A supplement containing multiple types of gluconeogenic substrates alters intake but not productivity of heat-stressed Afshari lambs

Citation: Mahjoubi, E., Amanlou, H., Yazdi, M. H., Aghaziarati, N., Noori, G. R., Vahl, C. I., . . . Baumgard, L. H. (2016). A supplement containing multiple types of gluconeogenic substrates alters intake but not productivity of heat-stressed Afshari lambs. Journal of Animal Science, 94(6), 2497-2505. doi:10.2527/jas2015-9697Thirty-two Afshari lambs were used in a completely randomized design with a 2 x 2 factorial arrangement of treatments to evaluate a nutritional supplement designed to provide multiple gluconeogenic precursors during heat stress (HS). Lambs were housed in thermal neutral (TN) conditions and fed ad libitum for 8 d to obtain covariate data (period 1 [P1]) for the subsequent experimental period (period 2 [P2]). During P2, which lasted 9 d, half of the lambs were subjected to HS and the other 16 lambs were maintained in TN conditions but pair fed (PFTN) to the HS lambs. Half of the lambs in each thermal regime were fed (top-dressed) 100 g/d of a feed supplement designed to provide gluconeogenic precursors (8 lambs in HS [heat stress with Glukosa {HSG}] and 8 lambs in PFTN [pair-fed thermal neutral with Glukosa]) and the other lambs in both thermal regimes were fed only the basal control diet (HS without Glukosa [HSC] and pair-fed thermal neutral without Glukosa). Heat stress decreased DMI (14%) and by design there were no differences between the thermal treatments, but HSG lambs had increased DMI (7.5%; P < 0.05) compared with the HSC lambs. Compared with PFTN lambs, rectal temperature and skin temperature at the rump, shoulder, and legs of HS lambs were increased (P < 0.05) at 0700 and 1400 h. Rectal temperature at 1400 h decreased for HSG lambs (0.15 +/- 0.03 degrees C; P < 0.05) compared with HSC lambs. Despite similar DMI between thermal treatments, ADG for HS and PFTN lambs in P2 was decreased 55 and 85%, respectively, compared with lambs in P1 (P < 0.01). Although the prefeeding glucose concentration was not affected by thermal treatment or diet, HSG lambs had increased postfeeding glucose concentration compared with HSC lambs (P < 0.05). In contrast to the glucose responses, circulating insulin was influenced only by thermal treatment; HS lambs had increased insulin concentration (P < 0.01) before feeding and decreased concentration (P < 0.05) after feeding compared with PFTN lambs. Heat-stressed lambs had decreased NEFA concentration before feeding (P < 0.01) but not after feeding relative to PFTN lambs. Although this nutritional strategy did not affect ADG, the lower rectal temperature in HSG lambs indicates that dietary inclusion of a mixture of glucogenic precursors can potentially benefit animal health during HS

Biharmonic pattern selection

A new model to describe fractal growth is discussed which includes effects due to long-range coupling between displacements $u$. The model is based on the biharmonic equation $\nabla^{4}u =0$ in two-dimensional isotropic defect-free media as follows from the Kuramoto-Sivashinsky equation for pattern formation -or, alternatively, from the theory of elasticity. As a difference with Laplacian and Poisson growth models, in the new model the Laplacian of $u$ is neither zero nor proportional to $u$. Its discretization allows to reproduce a transition from dense to multibranched growth at a point in which the growth velocity exhibits a minimum similarly to what occurs within Poisson growth in planar geometry. Furthermore, in circular geometry the transition point is estimated for the simplest case from the relation $r_{\ell}\approx L/e^{1/2}$ such that the trajectories become stable at the growing surfaces in a continuous limit. Hence, within the biharmonic growth model, this transition depends only on the system size $L$ and occurs approximately at a distance $60 \%$ far from a central seed particle. The influence of biharmonic patterns on the growth probability for each lattice site is also analysed.Comment: To appear in Phys. Rev. E. Copies upon request to [email protected]

Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter

© 2020 Wiley Periodicals, Inc. Background: The healthcare burden posed by the coronavirus disease 2019 (COVID-19) pandemic in the New York Metropolitan area has necessitated the postponement of elective procedures resulting in a marked reduction in cardiac catheterization laboratory (CCL) volumes with a potential to impact interventional cardiology (IC) fellowship training. Methods: We conducted a web-based survey sent electronically to 21 Accreditation Council for Graduate Medical Education accredited IC fellowship program directors (PDs) and their respective fellows. Results: Fourteen programs (67%) responded to the survey and all acknowledged a significant decrease in CCL procedural volumes. More than half of the PDs reported part of their CCL being converted to inpatient units and IC fellows being redeployed to COVID-19 related duties. More than two-thirds of PDs believed that the COVID-19 pandemic would have a moderate (57%) or severe (14%) adverse impact on IC fellowship training, and 21% of the PDs expected their current fellows\u27 average percutaneous coronary intervention (PCI) volume to be below 250. Of 25 IC fellow respondents, 95% expressed concern that the pandemic would have a moderate (72%) or severe (24%) adverse impact on their fellowship training, and nearly one-fourth of fellows reported performing fewer than 250 PCIs as of March 1st. Finally, roughly one-third of PDs and IC fellows felt that there should be consideration of an extension of fellowship training or a period of early career mentorship after fellowship. Conclusions: The COVID-19 pandemic has caused a significant reduction in CCL procedural volumes that is impacting IC fellowship training in the NY metropolitan area. These results should inform professional societies and accreditation bodies to offer tailored opportunities for remediation of affected trainees

Outcomes of open repair of postdissection abdominal aortic aneurysms

Background: Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA. Methods: A retrospective cohort study was conducted of all consecutive patients treated with open repair for PDAAA after a Stanford type A or type B thoracic aortic dissection between January 2006 and December 2017 in two vascular referral centers. Preceding type B dissection treatment could include conservative or surgical management. Primary outcomes were 30-day mortality, complication rates, survival, and reintervention-free survival. Survival and reintervention-free survival were analyzed using the Kaplan-Meier method. Reintervention was defined as any endovascular or surgical intervention after the index procedure. Results: Included were 36 patients (27 men [75%]) with a median age of 64 years (range, 35-81 years). The 30-day mortality was 2.7%. The median follow-up was 16 months (range, 0-88 months). The postoperative course was uneventful in 21 patients (58%). The most frequent complications were postoperative bleeding requiring repeat laparotomy (n = 4), pneumonia (n = 3), congestive heart failure (n = 2), new-onset atrial fibrillation (n = 2), mesenteric ischemia requiring left hemicolectomy (n=1), and ischemic cerebrovascular accident (n = 1). Renal failure requiring hemodialysis developed in one patient. The overall survival at 1 year was 88.8%. Reintervention-free survival was 95.5% after 1 year and 88.6% after 2 years. Conclusions: Open repair of PDAAA can be performed with a low mortality rate and an acceptable complication rate, comparable with elective open repair of abdominal aortic aneurysms without dissection

CD28 between tolerance and autoimmunity: The side effects of animal models [version 1; referees: 2 approved]

Regulation of immune responses is critical for ensuring pathogen clearance and for preventing reaction against self-antigens. Failure or breakdown of immunological tolerance results in autoimmunity. CD28 is an important co-stimulatory receptor expressed on T cells that, upon specific ligand binding, delivers signals essential for full T-cell activation and for the development and homeostasis of suppressive regulatory T cells. Many in vivo mouse models have been used for understanding the role of CD28 in the maintenance of immune homeostasis, thus leading to the development of CD28 signaling modulators that have been approved for the treatment of some autoimmune diseases. Despite all of this progress, a deeper understanding of the differences between the mouse and human receptor is required to allow a safe translation of pre-clinical studies in efficient therapies. In this review, we discuss the role of CD28 in tolerance and autoimmunity and the clinical efficacy of drugs that block or enhance CD28 signaling, by highlighting the success and failure of pre-clinical studies, when translated to humans

European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part IV: deep brain stimulation

In 2011 the European Society for the Study of Tourette Syndrome (ESSTS) published its first European clinical guidelines for the treatment of Tourette Syndrome (TS) with part IV on deep brain stimulation (DBS). Here, we present a revised version of these guidelines with updated recommendations based on the current literature covering the last decade as well as a survey among ESSTS experts. Currently, data from the International Tourette DBS Registry and Database, two meta-analyses, and eight randomized controlled trials (RCTs) are available. Interpretation of outcomes is limited by small sample sizes and short follow-up periods. Compared to open uncontrolled case studies, RCTs report less favorable outcomes with conflicting results. This could be related to several different aspects including methodological issues, but also substantial placebo effects. These guidelines, therefore, not only present currently available data from open and controlled studies, but also include expert knowledge. Although the overall database has increased in size since 2011, definite conclusions regarding the efficacy and tolerability of DBS in TS are still open to debate. Therefore, we continue to consider DBS for TS as an experimental treatment that should be used only in carefully selected, severely affected and otherwise treatment-resistant patients

European clinical guidelines for Tourette syndrome and other tic disorders—version 2.0. Part III: pharmacological treatment

In 2011, the European Society for the Study of Tourette Syndrome (ESSTS) published the first European guidelines for Tourette Syndrome (TS). We now present an update of the part on pharmacological treatment, based on a review of new literature with special attention to other evidence-based guidelines, meta-analyses, and randomized double-blinded studies. Moreover, our revision took into consideration results of a recent survey on treatment preferences conducted among ESSTS experts. The first preference should be given to psychoeducation and to behavioral approaches, as it strengthens the patients’ self-regulatory control and thus his/her autonomy. Because behavioral approaches are not effective, available, or feasible in all patients, in a substantial number of patients pharmacological treatment is indicated, alone or in combination with behavioral therapy. The largest amount of evidence supports the use of dopamine blocking agents, preferably aripiprazole because of a more favorable profile of adverse events than first- and second-generation antipsychotics. Other agents that can be considered include tiapride, risperidone, and especially in case of co-existing attention deficit hyperactivity disorder (ADHD), clonidine and guanfacine. This view is supported by the results of our survey on medication preference among members of ESSTS, in which aripiprazole was indicated as the drug of first choice both in children and adults. In treatment resistant cases, treatment with agents with either a limited evidence base or risk of extrapyramidal adverse effects might be considered, including pimozide, haloperidol, topiramate, cannabis-based agents, and botulinum toxin injections. Overall, treatment of TS should be individualized, and decisions based on the patient’s needs and preferences, presence of co-existing conditions, latest scientific findings as well as on the physician’s preferences, experience, and local regulatory requirements

Insulin and GH Signaling in Human Skeletal Muscle In Vivo following Exogenous GH Exposure: Impact of an Oral Glucose Load

GH induces acute insulin resistance in skeletal muscle in vivo, which in rodent models has been attributed to crosstalk between GH and insulin signaling pathways. Our objective was to characterize time course changes in signaling pathways for GH and insulin in human skeletal muscle in vivo following GH exposure in the presence and absence of an oral glucose load.Eight young men were studied in a single-blinded randomized crossover design on 3 occasions: 1) after an intravenous GH bolus 2) after an intravenous GH bolus plus an oral glucose load (OGTT), and 3) after intravenous saline plus OGTT. Muscle biopsies were taken at t = 0, 30, 60, and 120. Blood was sampled at frequent intervals for assessment of GH, insulin, glucose, and free fatty acids (FFA).GH increased AUC(glucose) after an OGTT (p<0.05) without significant changes in serum insulin levels. GH induced phosphorylation of STAT5 independently of the OGTT. Conversely, the OGTT induced acute phosphorylation of the insulin signaling proteins Akt (ser(473) and thr(308)), and AS160.The combination of OGTT and GH suppressed Akt activation, whereas the downstream expression of AS160 was amplified by GH. WE CONCLUDED THE FOLLOWING: 1) A physiological GH bolus activates STAT5 signaling pathways in skeletal muscle irrespective of ambient glucose and insulin levels 2) Insulin resistance induced by GH occurs without a distinct suppression of insulin signaling proteins 3) The accentuation of the glucose-stimulated activation of AS 160 by GH does however indicate a potential crosstalk between insulin and GH.ClinicalTrials.gov NCT00477997

Effects of Dietary Corn Dried Distillers Grains with Solubles Withdrawal on Finishing Pig Performance and Carcass Characteristics

Two experiments were conducted to evaluate the effects of removing corn dried distillers grains with solubles (DDGS) at increasing intervals before harvest on finishing pig performance and carcass characteristics. For Exp. 1, 985 finishing pigs [initially 219 ± 5.5 lb body weight (BW)] were used in a 28-d growth study. There were 12 pens per treatment with 19 to 21 pigs per pen. There were four treatments decreasing in duration of withdrawal of DDGS from diets before final marketing: 28, 21, 14, or 0 d withdrawal. Regardless of treatment, pens of pigs were topped according to a typical summer marketing strategy with one top prior to final barn dump. All pens were topped by removing the 17% heaviest pigs on d -21 resulting in a final barn dump of approximately 83% of starting barn inventory. Overall, there was no evidence for effects of DDGS withdrawal time on final BW, average daily feed intake (ADFI), or feed efficiency (F/G; P \u3e 0.111); however, as withdrawal time increased, average daily gain (ADG) linearly increased (P = 0.022) and iodine value decreased (linear, P = 0.001). There was no evidence for treatment differences for hot carcass weight (HCW) or loin depth (P \u3e 0.106); however, dressing percentage was linearly increased (P = 0.001) with increased withdrawal time. Backfat depth was also decreased (quadratic; P = 0.019) and percentage lean increased (quadratic; P = 0.033) as DDGS withdrawal time increased. Feed cost and gain value were increased (linear, P \u3c 0.020) resulting in a marginally significant (P \u3c 0.100) increase in income over feed cost (IOFC) with increased withdrawal duration. In Exp. 2, 1,158 finishing pigs (initially 232 ± 4.3 lb BW) were used in a 35-d growth study. There were 15 pens per treatment with 17 to 21 pigs per pen. Similar to the first experiment, there were four treatments decreasing in duration of withdrawal of DDGS from diets before final marketing: 35, 28, 14, or 0 d withdrawal. All pens were topped according to a typical winter marketing strategy with two marketing events prior to the final barn dump. All pens were marketed by removing the 15% heaviest pigs on d -28, the 28% heaviest pigs on d -14, and a final barn dump of approximately 57% of starting barn inventory. There was no evidence that final BW, overall ADG, or overall F/G differed across treatments with increasing DDGS withdrawal times (P \u3e 0.116). Overall average daily feed intake increased (linear, P = 0.015) as time withdrawn from DDGS before final marketing increased. Iodine value decreased (P \u3c 0.022) and dressing percentage increased (linear; P = 0.034) with increasing withdrawal time. Lastly, feed cost and feed cost per lb of gain increased (linear, P \u3c 0.003) with increasing DDGS withdrawal time. In conclusion, these experiments demonstrate that longer feeding duration of DDGS before harvest decreases carcass yield and increases iodine value. Feed cost is reduced with longer feeding of DDGS, yet the gain value and IOFC responses varied depending on the marketing strategy