Energy Expenditure Estimation From Respiratory Magnetometer Plethysmography: A Comparison Study

Physical activity (PA) quantification by estimating energy expenditure (EE) is essential to health. Reference methods for EE estimation often involve expensive and cumbersome systems to wear. To address these problems, light-weighted and cost-effective portable devices are developed. Respiratory magnetometer plethysmography (RMP) is among such devices, based on the measurements of thoraco-abdominal distances. The aim of this study was to conduct a comparative study on EE estimation with low to high PA intensity with portable devices including the RMP. Fifteen healthy subjects aged 23.84±4.36 years were equipped with an accelerometer, a heart rate (HR) monitor, a RMP device and a gas exchange system, while performing 9 sedentary and physical activities: sitting, standing, lying, walking at 4 and 6 km/h, running at 9 and 12 km/h, biking at 90 and 110 W. An artificial neural network (ANN) as well as a support vector regression algorithm were developed using features derived from each sensor separately and jointly. We compared also three validation approaches for the ANN model: leave one out subject, 10 fold cross-validation, and subject-specific. Results showed that 1. for portable devices the RMP provided better EE estimation compared to accelerometer and HR monitor alone; 2. combining the RMP and HR data further improved the EE estimation performances; and 3. the RMP device was also reliable in EE estimation for various PA intensities.

Questionnaire and tools: clinical powerful instrument in acromegaly diagnosis and management

PURPOSE

Acromegaly is a rare chronic disease characterized by systemic comorbidity and reduced quality of life. Although achieving biochemical control has always been the primary goal of acromegaly therapy, recent evidence has shown that the traditional assessment does not adequately capture the complexity of symptoms and patients' perception. These findings result in the need to improve a fast decision-making process of the clinician, who should not only take into account biochemical-instrumental criteria, but also patients' symptoms. With the aim of supporting the clinician in the diagnostic and therapeutic decision-making process several disease-specific tools have been developed. The aim of this review is to provide a description of the acromegaly-specific tools, presenting their main features, their application in daily practice, and their efficacy and utility.

METHODS

A systematic search of Medline/PubMed, ISI-Web of Knowledge, and Google Scholar databases was done.

RESULTS

Specific instruments and questionnaires have recently been developed to assist clinicians in the assessment of acromegaly. These are either Patient-Reported Outcome tools, such as Acromegaly Quality of Life Questionnaire (AcroQoL) and Pain Assessment Acromegaly Symptom Questionnaire (PASQ), or Clinician-Reported Outcome tools, such as ACROSCORE, SAGIT^® and Acromegaly Disease Activity Tool (ACRODAT^®). Such tools are extremely flexible and, therefore, have been widely adopted by endocrinologists and other professionals, so much so that they have also been included as recommendations in the 2018 international guidelines.

CONCLUSION

Questionnaires and tools are useful in the management of acromegaly patients. They help clinicians evaluate patients' symptoms and could assist in the evaluation of disease activity.

Effects of forage quantity and access-time restriction on feeding behaviour, feed efficiency, nutritional status, and dairy performance of dairy cows fed indoors

Optimising feed is a key challenge for dairy livestock systems, as forage stock shortages are increasingly frequent and feed is the biggest operating cost. The aim of this experiment was to evaluate the effects of reducing forage quantity and access time on dairy performance and animal nutritional status during indoor feeding. Twenty-seven Montbéliarde and Holstein cows were randomly allocated to three groups of nine cows balanced by breed, parity, days in milk, and milk yield. The three groups were given 3.9 kg DM/day of second-cut hay and 4.5 kg/day of concentrate and either i) ad libitum access to first-cut hay (Ad Libitum group; AL), ii) 10.5 kg/day of first-cut hay (Quantity-restricted group; QR), or iii) 10.5 kg/day of first-cut hay but with access time restricted to only 2 h in the morning and 2 h in the afternoon (Quantity-and-Time-restricted group; QTR). Milk yield, composition and coagulation properties, cow nutritional status (weight, body condition score, blood metabolites) and cow activities were recorded. The AL group ingested 10 % more feed than the QR group and 16 % more feed than the QTR group. Organic matter digestibility was lower in the AL group than in the QR and QTR groups whereas feed efficiency did not differ. Milk yield was not significantly different among the three groups. Compared to the QR and QTR groups, the AL group had significantly higher milk fat (35.9 vs 32.9 and 32.8 g/kg of milk) and milk protein content (29.5 vs 27.7 and 28.5 g/kg of milk). QR and QTR cows mobilised their body fat, resulting in a lower final body condition score, and tended to have a lower blood non-esterified fatty acid concentration than the AL group. QTR cows showed greater body fat mobilisation, but their final corrected BW was not different from AL cows. Access-time restriction did not impact fat and protein content but led to decreased casein, lactose contents and casein-to-whey protein ratio. The forage savings achieved through this feed management practice could prove economically substantial when forage prices increase. This practice can be of interest in grassland systems to overcome certain climatic hazards without having to resort to purchases or to increase the farm's forage autonomy.

P-632 Evaluation of low AMH levels in young women

Study question

The primary objective was to evaluate impact of a low AMH level on the live birth rate in a population of young women IVF/ICSI .

Summary answer

Low AMH level in young women in FIV/ICSI is not expected to have an impact on the live birth.

What is known already

AMH is an important criterion for defining ovarian reserve. The majority of studies have shown that the AMH level in the general population is not correlated with the chances of spontaneous pregnancy.

The management remains a challenge and must be individualized taking into account the new quantitative and qualitative criteria to be defined (POSEIDON classification). Finally, we know that the pregnancy rate is correlated to the rate of euploid embryos, and that the rate is higher before 35 years of age.

Study design, size, duration

In this single-center retrospective study from January 2015 to December 2020, 1824 IVF/ICSI attempts were analyzed.

We analyzed the live birth rate according to 2 categories of young women matched by AMH level.

Participants/materials, setting, methods

We analyzed the live birth rate according to 2 categories of young women managed in IVF/ICSI protocol.

A first group was ≤30 years old and a second group was between 31 and 35 years old.

Then, we matched each of these groups to an AMH level, AMH<1ng/mL and AMH ≥1ng/mL.

We analyzed the live birth rate of 4 groups of young women.

Main results and the role of chance

1824 IVF/ICSI attempts were analyzed in this study. We have 539 women under 30 years of age and 1285 women between 31 and 35 years of age.

For women aged ≤30 years, the group with AMH<1ng/mL had a non-statistically significant live birth rate compared to those with AMH≥1ng/mL (31% vs 32.7% p = 1).

For women aged 31-35 years, the group with AMH<1ng/mL, has a statistically significant lower live birth rate compared to those with AMH≥1ng/mL (14.5% vs 29.3% p = 0.001).

Limitations, reasons for caution

The main limitation of our study is the few number of patients.

Wider implications of the findings

This study tries to demonstrate that low AMH levels in young women do not predict a poor IVF/ICSI success rate. Conclusions should not be drawn too quickly for low AMH in this population. However, the threshold AMH level is still debated in the studies and should be further adjusted.

Trial registration number

not applicable

Animal performance and stress at weaning when dairy cows suckle their calves for short versus long daily durations

Calves in most dairy farms are separated from their dams either immediately or within a few hours after birth, prompting increasing concern of the society for reasons of animal welfare. The aim of this study was to identify systems to maintain cow-calf contact (CCC) that balance the benefits for calf growth and health against the negative impacts on sellable milk and stress at weaning. We tested reuniting cows and calves for 20 min before (Before-group) or 2.5 h after (After-group) morning milking (in Trial 1) or for a 9 h period between the morning and evening milkings (Half-day-group, in Trial 2). In Control-groups, calves were separated from their dam at birth and fed with artificial nipple with tank milk provided daily at 13% (Trial 1) and 14% (Trial 2) of their BW. In both trials, each practice was applied on a group of 14 dam-calf pairs (7 Holstein [Ho] and 7 Montbéliarde [Mo]). All calves were weaned at a BW of at least 100 kg. In Trial 1, the After-group was prematurely stopped when the calves were eight weeks of age as calf growth became limited (340 g/d) due to low milk intakes (2.97 kg/d). During the first eight weeks of lactation, milk yield at the parlour was 29%, 51% and 42% lower in After-, Before- and Half-day-cows respectively compared to Controls. From week 14 to 16 when all calves were separated from their dam, Before-cows still produced 25% less milk than Control-cows while Half-day-cows reached the milk yield of Control-cows within a week. There were no significant differences in milk somatic cell count and in frequency of health disorders (cows and calves) between suckling and Control-groups. Compared to Control-calves, calf growth until weaning was higher in the suckling calves in Trial 1 (861 vs 699 g/d) and similar in Trial 2 (943 vs 929 g/d). At weaning, Before- and Half-day-calves started to vocalise earlier and continued to vocalise longer than Controls. In conclusion, the best compromise between cow milk yield and calf growth is a long period of CCC (9 h) between the morning and evening milkings. Still abrupt weaning stresses both cows and calves even if CCC has been restricted before separation.

Review: Quality and authentication of organic animal products in Europe

The 'organic' label guarantees a production process that avoids the use of synthetic fertilisers, pesticides and hormones and minimises the use of veterinary drugs; however, consumers are demanding guarantees regarding food quality. This article reviews the current state of knowledge on the quality of organic animal products, including the authentication of their organic origin. Quality has been considered as an integrative combination of six core attributes: commercial value, and nutritional, sensory, technological, convenience and safety attributes. The comparison of these attributes between organic and conventional animal products shows high heterogeneity due to variability in farming pratices in both organic and conventional systems. To overcome this, we pinpoint the farming practices underlying the differences observed. This enables light to be shed on the consequences of possible trajectories of organic farming, if specifications are relaxed or tightened up on commitments concerning farming practices that impact product quality. Two recent meta-analyses showed better nutritional attributes in organic milk and meat linked to their higher poly-unsaturated fatty acid (PUFA) content, particularly n-3 PUFAs. Regarding safety, we point to a lack of integrated studies quantifying the balance between positive and negative effects. Organic farming reduces the risk of drug residues and antibiotic resistance, but both outdoor rearing and a frequently longer rearing period increase the animals' exposition to environmental contaminants and the risk of their bioaccumulation in milk, eggs, meat and fish flesh. We highlight antagonisms between quality attributes for certain animal products (lamb, pork). In general, attributes are more variable for organic products, which can be explained by lower genetic selection (poultry), lower inputs and/or greater variability in farming conditions. However, the literature does not address the implications of this greater variability for the consumers' acceptability and the necessary adaptation of manufacturing processes. Further research is needed to document the impacts on human nutritional biomarkers and health. Methods used to authenticate organic origin are based on differences in animal diet composition between organic and conventional systems, but their reliability is hampered by the variability in farming practices.

A quantitative review of on-farm feeding practices to enhance the quality of grassland-based ruminant dairy and meat products

In the last decades, a large body of evidence has highlighted the major role of feeding management practices in improving specific nutritional, technological and sensory quality traits of ruminant products. However, results have been mostly obtained under controlled conditions, and have been rarely validated on-farm. Therefore, a quantitative review was conducted to quantify the effects of on-farm feeding management practices on carotenoids, fat-soluble vitamins, colour, fatty acids (FAs), terpenes and sensory properties in the main animal product categories (PCs): dairy products from cattle (DC), sheep (DS) and goat (DG), and meat from cattle (MC) and sheep (MS). Four feeding scenarios were selected according to the consistency of on-farm studies in the literature: (a) feeding "Fresh herbage" instead of conserved forages; (b) ban any form of silage ("Silage-free"); (c) ban maize silage ("Maize silage-free"); (d) feeding forages from permanent grasslands rich in species or plant secondary metabolites (PSMs) ("PSM-rich permanent grassland"). Feeding fresh herbage increased the concentration of carotenoids, fat-soluble vitamin, n-3 FA, rumenic acid, and branched chain FA (BCFA), and reduced the concentration of saturated FA, for all PC, with overall stronger effect for dairy products than for meat. The texture of meat and dairy products was marginally affected, whereas feeding fresh herbage decreased lactic and increased vegetal notes in DC. The "Silage-free" feeding scenario resulted in increased vaccenic acid, rumenic acid, BCFA, and C18:3n-3 in DC. The "Maize silage-free" feeding scenario lowered n-6 FA whereas increased n-3, rumenic acid and BCFA concentrations in DC. Feeding ruminants with forages from "PSM-rich permanent grasslands" increased monounsaturated FA, n-3 FA and rumenic acid and decreased n-6 FA in dairy products, and only marginally affected meat FA composition. The DC from "PSM-rich permanent grasslands" showed higher intense, spicy and animal notes. Overall, the differences between feeding management practices observed on farm were smaller than those observed under controlled trials. Several confounding factors, not controlled when operating under on-farm conditions, could be at the origin of these divergences (i.e. mixed diets, forage characteristics, animal-related factors). This review confirmed that farming practices may differently affect several quality traits of ruminant products. It also highlighted the uneven knowledge on the effect of feeding management depending on the PC: larger for milk than for meat and decreasing when moving from cattle to sheep and from sheep to goat.

O-200 Frozen embryo transfer: Miscarriage rates depending on the starting day of intramuscular progesterone

Study question

Objective was to assess whether adjusting starting day of intramuscular progesterone the day of vaginal supplementation versus day of embryo transfer or later, might affect the outcome of the cycle.

Summary answer

additional injection of intramuscular progesterone the day of progesterone initiation or later, is not likely to be more effective on live birth and miscarriage rates.

What is known already

There is no consensus on the most effective method of endometrium preparation prior to FET. However, many studies report that high serum progesterone concentration during the implantation period is associated with optimal live birth rates. Adjusting progesterone treatment the day of embryo transfer seems to be too late and ineffective for rescuing low progesterone levels and should be done before.

Study design, size, duration

In this single center prospective study from October 2019 to november 2020, 239 patients undergoing hormonal replacement therapy protocol for frozen embryo transfer were randomly divided into two groups: additional injection of intramuscular progesterone the day of progesterone initiation or intramuscular progesterone the day of embryo transfer. We compare these results to our previous protocol beginning intramuscular progesterone day 22 of the treatment.

Participants/materials, setting, methods

Our frozen embryo transfer protocol consists to initiate GnRH agonist the day 1 of the cycle. After 14 days of estrogens, we introduce vaginal progesterone, prior to embryo transfer. Patients in group A received an additional injection of intramuscular progesterone the day of progesterone initiation. The group B received intramuscular progesterone the day of embryo transfer. For both, intramuscular injection of progesterone was followed every 3 days.

Main results and the role of chance

239 patients were enrolled in this study, 125 in the group A and 114 in the group B. The ongoing pregnancy rate in the group A was 26.4 % and miscarriage rate 7.2%, not statistically different from ongoing pregnancy rate and miscarriage rate of women in the group B (22.81 %, p = 0.66/ 6.14%, p = 0.8).

The ongoing pregnancy rate in the group D22 was 24.89 % et miscarriage rate 7.2%, not statistically different from ongoing pregnancy rate of women in the group A and B (p = 0.78 and p = 0.31).

Limitations, reasons for caution

The main limitation of our study is the lack of randomization for the group with additional progesterone IM on day 22. The study is actually followed to enroll more patients in 3 different groups.

Wider implications of the findings

This study tries to determine optimal adaptive management of hormonal replacement treatment for embryo transfer in patients with potential low progesterone values.

Trial registration number

no applicable

Co-construction of a method for evaluating the intrinsic quality of bovine milk in relation to its fate

There are time-tested assessments for the environmental and economic aspects of sustainability. Its societal aspect has mainly been approached through the assessment of animal welfare. However, the intrinsic quality of milk is seldom taken into account. We developed a participatory construction method for the overall assessment of intrinsic milk quality in its different dimensions (sensory, technological, nutritional and health), according to the fate of the raw milk. Two assessment models were developed, for semi-skimmed standardized ultra-high temperature (UHT) milk and for pressed uncooked non-standardized raw milk cheese. They were constructed by a participatory approach involving experts in the dairy sector with the aim to obtain a diagnostic tool that could be used in the field to help farmers to manage the quality of their milk (by prioritizing improvements on major problems). They were shaped from prerequisite specifications (limited costs and time of application, desire to obtain a transparent tool with all the steps kept visible) and current technical and scientific knowledge. They were based on indicators obtained from raw bulk tank milk analyses (30 for UHT milk and 50 for cheese assessments), which were then aggregated into criteria, principles, dimensions and overall intrinsic quality at farm level. The assessment models had parts in common, for example, same four dimensions, common indicators for health and nutritional dimensions. They also had process-specific features: units chosen, criteria, indicators and weightings in relation to the final product specifications. For instance, sensory and technological dimensions are more complex and preponderant in the cheese assessment (three principles for cheese vs one for UHT milk in both dimensions). Another example is the lack of microbial pathogens (as potential health risk for consumer) in the UHT milk assessment because of pasteurization. The assessment models then underwent a sensitivity analysis and an application in 30 farms in indoor and grazing periods to finally obtain overall UHT milk and cheese quality scores at a 1-year level. The tool was found to be applicable at farm level. However, we observed low overall quality scores with a narrow dispersion, characteristic of a severe evaluation. Even so, the assessment models showed up seasonal differences of the UHT milk and cheese quality at both overall and dimensional levels. In the light of new scientific knowledge and future quality objectives, these are adaptable to other dairy products allowing for their specific features.

An inverse modelling study on the local volume changes during early morphoelastic growth of the fetal human brain

We take a data-driven approach to deducing the local volume changes accompanying early development of the fetal human brain. Our approach uses fetal brain atlas MRI data for the geometric changes in representative cases. Using a nonlinear continuum mechanics model of morphoelastic growth, we invert the deformation obtained from MRI registration to arrive at a field for the growth deformation gradient tensor. Our field inversion uses a combination of direct and adjoint methods for computing gradients of the objective function while constraining the optimization by the physics of morphoelastic growth. We thus infer a growth deformation gradient field that obeys the laws of morphoelastic growth. The errors between the MRI data and the forward displacement solution driven by the inverted growth deformation gradient field are found to be smaller than the reference displacement by well over an order of magnitude, and can be driven even lower. The results thus reproduce the three-dimensional growth during the early development of the fetal brain with controllable error. Our findings confirm that early growth is dominated by in plane cortical expansion rather than thickness increase.

Feeding cows with hay, silage, or fresh herbage on pasture or indoors affects sensory properties and chemical composition of milk and cheese

In European countries, silage-free feeding is an ancient tradition and has a particularly positive reputation among consumers. In the present study, we compared grass-based forages from the same plot conserved as hay or silage or fed fresh either on pasture or indoors, and we evaluated the differences in sensory properties of milk and uncooked pressed cheese. All herbage from the first cut of a grassland dominated by perennial ryegrass was harvested on the same day and preserved either as hay or silage. The first regrowth of the same plot was used for strip grazing or green feeding indoors. Balanced by breed, 24 Montbéliarde and 24 Holstein cows were allocated to the 4 treatments. Apart from the forages, the late-lactation cows received 3 kg/d of dry matter from concentrate. After 2 wk of dietary adaptation, the bulk milk of 3 subgroups, each with 4 cows, was collected. Part of the milk was pasteurized, and part was left raw and partly transformed to small-sized Cantal-type cheese ripened for 9 wk. Milk and cheese underwent descriptive sensory analysis by a trained sensory panel, as well as analyses of physicochemical traits. Volatile organic compounds of the cheeses were also analyzed. Raw and pasteurized milk from hay-fed cows had less intense odors of cooked milk, cream, and barnyard than milk from grazing cows, whereby the effect of pasteurization did not differ between herbage utilization methods. Cheeses obtained from cows fed fresh herbage (grazing and indoors) were clearly yellower than cheeses from silage- and hay-fed cows, which coincided with the color intensity perceived by the panelists. Moreover, cheeses from cows fed fresh herbage had more intense barnyard and dry fruit flavors, were perceived as creamier and having less lactic odor, and exhibited more fat exudation than those from cows fed conserved herbage. Only a few differences were observed in milk and cheeses from hay-fed compared with silage-fed cows, and those differences were far less pronounced than those of milk and cheeses from cows fed fresh herbage. In conclusion, the present study did not substantiate assumptions of clear sensory differences of milk and uncooked pressed cheese from hay-fed compared with silage-fed cows. For the first time, this study reports that the global flavor intensity of cheeses from indoor green-fed cows is similar to that of cheeses derived from cows fed conserved forages, whereas cheeses from grazing cows have the greatest global flavor intensity.

An inverse modelling study on the local volume changes during early morphoelastic growth of the fetal human brain

We take a data-driven approach to deducing the local volume changes accompanying early development of the fetal human brain. Our approach uses fetal brain atlas MRI data for the geometric changes in representative cases. Using a nonlinear continuum mechanics model of morphoelastic growth, we invert the deformation obtained from MRI registration to arrive at a field for the growth deformation gradient tensor. Our field inversion uses a combination of direct and adjoint methods for computing gradients of the objective function while constraining the optimization by the physics of morphoelastic growth. We thus infer a growth deformation gradient field that obeys the laws of morphoelastic growth. The errors between the MRI data and the forward displacement solution driven by the inverted growth deformation gradient field are found to be smaller than the reference displacement by well over an order of magnitude, and can be driven even lower. The results thus reproduce the three-dimensional growth during the early development of the fetal brain with controllable error. Our findings confirm that early growth is dominated by in plane cortical expansion rather than thickness increase.

Topics and trends in Mountain Livestock Farming research: a text mining approach

Pasture-based and small-scale livestock farming systems are the main source of livelihood in the mountain primary sector, ensuring socioeconomic sustainability and biodiversity in rural communities throughout Europe and beyond. Mountain livestock farming (MLF) has attracted substantial research efforts from a wide variety of scientific communities worldwide. In this study, the use of text mining and topic modelling analysis drew a detailed picture of the main research topics dealing with MLF and their trends over the last four decades. The final data corpus used for the analysis counted 2 679 documents, of which 92% were peer-reviewed scientific publications. The number of scientific outputs in MLF doubled every 10 years since 1980. Text mining found that milk, goat and sheep were the terms with the highest weighed frequency in the data corpus. Ten meaningful topics were identified by topic analysis: T1-Livestock management and vegetation dynamics; T2-Animal health and epidemiology; T3-Methodological studies on cattle; T4-Production system and sustainability; T5-Methodological studies; T6-Wildlife and conservation studies; T7-Reproduction and performance; T8-Dairy/meat production and quality; T9-Land use and its change and T10-Genetic/genomic studies. A hierarchical clustering analysis was performed to explore the interrelationships among topics, and three main clusters were identified: the first focused on sustainability, conservation and socioeconomic aspects (T4; T6 and T9), the second was related to food production and quality (T7 and T8) and the last one considered methodological studies on mountain flora and fauna (T1; T2; T3; T5 and T10). The 10 topics identified represent a useful and a starting source of information for further and more detailed analysis (e.g. systematic review) of specific research or geographical areas. A truly holistic and interdisciplinary research approach is needed to identify drivers of change and to understand current and future challenges faced by livestock farming in mountain areas.

Outcome of the glutaric aciduria type 1 (GA1) newborn screening program in Manitoba: 1980–2020

Glutaric aciduria type 1 (GA1) is a severe inherited neurometabolic disorder whose clinical outcome has improved after implementation of newborn screening (NBS) programs and prompt beginning of guideline-directed presymptomatic metabolic treatment. We report the outcome of our 40-year experience with the diagnosis and management of GA1 which has improved but remains suboptimal.

Prediction of indicators of cow diet composition and authentication of feeding specifications of Protected Designation of Origin cheese using mid-infrared spectroscopy on milk

The ability of mid-infrared spectroscopy (MIR) to predict indicators (1) of diet composition in dairy herds and (2) for the authentication of the cow feeding restrictions included in the specification of 2 Protected Designation of Origin (PDO) cheeses (Cantal and Laguiole) was tested on 7,607 bulk milk spectra from 1,355 farms located in the Massif Central area of France. For each milk sample, the corresponding cow diet composition data were obtained through on-farm surveys. The cow diet compositions varied largely (i.e., from full grazing for extensive farming systems to corn silage-based diets, which are typical of more intensive farming systems). Partial least square regression and discriminant analysis were used to predict the proportion of different feedstuffs in the cows' diets and to authenticate the cow feeding restrictions for the PDO cheese specifications, respectively. The groups for the discriminant analysis were created by dividing the data set according to the threshold of a specific feedstuff. They were issued based on the specifications of the restriction of the PDO cheese. The pasture proportion in the cows' diets was predicted by MIR with an coefficient of determination in external validation (R²V) = 0.81 and a standard error of prediction of 11.7% dry matter. Pasture + hay, corn silage, conserved herbage, fermented forage, and total herbage proportion in the cows' diets were predicted with a R²V >0.61 and a standard error of prediction <14.8. The discrimination models for pasture presence, pasture ≥50%, and pasture ≥57% in the cows' diets achieved an accuracy and specificity ≥90%. A sensitivity and precision ≥85% were also observed for the pasture proportion discrimination models, but both of these indexes decreased at increasing thresholds from 0 to 50, and 57% pasture in the cows' diets. An accuracy ≥80% was also observed for pasture + hay ≥72%, herbage ≥50%, pasture + hay ≥25%, absence of fermented herbage, absence of corn silage, and corn silage ≤30% in the cows' diets, but for several models, either the sensitivity or precision was lower than the accuracy. Models built on the simultaneous respect of all the criteria of the feeding restrictions of PDO cheese specifications achieved an accuracy, specificity, sensitivity, and precision >90%. Both the regression and discriminant MIR models for bulk milk can provide useful indicators of cow diet composition and PDO cheese specifications to producers and consumers (farmers, dairy plants).

Development of a microsphere-based immunoassay for the serological detection of glanders in equids

Burkholderia mallei is the etiologic agent of glanders, an infectious disease of solipeds, with renewed scientific interest due to its increasing incidence in different parts of the world. More rapid, sensitive and specific assays are required by laboratories for confirmatory testing of this disease. A microsphere-based immunoassay consisting of beads coated with B. mallei recombinant proteins (BimA, GroEL, Hcp1, and TssB) has been developed for the serological diagnosis of glanders. The proteins' performance was compared with the OIE reference complement fixation test (CFT) and an indirect enzyme-linked immunosorbent assay (iELISA) on a large panel of sera comprised of uninfected horses (n=198) and clinically confirmed cases of glanders from India and Pakistan (n=99). Using Receiver Operating Characteristics (ROC) analysis and adjusting the cutoff levels, Hcp1 (Se=100%, Sp=99.5%) and GroEL (Se= 97%, Sp=99.5%) antigens exhibited the best specificity and sensitivity. Neither Hcp1 and GroEL proteins, nor iELISA reacted with doubtful and positive CFT samples from glanders free countries which further confirmed the false positive reactions seen in CFT.

Aneuploïdie 47,XYY et schizophrénie avec troubles du comportement : report de cas et discussion de la littérature

Nous rapportons le cas d’un jeune patient âgé de 22 ans, adressé à notre consultation devant un tableau de schizophrénie atypique, pour recherche d’un diagnostic différentiel. L’histoire neurodéveloppementale révèle des troubles des apprentissages mis en évidence à l’entrée en primaire avec une dyslexie, une dyspraxie, des troubles attentionnels avec comportements oppositionnels. Après une classe de 6e difficile, le patient est orienté vers un apprentissage en alternance et obtient un CAP en mécanique automobile. La première décompensation psychotique a lieu à l’âge de 20 ans dans un contexte de surmenage. Le tableau clinique est dominé par une dissociation psychique avec hermétisme. Le patient est très agressif et mégalomaniaque. Il présente des crises clastiques difficilement contrôlables. Devant la coexistence de troubles importants du comportement, d’une grande taille (202 cm), de doigts courts et d’une dysmorphie faciale (rétraction de l’étage moyen du visage avec prognatisme), un caryotype est effectué avec mise en évidence d’une aneuploïdie de type 47,XYY. La revue de littérature portant sur les liens entre les troubles du comportement avec troubles neurocognitifs et l’aneuploïdie de type XYY sont bien documentés. Les liens avec la schizophrénie sont plus contradictoires. Le repérage des affections gonosomiques est important en population souffrant de troubles mentaux atypiques afin de mieux caractériser les troubles cognitifs qui y sont associés et qui pourraient avoir un rôle dans les manifestations comportementales. Chez ce patient, la remédiation cognitive a eu un impact très positif sur les manifestations comportementales. Une telle prise en charge serait donc à envisager chez les patients porteurs d’aneuploïdie avec troubles cognitifs caractérisés.

Review: Authentication of grass-fed meat and dairy products from cattle and sheep

Meat and dairy products derived from grassland carry premium values and sensory and nutritional qualities that aroused much interest for authentication methods to guarantee grassland origin claims. This article reviews the current state of knowledge on the authentication of meat and dairy of grassland origin from food analysis in both cattle and sheep. A range of methods alone or combined, involving analysis of elemental or molecular constituents of food product and fingerprinting profiling combined with chemometrics, have been developed and proved useful to differentiate contrasted feeding regimes and authenticate grass-fed meat and dairy. Their robustness and discriminatory reliability in more complex feeding conditions, such as in the case of dietary switches or when grass only makes up part of the animal's diet, are under active investigation. Our review highlights the possibilities and limitations of these methods, the latter being chiefly posed by variations in the quantity, characteristics and composition of grassland feedstuffs consumed by animals, which are nevertheless inherent to grassland-based production systems, variations in animal responses within and across breeds, and difficulties in detecting the consumption of non-grass feedstuffs by the animal. It also highlights a number of issues for consideration, points of caution and caveats in applying these methods. Scientists agree that much of the research carried out so far has been a 'proof of concept' type and that efforts should be made in the future to develop more databases to help gain genericity and robustness.

Consequences of walking or transport by truck on milk yield and quality, as well as blood metabolites, in Holstein, Montbéliarde, and Valdostana dairy cows

In the mountains, the traditional practice of transhumance is common in dairy production systems to make use of the high-altitude summer pastures. Although the effects of highland grazing have been intensively studied with respect to cow performance and milk and cheese quality, the actual moving of the animals to the highlands and the consequences of this stressor for performance and milk quality in the days immediately following transhumance has not been investigated in detail. The aim of the present study was to compare the effects of a 6-km walk (lasting 1.5 h) to those of a truck transport of 10.5 km (lasting 1 h), simulating cow movement in transhumance systems, as well as a control treatment in which cows were not moved. The experiment included 12 late-lactating Valdostana Red Pied, 12 Montbéliarde, and 12 Holstein cows (i.e., breeds contrasting in genetic merit for milk production). Each cow was subjected to each treatment in a 3-wk Latin square design. Milk yield was measured, and milk and blood samples were taken around the transhumance simulation events. Cows of the 3 breeds responded similarly to both movement treatments. Walking decreased milk yield by 1 kg/milking, but truck transport did not affect milk yield. Both treatments led to an increase in plasma nonesterified fatty acids and milk somatic cell count compared with controls, and truck transport increased milk fat content. Milk coagulation properties were better for Valdostana Red Pied and Montbéliarde cows than for Holstein cows but were not affected by walking or truck transport. Further studies aiming to compare the 3 breeds should include a wider range of response variables over a longer term, including reproduction performance and repeated transhumance.

Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients

Background

Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment — e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment.

Patients and methods

The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor–positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points.

Results

Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use.

Conclusions

CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.

•

Pain levels of myalgia/limb pain and arthralgia increase under letrozole intake.

•

Within one year pain levels increase in both, CAM users as well as non-CAM users.

•

In CAM users pain levels were higher at all time points than in non-CAM users.

•

The greatest increase of pain levels was noted in the first six treatment months.

•

CAM does not prevent or improve the development of myalgia/limb pain and arthralgia.

Grazing behaviour of dairy cows on biodiverse mountain pastures is more influenced by slope than cow breed

The aim of this study was to determine how cows with different genetic merit behave and perform when grazing biodiverse and heterogeneous mountain pastures with different slopes. Three groups of 12 cows in late lactation, each composed of four Holstein, four Montbéliarde and four Valdostana Red Pied cows, breeds of increasing presumed robustness and decreasing milk yield (MY) potential. Cows grazed without concentrate either on a low-diversity flat pasture or on two species-rich mountainous pastures having slopes of either 7° or 22°. Milk yield, BW and grazing behaviour were monitored two times in the first and once in the second grazing cycle. Cows of different breeds had similar behaviour on all pastures. The Montbéliarde cows performed close to their production potential; Holstein and Valdostana cows produced less milk than anticipated. No breed difference in terms of BW loss was found. The Valdostana cows exhibited the least selective behaviour with respect to plant species and plant growth stage. Still, all cows searched for the most palatable vegetation regardless of pasture diversity. On the steep pasture, cows optimised the trade-off between ingesting and saving energy to obtain feed. They remained longer at the lowest zone and selected forbs, whereas cows on the flatter pasture went to the upper zone to select grasses. The present study gave no evidence for a superior short-term adaptation to harsh grazing conditions through an optimised feeding behaviour of the Valdostana breed compared to Montbéliarde and Holstein cows.

Forage system is the key driver of mountain milk specificity

The aims of this work were to determine the effect of upland origin on milk composition when comparing similar lowland and upland production system and to highlight the factors responsible for the added value of upland milk from commercial farms. Tanker milk from 55 groups of farms (264 farms in total) in France, Slovakia, and Slovenia was collected twice during the indoor season and 3 times during the outdoor season. The tanker rounds were selected in each country to be balanced according to their origin (lowland or upland) and within upland or lowland groups, according to the forage systems: corn-based or grass-based forage system. At each milk sampling, the production conditions were recorded through on-farm surveys. The milk was analyzed for gross composition, carotenoids, minerals, fatty acids, phenolic compound derivatives, volatile organic compound concentrations, and color. The milk from upland and lowland areas differed in their contents of a few constituents. Upland milk was richer in not identified (n.i.) retention time (Rt) 13,59, 4-methylpentylbenzene, 1-methyl-2-n-hexylbenzene, and β-caryophyllene than lowland milk. These differences could be most likely attributable to the utilization of highly diversified and extensively managed semi-natural grasslands. The higher forbs content of upland pastures could be related as well to the richness in C18:3n-3, CLA cis-9,trans-11, MUFA, and PUFA we observed in upland compared with lowland milk during the outdoor season. In contrast, grazing on lowland pastures rich in grasses gave a yellower milk that was richer in β-carotene. Out of the few compounds showing a significant effect of origin or its interaction, most of the milk constituents were unaffected by the origin at all. However, almost all milk constituents differed according to the forage system and the season, and the differences observed between seasons can be attributed to differences in the cow diet composition.

Interactions between oral commensal Candida and oral bacterial communities in immunocompromised and healthy children

Candida species are usually found as commensal microorganisms in the oral cavity of healthy people. During chemotherapy, cytostatic drugs lead to depletion of the oral flora with the emergence of a dominant bacterial species. The transition from commensal to pathogenic state, further associated with yeast colonization and oral mucositis implies a replacement of the dominant microorganism by Candida albicans. This process goes plausibly through cooperation between C. albicans and bacteria. This study focused on the first step of cooperation between microorganisms isolated from the same oral flora either of leukemic or healthy children. C. albicans isolated from 8/20 children were cultured to display their noninvasive blastosporic yeast form and mixed with their dominant bacteria to study the capacity of planktonic aggregation and the early state of biofilm formation. None of the dominant bacteria opposed the presence of yeast, on the contrary, an interesting cooperation was observed. This behavior is apparently different from that observed when mixing the type strains. In fact, three mutated C. albicans strains display, by their spontaneous ability to form filament, enhanced risks of virulence for leukemic ill carriers. Despite such risks, neither oral nor systemic pathology were observed in ill patients probably because the study was conducted during the first course of chemotherapy and Candida colonization is related to the number of chemotherapeutic cycles. The presence of C. albicans during the initial cycle represents, by its ability to interact with oral bacteria, an actual threat for further cures.

Gestational diabetes and the risk of late stillbirth: a case-control study from England, UK

OBJECTIVE

To explore the separate effects of being 'at risk' of gestational diabetes mellitus (GDM) and screening for GDM, and of raised fasting plasma glucose (FPG) and clinical diagnosis of GDM, on the risk of late stillbirth.

DESIGN

Prospective case-control study.

SETTING

Forty-one maternity units in the UK.

POPULATION

Women who had a stillbirth ≥28 weeks of gestation (n = 291) and women with an ongoing pregnancy at the time of interview (n = 733).

METHODS

Causal mediation analysis explored the joint effects of (i) 'at risk' of GDM and screening for GDM and (ii) raised FPG (≥5.6 mmol/l) and clinical diagnosis of GDM on the risks of late stillbirth. Adjusted odds ratios (aOR) were estimated by logistic regression adjusted for confounders identified by directed acyclic graphs.

MAIN OUTCOME MEASURES

Screening for GDM and FPG levels RESULTS: Women 'at risk' of GDM, but not screened, experienced 44% greater risk of late stillbirth than those not 'at risk' (aOR 1.44, 95% CI 1.01-2.06). Women 'at risk' of GDM who were screened experienced no such increase (aOR 0.98, 95% CI 0.70-1.36). Women with raised FPG not diagnosed with GDM experienced four-fold greater risk of late stillbirth than women with normal FPG (aOR 4.22, 95% CI 1.04-17.02). Women with raised FPG who were diagnosed with GDM experienced no such increase (aOR 1.10, 95% CI 0.31-3.91).

CONCLUSIONS

Optimal screening and diagnosis of GDM mitigate the higher risks of late stillbirth in women 'at risk' of GDM and/or with raised FPG. Failure to diagnose GDM leaves women with raised FPG exposed to avoidable risk of late stillbirth.

TWEETABLE ABSTRACT

Risk of #stillbirth in gestational diabetes is mitigated by effective screening and diagnosis.

Abstract P4-16-10: Bone health in young women with breast cancer

Introduction:

There are limited data and consensus regarding bone mineral density (BMD) monitoring, and management of bone loss in younger women with breast cancer (BC). Adjuvant endocrine therapy for estrogen receptor positive (ER+) BC may include ovarian function suppression (OFS) plus use of aromatase inhibitors (AIs) for 5-10 years, both of which contribute to bone loss. The WHO risk prediction tool FRAX does not include BC or AI use as independent risk factors in its calculation thus underestimating risk of fracture. This study aims to evaluate current screening and management of bone health in young women with BC.

Methods:

A retrospective, IRB-approved chart review was performed in consecutive women ≤40 with BC diagnosed at Loyola University Chicago Medical Center between 01/01/2015 and 12/13/17. Demographic data, BC treatment, and factors contributing to secondary causes of bone loss were collected through 4/1/18. A descriptive analysis included summary values for all categorical and continuous risk factors.

Results:

BC ≤40yrs was identified in 136 women; 18 were excluded due to missing data. The analysis was performed on 118 patients (pts). Mean pt age was 34.6 yrs (SD 4.7). Stage at diagnosis included: stage 0 = 9 (7.6%), stage 1 = 26 (22%), stage 2 = 44 (37.3%), stage 3 = 23 (19.5%), stage 4 = 7 (5.9%), unknown = 9 (7.6%). Seventy-nine (67%) had ER+ BC; 32 (27.1%) had HER2-positive disease. The majority of pts (101, 85.6%) received chemotherapy in their treatment plan. Menopause was documented in 69 (59.0%) pts. Goserelin was used in 31 pts (44.9%), oophorectomy in 17 (24.6%), both in 5 (7.2%). Tamoxifen was used in 44 (55.7%) ER+ pts; 34 (43.0%) received an AI, and 18 (22.8%) received sequential tamoxifen and AI. 25 Hydroxy-Vitamin D (25 OHD) levels were checked in 61 (51.7%); 43 (70.5%) had levels &lt;30 ng/ml; 24 (55.8%) received vitamin (vit) D supplementation. There was no difference in the 25 OHD in pre- and post-menopausal women (p=0.64). Pts with vit D deficiency had a median BMI of 26.8 vs 23.8 in those with sufficient vit D levels (exact p=.049). Secondary diagnoses contributing to low BMD were identified in 14 (11.8%). Dual energy xray absorptiometry (DXA) scans were checked in 23 pts (19.7%), 18 of whom were post-menopausal. At the femur, 0 pts had a z-score (age-matched standard deviation) of ≤-2.0, 9 pts (39.1%) had a score between 0 to -2.0. At the lumbar spine, 1 pt (4.3%) had a z-score ≤-2.0, 9 pts (39.1%) had a z-score between 0 to -2.0. No T-scores were in the osteoporosis range; 11 pts had T-scores at both femur and lumbar spine in the osteopenia range. The median 10 yr probability of a major osteoporotic fracture (FRAX score) was 1.9% (1.6-2.7%); the median 10 yr probability for hip fracture was 0.1% (0.10-0.20%). There were no differences in FRAX scores between pre- and post-menopausal women. No fractures were reported in the time period studied. Anti-resorptive therapy was used only in patients with metastatic bone disease.

Conclusions:

25 OHD and DXA scans are not routinely checked in younger women diagnosed with BC. Vit D deficiency and evidence of bone loss is prevalent in those pts who do undergo testing. Further research and guidelines are necessary to address management of bone health in young women with BC to minimize future fracture risk and morbidity.

Citation Format: Wendell KB, Nadeem S, Martin B, Camacho PM, Albain KS, Robinson P, Lo SS. Bone health in young women with breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-16-10.

Erratum to: Measurement of the W boson polarisation in t t ¯ events from pp collisions at s = 8 TeV in the lepton + jets channel with ATLAS

[This corrects the article DOI: 10.1140/epjc/s10052-017-4819-4.].

Skin cancer knowledge, attitudes, beliefs, and prevention practices among medical students: A systematic search and literature review

BACKGROUND

As future physicians, medical students will play an important role in the prevention of skin cancers by becoming directly involved in skin cancer prevention education and counseling patients about the hazards of ultraviolet light.

OBJECTIVE

We assessed the skin cancer-related knowledge, attitudes, beliefs, and prevention practices reported in previous studies of medical students.

METHODS

The search for relevant articles was performed in four electronic databases: PubMed (Medline), Cumulative Index to Nursing and Allied Health, ERIC, and PsycINFO. Studies were included if they met the following criteria: 1) targeted medical students; 2) assessed sun avoidance, sun protection, skin self-examination, and/or indoor tanning behaviors; 3) were published in peer-reviewed journals; and 4) complete data were available for extraction.

RESULTS

A total of 21 studies are included in this review. Important findings include moderate-to-high levels of skin cancer knowledge and low levels of both sunscreen and ultraviolet light knowledge. The attitudes and knowledge of medical students reflect a low level of concern with regard to the perceived importance of skin cancer compared with other forms of cancer despite a high level of concern for the importance of skin cancer prevention. Furthermore, this review demonstrated that medical students fail to protect themselves routinely from the sun and have a high interest in tanning bed use.

CONCLUSION

This review demonstrates the need to educate medical students about skin cancer and skin cancer preventive behaviors. New strategies and educational campaigns should be developed to communicate better information on skin cancer morbidity, mortality, and prevention to medical students. This will pay dividends by improving the practice of these future physicians in all specialties.