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Providing elevated structures in the pullet rearing environment affects behavior during initial acclimation to a layer aviary.
Get PDFSpatial abilities of hens are particularly sensitive to development during early life. Experiences in pullet housing may have lasting consequences on adult hens' movements in cage-free environments. We tested whether opportunities to access elevated spaces during rearing improved hens' use of a multitiered aviary. Female Dekalb White pullets were reared in either floor pens (FL), single-tiered aviaries (ST), or 2-tiered aviaries (TT; n = 5 pens/environment) through 16 wk of age. Rearing structures were replaced with identical multitiered aviaries at 17 wk. The distribution of the flock within the aviary and the vertical transitions of 10 focal hens/pen across the aviary were determined from videos recorded during their first (D1) and seventh (D7) day of aviary access, as well as at 19, 23, and 27 wk of age. Prevalence of floor eggs was recorded weekly from 17 to 28 wk of age. On D1, more ST and TT hens utilized the aviary during the daytime (P = 0.0077), made more vertical transitions when searching for a roosting spot in the evening (P = 0.0021), and maintained a consistent distance traveled during transitions compared to FL hens (P = 0.02). These differences disappeared by D7, except that ST and TT hens continued to roost on the highest perches of the aviary more (P < 0.0001) than FL hens through 27 wk of age. FL hens laid more floor eggs than ST and TT hens for the first 2 wk of lay (P < 0.0001). The majority (97.9%) of vertical transitions was controlled. Uncontrolled transitions were highest at D1 and decreased by D7 (P = 0.0009) and were not affected by rearing (P = 0.33). The results suggest that hens reared with minimal height are hesitant to use the laying hen aviaries when they are first transferred. They acclimate within 1 to 2 wk, but continue to roost less in the highest accessible level
The role of calcium in the prevention of erosive tooth wear: a systematic review and meta-analysis.
No full textOBJECTIVES
The loss of hard dental tissue due to recurrent acid challenges and mechanical stresses without bacterial involvement is known as erosive tooth wear (ETW). Many studies in the literature have concentrated on variables that may affect the ETW process and prevent its occurrence or reduce its advancement. However, to date, no previous systematic review has evaluated the role of calcium in preventing ETW. Therefore, the purpose of the present systematic review was to review and critically appraise the scientific evidence regarding the role of calcium formulations in the prevention of ETW.
METHODS
The review protocol was registered in the PROSPERO international prospective register of systematic reviews (Ref: CRD42021229819). A literature search was conducted in electronic databases to identify in situ randomized controlled trials evaluating the prevention of ETW following the application of calcium formulations. The outcomes studied included mean enamel loss, surface microhardness, surface roughness, mean erosion/softening depth, mineral loss/precipitation and remineralization. Study characteristics and outcomes of included studies were summarized. Cochrane's risk-of-bias tool 2.0 was used to assess the quality of eligible studies, and meta-analysis using a random effects model was performed.
RESULTS
The search retrieved 869 studies of which 21 were considered eligible. Regarding the results of the quality assessment for potential risk of bias in all included studies, overall, 5 studies were considered as being at low risk, another 12 at unclear risk and 4 at high risk of bias. The findings of the studies showed that the addition of calcium in juice drinks led to reduced enamel loss, with blackcurrant juice presenting 2.6 times statistically significant less enamel loss compared to orange juice (p = 0.0001, I2 = 89%). No statistically significant difference in mean surface microhardness of eroded enamel was recorded between chewing gum with or without casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (p = 0.31, I2 = 71%). Contradictory were the results regarding the effect of milk and CPP-ACP pastes on prevention of ETW.
CONCLUSIONS
Calcium formulations play an important role in ETW prevention, mainly through their addition to acidic drinks
Older adults' attitudes towards deprescribing and medication changes: a longitudinal sub-study of a cluster randomised controlled trial.
Get PDFOBJECTIVE
To investigate the association between older patients' willingness to have one or more medications deprescribed and: (1) change in medications, (2) change in the appropriateness of medications and (3) implementation of prescribing recommendations generated by the electronic decision support system tested in the 'Optimising PharmacoTherapy In the Multimorbid Elderly in Primary CAre' (OPTICA) trial.
DESIGN
A longitudinal sub-study of the OPTICA trial, a cluster randomised controlled trial.
SETTING
Swiss primary care settings.
PARTICIPANTS
Participants were aged ≥65 years, with ≥3 chronic conditions and ≥5 regular medications recruited from 43 general practitioner (GP) practices.
EXPOSURES
Patients' willingness to have medications deprescribed was assessed using three questions from the 'revised Patient Attitudes Towards Deprescribing' (rPATD) questionnaire and its concerns about stopping score.
MEASURES/ANALYSES
Medication-related outcomes were collected at 1 year follow-up. Aim 1 outcome: change in the number of long-term medications between baseline and 12 month follow-up. Aim 2 outcome: change in medication appropriateness (Medication Appropriateness Index). Aim 3 outcome: binary variable on whether any prescribing recommendation generated during the OPTICA medication review was implemented. We used multilevel linear regression analyses (aim 1 and aim 2) and multilevel logistic regression analyses (aim 3). Models were adjusted for sociodemographic variables and the clustering effect at GP level.
RESULTS
298 patients completed the rPATD, 45% were women and 78 years was the median age. A statistically significant association was found between the concerns about stopping score and the change in the number of medications over time (per 1-unit increase in the score the average number of medications use was 0.65 higher; 95% CI: 0.08 to 1.22). Other than that we did not find evidence for statistically significant associations between patients' agreement with deprescribing and medication-related outcomes.
CONCLUSIONS
We did not find evidence for an association between most measures of patient agreement with deprescribing and medication-related outcomes over 1 year.
TRIAL REGISTRATION NUMBER
NCT03724539
The Impact of Blood Morphological Parameters on Treatment Outcomes in Tennis Elbow Patients Receiving Platelet-Rich Plasma (PRP) Therapy: A Prospective Study.
Get PDFPlatelet-rich plasma (PRP) therapy holds substantial promise for the treatment of tennis elbow, a complex and challenging musculoskeletal condition. The aim of the study was to assess whether there are correlations between the levels of individual morphotic elements determined in whole blood and the outcomes of tennis elbow treatment with PRP injection, as measured using patient-reported outcome measures (PROMs) such as the Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QDASH), and Patient-Rated Tennis Elbow Evaluation (PRTEE). A prospective analysis was conducted on 107 patients (132 elbows) undergoing lateral epicondylitis treatment with (PRP) injections. Patients completed VAS, PRTEE, and QDASH questionnaires on the day of PRP administration and at established checkpoints (2, 4, 8, 12, 24, 52, and 104 weeks). Minimal clinically important difference (MCID) was employed to assess the treatment effects. Then, correlations were measured within each PROM, and the impact of the concentration of individual blood parameters on the MCID outcomes was assessed. Analyzing the relationships between the MCID+ and MCID- groups, significant correlations for the VAS and QDASH scales were observed. The level of individual morphotic elements in the blood may have influenced the treatment outcome, as measured using specific patient-reported outcome measures (PROMs). Regarding the VAS scale, factors favoring a positive treatment outcome included higher values of eosinophils (EOS) and basophils (BASO). For the QDASH scale, these factors were a lower value of mean corpuscular volume (MCV) and a higher mean corpuscular hemoglobin (MCH). The levels of certain blood parameters, such as EOS and BASO, in the current study influenced the classification of patients into MCID+ or MCID- groups, based on the VAS and QDASH scales
Neurocysticercosis: The duration of its preclinical phase relies on the parasite location.
No full textOBJECTIVES
Neurocysticercosis (NC) is a heterogeneous disease particularly in terms of response to treatment and prognosis. Parasite localization is one of the main factors involved in this heterogeneity. In this study we aim to determine whether differences in the duration of the preclinical phase associated with parasite location, could contribute to said heterogeneity.
METHODS
Ninety-nine patients were included, 24 with parasites in the parenchyma (PAR), 56 in the subarachnoid (SA) space and 19 in the ventricular system (IV). A questionnaire designed to assess exposure to classic NC risk factors 5, 10, 15, 20 and more than 20 years prior to diagnosis was applied. The results were compared between the three groups. Also, asymptomatic relatives of patients who had shared their living conditions in childhood or more recently were included and underwent brain scan and blood testing for specific antibodies.
RESULTS
Over the course of their lives, exposure to risk factors decreased significantly for all patients, although the decrease was more evident in patients with parasites in the SA space (p < 0.001) compared to patients with PAR (p = 0.011) or IV cysts (p = 0.020). Five years prior to diagnosis, exposure to risk factors was significantly higher in patients with PAR or IV NC than in patients with SA NC (p = 0.04). Furthermore, individuals in close contact with PAR or IV patients in the years preceding diagnosis were more likely to have asymptomatic NC, specific antibodies in sera, particularly IgM, compared to individuals in close contact with SA patients during the same period.
CONCLUSIONS
All these findings are highly suggestive of the possibility of a more recent infection of patients affected by parenchymal and ventricular NC than of patients with subarachnoid NC. Consequently, subarachnoid disease could be considered a chronic disease, which, probably contributes to the severity of the disease as well as the minimal response to medical treatment
Recent Bendamustine Treatment Before Apheresis Has a Negative Impact on Outcomes in Patients With Large B-Cell Lymphoma Receiving Chimeric Antigen Receptor T-Cell Therapy.
No full textPURPOSE
Approximately 30%-40% of patients with relapsed/refractory (R/R) large B-cell lymphoma (LBCL) infused with CD19-targeted chimeric antigen receptor (CAR) T cells achieve durable responses. Consensus guidelines suggest avoiding bendamustine before apheresis, but specific data in this setting are lacking. We report distinct outcomes after CAR T-cell therapy according to previous bendamustine exposure.
METHODS
The study included CAR T-cell recipients from seven European sites. Safety, efficacy, and CAR T-cell expansion kinetics were analyzed according to preapheresis bendamustine exposure. Additional studies on the impact of the washout period and bendamustine dose were performed. Inverse probability treatment weighting (IPTW) and propensity score matching (PSM) analyses were carried out for all efficacy comparisons between bendamustine-exposed and bendamustine-naïve patients.
RESULTS
The study included 439 patients with R/R LBCL infused with CD19-targeted commercial CAR T cells, of whom 80 had received bendamustine before apheresis. Exposed patients had significantly lower CD3+ cells and platelets at apheresis. These patients had a lower overall response rate (ORR, 53% v 72%; P < .01), a shorter progression-free survival (PFS, 3.1 v 6.2 months; P = .04), and overall survival (OS, 10.3 v 23.5 months; P = .01) in comparison with the bendamustine-naïve group. Following adjustment methods for baseline variables, these differences were mitigated. Focusing on the impact of bendamustine washout before apheresis, those with recent (<9 months) exposure (N = 42) displayed a lower ORR (40% v 72%; P < .01), shorter PFS (1.3 v 6.2 months; P < .01), and OS (4.6 v 23.5 months; P < .01) in comparison with bendamustine-naïve patients. These differences remained significant after IPTW and PSM analysis. Conversely, the cumulative dose of bendamustine before apheresis did not affect CAR-T efficacy outcomes.
CONCLUSION
Recent bendamustine exposure before apheresis was associated with negative treatment outcomes after CD19-targeted CAR T-cell therapy and should be therefore avoided in CAR T-cell candidates
Sulphur dioxide in the mid-infrared transmission spectrum of WASP-39b.
Get PDFThe recent inference of sulphur dioxide (SO2) in the atmosphere of the hot (∼1100 K), Saturn-mass exoplanet WASP-39b from near-infrared JWST observations (1-3) suggests that photochemistry is a key process in high temperature exoplanet atmospheres (4). This is due to the low (<1 ppb) abundance of SO2 under thermochemical equilibrium, compared to that produced from the photochemistry of H2O and H2S (1-10 ppm) (4-9). However, the SO2 inference was made from a single, small molecular feature in the transmission spectrum of WASP-39b at 4.05 μm, and therefore the detection of other SO2 absorption bands at different wavelengths is needed to better constrain the SO2 abundance. Here we report the detection of SO2 spectral features at 7.7 and 8.5 μm in the 5-12 μm transmission spectrum of WASP-39b measured by the JWST Mid-Infrared Instrument (MIRI) Low Resolution Spectrometer (LRS) (10). Our observations suggest an abundance of SO2 of 0.5-25 ppm (1σ range), consistent with previous findings (4). In addition to SO2, we find broad water vapour absorption features, as well as an unexplained decrease in the transit depth at wavelengths longer than 10 μm. Fitting the spectrum with a grid of atmospheric forward models, we derive an atmospheric heavy element content (metallicity) for WASP-39b of ∼7.1-8.0 × solar and demonstrate that photochemistry shapes the spectra of WASP-39b across a broad wavelength range
Prognostic value of right ventricular dyssynchrony in adults with repaired tetralogy of Fallot.
Get PDFOBJECTIVE
Residual sequelae after surgical repair of tetralogy of Fallot (rTOF) affect clinical outcome. We investigated the prognostic impact of right ventricular (RV) dyssynchrony in adults with rTOF years after the surgical repair.
METHODS
Patients from the Swiss Adult Congenital HEart disease Registry were included. NT-proBNP levels, echocardiography, exercise testing and MRI data were collected. An offline strain analysis to quantify RV-ventricular and interventricular dyssynchrony was performed. The standard deviation of the time-to-peak shortening (TTP) of six RV segments defined the RV Dyssynchrony Index (RVDI). Maximal difference of TTP between RV and left ventricular segments defined the interventricular shortening delay (IVSD). Predictors of a composite adverse event (arrhythmias, hospitalisation for heart failure and death) were identified by multivariate Cox regression analysis. Their median values were used to create a risk score.
RESULTS
Out of 285 included patients (mean age 34±14 years), 33 patients (12%) experienced an adverse event during a mean follow-up of 48±21 months. No correlation was found between RVDI, IVSD and clinical events. NT-proBNP, right atrial area and peak heart rate were independent predictors of outcomes. After 4 years-follow-up, no adverse events occurred in patients at low risk (score=0 points), while an adverse event occurred in 62% of patients at high risk (score=3 points, p<0.001).
CONCLUSION
In our cohort of adults with rTOF, surrogates of RV dyssynchrony did not correlate with outcomes. A multimodality approach was effective in predicting the risk for adverse events
The structure of metacognition in middle childhood: Evidence for a unitary metacognition-for-memory factor.
Get PDFIt has been debated whether children's metacognitive monitoring and control processes rely on a general resource or whether metacognitive processes are task specific. Moreover, findings about the extent to which metacognitive processes are related to first-order task performance are mixed. The current study aimed to uncover the relationships among children's monitoring (discrimination between correct and incorrect responses), control (accurate withdrawal of wrong answers), and performance across three memory-based learning tasks: Kanji learning, text comprehension, and secret code learning. All tasks consisted of a study phase, a test phase, monitoring (confidence judgments), and control (maintaining/withdrawing responses). Participants were 325 children (151 second graders [Mage = 8.12 years] and 174 fourth graders [Mage = 10.20 years]). Confirmatory factor analyses showed that a model in which monitoring and control loaded on a joint factor and performance on a separate factor provided the best fit to the data. Fourth graders had better monitoring and control accuracy than second graders. However, the factor structure of metacognition was similar for both age groups, contradictory to the assumption that metacognition generalizes across tasks as children grow older. After accounting for task-specific processes, monitoring and control skills for language-based memory tasks appear to be generalizable in middle childhood. In sum, children's monitoring and control for three separate memory tasks appear to reflect a unitary metacognition-for-memory factor related to, but distinguishable from, performance
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