Cross-sectional study investigating the components and quality of colostrum and colostrum replacement products fed to Ontario dairy goat kids.

Colostrum replacement products for use in goat kids are sourced from bovine colostrum and often used by producers to supplement or replace maternal colostrum to prevent infections. To compare the colostrum replacement products fed on-farm to caprine colostrum a cross-sectional study was undertaken. Ontario dairy goat producers were asked to collect first milking colostrum from their goats and samples of the reconstituted commercial replacement product currently in use. The frozen samples were thawed and submitted for testing of fat, protein and lactose content, IgG1 concentration and aerobic bacterial culture. Compared with caprine colostrum, the reconstituted replacement products were lower in protein (11.7%; P = 0.0007), and fat (4.6%; P < 0.0001) and higher in lactose (5.4%; P < 0.0001) on average. The average IgG1 concentration in goat colostrum (53.5 g/L; range: 16.6-1985.8) was significantly higher than in colostrum replacement products (33.7 g/L; range: 10.7-55.3) (P < 0.0001). The Brix cut-point for good quality goat colostrum (50 g/L) was calculated at 23% (sensitivity = 69.6%, specificity = 88.0%) for goat colostrum and 26% for the colostrum replacement product (sensitivity = 87.5%, specificity = 100%). The average aerobic count for goat colostrum was lower (2.95 log10 cfu/mL) than the colostrum replacement product samples that were cultured (3.85 log10 cfu/mL; P < 0.0001). Further investigation into colostrum replacement products, including on-farm storage of opened powdered product and mixing and storage of reconstituted product, is warranted. Variability in the levels of IgG1, aerobic bacterial growth and fat, protein and lactose content in colostrum replacement products also requires further exploration to determine their effects on kid health.

Impact of the COVID-19 pandemic on the use of an inpatient and community palliative care service.

BACKGROUND: The COVID-19 pandemic disrupted the usual provision of healthcare, changing models of care, clinical loads, service provision and patient behaviour. AIMS: This study assesses the impact of COVID-19 on community and inpatient palliative care service provision. METHODS: A retrospective audit and comparison of service use conducted over two defined periods, before and during the COVID-19 pandemic, 2019-2020. FINDINGS: The community palliative care service had a 9% increase in referrals, with a lower proportion of referrals (2.4%) from subacute/palliative care hospitals during the COVID-19 pandemic. Provision of care during the pandemic included less face-to-face contact with patients (24.1% versus 30.2% before), and markedly more contact with patients via videoconference (2.1% versus 0.1% before the pandemic). CONCLUSION: The community specialist palliative care service was busier during the pandemic period, and experienced a shift in mode of care delivery, while the inpatient unit experienced no difference in service use.

Impact of expected parental death on the health of adolescent and young adult children: A systematic review of the literature.

BACKGROUND: Few studies of health impacts of parental death focus on the developmental stage of adolescence and young adulthood and in particular, expected parental death from terminal illness. AIM: To systematically review the health impact of expected parental death on adolescent and young adult children aged 15-25 years and provide a basis for further research and clinical practice. DESIGN: Systematic review registered on PROSPERO (CRD42017080282). DATA SOURCES: Pubmed, PsycINFO, CINAHL, MEDLINE and Cochrane databases were searched with no restrictions on publication date with the last search in March 2021. Eligible articles included studies of adolescent and young adult children (defined by age range of 15-25 years) exposed to parental death due to terminal illness, and with reported health outcomes (physical, psychological or social). Articles were reviewed using the QualSyst tool. RESULTS: Ten articles met the inclusion criteria. Adolescent and young adult children reported poor family cohesion and communication with associated negative psychological outcomes. They reported distrust in the health care provided to their terminally ill parent, increased psychological distress and risk of unresolved grief, anxiety and self-harm. Some experience was positive with posttraumatic growth identified. CONCLUSIONS: This review specifically analysed the health impact of expected parental death on adolescent and young adult children. It highlights their need for age-appropriate psychosocial support and clear information during parental illness, death and bereavement.

Industrial Relevance of Trichoderma reesei as an Enzyme Producer.

Trichoderma reesei's potential as a rapid and efficient biomass degrader was first recognized in the 1950s when it was isolated from Army textiles during World War II. The microbe secreted cellulases that were degrading cotton-based tents and clothing of service members stationed on the Solomon Islands. In the 1970s, at the time of the first global oil crisis, research interest in T. reesei gained popularity as it was explored as part of the solution to the worlds growing dependence on fossil fuels. Much of this early work focused on classical mutagenesis and selection of hypercellulolytic strains. This early lineage was used as a starting point for both academic research with the goal of understanding secretion and regulation of expression of the complex mixture of enzymes required for cellulosic biomass decay as well as for its development as a host for industrial enzyme production. In 2001, at the onset of the second major oil crisis, the US Department of Energy supported research programs in microbial cellulases to produce ethanol from biomass which led to another surge in the study of T. reesei. This further accelerated the development of molecular biology and recombinant DNA tools in T. reesei. In addition to T. reesei's role in bio-ethanol production, it is used to produce industrial enzymes with a broad range of applications supporting the bio-based economy. To date there are around 243 commercially available enzyme products manufactured by fermentation of microorganisms; 30 of these are made using Trichoderma as a host, 21 of which are recombinant products sold for use in food, feed, and technical applications including textiles and pulp and paper.

Supporting choice: an innovative model of integrated palliative care funded by a private health insurer.

BACKGROUND: The number of Australians dying each year is predicted to double in the next 25 years and there is an urgent need to establish sustainable models for providing high quality end-of-life care. An innovative community care model (Bupa Palliative Care Choices Program or BPCCP) was developed and piloted with the purpose of supporting patients in achieving their choices surrounding end-of-life care. AIMS: This study evaluates whether BPCCP patients were more likely to die in their place of choice compared with patients receiving standard care. Additional aims were evaluating patient and carer satisfaction and insurer cost. METHODS: This prospective, comparative cohort study comprises a clinical chart audit and survey of patient and carer experience. RESULTS: More BPCCP participants preferred to die at home (53% vs 31%). A lower proportion of BPCCP patients died in acute hospitals (10% vs 19%) and more of this cohort died at home (46% vs 26%). In both cohorts, nearly 90% of patients were able to die in their preferred location. Patient and carer satisfaction with the programme was very high in the small cohort who responded to the survey. There was a decrease in average claims spend per patient enrolled in the programme during the first 12-month period of implementation compared with historical claims spend for inpatients only. CONCLUSIONS: This evaluation of an innovative community palliative care intervention indicates that the extra services available to patients support the choice of dying at home and the ability to do so while generating claims cost efficiencies.

Tricodisplasia espinulosa asociada a leucemia linfoblástica aguda en edad pediátrica: revisión de la literatura a propósito de un caso / Trichodysplasia spinulosa associated with acute lymphoblastic leukemia in pediatric age: review of the literature regarding a case

La tricodisplasia espinulosa es una patología viral infrecuente causada por un tipo de poliomavirus, el cual se da siempre en contexto de inmunosupresión. Existen reportes que estiman una seroprevalencia en adultos de 70%, y hasta 90% en inmu-nocomprometidos. El cuadro clínico se caracteriza por pápulas color piel hiperqueratósicas en zonas centro faciales, orejas y tronco, asintomáticas o con prurito escaso. Existen métodos de confirmación diagnóstica como PCR o test de Elisa, que no se encuentran disponibles en Chile. Por lo tanto, en nuestro contexto el estudio histopatológico es fun-damental, dada su accesibilidad y que los hallazgos de la biopsia son característicos. El manejo debe siempre considerar, de ser posible, disminuir la in-munosupresión del paciente. Otras medidas son: extracción manual de las lesiones y aplicación de cidofovir o valganciclovir tópicos

Trichodysplasia spinulosa is an infrequent viral pathology caused by a type of polyomavirus, which always occurs in context of immunosuppression. There are reports that estimate sero-prevalence in adults of 70%, and 90% in immunocompromised. Patients have numerous, mildly pruritic, folliculocentric, flesh-colored to pink papules with central keratinaceous spines. There are methods of diagnostic confirmation such as PCR or Elisa test, not available in Chile. The-refore, in our context the histopathological study is fundamental because biopsy findings are cha-racteristic. Management should always consider, if possible, decrease the immunosuppression of the patient. Other measures consist of manual extraction and cidofovir or topical valganciclovir.

Genome wide transcriptome analysis provides bases on colonic mucosal immune system development affected by colostrum feeding strategies in neonatal calves.

BACKGROUND: Delivery of colostrum within the first several hours after birth is vital for establishing successful passive immunity in neonatal dairy calves. However, it is unclear whether a difference in colostrum feeding strategy can affect the development of the calf gastrointestinal tract. The aim of this study was to evaluate the effect of colostrum feeding time within the first 12 h after birth on the colonic mucosal immune system in neonatal calves using a genome wide transcriptome analysis. RESULTS: RNA sequencing-based transcriptome analysis of colon tissues collected from 27 male Holstein calves which were randomly assigned to one of three colostrum feeding strategies - (immediately after birth (TRT0); 6 h after birth (TRT6); 12 h after birth (TRT12)) - and euthanized at 51 h of age detected 15,935 ± 210, 15,332 ± 415, and 15,539 ± 440 expressed genes in the colon under three treatments, respectively. The core transcriptome of the colon included 12,678 genes, with enriched "cellular process" and "metabolic process" as the top two biological functions with 802 of them being immune function related genes. Principal component analysis of the colon transcriptomes did not display a clear separation by colostrum feeding strategy and differential abundance analyses showed no significant difference in the expression of immune related genes among the treatments. Additionally, a weighted gene co-expression network analysis identified 4 significant (|correlation| > 0.50 and p ≤ 0.05) gene modules consisting of 122 immune related genes, which were positively or negatively correlated with the abundance of Lactobacillus and Faecalibacterium prausnitzii in the colon. CONCLUSION: Transcriptome analysis indicates that the development of the colonic mucosal immune system in neonatal calves may be independent of the timing of initial colostrum meal within 12 h after birth. Our results also provide a molecular understanding of colonic biological function in neonatal calves and extends knowledge on how host gene expression profiles are associated with the abundance of specific bacterial groups in the colon.

Short communication: The effect of heat treatment of bovine colostrum on the concentration of oligosaccharides in colostrum and in the intestine of neonatal male Holstein calves.

The objective of this study was to determine the effect of the heat treatment (HT, 60°C for 60 min) on the concentration of bovine colostrum oligosaccharides (bCO) in pooled bovine colostrum and the intestine of neonatal male Holstein calves after feeding. First-milking colostrum was pooled from both primiparous and multiparous cows, and half of the pooled colostrum was heat-treated at 60°C for 60 min (HC), whereas the other half was not heat-treated and remained fresh (FC). At birth, 32 male Holstein calves were randomly assigned to 1 of 3 treatment groups: (1) control calves that did not receive colostrum for the duration of the experiment and were euthanized at 6 h (NC, n = 4) or 12 h (NC, n = 4), (2) calves fed fresh colostrum (FC) and were euthanized at 6 h (FC, n = 6) or 12 h (FC, n = 6), or (3) calves fed heat-treated colostrum (HC) and euthanized at 6 h (HC, n = 6) or 12 h (HC, n = 6). All calves were fed 2 L of colostrum within 1 h after birth. At dissection, digesta of the distal jejunum, ileum, and colon was collected and analyzed by liquid chromatography-mass spectrometry to determine the concentration of bCO within each intestinal region. The heat-treated colostrum displayed numerically higher concentrations of total bCO (3,511.6 µg/g) when compared with fresh colostrum (1,329.9 µg/g), with 3'-sialyllactose being the most abundant bCO in both fresh and HT colostrum. In contrast, calves fed HT colostrum displayed a lower amount of total bCO in the distal jejunum (221.91 ± 105.3 vs. 611.26 ± 265.1 µg/g), ileum (64.97 ± 48.39 vs. 344.04 ± 216.87 µg/g), and colon (25.60 ± 13.1 vs. 267.04 ± 125.81 µg/g) at 6 h of life when compared with calves fed fresh colostrum. No differences were observed in regard to the concentrations of total bCO in the intestine of FC and HC calves at 12 h of life. It is speculated that lower concentrations of bCO in the gastrointestinal tract of HC calves at 6 h of life could be due to the early establishment of beneficial bacteria, such as Bifidobacterium, in HC calves and their subsequent metabolism of bCO as a carbon source. These findings suggest that the heat treatment of colostrum increases the amount of free bCO, which may serve as prebiotics available to microbiota within the intestine of the neonatal calf.

Assessing the practice of palliative care doctors: what driving advice do they give patients with advanced disease?

BACKGROUND: There is little research and no clear guidelines for clinicians to follow when instructing patients with advanced disease about driving. AIMS: To investigate current practice in providing advice to patients with advanced disease and identify areas of consensus or variation with the Australian driving guidelines. METHODS: An online survey was distributed to Australian members of the Australian and New Zealand Society of Palliative Medicine. Responses were analysed using descriptive statistics. RESULTS: The survey was distributed to 322 Australian and New Zealand Society of Palliative Medicine members and received 92 responses (29% response rate). Most respondents were aware of the driving guidelines (76%) and about half of the respondents had read the driving guidelines (55%). The majority of respondents had been asked to provide advice about driving to their patient or patient's caregiver (91%). Most respondents had asked a patient to stop driving (94%), but only 27% had reported a patient to the Driver Licensing Authority. Only 14% of respondents were in consensus with the guidelines in providing driving advice to a patient with asymptomatic brain metastases. Most doctors (64%) advise patients to refrain temporarily from driving post-short-acting oral morphine, with 4 h (36%) being the most common time period for not driving. CONCLUSIONS: This is the first survey investigating the practice of Australian doctors in assessing fitness to drive of patients with advanced disease. The survey found wide variability in practice and substantial discordance with current driving guidelines.

Single-molecule dynamics of phytochrome-bound fluorophores probed by fluorescence correlation spectroscopy.

Fluorescence correlation spectroscopy (FCS) was used to investigate the hydrodynamic and photophysical properties of PR1 (phytofluor red 1), an intensely red fluorescent biliprotein variant of the truncated cyanobacterial phytochrome 1 (Cph1Delta, which consists of the N-terminal 514 amino acids). Single-molecule diffusion measurements showed that PR1 has excellent fluorescence properties at the single-molecule level, making it an interesting candidate for red fluorescent protein fusions. FCS measurements for probing dimer formation in solution over a range of protein concentrations were enabled by addition of Cph1Delta apoprotein (apoCph1Delta) to nanomolar solutions of PR1. FCS brightness analysis showed that heterodimerization of PR1 with apoCph1Delta altered the chemical environment of the PR1 chromophore to further enhance its fluorescence emission. Fluorescence correlation measurements also revealed interactions between apoCph1Delta and the red fluorescent dyes Cy5.18 and Atto 655 but not Alexa Fluor 660. The concentration dependence of protein:dye complex formation indicated that Atto 655 interacted with, or influenced the formation of, the apoCph1 dimer. These studies presage the utility of phytofluor tags for probing single-molecule dynamics in living cells in which the fluorescence signal can be controlled by the addition of various chromophores that have different structures and photophysical properties, thereby imparting different types of information, such as dimer formation or the presence of open binding faces on a protein.

Multiple roles of a conserved GAF domain tyrosine residue in cyanobacterial and plant phytochromes.

The phytochrome family of red/far-red photoreceptors has been optimized to support photochemical isomerization of a bound bilin chromophore, a process that triggers a conformational change and modulates biochemical output from the surrounding protein scaffold. Recent studies have established that the efficiency of this photochemical process is profoundly altered by mutation of a conserved tyrosine residue (Tyr176) within the bilin-binding GAF domain of the cyanobacterial phytochrome Cph1 [Fischer, A. J., and Lagarias, J. C. (2004) Harnessing phytochrome's glowing potential, Proc. Natl. Acad. Sci. U.S.A. 101, 17334-17339]. Here, we show that the equivalent mutation in plant phytochromes behaves similarly, indicating that the function of this tyrosine in the primary photochemical mechanism is conserved. Saturation mutagenesis of Tyr176 in Cph1 establishes that no other residue can support comparably efficient photoisomerization. The spectroscopic consequences of Tyr176 mutations also reveal that Tyr176 regulates the conversion of the porphyrin-like conformation of the bilin precursor to a more extended conformation. The porphyrin-binding ability of the Tyr176Arg mutant protein indicates that Tyr176 also regulates the ligand-binding specificity of apophytochrome. On the basis of the hydrogen-bonding ability of Tyr176 substitutions that support the nonphotochemical C15-Z,syn to C15-Z,anti interconversion, we propose that Tyr176 orients the carboxyl side chain of a conserved acidic residue to stabilize protonation of the bilin chromophore. A homology model of the GAF domain of Cph1 predicts a C5-Z,syn, C10-Z,syn, C15-Z,anti configuration for the chromophore and implicates Glu189 as the proposed acidic residue stabilizing the extended conformation, an interpretation consistent with site-directed mutagenesis of this conserved acidic residue.

Harnessing phytochrome's glowing potential.

Directed evolution of a cyanobacterial phytochrome was undertaken to elucidate the structural basis of its light sensory activity by remodeling the chemical environment of its linear tetrapyrrole prosthetic group. In addition to identifying a small region of the apoprotein critical for maintaining phytochrome's native spectroscopic properties, our studies revealed a tyrosine-to-histidine mutation that transformed phytochrome into an intensely red fluorescent biliprotein. This tyrosine is conserved in all members of the phytochrome superfamily, implicating direct participation in the primary photoprocess of phytochromes. Fluorescent phytochrome mutants also hold great promise to expand the present repertoire of genetically encoded fluorescent proteins into the near infrared.