Live Yeast Supplementation and Heat Stress on Ruminal Fusobacterium necrophorum Counts

Reduced average daily gains and feed efficiencies, as well as liver condemnations associated with severe liver abscesses in feedlot cattle, are economic liabilities to producers and packers. Fusobacterium necrophorum, a Gram-negative ruminal bacterium, is the primary etiological agent of liver abscesses in grain-fed cattle. F. necrophorum survives elevated rumen temperatures during heat stress and exploits ruminal acidosis in conjunction with rumenitis as an opportunity to invade ruminal epithelium and enter portal circulation to reach the parenchyma of the liver. Live yeast supplementation has been shown to stabilize ruminal pH levels away from acidotic conditions during heat stress in dairy cattle

Evaluation of Techniques in Ruminant Nutrition for Sustainable Production

The objective of this work was to evaluate four different techniques in ruminant production in order to increase the sustainability of the system. The first study tested the hypothesis that yeast supplementation during heat-stress inducing environmental conditions may change energy partitioning, nitrogen metabolism, and ruminal parameters in growing ruminants. Additionally, this study used an in vitro model to simulate the lasting effects of elevated environmental conditions and yeast supplementation on the fermentation dynamics of rumen microorganisms. This study did not find any positive or negative impacts of yeast supplementation on energy partitioning and nitrogen metabolism during high climatic condition. The in vitro study showed that previous exposure to high temperatures and humidity as well as yeast supplementation could change the fermentation patterns of rumen microorganisms. The second study examined the effects of post-incubation handling of in vitro fermentation bottles. This study found differences in pressure, volume, temperature, and methane concentration depending on post-incubation handling method. Additionally, this study concluded that the presence of water vapor may be a source of inflation when comparing in vitro measurements to in vivo measurements of methane. The study proposed a series of equations to remove water vapor from the estimated methane concentrations. The third study compared volatile fatty acid (VFA) determination protocols using gas chromatography (GC) or high-performance liquid chromatography (HPLC). Both rumen fluid samples and chemical standards were used to determine the predictive adequacy of the two equipment methods. The HPLC method was more precise and accurate when compared to the GC method when using the chemical standards. The GC protocol consistently overpredicted concentrations of VFA in rumen fluid when compared to the results of the HPLC protocol. This study suggests expansion of this investigation to alternate machines and laboratories. The fourth study developed a lysine-based medium to selectively enumerate Fusobacterium necrophorum from the bovine rumen and compared enumeration efficacy to a previously published selective lactate-based medium. While the modified-lysine medium did not enumerate F. necrophorum as well as the modified-lactate medium, this study provided valuable insight into the dynamics between yeast or virginiamycin supplementation and F. necrophorum. There was an increase of ruminal counts of F. necrophorum with live yeast supplementation and a dose-dependent increase when animals were supplemented with virginiamycin. Fusobacterium varium was also found in notable concentrations in rumen contents. Lastly, this study concluded that the enumerated populations of F. necrophorum are significantly less than the reported concentrations, possibly due to regional differences of sampled animals

Venous thromboembolism (VTE) risk screening in residential aged care facilities post-surgery

Aims: Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It is a leading cause of morbidity and mortality in the geriatric post-surgical population. Hip fracture patients and those with a protracted post-operative recovery are at higher risk. Despite evidence that risk assessment and thromboprophylaxis as the most effective methods of VTE prevention, there is no identified VTE risk screening tool utilised in the Australian residential aged care sector. This study assessed the use of VTE risk screening protocols and awareness of VTE in residential aged care facilities, including in the higher risk post-surgical patient. Methods: A cross-sectional survey directed at policy managers was distributed via email to providers of all aged care facilities in New South Wales (NSW) and the Australian Capital Territory (ACT) with 10 or more residents. Results: A total of 16.3% (49/301) of providers responded, representing 28.6% (249/871) of aged care facilities and 31.7% (20,958/66,121) of residents in NSW and ACT. A written protocol for VTE risk screening was used by 1.2% (3/249) of facilities, and 79.5% (198/249) were unaware that VTE is an issue in the population. Only 0.8% (2/249) were aware that risk screening and prophylaxis is required to prevent VTE, though none were acting upon this. No facility had specific post-surgical processes for VTE risk assessment or prevention. Conclusion: The majority of residential aged care facilities do not have VTE risk screening protocols and are unaware of the threat that this omission poses, particularly in post-surgical patients

[In Press] Venous thromboembolism risk screening, training and provider awareness in Australian residential aged care facilities

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in the geriatric post-surgical population, and its prevention is a public health priority. The aim of this study was to assess the use of VTE risk screening and training protocols, and VTE awareness in the Australian residential aged care sector. A cross-sectional survey was conducted that was directed at facility and policy managers of community aged care facilities with ≥10 residents in two Australian states and territories. Forty-nine of 301 (16.3%) providers responded, representing 249/871 (28.6%) aged care facilities and 20,958/66,121 (31.7%) residents. VTE risk screening protocols were used by 1.2% of facilities (3/249), and 79.5% (198/249) were unaware that VTE is an issue in this population. Only 0.8% (2/249) were aware that risk screening and prophylaxis is required to prevent VTE; none were acting upon this. No facility had specific VTE risk assessment or prevention processes in place. Most residential aged care facilities surveyed do not have VTE risk screening protocols and were unaware of the risk that may be associated with this omission. These results have implications for development and implementation of national and international VTE risk screening guidelines in community care

Nusinersen versus Sham Control in Later-Onset Spinal Muscular Atrophy

International audienceBACKGROUND Nusinersen is an antisense oligonucleotide drug that modulates pre-messenger RNA splicing of the survival motor neuron 2 (SMN2) gene. It has been developed for the treatment of spinal muscular atrophy (SMA). METHODS We conducted a multicenter, double-blind, sham-controlled, phase 3 trial of nusinersen in 126 children with SMA who had symptom onset after 6 months of age. The children were randomly assigned, in a 2: 1 ratio, to undergo intrathecal administration of nusinersen at a dose of 12 mg (nusinersen group) or a sham procedure (control group) on days 1, 29, 85, and 274. The primary end point was the least-squares mean change from baseline in the Hammersmith Functional Motor Scale-Expanded (HFMSE) score at 15 months of treatment; HFMSE scores range from 0 to 66, with higher scores indicating better motor function. Secondary end points included the percentage of children with a clinically meaningful increase from baseline in the HFMSE score (>= 3 points), an outcome that indicates improvement in at least two motor skills. RESULTS In the prespecified interim analysis, there was a least-squares mean increase from baseline to month 15 in the HFMSE score in the nusinersen group (by 4.0 points) and a least-squares mean decrease in the control group (by -1.9 points), with a significant between-group difference favoring nusinersen (least-squares mean difference in change, 5.9 points; 95% confidence interval, 3.7 to 8.1; P< 0.001). This result prompted early termination of the trial. Results of the final analysis were consistent with results of the interim analysis. In the final analysis, 57% of the children in the nusinersen group as compared with 26% in the control group had an increase from baseline to month 15 in the HFMSE score of at least 3 points (P< 0.001), and the overall incidence of adverse events was similar in the nusinersen group and the control group (93% and 100%, respectively). CONCLUSIONS Among children with later-onset SMA, those who received nusinersen had significant and clinically meaningful improvement in motor function as compared with those in the control group. (Funded by Biogen and Ionis Pharmaceuticals; CHERISH ClinicalTrials. gov number, NCT02292537.