Short communication: Genetic parameters for post-weaning visual scores and reproductive traits in Suffolk sheep

          The aim of this study was to estimate the coefficients of heritability and genetic correlations among visual scores (conformation, CPW; precocity, PPW; musculature, MPW) and reproductive traits: age at first lambing (AFL) and scrotal circumference (SC) evaluated at 180 days of age in Suffolk lambs. In the statistical model only the additive genetic effect was considered as random effect. The heritability estimates by univariate analyses for CPW, PPW, MPW, AFL and SC were 0.08, 0.12, 0.09, 0.20 and 0.22, respectively. The genetic correlations among AFL and CPW, PPW, MPW were -0.26, 0.19, and 0.08, respectively. The genetic correlation among SC and CPW, PPW, MPW were, respectively, 0.54, 0.88 and 0.86, and between AFL and SC was 0.26. The direct selection for conformation, precocity and musculature at 180 days of age and age at first lambing will provide slow genetic progress due to low heritability estimates. It is possible to obtain genetic gain in sexual precocity through selection on scrotal circumference in Suffolk rams. The favorable genetic correlation among visual scores and SC and between CPW and AFL, indicated the possibility to gain in genetic progress for reproductive traits through indirect selection of the visual scores in Suffolk sheep

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Avaliação da eficiência da desinfecção de teteiras e dos tetos no processo de ordenha mecânica de vacas

O presente trabalho teve como objetivos avaliar a eficiência do processo de desinfecção de teteiras por imersão em solução desinfetante utilizando duas fontes de cloro, hipoclorito de sódio e cloro orgânico, a dinâmica de cloro residual nesses dois tipos de soluções, ao longo do processo de ordenha, e a eficiência de três métodos de desinfecção: imersão, spray e esponja na remoção de microrganismos dos tetos de vacas em lactação, utilizando o cloro como desinfetante. Foram determinados os números de coliformes totais, coliformes fecais, Staphylococcus sp e microrganismos mesófilos nas amostras colhidas das teteiras, dos tetos e da solução desinfetante. Os resultados obtidos demonstraram que a prática da desinfecção de teteiras entre vacas, utilizando-se hipoclorito de sódio ou dicloroisocianurato de sódio como fontes de cloro, na concentração em torno de 150ppm não foi eficiente na redução dos microrganismos presentes nas teteiras. A solução desinfetante a base de dicloroisocianurato de sódio apresentou maior estabilidade. Os métodos de desinfecção dos tetos proporcionaram redução nos números de microrganismos pesquisados, em todos os tratamentos utilizados, mostrando ser uma ferramenta simples para minimizar o risco de transmissão de patógenos durante a ordenha e aumentar a qualidade microbiológica do leite produzido.The purpose of this investigation was to evaluate the efficiency of the teatcup disinfection process by immersion into a disinfectant solution, using sodium hypochlorite and organic chlorine, to verify the residual chlorine dynamics in both solutions during milking time, and to evaluate three premilking disinfection methods: immersion, spray and sponge. Total coliforms, fecal coliforms, Staphylococcus sp and mesophilic microorganism counting was done. The results showed that the disinfecting clusters between individual cows, using immersion in sodium hypochlorite or organic chlorine solutions with a concentration of 150ppm, was not efficient for the rubber teatcup microorganism reduction. The organic chlorine solution showed more stability. Teatcup is a potential microorganism vehicle for milk and the mammary gland. Disinfection of the teats reduced the number of the microorganisms studied in all treatments, showing to be a simple method that can be used to reduce the microrganism transmission risks during milking and to increase the microbial quality of the milk.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

A relatively common homozygous TRAPPC4 splicing variant is associated with an early-infantile neurodegenerative syndrome

Trafficking protein particle (TRAPP) complexes, which include the TRAPPC4 protein, regulate membrane trafficking between lipid organelles in a process termed vesicular tethering. TRAPPC4 was recently implicated in a recessive neurodevelopmental condition in four unrelated families due to a shared c.454+3A>G splice variant. Here, we report 23 patients from 17 independent families with an early-infantile-onset neurodegenerative presentation, where we also identified the homozygous variant hg38:11:119020256 A>G (NM_016146.5:c.454+3A>G) in TRAPPC4 through exome or genome sequencing. No other clinically relevant TRAPPC4 variants were identified among any of over 10,000 patients with neurodevelopmental conditions. We found the carrier frequency of TRAPPC4 c.454+3A>G was 2.4-5.4 per 10,000 healthy individuals. Affected individuals with the homozygous TRAPPC4 c.454+3A>G variant showed profound psychomotor delay, developmental regression, early-onset epilepsy, microcephaly and progressive spastic tetraplegia. Based upon RNA sequencing, the variant resulted in partial exon 3 skipping and generation of an aberrant transcript owing to use of a downstream cryptic splice donor site, predicting a premature stop codon and nonsense mediated decay. These data confirm the pathogenicity of the TRAPPC4 c.454+3A>G variant, and refine the clinical presentation of TRAPPC4-related encephalopathy