108 research outputs found
Effect of natural zeolite on live weight changes, ruminal fermentation and nitrogen metabolism of ewe lambs
The objective of this study was to evaluate the effects of natural zeolite on the performance and nitrogen metabolism of Rambouillet ewe lambs. Forty Rambouillet ewe lambs with an initial weight of 41.06 ± 3.9 kg were randomly assigned to one of four experimental diets, namely 0, 20, 40 and 60 g of natural zeolite (Comercializadora OmegaŸ México) per kg dietary dry matter in a completely randomized design and sixteen ewe lambs were used in a 4 x 4 Latin square metabolism study. Performance was not modified by natural zeolite levels in the diet, and daily gain showed a quadratic response. Ammonia concentration at 8 and 12 hours increased linearly with zeolite. Zeolite increased ruminal pH linearly at 8 and 12 hours. Acetate and butyrate presented a quadratic response, and total ruminal volatile fatty acid concentration was linearly increased by zeolite. Nitrogen retention showed a linear and quadratic response to zeolite. The estimated fractions of protein digested in the small intestine, when rumen-fermentable energy was limiting (PDIE) and when rumen-fermentable nitrogen was limiting, showed a linear and quadratic response to zeolite. PDIE was positively correlated (r = 0.96) with average daily gain.Keywords: Sheep, ammonium, ruminal fermentation, productive, soluble nitroge
Achieving global biodiversity goals by 2050 requires urgent and integrated actions
Governments are negotiating actions intended to halt biodiversity loss and put it on a path to recovery by 2050. Here, we show that bending the curve for biodiversity is possible, but only if actions are implemented urgently and in an integrated manner. Connecting these actions to biodiversity outcomes and tracking progress remain a challenge
Genetic Testing to Inform Epilepsy Treatment Management From an International Study of Clinical Practice
IMPORTANCE: It is currently unknown how often and in which ways a genetic diagnosis given to a patient with epilepsy is associated with clinical management and outcomes.
OBJECTIVE: To evaluate how genetic diagnoses in patients with epilepsy are associated with clinical management and outcomes.
DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cross-sectional study of patients referred for multigene panel testing between March 18, 2016, and August 3, 2020, with outcomes reported between May and November 2020. The study setting included a commercial genetic testing laboratory and multicenter clinical practices. Patients with epilepsy, regardless of sociodemographic features, who received a pathogenic/likely pathogenic (P/LP) variant were included in the study. Case report forms were completed by all health care professionals.
EXPOSURES: Genetic test results.
MAIN OUTCOMES AND MEASURES: Clinical management changes after a genetic diagnosis (ie, 1 P/LP variant in autosomal dominant and X-linked diseases; 2 P/LP variants in autosomal recessive diseases) and subsequent patient outcomes as reported by health care professionals on case report forms.
RESULTS: Among 418 patients, median (IQR) age at the time of testing was 4 (1-10) years, with an age range of 0 to 52 years, and 53.8% (n = 225) were female individuals. The mean (SD) time from a genetic test order to case report form completion was 595â(368) days (range, 27-1673 days). A genetic diagnosis was associated with changes in clinical management for 208 patients (49.8%) and usually (81.7% of the time) within 3 months of receiving the result. The most common clinical management changes were the addition of a new medication (78 [21.7%]), the initiation of medication (51 [14.2%]), the referral of a patient to a specialist (48 [13.4%]), vigilance for subclinical or extraneurological disease features (46 [12.8%]), and the cessation of a medication (42 [11.7%]). Among 167 patients with follow-up clinical information available (mean [SD] time, 584â[365] days), 125 (74.9%) reported positive outcomes, 108 (64.7%) reported reduction or elimination of seizures, 37 (22.2%) had decreases in the severity of other clinical signs, and 11 (6.6%) had reduced medication adverse effects. A few patients reported worsening of outcomes, including a decline in their condition (20 [12.0%]), increased seizure frequency (6 [3.6%]), and adverse medication effects (3 [1.8%]). No clinical management changes were reported for 178 patients (42.6%).
CONCLUSIONS AND RELEVANCE: Results of this cross-sectional study suggest that genetic testing of individuals with epilepsy may be materially associated with clinical decision-making and improved patient outcomes
Prevalence and risk factors of constipation and pollakisuria among older homeâcare patients
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