Use of Prevotella bryantii 25A as a Probiotic to Reduce the Risk of Ruminal Acidosis in Dairy Cows

This study was conducted to determine if adding relatively large quantities of a rapid growing, starch fermenting rumen bacterium, Prevotella bryanti, strain 25A, to the rumen of dairy cows would modulate rumen fermentation to reduce the risk of sub-acute ruminal acidosis (SARA). Twelve rumen fistulated dairy cows were fed an energy dense barley diet during a 3 week pre-partum period and then for 7 weeks post partum. Cells of P. bryantii that had been grown in a 100 liter fermenter were stored as frozen cells and then added daily to the rumen of six of the cows. Cows receiving the inoculum had lower post-feeding ruminal lactic acid, higher ruminal acetate and butyrate, and higher production of milk fat. However, since neither experimental nor control cows developed signs of SARA under the feeding conditions of this experiment, conclusions about protection against SARA by P. bryantii can not be reached

Treatment with exenatide once weekly or twice daily for 30 weeks is associated with changes in several cardiovascular risk markers

Background Dyslipidemia and type 2 diabetes are two of the most significant risk factors for the development of cardiovascular disease. Measurement of lipoprotein subclasses provides important information about derangements in lipid metabolism and helps refine cardiovascular risk assessment. Exenatide, a glucagon-like peptide 1 receptor agonist, improved glycemic control, obesity, hypertension, and dyslipidemia in patients with type 2 diabetes in clinical trials. Methods In the DURATION-1 trial, patients with type 2 diabetes were treated with exenatide once weekly or twice daily for 30 weeks. This post hoc analysis evaluated the impact of exenatide on lipoprotein subclasses in 211 DURATION-1 patients using vertical auto profile methodology and the Statistical Package for the Social Sciences general linear model adjusted for glycosylated hemoglobin (HbA1c) and weight. Results Baseline lipids and high sensitivity C-reactive protein were normal overall based on the standard lipid panel. Once-weekly exenatide reduced apolipoprotein B and the apolipoprotein B to apolipoprotein A1 ratio (P \u3c 0.05), independent of glycemic improvement and weight loss. A significant shift in lipoprotein pattern away from small, dense low-density lipoprotein-4 cholesterol was also observed (P \u3c 0.05). Exenatide once weekly increased high-density lipoprotein-2 cholesterol, even after adjustment for changes in HbA1c and weight (P \u3c 0.05). Triglycerides, very low-density lipoprotein cholesterol, and high sensitivity C-reactive protein were reduced with both the once-weekly and twice-daily exenatide regimens (P \u3c 0.05). Conclusion In this post hoc analysis, exenatide significantly improved a number of cardiovascular risk markers. Continuous exenatide exposure with exenatide once weekly elicited a greater response than did immediate-release exenatide twice daily, generally independent of glycemic improvement and weight loss. Thus, in addition to improving glycemic control, exenatide induced favorable changes in lipid and lipoprotein metabolism and decreased systemic inflammation

Capacitación y entrenamiento en el reciclado de polímeros

Etilplast es una cooperativa de trabajo, dedicada a la compra, revalorización mediante reciclado mecánico y venta de termoplásticos en la localidad de Benavidez, partido de Tigre (BA). Fue constituida cuando un grupo de cartoneros de la zona decidieron, en vez de vender el producto tal cual lo recolectaban, agregarle valor procesándolo. La empresa, a lo largo del tiempo y con mucho esfuerzo, fue creciendo e incorporando maquinaria para lograr un producto con mayor valor, mejor calidad y la automatización de ciertos procesos. Los integrantes no sólo aprendieron a reciclar plástico, sino que también obtuvieron conocimientos sobre la construcción de las maquinarias y la manera de autogestionarse. La Universidad Nacional de La Plata, en su función de transferencia, debe garantizar la articulación y asignación de recursos. Se prevé el desarrollo de la capacitación contemplando aspectos de la administración y gestión microempresarial como también de las técnicas específicas del proceso de reciclado conjuntamente con su recolección y clasificación en origen.Eje: Investigación e innovación para la inclusión socialFacultad de Ingenierí

Should Age-Dependent Absolute Risk Thresholds Be Used for Risk Stratification in Risk-Stratified Breast Cancer Screening?

In risk-stratified cancer screening, multiple risk factors are incorporated into the risk assessment. An individual’s estimated absolute cancer risk is linked to risk categories with tailored screening recommendations for each risk category. Absolute risk, expressed as either remaining lifetime risk or shorter-term (five- or ten-year) risk, is estimated from the age at assessment. These risk estimates vary by age; however, some clinical guidelines (e.g., enhanced breast cancer surveillance guidelines) and ongoing personalised breast screening trials, stratify women based on absolute risk thresholds that do not vary by age. We examine an alternative approach in which the risk thresholds used for risk stratification vary by age and consider the implications of using age-independent risk thresholds on risk stratification. We demonstrate that using an age-independent remaining lifetime risk threshold approach could identify high-risk younger women but would miss high-risk older women, whereas an age-independent 5-year or 10-year absolute risk threshold could miss high-risk younger women and classify lower-risk older women as high risk. With risk misclassification, women with an equivalent risk level would be offered a different screening plan. To mitigate these problems, age-dependent absolute risk thresholds should be used to inform risk stratification

The influence of genotype on warfarin maintenance dose predictions produced using a Bayesian dose individualization tool

Background A previously established Bayesian dosing tool for warfarin was found to produce biased maintenance dose predictions. In the following study, we aimed to (1) determine if the biased warfarin dose predictions previously observed could be replicated in a new cohort of patients from two different clinical settings, (2) explore the influence of CYP2C9 and VKORC1 genotype on the predictive performance of the Bayesian dosing tool, and (3) determine if the prior population used to develop the kinetic-pharmacodynamic (KPD) model underpinning the Bayesian dosing tool was sufficiently different from the test (posterior) population to account for the biased dose predictions. Methods The warfarin maintenance doses for 140 patients were predicted using the dosing tool and compared to the observed maintenance dose. The impact of genotype was assessed by predicting maintenance doses with prior parameter values known to be altered by genetic variability (e.g., EC50 for VKORC1 genotype). The prior population was evaluated by fitting the published kinetic-pharmacodynamic model, which underpins the Bayesian tool, to the observed data using NONMEM and comparing the model parameter estimates to published values. Results The Bayesian tool produced positively biased dose predictions in the new cohort of patients (mean prediction error [95% CI]; 0.32 mg/day [0.14, 0.5]). The bias was only observed in patients requiring ≥7 mg/day. The direction and magnitude of the observed bias was not influenced by genotype. The prior model provided a good fit to our data, suggesting that the bias was not caused by different prior and posterior populations. Conclusions Maintenance doses for patients requiring ≥7 mg/day were overpredicted. The bias was not due to the influence of genotype nor was it related to differences between the prior and posterior populations. There is a need for a more mechanistic model that captures warfarin dose–response relationship at higher warfarin dose

Canadian Healthcare Professionals’ Views and Attitudes toward Risk-Stratified Breast Cancer Screening

Given the controversy over the effectiveness of age-based breast cancer (BC) screening, offering risk-stratified screening to women may be a way to improve patient outcomes with detection of earlier-stage disease. While this approach seems promising, its integration requires the buy-in of many stakeholders. In this cross-sectional study, we surveyed Canadian healthcare professionals about their views and attitudes toward a risk-stratified BC screening approach. An anonymous online questionnaire was disseminated through Canadian healthcare professional associations between November 2020 and May 2021. Information collected included attitudes toward BC screening recommendations based on individual risk, comfort and perceived readiness related to the possible implementation of this approach. Close to 90% of the 593 respondents agreed with increased frequency and earlier initiation of BC screening for women at high risk. However, only 9% agreed with the idea of not offering BC screening to women at very low risk. Respondents indicated that primary care physicians and nurse practitioners should play a leading role in the risk-stratified BC screening approach. This survey identifies health services and policy enhancements that would be needed to support future implementation of a risk-stratified BC screening approach in healthcare systems in Canada and other countries

Comparison of pharmacist managed anticoagulation with usual medical care in a family medicine clinic

Background The beneficial outcomes of oral anticoagulation therapy are dependent upon achieving and maintaining an optimal INR therapeutic range. There is growing evidence that better outcomes are achieved when anticoagulation is managed by a pharmacist with expertise in anticoagulation management rather than usual care by family physicians. This study compared a pharmacist managed anticoagulation program (PC) to usual physician care (UC) in a family medicine clinic. Methods A retrospective cohort study was carried out in a family medicine clinic which included a clinical pharmacist. In 2006, the pharmacist assumed anticoagulation management. For a 17-month period, the PC group (n = 112) of patients on warfarin were compared to the UC patients (n = 81) for a similar period prior to 2006. The primary outcome was the percentage of time patients' INR was in the therapeutic range (TTR). Secondary outcomes were the percentage of time in therapeutic range within ± 0.3 units of the recommended range (expanded TTR) and percentage of time the INR was >5.0 or <1.5. Results The baseline characteristics were similar between the groups. Fifty-five percent of the PC group was male with a mean age of 67 years; 51% of the UC group was male with a mean age of 71 years. The most common indications for warfarin in both groups were atrial fibrillation, mechanical heart valves and deep vein thrombosis. The TTR was 73% for PC and 65% for UC (p 5 were 0.3% for PC patients and 0.1% for UC (p < 0.0001). Conclusion The pharmacist-managed anticoagulation program within a family practice clinic compared to usual care by the physicians achieved significantly better INR control as measured by the percentage of time patients' INR values were kept in both the therapeutic and expanded range. Based on the results of this study, a collaborative family practice clinic using pharmacists and physicians may be an effective model for anticoagulation management with these results verified in future prospective randomized studies