Comparing the responses of grain-fed feedlot cattle under moderate heat load and during subsequent recovery with those of feed-restricted thermoneutral counterparts: blood cells and inflammatory markers

Given the climate projections for livestock rearing regions globally, understanding the inflammatory status of livestock under various heat loads will be informative to animal welfare and management. A survey of plasma inflammatory markers was conducted, and blood leucocyte counts followed to investigate the capacity of the ~ 500 kg grain fed Black Angus steer to respond to and recover from a moderate heat load challenge. Two sequential cohorts of 12 steers were housed in climate-controlled rooms (CCR) for 18 days. A thermally challenged (TC) group (n = 2 × 6) experienced five consecutive periods: PreChallenge, Challenge, and Recovery within the CCR, and 40 days in outdoor pens (PENS and Late PENS). PreChallenge (5 days) and Recovery (7 days) delivered thermoneutral conditions, whereas in Challenge the TC steers experienced a diurnal temperature range of 28-35 °C. A feed-restricted thermoneutral (FRTN) treatment (n = 2 × 6) was run concurrently to differentiate between responses to reduced feed intake alone and moderate heat stress. Blood neutrophil counts were particularly sensitive to moderate heat load with higher numbers during Challlenge and in PENs. The plasma concentrations of TNFα and IL-1β were depressed in the TC group compared to the FRTN counterparts and remained so for 40 days after Challenge. Linear relationships of the concentrations of IL-1β, IL-10, and haptoglobin with rumen temperature or dry matter intake detected in the FRTN group were altered or absent in the TC group. The findings suggest significant impacts of moderate heat load on the inflammatory status of feedlot cattle.

Cholecalciferol complexation with hydroxypropyl-β-cyclodextrin (HPBCD) and its molecular dynamics simulation

The focus of the current study is to investigate cholecalciferol (vitamin D3) solubilization by hydroxypropyl-β-cyclodextrin (HPBCD) complexation through experimental and computational studies. Phase solubility diagram of vitamin D3 (completely insoluble in water) has an A_P profile revealing a deviation from a linear regression with HPBCD concentration increase. Differential scanning calorimetry (DSC) is the best tool to confirm complex formation by disappearance of cholecalciferol exothermic peak in cholecalciferol-HPBCD complex thermogram, due to its amorphous state by entering HPBCD inner hydrophobic cavity, similarly validated by Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD). A_P solubility diagram profile can be associated with cholecalciferol-HPBCD complex instability in liquid phase requiring spray drying to bring it to a solid dispersion state (always more stable) illustrated by scanning electron microscopy (SEM). Computational studies led to a deeper understanding and clarification, at molecular level, of the interactions within cholecalciferol-HPBCD complex. Thermodynamics and geometry of the complex were investigated by molecular dynamics (MD) simulation.

Heart Failure With Cardiogenic Shock as a Manifestation of Untreated POEMS (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein, Skin Changes) Syndrome

POEMS syndrome (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) is a rare paraneoplastic syndrome due to a plasma cell disorder. Diagnosis requires peripheral neuropathy and a monoclonal plasma cell disorder along with one major and one minor criteria, but cardiac manifestations are uncommon. The pathogenesis of POEMS syndrome is not well understood but it is thought to involve overproduction of proinflammatory cytokines, such as vascular endothelial growth factor (VEGF), interleukin-1 beta (IL-1B), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha). POEMS syndrome commonly presents in the fifth to sixth decade of life, mainly in non-Hispanic Caucasian individuals, and affects more men than women (2:1). We report a unique case of a 28-year-old African American female with a history of POEMS syndrome and a new diagnosis of dilated, non-ischemic cardiomyopathy and New York Heart Association (NYHA) class IV, stage D heart failure with an ejection fraction (EF) of 30% as a result of the natural progression of her untreated POEMS syndrome.

Optimising Radium 223 Therapy for Metastatic Castration-Resistant Prostate Cancer -5-year Real-World Outcome: Focusing on Treatment Sequence and Quality of Life

AIMS

Real-world evidence of radium 223 (Ra-223) for the treatment of men with metastatic castration-resistant prostate cancer is emerging. In this prospective single-centre service evaluation, we report for the first time in the UK, real-world quality of life (QoL) and survival outcomes, including the sequencing impact, in 228 treated patients. We aim to share our 5-year experience on how to optimise Ra-223 treatment.

MATERIALS AND METHODS

Patients who received Ra-223 therapy between 2014 and 2018 at the Northern Centre for Cancer Care, Newcastle upon Tyne, UK were included in this evaluation. Demographics, clinical characteristics, blood parameters, treatment sequencing and QoL data using abbreviated Functional Assessment of Cancer Therapy-Prostate questionnaires were prospectively collected and analysed.

RESULTS

In total, 228 patients were included; median age 72 years (51-87). The medium overall survival was 11.1 months. Overall survival in post-chemotherapy and chemotherapy-naïve patients was 8.1 and 12.3 months, respectively (P = 0.02, hazard ratio 1.52, 95% confidence interval 1.06-2.17); in pre-enzalutamide and post-enzalutamide patients was 11.3 and 10.4 months, respectively (P = 0.65, hazard ratio 0.92, 95% confidence interval 0.63-1.33); in pre-abiraterone and prednisolone and post-abiraterone and prednisolone patients was 11.8 and 10.5 months, respectively (P = 0.08, hazard ratio 0.74, 95% confidence interval 0.51-1.06); in this latter group, the fracture rate was 24% (15/63). QoL post Ra-223 (n = 101 evaluated) showed that pain scores improved in 54%, there was no change in 17% and pain scores worsened in 30% of treated patients. Overall QoL scores showed a similar trend. QoL was not significantly associated with overall survival.

CONCLUSIONS

Ra-223 palliates pain and improves disease-related QoL in most patients in the real-world setting. Our survival outcome is comparable with other real-world studies. Chemotherapy-naïve patients seemed to have better survival than those who received prior chemotherapy. No significant survival differences were observed between pre- and post-abiraterone and prednisolone or enzalutamide patients. The fracture rate in the post-abiraterone and prednisolone group seemed to be high. Bone health evaluation and protection should be incorporated as standard of care.

An unusual case of a completely eroded gastric band and port tubing removed via endoscopy alone

Bariatric surgery is an established intervention providing significant health benefits to patients with obesity. As a result, the National Institute for Health and Care Excellence now recommends bariatric surgery for those that fulfil the eligibility criteria, while emphasising the need for multidisciplinary care before and after surgery. The UK National Bariatric Surgery Registry shows gastric band procedures to be the second most common bariatric procedure performed in the UK. Gastric band erosion is a known potential complication treated primarily by laparoscopic removal of band and repair of stomach. To our knowledge, we present the first case of a partially eroded gastric band with separate gastric fistulation of the port tubing. The band was removed via endoscopy without the need for a cutaneous exploration as the port had previously been removed at incisional hernia surgery. Owing to the fact that the tubing and band were both evident within the lumen of the stomach, complete band erosion was inferred and therefore endoscopic removal thought to be indicated. In actual fact, there was separate erosion of the band and tubing; more specifically, the gastric band clasp had not eroded fully and while endoscopic removal was still possible, it was challenging and required the band to be divided. This case highlights the importance of careful patient selection, involvement of multidisciplinary care prior and after surgery and close follow-up to facilitate timely identification and management of complications.

Clinicopathological features of squamous cell carcinoma of the oral cavity and oropharynx in young patients

Our aim was to examine the clinicopathological features of squamous cell carcinoma (SCC) of the oral cavity and oropharynx in a group of young patients who were dignosed during a 15-year period (2000-2014). Patients' clinical details, risk factors, and survival were obtained from medical records. Formalin-fixed, paraffin-embedded, tissue was tested for high-risk human papillomavirus (HPV). The results were compared with those of a matching group of older patients. We identified 91 patients who were younger than 45 years old, and the 50 youngest patients were studied in detail. The male:female ratio was 2:1, with more tumours located in the oral cavity than in the oropharynx (35 compared with 15). HPV-related SCC was restricted to the oropharynx. When matched for site, stage and HPV status, five-year overall survival was similar in young and matched older patients (log-rank test, p=0.515). Our findings suggest that young patients with oral SCC have a disease profile similar to that of older patients with the condition. It is plausible that prognostic information generally available for oral cancers is applicable to young patients with the disease.

Variability in the prescribing of intravenous fluids: A cross sectional multicentre analysis of clinical practice

AIMS

Intravenous (IV) fluid administration continues to be a mainstay of care in General Surgery. Yet if they are prescribed incorrectly significant morbidity including electrolyte abnormalities, renal impairment and cardiac failure can develop. Despite this, it is frequently the responsibility of the most junior staff to prescribe IV fluids. We aim to analyse the understanding of IV fluid prescribing amongst junior doctors and to describe variability in clinical practice.

METHODS

We undertook a multicentre questionnaire study. Foundation doctors and specialty trainees were invited to undertake a two part paper-based questionnaire. Part one analysed baseline knowledge of the concentration of commonly prescribed fluids. Part two consisted of four clinical vignettes requiring a IV fluid prescribing decision by the surveyed doctor.

RESULTS

A total of 143 Doctors working in 8 hospitals were recruited. 65 (45.5%) doctors correctly stated the daily maintenance fluid requirements of water for an adult (25-30 mls/kg/day), while only 54 (37.8%) knew the sodium concentration of 0.9% NaCl. Lack of postgraduate experience (p = 0.011), qualifying from a medical school outside the United Kingdom (p < 0.0001) and working in one of the eight hospitals in this study (p < 0.0001) were associated with a lower knowledge level. There was limited consensus in prescribing in the responses to the 4 clinical scenarios, with 69 unique combinations of fluid choice, rate and volume prescribed.

CONCLUSIONS

Knowledge of the constituents of common IV fluids and routine requirement for fluid and common electrolytes is poor across junior doctors of all grades, driving large variation in clinical practice.

Common questions about the diagnosis and management of benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a common condition that increases in prevalence with age. A history should include onset, duration, and severity of lower urinary tract symptoms and medication use to rule out other causes of symptoms. Physical examination includes a digital rectal examination and assessment for bladder distention or neurologic impairment. Recommended tests include serum prostate-specific antigen measurement and urinalysis to help identify infection, genitourinary cancer, or calculi as an alternative cause of lower urinary tract symptoms. BPH severity is assessed using validated, self-administered symptom questionnaires such as the American Urological Association Symptom Index or International Prostate Symptom Score. Mild or nonbothersome symptoms do not require treatment. Bothersome symptoms are managed with lifestyle modifications, medications, and surgery. Alpha blockers are first-line medications for BPH. Surgical referral is indicated if BPH-related complications develop, medical therapy fails, or the patient chooses it. Dietary supplements, such as saw palmetto, pygeum, cernilton, and beta sitosterols, and acupuncture are not recommended for the management of BPH.

Cloning, recombinant expression and inhibitor profiles of dihydrofolate reductase from the Australian sheep blow fly, Lucilia cuprina

While dihydrofolate reductase (DHFR) is an important drug target in mammals, bacteria and protozoa, no inhibitors of this enzyme have been developed as commercial insecticides. We therefore examined the potential of this enzyme as a drug target in an important ectoparasite of livestock, the Australian sheep blow fly, Lucilia cuprina (Diptera: Calliphoridae) (Wiedemann). The non-specific DHFR inhibitors aminopterin and methotrexate significantly inhibited the growth of L. cuprina larvae, with IC50 values at µg levels. Trimethoprim and pyrimethamine were 5-30-fold less active. Relative IC50 values for the inhibition of recombinant L. cuprina DHFR by various inhibitors were in accordance with their relative effects on larval growth. The active-site amino acid residues of L. cuprina DHFR differed by between 34% and 50% when compared with two mammalian species, as well as two bacteria and two protozoa. There were significant charge and size differences in specific residues between the blow fly and human DHFR enzymes, notably the L. cuprina Asn21, Lys31 and Lys63 residues. This study provides bioassay evidence to highlight the potential of blow fly DHFR as an insecticide target, and describes differences in active site residues between blow flies and other organisms which could be exploited in the design of blow fly control chemicals.

Synthesis of phenanthridines via palladium-catalyzed picolinamide-directed sequential C-H functionalization

We report a new synthesis of phenanthridines based on palladium-catalyzed picolinamide-directed sequential C-H functionalization reactions starting from readily available benzylamine and aryl iodide precursors. Under the catalysis of Pd(OAc)2, the ortho-C-H bond of benzylpicolinamides is first arylated with an aryl iodide. The resulting biaryl compound is then subjected to palladium-catalyzed picolinamide-directed intramolecular dehydrogenative C-H amination with PhI(OAc)2 oxidant to form the corresponding cyclized dihydrophenanthridines. The benzylic position of these dihydrophenanthridines could be further oxidized with Cu(OAc)2, removing the picolinamide group and providing phenathridine products. The cyclization and oxidation could be carried out in a single step and afford phenathridines in moderate to good yields.

The effect of combination treatment with trenbolone acetate and estradiol-17β on skeletal muscle expression and plasma concentrations of oxytocin in sheep

Implantation of trenbolone acetate (TBA) in conjunction with estradiol-17β (E(2)) increases growth, feed conversion efficiency, and carcass leanness in cattle. Our previous study in Brahman steers suggested that the neuropeptide hormone oxytocin (OXT) may be involved in increasing muscle growth after TBA-E(2) treatment. The present study aimed to determine whether OXT mRNA expression in the longissimus muscle (LM) is also up-regulated in TBA-E(2-)implanted wethers as has been found in steers. Real-time quantitative PCR was used to measure the expression of the gene encoding the OXT precursor, three genes with increased expression in the LM muscle of TBA-E(2)-treated steers, MYOD1 (muscle transcription factor), GREB1 (growth regulation by estrogen in breast cancer 1), and WISP2 (Wnt-1 inducible signaling pathway protein 2), and two genes encoding IGF pathway proteins, IGF1, IGFR, in the LM of both untreated and TBA-E(2)-treated wethers. The expression of OXT mRNA in wethers that received the TBA-E(2) treatment was increased ~4.4-fold (P = 0.01). TBA-E(2) treatment also induced a 2.3-fold increase in circulating OXT (P = 0.001). These data, together with the observation that untreated wethers had much higher baseline concentrations of circulating OXT than previously observed in steers, suggest that wethers and steers have quite different OXT hormone systems. TBA-E(2) treatment had no effect on the expression of IGF1, IGFR, and the muscle regulatory gene MYOD1 mRNA levels in wethers (P ≥ 0.15), but there was an increase in the expression of the two growth-related genes, GREB1 (P = 0.001) and WISP2 (P = 0.04). Both genes are common gene targets for both the estrogen and androgen signaling pathways. Consequently, their actions may contribute to the positive interaction between TBA and E(2) on additive improvements on muscle growth.

Sandwiched graphene--membrane superstructures

We demonstrate by molecular dynamics simulations that graphene sheets could be hosted in the hydrophobic interior of biological membranes formed by amphiphilic phospholipid molecules. Our simulation shows that these hybrid graphene--membrane superstructures might be prepared by forming hydrated micelles of individual graphene flakes covered by phospholipids, which can be then fused with the membrane. Since the phospholipid layers of the membrane electrically isolate the embedded graphene from the external solution, the composite system might be used in the development of biosensors and bioelectronic materials.

Effect of planting date on Lissorhoptrus oryzophilus (Coleoptera: Curculionidae) density-yield relationship on rice in southeastern Texas

Results of planting date and insecticide efficacy experiments targeting Lissorhoptrus oryzophilus Kuschel (Coleoptera: Curculionidae) on rice, Oryza sativa L., in southeastern Texas between 2002 and 2007 were used to determine density-yield relationships as a function of planting date. Soil core samples were collected on two dates during main crop development to estimate immature L. oryzophilus populations followed by main and ratoon crop harvests. Analysis of covariance (ANCOVA) revealed that planting date did not affect the density-main crop yield relationship during most years and that these relationships varied substantially among years. For ratoon crop yield, an effect of main crop L. oryzophilus immature infestation was detected during some years, but the real effect of these populations on ratoon crop yield remains unclear. Using estimates of yield reduction per L. oryzophilus immature, economic injury levels were calculated. Main crop yields from treated plots and first soil core sample L. oryzophilus immature populations from untreated plots were significantly higher in plots planted at recommended dates than in plots planted earlier or later. This suggests that the presence of high populations of reproductive L. oryzophilus coincides with the period when rice fields planted at optimum dates are flooded. Results from this study reinforce the importance of managing L. oryzophilus populations when planting rice at recommended dates in southeastern Texas.