Weed anemone menace in marine aquaria and its management

Sea anemones are coming under the Phylum Cnidaria and Class Anthozoa. Like many Cnidarians, sea anemones contain specialized cells, known as cnidocytes or nematocytes, in their body column, oral disc, pharynx, tentacles and mesenterial filaments. Sea anemones of Aiptasia genus are distributed in temperate and tropical oceans attached to any hard substratum. The genus Aiptasia includes 13 species all equipped with 96 tentacles which are filled with nematocysts to sting their prey. The name Aiptasia itself means ‘beautiful’, however in marine aquarium keeping even if few Aiptasia are found in the tank it should not be taken so lightly. A hardy species it can explode in numbers within weeks. Aiptasia is a zooxanthellate anemone and survives well in the illuminated marine aquarium due to the photosynthetic activity of its algal symbiont

The Impact of Lameness on Dairy Cattle Welfare: Growing Need for Objective Methods of Detecting Lame Cows and Assessment of Associated Pain

Dairy cows are the major animals reared for milk production worldwide. Lameness is a manifestation of painful condition due to injury or disease in the foot, regarded as a major welfare problem in dairy cows. An effective lameness management requires prompt identification of lame cows. The objectives of this systematic review were to discuss the various techniques of detecting lameness, assessment of the associated pain, and the impact of lameness on dairy cow welfare. Results from the literature search yielded 534 papers, with 102 papers meeting the inclusion criteria. The eligible studies were discussed in two sections which were; (1) lameness detection systems and their application in pain assessment using four methods: gait and behavioral variables, physiological parameters, pressure nociceptive threshold and blood biomarkers; (2) impact of lameness on animal-based welfare measures. Despite the limitations in the use of automated locomotion scoring systems, results showed the technique remains a promising tool for the prompt detection of lame cows compared with manual systems (MLSS). More investigation of such systems could aid the validation of pain in cows with various degree of lameness. Further studies are required for early lameness detection and minimizing the welfare implications in dairy herds

Tumor Necrosis Factor-Alpha Signaling May Contribute to Chronic West Nile Virus Post-Infectious Proinflammatory State

Background: West Nile virus (WNV) causes a spectrum of human disease ranging from a febrile illness (WNV fever) to severe neuroinvasive disease (meningitis, encephalitis, acute flaccid paralysis). Since WNV gained entry into North America in 1999, clinicians caring for WNV survivors have observed persistent neurological symptoms occurring long-after the production of neutralizing antibodies and clearance of the virus. Accordingly, alternative pathogeneses other than direct viral invasion have been hypothesized to explain these post-infectious symptoms. The dominant hypothesis is that antiviral inflammatory responses triggered initially to clear WNV may persist to promote a post-infectious proinflammatory state. Methods: In 4 serologically-confirmed WNV patients with persistent post-infectious symptoms (3 WNV fever, 1 neuroinvasive disease), we ordered a comprehensive cytokine panel at weeks 8, 10, 12, and 36 months post-onset of illness, respectively, to better understand the pathophysiology of the protracted symptoms. Results: All patients had abnormally elevated tumor necrosis factor alpha (TNF-α), a major molecule triggering antiviral cytokines and chronic inflammation in many human autoimmune diseases, but heretofore not reported to be upregulated in human WNV infection. Three patients also had elevations of other proinflammatory proteins. Major symptoms included fatigue, arthralgias, myalgias, generalized or multifocal pain or weakness, imbalance, headaches, cognitive problems, and symptoms of dysautonomia. Conclusion: The findings provide support for an extended post-infectious proinflammatory state that may contribute to chronic inflammation and long-term morbidity in some WNV survivors and further suggest that TNF-α may play a pathogenic role in initiating this inflammatory environment. Clinical trials may be warranted to determine if TNF-α inhibitors or other immunosuppressive agents can improve patient outcomes

Assessment of Machine Learning Detection of Environmental Enteropathy and Celiac Disease in Children

University of Virginia Center for Engineering in Medicine GrantBill and Melinda Gates Foundation grants OPP1066203 and OPP1066118University of Virginia THRIV Scholar Career Development Award awarded to Dr Syed

Preventive Hoof Trimming and Animal-Based Welfare Measures Influence the Time to First Lameness Event and Hoof Lesion Prevalence in Dairy Cows

Background: The objectives of this study were to, (1) investigate the impact of the Dutch five-step hoof trimming (HT) technique on time to lameness and hoof lesion prevalence in grazing (GR) and non-grazing (NGR) dairy cows, and (2) determine the association between potential benefits of HT and animal-based welfare measures during lactation. A total of 520 non-lame cows without hoof lesions from 5 dairy farms (GR = 2, NGR = 3) were enrolled at early (within 30 days in milk; DIM) and late lactation (above 200 DIM), and randomly allocated to either trimmed (HGR or HNGR) or control groups (CON-GR and CON-NGR). Locomotion scores, body condition, hock condition, leg hygiene, and hoof health were assessed at monthly intervals until the following 270 days in milk. The data were analyzed using Kaplan-Meier survival analysis, multivariable Cox, and logistic regression models. The overall incidence rate of lameness was 36.2 cases/100 cows/month, with corresponding rates of 27.4, 31.9, 48.4, and 45.8 cases/100 cows/month in HGR, HNGR, CON-GR, and CON-NGR, respectively. Time to first lameness event was significantly higher in HGR (mean ± S.E; 8.12 ± 0.15) compared to CON-GR (7.36 ± 0.26), and in HNGR (8.05 ± 0.16) compared to CON-NGR (7.39 ± 0.23). The prevalence of hoof lesions in the enrolled cows was 36.9%, with a higher occurrence in CON-GR (48.8%) than HGR (23.2%), and in CON-NGR (52.6%) compared to HNGR (32.2%). The majority of hoof lesions were non-infectious in grazing (HGR vs. CON-GR; 21.3 vs. 33.3%) and non-grazing herds (HNGR vs. CON-NGR; 25.0 vs. 40.4%). The risk of lameness was higher in underconditioned cows (Hazard ratio; HR = 3.1, 95% CI 1.2–7.4), presence of hoof lesion (HR = 33.1, 95% CI 17.6–62.5), and there was variation between farms. Aside HT, lower parity (OR = 0.4, 95% CI 0.2–0.8), normal hock condition (OR = 0.06; 95% 0.01–0.29), and absence of overgrown hoof (OR = 0.4; 95% 0.2–0.7) were protective against non-infectious hoof lesions. Functional HT is beneficial as a lameness preventive strategy during lactation; however, ensuring older cows are in good body condition and free from hock injuries are equally important

Early-childhood linear growth faltering in low- and middle-income countries

Globally, 149 million children under 5 years of age are estimated to be stunted (length more than 2 standard deviations below international growth standards) 1,2. Stunting, a form of linear growth faltering, increases the risk of illness, impaired cognitive development and mortality. Global stunting estimates rely on cross-sectional surveys, which cannot provide direct information about the timing of onset or persistence of growth faltering—a key consideration for defining critical windows to deliver preventive interventions. Here we completed a pooled analysis of longitudinal studies in low- and middle-income countries (n = 32 cohorts, 52,640 children, ages 0–24 months), allowing us to identify the typical age of onset of linear growth faltering and to investigate recurrent faltering in early life. The highest incidence of stunting onset occurred from birth to the age of 3 months, with substantially higher stunting at birth in South Asia. From 0 to 15 months, stunting reversal was rare; children who reversed their stunting status frequently relapsed, and relapse rates were substantially higher among children born stunted. Early onset and low reversal rates suggest that improving children’s linear growth will require life course interventions for women of childbearing age and a greater emphasis on interventions for children under 6 months of age

Child wasting and concurrent stunting in low- and middle-income countries

Sustainable Development Goal 2.2—to end malnutrition by 2030—includes the elimination of child wasting, defined as a weight-for-length z-score that is more than two standard deviations below the median of the World Health Organization standards for child growth 1. Prevailing methods to measure wasting rely on cross-sectional surveys that cannot measure onset, recovery and persistence—key features that inform preventive interventions and estimates of disease burden. Here we analyse 21 longitudinal cohorts and show that wasting is a highly dynamic process of onset and recovery, with incidence peaking between birth and 3 months. Many more children experience an episode of wasting at some point during their first 24 months than prevalent cases at a single point in time suggest. For example, at the age of 24 months, 5.6% of children were wasted, but by the same age (24 months), 29.2% of children had experienced at least one wasting episode and 10.0% had experienced two or more episodes. Children who were wasted before the age of 6 months had a faster recovery and shorter episodes than did children who were wasted at older ages; however, early wasting increased the risk of later growth faltering, including concurrent wasting and stunting (low length-for-age z-score), and thus increased the risk of mortality. In diverse populations with high seasonal rainfall, the population average weight-for-length z-score varied substantially (more than 0.5 z in some cohorts), with the lowest mean z-scores occurring during the rainiest months; this indicates that seasonally targeted interventions could be considered. Our results show the importance of establishing interventions to prevent wasting from birth to the age of 6 months, probably through improved maternal nutrition, to complement current programmes that focus on children aged 6–59 months

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care