAcn of heifers during their first year of life. In this study, whole blood samples were obtained from German Holstein heifer calves 36 to 48 h after birth (wk 1) and at wk 12 and wk 16 of life (n = 37), as well as from 31 calves when reaching 1 yr of age. Calves were fed either a high level of MR (14% solids) at 10 L/d (1.4 kg of MR/d; n = 18) or a restrictive low level at 5.7 L/d (0.8 kg of MR/d; n = 19) until linear weaning in wk 13 to 14 of life. Additional whole blood samples were taken from their respective dams 36 to 48 h after calving. Relative TL (qT) and mtDNAcn in cells from whole blood were measured by multiplex quantitative PCR. The greatest qT values were observed in neonates (36-48 h after birth), with decreasing qT values thereafter. Delta qT values were calculated as ΔqT = qT (first year of life) - initial qT (36-48 h after birth). We found no effect of the feeding regimen on qT values, but qT decreased with age. The mtDNAcn was lowest in neonates, increased until wk 12 of life, and then remained at a constant level until after weaning (wk 16). After the first year of life, mtDNAcn was decreased and returned to levels comparable to those of the neonatal stage. No differences in mtDNAcn were detectable between feeding groups within each time point. When comparing the values of qT and mtDNAcn between the calves and their dams after calving (36-48 h after birth and after calving), greater values were observed in calves than in dams. Delta qT values were negative in all but 2 calves (on the restricted diet), indicating that the change in TL with age was not uniform among individual animals, whereas no difference in mean ΔqT values occurred between the feeding groups. Additional analyses of the correlation between qT, mtDNAcn, and various indicators of oxidative status from birth until wk 16 of life did not indicate major interactions between oxidative status, qT and mtDNAcn. The results of this study support an age-dependent decrease of TL in calves independent of the MR feeding level and show the dynamic changes of mtDNAcn in early life.

A RETROSPECTIVE ANALYSIS OF MORBIDITY AND MORTALITY IN CAPTIVE BLUE-CROWNED LAUGHING THRUSHES (PTERORHINUS COURTOISI): 1998-2018.

The blue-crowned laughingthrush (BCLT) (Pterorhinus courtoisi) is a species of critically endangered passerine that is part of a Global Species Management Plan and experiences high mortality rates in some collections. Complete necropsy and medical records from 15 European institutions that housed BCLT between 1998 and 2018 were assessed to evaluate morbidity and mortality in the captive population. Medical records for 407 BCLT were received; a total of 191 morbidity events were recorded from 111 individual BCLT. The most common cause of morbidity was coccidial disease, including systemic isosporosis (30.4%, n = 58). Age was a significant factor contributing to mortality, with 53% of deaths occurring between 0 and 14 d old and 78% by 1 yr of age. The most common cause of death was trauma (22.8%, n = 31), followed by systemic isosporosis (22%, n = 30). Of the 343 deceased birds for which records were provided, 50.4% had a necropsy performed and 40.5% had histopathology carried out postmortem. Based on these findings, BCLT should be managed carefully to mitigate risk of trauma, and screening for isosporosis should be performed. Institutions should carry out standardized necropsies and histopathology on every BCLT that dies in their collection to elucidate the etiology of disease in this critically endangered species.

Science, Medicine, and the Anesthesiologist

Science, Medicine, and the Anesthesiologist

Mortality audit of COVID-19 infection among children.

As severe COVID-19 and mortality are not common in children, there is a scarcity of data regarding the cause of mortality in children infected with SARS-CoV-2. This study was aimed to describe the all-cause mortality and COVID-19 death (disease-specific mortality) in children with SARS-CoV-2 infection admitted to a paediatric COVID facility in a tertiary care centre. Data with respect to clinical, epidemiological profile and causes of death in non-survivors (0-12 yr old) of SARS-CoV-2 infection admitted to a dedicated tertiary care COVID hospital in north India between April 2020 and June 2021 were retrieved and analyzed retrospectively. A total of 475 SARS-CoV-2-positive children were admitted during the study period, of whom 47 died [18 neonates, 14 post-neonatal infants and 15 children (1-12 yr of age)]. The all-cause mortality and COVID-19 death (disease-specific mortality) were 9.9 per cent (47 of 475) and 1.9 per cent (9 of 475), respectively. Underlying comorbidities were present in 35 (74.5%) children, the most common being prematurity and perinatal complications (n=11, 24%) followed by congenital heart disease (n=6, 13%). The common causes of death included septic shock in 10 (21%), COVID pneumonia/severe acute respiratory distress syndrome in nine (19%), neonatal illnesses in eight (17%), primary central nervous system disease in seven (15%) and congenital heart disease with complication in six (13%) children. Our results showed a high prevalence of underlying comorbidities and a low COVID-19 death (disease-specific mortality). Our findings highlight that mortality due to COVID-19 can be overestimated if COVID-19 death and all-cause mortality in children infected with SARS-CoV-2 are not separated. Standardized recording of cause of death in children with SARS-CoV-2 infection is important.