Mink are an important animal commodity group in Canada and excessive kit mortality represents a significant loss to production. National biosecurity standards have been developed for Canadian mink ...farms, but it is unclear how well these standards have been implemented as there are no studies correlating management practices of mink producers with causes of death in mink kits. To that end, we surveyed Ontario mink producers on their biosecurity and management practices and conducted almost 5660 post mortem examinations on found-dead, preweaned kits to characterize mink farm biosecurity practices and causes of death in preweaned kits.
We found that very few biosecurity and management practices were uniformly used by producers, despite good awareness of appropriate practices. Use of personal protective equipment was implemented by fewer than 50% of respondents, while control of mink shed access, disinfection of feed containers after use, and use of a rodent control program were the only practices implemented by greater than 70% of respondents. Only 18% of producers reported regular use of antimicrobials in feed or water, although 91% stated they used antimicrobials for treatment of bacterial diseases on a regular basis. On post mortem examination, no gross abnormalities were noted in 71% of the kits, 45% were thought to be stillborn or aborted, 27% had some form of abnormal fluid distribution in the body, and 2% had a congenital malformation. A subset of 69 gastrointestinal tract samples was submitted for bacterial culture, of which 45 samples yielded sufficient growth. Most interesting was the identification of Salmonella enterica serovar Heidelberg in 11% of samples.
The results of this study will provide a benchmark for Canadian mink producers and their veterinarians, defining the areas to which greater attention should be given to ensure more rigorous biosecurity practices are in place. Ultimately, these improvements in practices may contribute to increased mink production and animal well-being.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•First study of use of oromucosal midazolam maleate (OMM) in adults in community.•Oromucosal midazolam maleate is safe to use by trained non-clinical carers.•10-mg dose of OMM is effective for ...cessation of seizure in adults at status risk.•Oromucosal midazolam maleate is an effective rescue medication in adults with epilepsy in community settings.
Oro-mucosal midazolam maleate (OMM) with suitable training to family and carers is being increasingly recognized as the treatment of choice to mitigate the development of status epilepticus in non-hospital community settings. There are no studies to describe the use, effectiveness, and suitable dosing of OMM in adults with epilepsy in community settings.
To describe the use, effectiveness, and dosing of OMM in the emergency treatment of epileptic seizures in community settings.
A retrospective observational study (2016–17) design was used with participant recruitment from four UK NHS secondary care outpatient clinics providing epilepsy management. Study sample was of adult people with epilepsy (PWE) having had a recent seizure requiring OMM. Data on patient demographics, patient care plans, details of a recent seizure requiring emergency medication, and dose of OMM were collected from medical records.
Study data from 146 PWE were included. The mean age of PWE was 41.0 years (SD 15.2) and mean weight was 64.8Kg (SD 18.2). Fifty-three percent of PWE were recorded as having intellectual disability. The most frequently used concomitant medications were lamotrigine (43%). The majority of seizures occurred at people’s homes (n = 92, 63%). OMM was most often administered by family/professional care-givers (n = 75, 48.4%). Generalized (tonic/clonic) seizures were recorded in most people (n = 106, 72.6%). The most common initial dose of OMM was 10 mg (n = 124, 84.9%). The mean time to seizure cessation after administration of this initial dose was 5.5 minutes (SD = 4.5, Median 5.0, IQR 2.1–5.0). Only a minority of seizures led to ambulance callouts (n = 18, 12.3%) or hospital admissions (n = 13, 9%).
This is the first observational study describing the use and effectiveness of OMM in adults in community settings. Minimal hospital admissions were reported in this cohort and the treatment was effective in ending seizures in adults in community settings.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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e15058
Background: Recent retrospective and subgroup analyses have evaluated the effects of capecitabine with acid-reducing agents both in the adjuvant setting for colon cancer and in ...the palliative setting for stage IV gastroesophageal malignancies. Efficacy outcomes in these studies are contradictory. Acid-reducing agents are thought to reduce the absorption of capecitabine by increasing gastric pH leading to a concern of decreased efficacy. Studies thus far have not included stage IV colorectal cancers, a common population who receives capecitabine-based regimens. Methods: We conducted a retrospective chart review of patients diagnosed with stage IV Gastro Intestinal (GI) cancers treated with capecitabine-based therapies between 2012 and 2018. Electronic health records were used for data collection. Descriptive statistics and COX regression model were utilized for data analysis. Results: Of the 249 charts that were screened for inclusion, 58 were included in this review. Thirty-eight (65.5%) had a diagnosis of colon cancer, 11 (19%) had rectal cancer, and 9 (15.5%) had other GI malignancies. The most common capecitabine-based regimens included XELOX alone (29%) or with bevacizumab (36%). During capecitabine treatment, 20 (34.5%) patients received concomitant acid-reducing therapy. This included 19 patients taking a PPI and 1 patient taking a H2 Inhibitor. Patients who did not receive acid-reducing therapy had a 1-year PFS of 23.7% compared to 25% in patients who did not, (HR 0.55, p = 0.46). The 1-year OS was 68.4% in the non-acid-reducing agent group and 60% in the patients who did receive acid-reducing agents during capecitabine treatment, respectively (HR 0.17, p = 0.68). Conclusions: Receiving acid-reducing agents concomitantly with capecitabine-based regimens appears to not have an effect on 1-year PFS or OS in patients with Stage IV GI cancers. These outcomes may have been affected by the sample size, incomplete home medication lists, and compliance issues with capecitabine. Larger population studies are needed to validate these findings and identify the significance of utilization of acid-reducing agents in patients with Stage IV GI cancers receiving capecitabine.
A Medical Outreach Elective Course Perry, Elizabeth; Storer, Amanda; Caldwell, David ...
American journal of pharmaceutical education,
05/2013, Volume:
77, Issue:
4
Journal Article
Peer reviewed
Open access
Objective. To design and implement a Medical Outreach Experience elective course and assess its impact on students’ level of confidence in organizing future medical outreach trips, providing ...population-specific pharmaceutical care, and achieving learning outcomes.
Design. A 2-credit hour elective course was designed for second- and third-year pharmacy students. The course was structured to include 3 sections over 1 semester, a 10-week training and preparation phase, followed by a weeklong international outreach experience and post-outreach reflection.
Assessment. Student achievement of curricular outcomes was measured using in-class activities, readings, reflections, and longitudinal projects, as well as performance during the outreach trip. Results from pre- and post-course surveys demonstrated significant improvement in student-rated confidence in several components of outreach trip organization and provision of pharmaceutical care.
Conclusions. Students completing the course exhibited increased confidence in their abilities to organize and practice on a medical outreach trip. All students met the learning outcomes of the course, which included providing comprehensive patient-specific pharmaceutical care, communicating effectively, promoting health improvement and self-care, thinking critically, and appropriately managing and using resources of the healthcare system. Students agreed that the elective course was a valuable addition to the curriculum.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, VSZLJ, ZAGLJ, ZRSKP
While FRPs initially come with a higher price than steel panels, the advantages they offer deliver cost savings and benefits over the long haul. Fiberglass does not corrode and offers a longer life ...span than steel with direct exposure to acids, salt, oil, and other common corrosives that are ever-present in environments charged with cold storage, food production, or the manufacturing of pharmaceutical products. Utilizing FRP technology delivers a return on investment with no shutdowns for seam repair and cleaning, and a more sanitary environment.
Human cytomegalovirus (CMV) reactivation is a frequent complication of allogeneic hematopoietic cell transplantation (HCT). Despite routine screening for CMV reactivation and early antiviral ...treatment, the rates of CMV-related complications after HCT remain high. Genetic variants in both the donor and recipient have been associated with the risk of CMV reactivation and disease after HCT, but these associations have not been validated, and their clinical importance remains unclear. In this study, we assessed 117 candidate variants previously associated with CMV-related phenotypes for association with CMV reactivation and disease in a cohort of 2169 CMV-seropositive HCT recipients. We also carried out a genome-wide association study (GWAS) for CMV reactivation and disease in the same cohort. Both analyses used a prespecified discovery and replication approach to control the risk of false-positive results. Among the 117 candidate variants, our analysis implicates only the donor ABCB1 rs1045642 genotype as a risk factor for CMV reactivation. This synonymous variant in P-glycoprotein may influence the risk of CMV reactivation by altering the efflux of cyclosporine and tacrolimus from donor lymphocytes. In the GWAS analysis, the donor CDC42EP3 rs11686168 genotype approached the significance threshold for association with CMV reactivation, although we could not identify a mechanism to explain this association. The results of this study suggest that most genomic variants previously associated with CMV phenotypes do not significantly alter the risk for CMV reactivation or disease after HCT.
•A synonymous variant in P-glycoprotein is associated with the risk of CMV reactivation after allogeneic HCT.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Capuchins are platyrrhines (monkeys found in the Americas) within the Cebidae family. For most of their taxonomic history, the two main morphological types of capuchins, gracile (untufted) and robust ...(tufted), were assigned to a single genus,
. Further, all tufted capuchins were assigned to a single species,
, despite broad geographic ranges spanning Central and northern South America. In 2012, tufted capuchins were assigned to their genus,
, with eight currently recognized species and five
species, although these numbers are still under debate.
retrotransposons are a class of mobile element insertion (MEI) widely used to study primate phylogenetics. However,
elements have rarely been used to study capuchins. Recent genome-level assemblies for capuchins (
; Cebus_imitator_1.0 and
GSC_monkey_1.0) facilitated large scale ascertainment of young lineage-specific
insertions. Reported here are 1607 capuchin specific and 678
specific
insertions along with candidate oligonucleotides for locus-specific PCR assays for many elements. PCR analyses identified 104 genus level and 51 species level
insertion polymorphisms. The
datasets reported in this study provide a valuable resource that will assist in the classification of archival samples lacking phenotypic data and for the study of capuchin phylogenetic relationships.
We present new arcminute-resolution maps of the Cosmic Microwave Background temperature and polarization anisotropy from the Atacama Cosmology Telescope, using data taken from 2013{2016 at 98 and 150 ...GHz. The maps cover more than 17,000 deg(^2), the deepest 600 deg(^2) with noise levels below 10µK-arcmin. We use the power spectrum derived from almost 6,000 deg(^2) of these maps to constrain cosmology. The ACT data enable a measurement of the angular scale of features in both the divergence-like polarization and the temperature anisotropy, tracing both the velocity and density at last-scattering. From these one can derive the distance to the last-scattering surface and thus infer the local expansion
rate, H0. By combining ACT data with large-scale information from WMAP we measure H0 = 67:6±1:1 km/s/Mpc, at 68% confidence, in excellent agreement with the independently measured Planck satellite estimate (from ACT alone we find H0 = 67:9± 1:5 km/s/Mpc). The ΛCDM model provides a good fit to the ACT data, and we find no evidence for deviations: both the spatial curvature, and the departure from the standard lensing signal in the
spectrum, are zero to within 1σ; the number of relativistic species, the primordial Helium fraction, and the running of the spectral index are consistent with ΛCDM predictions to within 1.5{2.2σ. We compare ACT, WMAP, and Planck at the parameter level and find good consistency; we investigate how the constraints on the correlated spectral index and baryon density parameters readjust when adding CMB large-scale information that ACT does not measure. The DR4 products presented here will be publicly released on the NASA Legacy Archive for Microwave Background Data Analysis.
We present the temperature and polarization angular power spectra of the CMB measured by the Atacama Cosmology Telescope (ACT) from 5400 deg
2
of the 2013–2016 survey, which covers >15000 deg
2
at 98 ...and 150 GHz. For this analysis we adopt a blinding strategy to help avoid confirmation bias and, related to this, show numerous checks for systematic error done before unblinding. Using the likelihood for the cosmological analysis we constrain secondary sources of anisotropy and foreground emission, and derive a “CMB-only” spectrum that extends to ℓ=4000. At large angular scales, foreground emission at 150 GHz is ∼1% of TT and EE within our selected regions and consistent with that found by
Planck
. Using the same likelihood, we obtain the cosmological parameters for ΛCDM for the ACT data alone with a prior on the optical depth of τ=0.065±0.015. ΛCDM is a good fit. The best-fit model has a reduced χ
2
of 1.07 (PTE=0.07) with
H
0
=67.9±1.5 km/s/Mpc. We show that the lensing BB signal is consistent with ΛCDM and limit the celestial EB polarization angle to ψ
P
=−0.07
̂
±0.09
̂
. We directly cross correlate ACT with
Planck
and observe generally good agreement but with some discrepancies in TE. All data on which this analysis is based will be publicly released.
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