527 Late-Breaking: Objective Assessment of Behaviour, Pain, and Lameness Due to Digital Dermatitis in Beef Cattle

Digital dermatitis (DD) is an infectious disease affecting cattle feet causing ulcerative and necrotic skin lesions. Most lesions are painful when palpated, some cause lameness and significantly impact animal welfare and productivity. Our objectives were: to determine if changes in behaviour were associated with DD in cattle, to quantify pain associated with DD lesions, and to determine the relationship between pain sensitivity and lameness, and DD and lesion temperature. In total, 255 animals across three feedlots were enrolled. A subset of 120 animals were fitted with accelerometers to record behaviour. Cattle were scored for lameness (Step-Up Locomotion Scoring System), both hind feet scored for DD (M-stage scoring system), the pressure pain threshold of lesions determined using pressure algometry and lesion temperature using thermal images. Animals and feet were classified as DD absent or present. Further, DD present was divided into active or chronic. Behaviour, 5 to 2 days before DD identification was analyzed. Animals with DD ruminated 3% less daily compared to animals without DD (P < 0.05). Further, animals with active lesions ruminated 5% less daily (P < 0.05). Daily inactivity time was greater in animals with DD and the effect of day depended on type of lesion (P < 0.05). Feet without DD lesions withstood 5.6N more pressure (P < 0.001). Active lesions were most sensitive withstanding 8.1N less pressure and chronic lesions 4.1N less pressure than DD absent feet (P < 0.05). Moderate to severely lame animals withstood 3.1N less pressure than sound animals (P < 0.001). Median maximum temperature (MMT) was higher in feet with DD compared to those without (P < 0.001) with MMT being highest in active lesions (P < 0.05). In conclusion, rumination is depressed, and inactivity increased in DD affected animals. Both active and chronic lesions are painful, lame animals have a lower pain threshold and DD is associated with higher lesion temperatures.

Response time and response time variability as indicators of response quality during static automated perimetry

Purpose Perimetry is a both demanding and strenuous examination method that is often accompanied by signs of fatigue, leading to false responses and thus incorrect results. Therefore, it is essential to monitor the response quality. The purpose of this study was to evaluate the response time (RT) and its variability (RTV) as quality indicators during static automated perimetry. Methods Size III Goldmann stimuli (25.7′) were shown with the OCTOPUS 900 perimeter in four visual field locations with 13 different stimulus luminance levels (0.04–160 cd/m2). An increased rate of false-positive and false-negative catch trials (25% each) served to monitor the response quality simultaneously together with response time recording. Data evaluation was divided into global and individual analysis. For global analysis, the agreement indices (AI, agreement between time periods with an increased number of false responses to catch trials and time periods with pathological response to time-based values set into relation to time periods in which only one of the two criteria was considered pathological) and for individual analysis, the Spearman correlation coefficients were calculated. Ophthalmologically normal subjects with a visual acuity ≥ 0.8, and a maximum spherical/cylindrical ametropia of ± 8.00/2.50 dpt were included. Results Forty-eight subjects (18 males, 30 females, age 22–78 years) were examined. The total number of false responses to catch trials was (median/maximum): 6/82. RT and RTV were compared to the occurrence of incorrect responses to catch trials. The resulting individual Spearman correlation coefficients (median/maximum) were for RT: ρRT = 0.05/0.35 and for RTV: ρRTV = 0.27/0.61. The global analysis of the RTV showed agreement indices (median/maximum) of AIRTV = 0.14/0.47. Conclusions According to this study, an increased portion of catch trials is suitable as a verification tool for possible response quality indicators. The RTV is a promising parameter for indicating the response quality.

Ketamine therapy for chronic pain in The Netherlands: a nationwide survey

Objectives Ketamine is used to treat chronic refractory pain. However, there are no scientific guidelines for ketamine use in the Netherlands. The aim of this survey was to provide an overview of the use of ketamine for chronic pain in the Netherlands. Methods All pain clinics in the Netherlands were contacted. A digital survey, available from June 2019 to January 2020, was sent to 68 pain clinics. The survey was completed by one pain physician as a representative of the entire pain department. The survey included questions about ketamine treatment indications, administration, dose, duration, treatment repetition and the inpatient or outpatient setting. Results The survey was completed by 51 pain clinics (75.0%). Thirty-one clinics used ketamine for chronic pain treatment. The most common indication was Complex Regional Pain Syndrome (83.9%). Pain clinics administered ketamine via intravenous infusions (96.8%), iontophoresis (61.3%), subcutaneous (3.2%) or oral administration (3.2%). Intravenous ketamine treatment was offered in an inpatient setting in 14 pain clinics, in both an inpatient and outpatient setting in 11 pain clinics and in six pain clinics in an outpatient setting. In the outpatient setting, the median starting dose was 5 mg/h (IQR=17.5–5). The median maximum dose was 27.5 mg/h (IQR=100–11.9). The median infusion duration was 6 h (IQR=8–4). In the inpatient setting, the median starting dose was 5 mg/h (IQR=5–1.5) and the median maximum dose was 25 mg/h (IQR=25–14). Patients were admitted to hospital for a median of 4 days (IQR=5–1). Conclusions The results of this Dutch nationwide survey study show that there are heterogeneous treatment protocols with different indications, treatment setting and dosing regimen for the treatment of chronic pain with ketamine. This study encourages the formulation of a broader consensus and the development of evidence based guidelines for ketamine treatment.

Disentangling the aging gene expression network of termite queens

Background Most insects are relatively short-lived, with a maximum lifespan of a few weeks, like the aging model organism, the fruit-fly Drosophila melanogaster. By contrast, the queens of many social insects (termites, ants and some bees) can live from a few years to decades. This makes social insects promising models in aging research providing insights into how a long reproductive life can be achieved. Yet, aging studies on social insect reproductives are hampered by a lack of quantitative data on age-dependent survival and time series analyses that cover the whole lifespan of such long-lived individuals. We studied aging in queens of the drywood termite Cryptotermes secundus by determining survival probabilities over a period of 15 years and performed transcriptome analyses for queens of known age that covered their whole lifespan. Results The maximum lifespan of C. secundus queens was 13 years, with a median maximum longevity of 11.0 years. Time course and co-expression network analyses of gene expression patterns over time indicated a non-gradual aging pattern. It was characterized by networks of genes that became differentially expressed only late in life, namely after ten years, which associates well with the median maximum lifespan for queens. These old-age gene networks reflect processes of physiological upheaval. We detected strong signs of stress, decline, defense and repair at the transcriptional level of epigenetic control as well as at the post-transcriptional level with changes in transposable element activity and the proteostasis network. The latter depicts an upregulation of protein degradation, together with protein synthesis and protein folding, processes which are often down-regulated in old animals. The simultaneous upregulation of protein synthesis and autophagy is indicative of a stress-response mediated by the transcription factor cnc, a homolog of human nrf genes. Conclusions Our results show non-linear senescence with a rather sudden physiological upheaval at old-age. Most importantly, they point to a re-wiring in the proteostasis network and stress as part of the aging process of social insect queens, shortly before queens die.

Association of Gastric Residual Volumes With Necrotising Enterocolitis in Extremely Preterm Infants

Necrotising enterocolitis (NEC) is a potentially serious illness with significant mortality and morbidity in preterm infants. Previous studies have reported association of volume and colour (bile and blood stained) of gastric residuals (GR) with NEC. We aimed to study this association in our cohort of extremely preterm (EP) infants. In a case-control study using retrospective data (January 2006-December 2011), EP (Gestation <28 weeks) infants with confirmed NEC ≥ Stage II (Cases) were compared with infants without NEC (Controls) matched for birth weight (BW) and gestational age (GA). Forty cases of NEC ≥ Stage II diagnosed at a median (IQR) age of 16.5 (10.3-23) days were compared with 40 controls matched for gestation (±3 days), and birth weight (±680 g). Median maximum GR volume (GRV) from birth to the day of occurrence of NEC was significantly higher in cases vs. controls (5.9 vs.3.7 ml; p<0.001). Increased maximum GRV was associated with NEC ≥ Stage II in adjusted analysis (aOR 1.36, 95%CI 1.06-1.75, p=0.017). There was no significant difference in GRV between cases and controls throughout the clinical course, including 72, 48 and 24 hours before the onset of NEC. However, green (65.0% vs. 27.5%, p=0.001) and haemorrhagic GRs (45.0% vs. 27.5%, p=0.092) were higher 24 hours before the diagnosis of NEC.Conclusion: GRV was not associated with NEC ≥ Stage II. However, green and haemorrhagic GRs were significantly higher 24 hours before the diagnosis of the illness. Adequately powered prospective studies are needed to confirm the significance of our findings.

Disentangling the aging network of a termite queen

Background: Most insects are relatively short-lived, with a maximum lifespan of a few weeks, like the aging model organism, the fruit-fly Drosophila melanogaster. By contrast, the queens of social insects (termites, ants, some bees and wasps) can live for more than a decade. This makes social insects promising new models in aging research providing insights into how a long reproductive life can be achieved. Yet, aging studies on social insect reproductives are hampered by a lack of quantitative data on age-dependent survival and time series analyses that cover the whole lifespan of such long-lived individuals. We studied aging in queens of the drywood termite Cryptotermes secundus by determining survival probabilities over more than 15 years and performed transcriptome analyses for queens of known age that covered their whole lifespan. Results: The maximum lifespan of C. secundus queens was 13 years with a median maximum longevity of 11.0 years. Time course and co-expression network analyses of gene expression patterns over time indicated a non-gradual aging pattern. It was characterized by networks of genes that became differentially expressed only late in life, namely after an age of 10 years, which associates well with the median maximum lifespan for queens. These old-age gene networks reflect processes of physiological upheaval. We detected strong signs of stress, decline, defence and repair at the transcriptional level of epigenetic control as well as at the post-transcriptional level with changes in transposable element activity and the proteostasis network. The latter depicts an upregulation of protein degradation, together with protein synthesis and protein folding, processes which are often down-regulated in old animals. The simultaneous upregulation of protein synthesis and autophagy is indicative for a stress-response mediated by the transcription factor cnc, a homolog of human nrf genes. Conclusion: Our results show non-linear senescence with a rather sudden physiological upheaval at old-age. Most importantly, they point to a re-wiring in the proteostatis network as central for explaining the long life of social insect queens.

Core temperature monitoring during cesarean delivery under spinal anesthesia: a quality improvement descriptive study

Aim: To analyze intraoperative temperature change over time following spinal anesthesia for cesarean delivery using temperature enabled Foley catheters. Materials & methods: 512 records of women who underwent scheduled cesarean deliveries were retrospectively identified from January 1, 2018 through September 9, 2018 using our anesthesia information management system. Results: Median minimum temperature at min 1 following foley insertion was 35.24°C (interquartile range: 1.43), with an average of 12 minutes until temperature equilibration at median maximum temperature of 36.54°C (interquartile range 0.39). Temperature dropped to a nadir of 35.9°C at the 45 min mark, reflecting an average 0.64°C decline in temperature. Conclusion: Bladder temperature is a useful surrogate for core temperature and offers a practical solution to continuous temperature monitoring in awake patients.

Predisposing factors to acute pancreatitis in patients with severe hypertriglyceridemia

Severe hypertriglyceridemia (HTG) is a rare condition defined as fasting triglyceride (TG) levels &gt;885 mg/dL. Besides the association between mild-moderate HTG and cardiovascular disease (CVD), severe HTG is a known risk factor for acute pancreatitis (AP). The factors predisposing patients with severe HTG to AP are not completely clear. Purpose Compare patients with severe HTG with and without AP and identify factors predisposing to AP. Methods We performed a retrospective search of patients with severe, refractory HTG in our hospital database over the last 10 years. Inclusion criteria: at least one TG≥2,000mg/dL and the latest on-therapy TG≥1,000mg/dL. Results From 692 patients with at least one TG≥1,000 mg/dL, 27 met the inclusion criteria. Nineteen (70%) were male, mean age 53±14 y-old. The median maximum TG value was 3,384mg/dL and the latest on-therapy TG was 1,791 mg/dL despite fibrate use; 70,4% were diabetics (44% insulin users; 41% had previous CVD). Patients with AP were younger, with higher fasting glucose and lower HDL-C. However, there were no differences between the AP and no AP groups, regarding maximum and latest TG, diagnosis of diabetes and treated HbA1C. Conclusion In this cohort of patients with severe, refractory HTG, those with AP were significantly younger, suggesting a greater genetic role for HTG in this group. There were no other relevant diferences between the AP and no AP groups. Conceivably, other unrecognized factors were at play accounting for the AP events. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Zerbini Foundation, FAPESP (The The São Paulo Research Foundation)

Distributed Quantiles Estimation of Sensor Network Measurements

A quantile is a value below which random draws from a distribution falls with a given probability. In a centralized setting where the cumulative distribution function (CDF) is unknown, empirical CDF can be used to estimate quantiles after data aggregation. In a distributed sensor network, it is challenging to estimate quantiles, as each sensor observes local measurement data with limited storage and transmission power, which makes it difficult to obtain the global ECDF. This paper proposes consensus-based quantile estimation for such networks, even when communication links are corrupted by independent random noise. The state-values are recursively updated with two steps: a local update based on measurement data and current state and averaging updated states with local nodes. The estimated state sequence is shown to be asymptotically unbiased and converges toward the sample quantile in the mean-square sense. Applications on the distributed estimation of trimmed mean; computation of median, maximum, or minimum values; and identification of outliers through simulation are also provided.

A Comparison Of Efece Systems With Tension Band Wiring For Patella Fracture Fixation In Cadavers

Background: EFECE Systems are newly-defined internal fixation systems, which are suitable for patella fracture fixation. The aim of this study was to compare the fixation strength of EFECE Systems with tension band wiring for transverse patellar fracture simulation on fresh frozen cadaver models. Methods: Quadriceps tendon-patella-patellar tendon (QT-P-PT) complex was prepared from human cadavers. After simulation of a transverse patella fracture, in Group 1, 5 patella were fixed with a pair of 1.2 mm EFECE wires and 4 EFECE devices. In Group 2, 5 patella were fixed with a pair of 1.2 mm Kirschner wires (K-wire) and a cerclage wire according to the tension band technique.Using a testing device with custom-made jaws, increasing distraction force was applied to these QT-P-PT complexes. Extension of these complexes with the distraction forces was observed. The maximum distraction force and the elongation during maximum force were evaluated. Results: After 5 experiments with the EFECE Systems, there was no EFECE wire breakage or EFECE wire-EFECE device catching failure. The median maximum force was 740 N (720-810N). During maximum distraction force the median extension was 2.5 mm (1.6-2.5 mm).After 5 experiments with the tension band technique, there was no K-wire breakage. The median maximum force was 330 N (240-510N). During this maximum distraction force the median extension was 3.4 mm (2.2-3.8 mm).Conclusions: Based on the biomechanical advantages, patella fracture treatment with EFECE systems may constitute a reasonable alternative in the treatment of patella fractures.