Investigating the effects of two weaning methods and two genetic hybrids on play behavior in weaner pigs (Sus scrofa)

In conventional pig production, suckling pigs are typically weaned between 3 and 5 weeks of age. This involves separation from the sow, dietary change, and regrouping in a novel environment, which challenge the welfare of pigs. We investigated the effects of two weaning methods [conventional weaning: two litters mixed in a weaner pen of different size and design (MOVE) vs. litter staying in the farrowing pen after removing the sow (STAY)] and two genetic hybrids [DanBred Yorkshire × Landrace (approximately 21 total pigs born/litter; DB) vs. Topigs Norsvin TN70 Yorkshire × Landrace (approximately 16 total pigs born/litter with higher individual birth weight and weaning weight than DB; TN)] on play behavior across weaning. Both genetic hybrids were inseminated with semen of DanBred Duroc boars. Litters were reduced to the number of functional teats at birth. The durations of locomotor-rotational play (LOC) and social play (SOC) of 24 indoor-housed litters [pigs/litter: (average ± SD) 13 ± 2; age at the weaning day: 26 ± 2 days] were video-recorded continuously between 14:00 h and 22:00 h on days −1, 1, and 2 relative to weaning and statistically analyzed with mixed-effects modeling at the individual level. Before weaning, TN pigs performed LOC longer than DB pigs. On day 2 post-weaning, STAY pigs engaged in more SOC than MOVE pigs. Moreover, TN pigs and STAY pigs displayed a steeper increase in LOC from days 1 to 2 than DB pigs and MOVE pigs, respectively. We demonstrated that pigs belonging to the genetic hybrid with higher weight at birth and weaning spent more time playing on the day before weaning. Additionally, weaning pigs in the farrowing pen and, hence, avoiding social mixing and relocation to an unfamiliar environment had a positive effect on social play after weaning. Our study illustrates that weaning stress in pigs may be reduced by using a genetic hybrid featuring higher birth and weaning weight and by keeping litters intact in a familiar environment after weaning. This study also supports the use of play behavior as an animal welfare indicator

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Information Technologies for Welfare Monitoring in Pigs and Their Relation to Welfare Quality®

The assessment of animal welfare on-farm is important to ensure that current welfare standards are followed. The current manual assessment proposed by Welfare Quality&reg; (WQ), although being an essential tool, is only a point-estimate in time, is very time consuming to perform, only evaluates a subset of the animals, and is performed by the subjective human. Automation of the assessment through information technologies (ITs) could provide a continuous objective assessment in real-time on all animals. The aim of the current systematic review was to identify ITs developed for welfare monitoring within the pig production chain, evaluate the ITs developmental stage and evaluate how these ITs can be related to the WQ assessment protocol. The systematic literature search identified 101 publications investigating the development of ITs for welfare monitoring within the pig production chain. The systematic literature analysis revealed that the research field is still young with 97% being published within the last 20 years, and still growing with 63% being published between 2016 and mid-2020. In addition, most focus is still on the development of ITs (sensors) for the extraction and analysis of variables related to pig welfare; this being the first step in the development of a precision livestock farming system for welfare monitoring. The majority of the studies have used sensor technologies detached from the animals such as cameras and microphones, and most investigated animal biomarkers over environmental biomarkers with a clear focus on behavioural biomarkers over physiological biomarkers. ITs intended for many different welfare issues have been studied, although a high number of publications did not specify a welfare issue and instead studied a general biomarker such as activity, feeding behaviour and drinking behaviour. The &lsquo;good feeding&rsquo; principle of the WQ assessment protocol was the best represented with ITs for real-time on-farm welfare assessment, while for the other principles only few of the included WQ measures are so far covered. No ITs have yet been developed for the &lsquo;Comfort around resting&rsquo; and the &lsquo;Good human-animal relationship&rsquo; criteria. Thus, the potential to develop ITs for welfare assessment within the pig production is high and much work is still needed to end up with a remote solution for welfare assessment on-farm and in real-time

Liraglutide in children and adolescents with type 2 diabetes

Metformin is the regulatory-approved treatment of choice for most youth with type 2 diabetes early in the disease. However, early loss of glycemic control has been observed with metformin monotherapy. Whether liraglutide added to metformin (with or without basal insulin treatment) is safe and effective in youth with type 2 diabetes is unknown. Patients who were 10 to less than 17 years of age were randomly assigned, in a 1:1 ratio, to receive subcutaneous liraglutide (up to 1.8 mg per day) or placebo for a 26-week double-blind period, followed by a 26-week open-label extension period. Inclusion criteria were a body-mass index greater than the 85th percentile and a glycated hemoglobin level between 7.0 and 11.0% if the patients were being treated with diet and exercise alone or between 6.5 and 11.0% if they were being treated with metformin (with or without insulin). All the patients received metformin during the trial. The primary end point was the change from baseline in the glycated hemoglobin level after 26 weeks. Secondary end points included the change in fasting plasma glucose level. Safety was assessed throughout the course of the trial. Of 135 patients who underwent randomization, 134 received at least one dose of liraglutide (66 patients) or placebo (68 patients). Demographic characteristics were similar in the two groups (mean age, 14.6 years). At the 26-week analysis of the primary efficacy end point, the mean glycated hemoglobin level had decreased by 0.64 percentage points with liraglutide and increased by 0.42 percentage points with placebo, for an estimated treatment difference of -1.06 percentage points (P<0.001); the difference increased to -1.30 percentage points by 52 weeks. The fasting plasma glucose level had decreased at both time points in the liraglutide group but had increased in the placebo group. The number of patients who reported adverse events was similar in the two groups (56 [84.8%] with liraglutide and 55 [80.9%] with placebo), but the overall rates of adverse events and gastrointestinal adverse events were higher with liraglutide. In children and adolescents with type 2 diabetes, liraglutide, at a dose of up to 1.8 mg per day (added to metformin, with or without basal insulin), was efficacious in improving glycemic control over 52 weeks. This efficacy came at the cost of an increased frequency of gastrointestinal adverse events. (Funded by Novo Nordisk; Ellipse ClinicalTrials.gov number, NCT01541215.)