Females and Housing First: An analysis of 18-month outcomes in a randomized controlled trial.

The main objective of this research was to qualitatively examine the impacts of Housing First (HF) specifically on those participants who identified themselves as female in response to question asking what their gender was. The data analyzed are from a larger, muti-site, randomized controlled trial. χ2 analysis was used to compare the life changes (coded as positive, neutral, or negative) experienced by 64 females (42 HF and 22 TAU). An in-depth qualitative analysis was conducted on 45 of these participants (23 HF and 22 TAU). Significantly more female HF participants reported making positive life changes from baseline to 18-month than those in TAU. Relative to females in TAU, female HF participants reported a number of specific positive changes, including enhanced safety, improved recovery in mental illness, greater reductions in drug use, and individual changes. The implications of findings for strengthening HF programs to meet the unique needs of female participants are discussed.

Association Between Diabetes and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis of Observational Studies.

PURPOSE: Metabolic diseases such as diabetes mellitus may play a role in the development and progression of prostate cancer (PC); however, this association remains to be explored in the context of specific PC stages. The objective of this study was to systematically review the evidence for an association between diabetes and overall, early, or advanced PC risk. MATERIALS AND METHODS: A systematic review with meta-analysis was performed (MEDLINE, EMBASE, and CINAHL) from inception until September 2023. Cohort and case-control studies that assessed PC risk in adult males (≥18 years) associated with type 2 diabetes mellitus or diabetes (if there was no distinction between diabetes type) were included. The Newcastle-Ottawa Scale (NOS) was used to assess study bias; those with NOS<7 were excluded. Evidence certainty was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method. RESULTS: Thirty-four studies (n=26 cohorts and n=8 case-controls) were included. Of these, 32 assessed diabetes and all PC stages combined, 12 included early PC stages, and 15 included advanced PC stages. Our meta-analysis showed diabetes had a protective effect against early PC development (n=11, risk ratio [RR]=0.71; 95% confidence interval [CI]=0.61-0.83, I²=84%) but no association was found for combined (n=21, RR=0.95; 95% CI=0.79-1.13, I²=99%) or advanced PC stages (n=15, RR=0.96; 95% CI=0.77-1.18, I²=98%) at diagnosis. According to GRADE, the evidence certainty was very low. CONCLUSIONS: Diabetes may be protective against early PC stages, yet evidence linking diabetes to risk across all stages, and advanced PC specifically, is less conclusive. High heterogeneity may partially explain discrepancy in findings and was mostly associated with study design, method used for PC diagnosis, and risk measures. Our results may aid risk stratification of males with diabetes and inform new approaches for PC screening in this group, especially considering the reduced sensitivity of prostate-specific antigen values for those with diabetes.

The use of accelerometers to improve estimation of the thermic effect of food in whole room calorimetry studies.

We tested whether spontaneous physical activity (SPA) from accelerometers could be used in a whole room calorimeter to estimate thermic effect of food (TEF). Eleven healthy participants (n = 7 females; age: 27 ± 4 yr; body mass index: 22.8 ± 2.6 kg/m2) completed two 23-h visits in randomized order: one "fed" with meals provided and one "fasted" with no food. SPA was measured by ActivPAL and Actigraph accelerometers. Criterion TEF was calculated as the difference in total daily energy expenditure (TDEE) between fed and fasted visits and compared with three methods of estimating TEF: 1) SPA-adjusted TEF (adjTEF)-difference in TDEE without SPA between visits, 2) Wakeful TEF-difference in energy expenditure obtained from linear regression and basal metabolic rate during waking hours, 3) 24-h TEF-increase in TDEE above SPA and sleeping metabolic rate. Criterion TEF was 9.4 ± 4.5% of TDEE. AdjTEF (difference in estimated vs. criterion TEF: activPAL: -0.3 ± 3.3%; Actigraph: -1.8 ± 8.0%) and wakeful TEF (activPAL: -0.9 ± 6.1%; Actigraph: -2.8 ± 7.6%) derived from both accelerometers did not differ from criterion TEF (all P > 0.05). ActivPAL-derived 24-h TEF overestimated TEF (6.8 ± 5.4%, P = 0.002), whereas Actigraph-derived 24-h TEF was not significantly different (4.3 ± 9.4%, P = 0.156). TEF estimations using activPAL tended to show better individual-level agreement (i.e., smaller coefficients of variation). Both accelerometers can be used to estimate TEF in a whole room calorimeter; wakeful TEF using activPAL is the most viable option given strong group-level accuracy and reasonable individual agreement.NEW & NOTEWORTHY Two research-grade accelerometers can effectively estimate spontaneous physical activity and improve the estimation of thermic effect of food (TEF) in whole room calorimeters. The activPAL demonstrates strong group-level accuracy and reasonable individual-level agreement in estimating wakeful TEF, whereas a hip-worn Actigraph is an acceptable approach for estimating 24-h TEF. These results highlight the promising potential of accelerometers in advancing energy balance research by improving the assessment of TEF within whole room calorimeters.

The 24-hour food frequency assessment screening tool (FAST24): Development and evaluation of a novel dietary screener to identify foods associated with weight change.

BACKGROUND & AIMS: Brief screening questionnaires can identify 'at risk' behaviors in clinical settings. However, there is currently no screener for dietary intake specifically developed using foods associated with body weight change and increased risk for multiple chronic conditions and diseases. METHODS: We developed a novel brief dietary screener, the 24-Hour Food Frequency Assessment Screening Tool Questionnaire (FAST24), to identify intake of foods associated with weight change. University students completed the FAST24 and the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) at two time points to assess acceptability and determine preliminary criterion validity against food categories from the United States Department of Agriculture (USDA) Food Patterns Equivalents Database (FPED). RESULTS: 202 individuals (age 20.4 ± 3.6 years; 65.7% females) completed the FAST24 in an average time of 2 min compared to 24 min for the ASA24. Over half of the food items from the FAST24 were matched to, and correlated with, standard USDA food pattern components (r's ranging from .15 to .58, p's < .05). Food items from the dietary data from the FAST24 were also highly correlated with the more intensive ASA24 application (r's ranging from .23 to .82, p's < .01), and were less time-consuming and burdensome to complete (p's < .0001). CONCLUSIONS: Findings support the continued refinement of the FAST24 as a rapid, valid primary care assessment tool for measuring USDA dietary intake patterns. Use of a short, simple screener such as the FAST24 has the potential for integration into large healthcare delivery settings to help establish a baseline for promoting relative behavior changes critical for long-term health and well-being.

The Effects of an Acute Bout of Aerobic or Resistance Exercise on Nonexercise Physical Activity.

Introduction/Purpose: A reduction in nonexercise physical activity (NEPA) after exercise may reduce the effectiveness of exercise interventions on weight loss in adults with overweight or obesity. Aerobic exercise (AEx) and resistance exercise (REx) may have different effects on NEPA. The purpose of this secondary analysis was to examine the effect of a single bout of AEx or REx on NEPA and sedentary behavior in inactive adults with overweight or obesity. Methods: Adults with overweight or obesity (n = 24; 50% male; age, 34.5 ± 1.5 yr; body mass index, 28.5 ± 0.9 kg·m-2) not meeting current physical activity guidelines completed a single 45-min bout of AEx, REx, or a sedentary control on different days in random order. After each condition, participants' NEPA was recorded for 84 h by accelerometer. Time spent sedentary and in light, moderate, and vigorous physical activity; steps; metabolic equivalent of task (MET)-hours; and sit-to-stand transitions were calculated using activity count data. Results: No differences were observed in the percent of waking time spent sedentary and in light, moderate, and vigorous activity between conditions (P > 0.05). No differences were observed in steps, MET-hours, or sit-to-stand transitions between conditions (P > 0.05). NEPA responses were variable among individuals, with approximately half of participants reducing and half increasing NEPA over the 84 h after each exercise condition. Conclusion: NEPA was not reduced after an acute bout of AEx or REx in a sample of inactive adults with overweight or obesity.

Trends in Diet and Cancer Research: A Bibliometric and Visualization Analysis.

Diet plays a critical role for patients across the cancer continuum. The World Cancer Research Fund International and the American Cancer Society have published evidence supporting the role of nutrition in cancer prevention. We conducted an analysis of the literature on dietary nutrients and cancer to uncover opportunities for future research. The objective of the bibliometric analysis was to describe trends in peer-reviewed publications on dietary components and cancer and to highlight research gaps. PubMed was queried for manuscripts with diet- and cancer-related keywords and Medical Subject Headings (MeSH) terms. Metadata covering 99,784 publications from 6469 journals were analyzed to identify trends since 1970 on diet topics across 19 tumor types. Publications focused largely on breast, colorectal, and liver cancer, with fewer papers linking diet with other cancers such as brain, gallbladder, or ovarian. With respect to "unhealthy" diets, many publications focused on high-fat diets and alcohol consumption. The largest numbers of publications related to "healthy" diets examined the Mediterranean diet and the consumption of fruits and vegetables. These findings highlight the need for additional research focused on under-investigated cancers and dietary components, as well as dietary studies during cancer therapy and post-therapy, which may help to prolong survivorship.

Total energy expenditure assessed by 24-h whole-room indirect calorimeter in patients with colorectal cancer: baseline findings from the PRIMe study.

BACKGROUND: Total energy expenditure (TEE) determines energy requirements, but objective data in patients with cancer are limited. OBJECTIVES: We aimed to characterize TEE, investigate its predictors, and compare TEE with cancer-specific predicted energy requirements. METHODS: This cross-sectional analysis included patients with stages II-IV colorectal cancer from the Protein Recommendation to Increase Muscle (PRIMe) trial. TEE was assessed by 24-h stay in a whole-room indirect calorimeter before dietary intervention and compared with cancer-specific predicted energy requirements (25-30 kcal/kg). Generalized linear models, paired-samples t tests, and Pearson correlation were applied. RESULTS: Thirty-one patients (56 ± 10 y; body mass index [BMI]: 27.9 ± 5.5 kg/m2; 68% male) were included. Absolute TEE was higher in males (mean difference: 391 kcal/d; 95% CI: 167, 616 kcal/d; P < 0.001), patients with colon cancer (mean difference: 279 kcal/d; 95% CI: 73, 485 kcal/d; P = 0.010), and patients with obesity (mean difference: 393 kcal/d; 95% CI: 182, 604 kcal/d; P < 0.001). Appendicular lean soft tissue (ß: 46.72; 95% CI: 34.27, 59.17; P < 0.001) and tumor location (colon-ß: 139.69; 95% CI: 19.44, 259.95; P = 0.023) independently predicted TEE when adjusted for sex. Error between measured TEE and energy requirements predicted by 25 kcal/kg (mean difference: 241 kcal/d; 95% CI: 76, 405 kcal/d; P = 0.010) or 30 kcal/kg (mean difference: 367 kcal/d; 95% CI: 163, 571 kcal/d; P < 0.001) was higher for patients with obesity, and proportional error was observed (25 kcal/kg: r = -0.587; P < 0.001; and 30 kcal/kg: r = -0.751; P < 0.001). TEE (mean difference: 25 kcal/kg; 95% CI: 24, 27 kcal/kg) was below predicted requirements using 30 kcal/kg (-430 ± 322 kcal/d; P < 0.001). CONCLUSIONS: This is the largest study to assess TEE of patients with cancer using whole-room indirect calorimeter and highlights the need for improved assessment of energy requirements in this population. Energy requirements predicted using 30 kcal/kg overestimated TEE by 1.44 times in a controlled sedentary environment and TEE was outside of the predicted requirement range for most. Special considerations are warranted when determining TEE of patients with colorectal cancer, such as BMI, body composition, and tumor location. This is a baseline cross-sectional analysis from a clinical trial registered at clinicaltrials.gov as NCT02788955 (https://clinicaltrials.gov/ct2/show/NCT02788955).

Pharmacokinetics of cancer therapeutics and energy balance: the role of diet intake, energy expenditure, and body composition.

Energy balance accounts for an individual's energy intake, expenditure, and storage. Each aspect of energy balance has implications for the pharmacokinetics of cancer treatments and may impact an individual's drug exposure and subsequently its tolerance and efficacy. However, the integrated effects of diet, physical activity, and body composition on drug absorption, metabolism, distribution, and excretion are not yet fully understood. This review examines the existing literature on energy balance, specifically the role of dietary intake and nutritional status, physical activity and energy expenditure, and body composition on the pharmacokinetics of cancer therapeutics. As energy balance and pharmacokinetic factors can be influenced by age-related states of metabolism and comorbidities, this review also explores the age-related impact of body composition and physiologic changes on pharmacokinetics among pediatric and older adult populations with cancer.

Pre-hospital emergency cricothyrotomy in dogs part 2: Airway sealing and ventilation using cricothyrotomy tubes.

Cricothyrotomy (CTT) has been recommended for use in the pre-hospital setting for military working dogs and Operational K9s during airway emergencies. Although the CTT can establish a patent airway for spontaneous ventilation, the ability to seal the airway and provide positive pressure ventilation (PPV) using tubes designed for humans has not been determined. Using various CTT tubes placed in cadaver dog airways, this study aimed to determine: (1) Whether the tube cuff could create a functional airway seal with safe intra-cuff pressures; (2) The magnitude of delivered tidal volume (TV) loss during a standard breath to assess the possibility of delivering an adequate tidal volume with a bag-valve device (BVM); (3) The best performing tubes for either test; (4) The reasons behind the findings using observations from upper airway endoscopy, dissection, and measurements. Cadaver dogs of similar weights to MWD and Operational K9 breeds had various CTT tubes placed including three from commercial kits, a standard endotracheal tube, and a tracheostomy tube. The minimum occlusive volume technique was used to inflate the tube cuff and a pressure ≤ 48 cm H2O with an adequate seal was considered successful. Individual TVs were calculated for each dog and added to the volume lost during delivery of a standard breath from an ICU ventilator. Endoscopy and airway dissection were performed to assess the relationship between tubes cuffs and the airway. The tubes from the CTT kits performed poorly with regards to producing an airway seal with the H&H tube failing to seal the airway all tests. Tracheal dimensions were significantly associated with successful airway sealing (P = 0.0004). Tidal volume loss could be compensated using a BVM in 34/35 tests with the H&H tube in cadaver 8 the only to fail. Tracheal airway sealing is influenced by airway anatomy when tube cuffs are inflated to a target pressure and larger tubes do not always provide a better seal. The CTT tubes tested have the potential to facilitate ventilation with a BVM under the conditions set in this study. The 8.0 mm endotracheal tube performed the best and the H&H the worst in both tests.

Ability of Anthropometric Measurements to Predict Metabolic Health among Patients in Alberta: A Cross-sectional Study in Primary Care.

Purpose: This study compared anthropometric and body fat percent (BF%) equations in relation to measures of metabolic health.Methods: BF% calculations (Bergman, Fels, and Woolcott) and anthropometric measurements were used to determine obesity among a sample of patients attending primary care in Alberta, Canada. Anthropometric variables included body mass index (BMI), waist circumference, waist:hip ratio, waist:height ratio, and calculated BF%. Metabolic Z-score was computed as the average of the individual Z-scores of triglycerides, total cholesterol, and fasting glucose and the number of standard deviations from the sample mean.Results: Five hundred and fourteen individuals were included (41.2% male, age: 53 ± 16y, BMI: 27.4 ± 5.7 kg/m2). BMI ≥ 30 kg/m2 detected the smallest number of participants (n = 137) as having obesity, while Woolcott BF% equation categorized the largest number of participants as having obesity (n = 369). No anthropometric or BF% calculation predicted metabolic Z-score in males (all p ≥ 0.05). In females, age-adjusted waist:height ratio had the highest prediction power (R2 = 0.204, p < 0.001), followed by age-adjusted waist circumference (R2 = 0.200, p < 0.001) and age-adjusted BMI (R2 = 0.178, p < 0.001).Conclusions: This study did not find evidence that BF% equations more strongly predicted metabolic Z-scores than other anthropometric values. In fact, all anthropometric and BF% variables were weakly related to metabolic health parameters, with apparent sex differences.

The effects of resistance exercise on appetite sensations, appetite related hormones and energy intake in hormone receptor-positive breast cancer survivors.

Appetite is a determinant of dietary intake and is impacted by sex hormones, exercise, and body composition among individuals without chronic conditions. Whether appetite is altered by exercise in the context of estrogen suppression and cancer survivorship is unknown. This randomized cross-over study compared appetite and ad libitum energy intake (EI) after acute resistance exercise (REx) versus sedentary (SED) conditions and in relation to body composition and resting metabolic rate (RMR) in breast cancer survivors (BCS). Physically inactive premenopausal females with previous stage I-III estrogen receptor-positive breast cancer completed a single bout of REx or SED 35 minutes after a standardized breakfast meal. Appetite visual analog scales and hormones (total ghrelin and peptide-YY [PYY]) were measured before and 30, 90, 120, 150, and 180 minutes post-meal and expressed as area under the curve (AUC). Participants were offered a buffet-type meal 180 minutes after breakfast to assess ad libitum EI. Body composition (dual X-ray absorptiometry) and RMR (indirect calorimetry) were measured during a separate visit. Sixteen BCS were included (age: 46 ± 2 y, BMI: 24.9 ± 1.0 kg/m2). There were no differences in appetite ratings or EI between conditions. There were no differences in appetite hormone AUC, but REx resulted in lower ghrelin 120 (-85 ± 39 pg/mL, p = 0.031) and 180 (-114 ± 43 pg/mL, p = 0.018) minutes post-breakfast and higher PYY 90 (21 ± 10 pg/mL, p = 0.028) and 120 (14 ± 7 pg/mL, p = 0.041) minutes post-breakfast. Fat-free mass and RMR negatively correlated with hunger and prospective food consumption AUC after SED, but not REx. In sum, a single REx bout temporarily reduces orexigenic and increases anorexic appetite hormones, but not acute subjective appetite sensations or EI.

Appetitive and Metabolic Responses to an Exercise versus Dietary Intervention in Adults with Obesity.

Introduction/Purpose: Dietary restriction (DIET) and aerobic exercise (AEX) interventions may impact energy balance differently. Our aim was to describe the effects of weight loss interventions via DIET or AEX on measures of energy balance. Methods: Adults with overweight or obesity were randomized to 12 weeks of DIET or AEX with similar calorie deficit goals. A study day was conducted before and after the intervention to assess subjective and hormonal (ghrelin, peptide-YY, glucagon-like peptide-1) appetite responses to a control meal, ad libitum energy intake (EI) at a single meal, and over three days of free-living conditions and eating behavior traits. Resting metabolic rate (RMR) was measured with indirect calorimetry and adjusted for body composition measured by dual X-ray absorptiometry. Non-exercise activity was measured using accelerometers. Results: Forty-four individuals were included (age: 37 ± 9 years, body mass index: 30.6 ± 3.1 kg/m2). Both interventions resulted in weight and fat mass loss. The DIET group lost fat-free mass, although differences between groups were not significant (DIET: -1.2 ± 1.7 kg, p<0.001; AEX: 0.4 ± 1.5 kg, p=0.186; p=0.095 interaction). There were no differences in RMR after body composition adjustment. Both interventions were associated with an increase in dietary restraint (DIET: 4.9 ± 1.2, AEX: 2.8 ± 0.7; p<0.001 in both groups). Hunger decreased with DIET (-1.4 ± 0.5, p=0.003), and disinhibition decreased with AEX (-1.5 ± 0.5, p<0.001), although these changes were not different between groups (i.e., no group × time interaction). No other differences in appetite, EI, or non-exercise physical activity were observed within or between groups. Conclusions: AEX did not result in compensatory alterations in appetite, ad libitum EI, or physical activity, despite assumed increased energy expenditure. Modest evidence also suggested that disinhibition and hunger may be differentially impacted by weight loss modality.

Antimicrobials in dog-to-dog bite wounds: A retrospective study of 1526 dog bite events (1999-2019).

BACKGROUND: Although dog-to-dog bite wounds (DBW) are common, few studies worldwide have evaluated antimicrobial usage patterns or appropriateness of use. OBJECTIVES: Report frequency and results of DBW cultures, including antimicrobial susceptibility patterns. Determine the most commonly prescribed antimicrobials and their appropriateness for the treatment of DBW, and if antimicrobial importance is associated with wound severity, clinic type or year. ANIMALS: One thousand five hundred twenty-six dog bite events involving 1436 dogs presenting with DBW from 3 Australian university clinics from 1999 to 2019. METHODS: Retrospective study. Medical records were reviewed for presenting signs, culture and susceptibility testing, antimicrobial treatment, and outcome. A partial proportional odds model was used to determine if use of higher importance antimicrobials was associated with wound severity, clinic, or year. RESULTS: Antimicrobials were prescribed in 88.1% (1344/1526) of DBW. Amoxicillin-clavulanic acid was prescribed in 73.4% (1121/1526) of dogs, followed by first-generation cephalosporins, 18.1% (277/1526). Of a total of 1647 antimicrobial prescriptions, underdosing occurred in 13.4% for AMC (220/1647) and 26.1% (81/310) of dogs prescribed first generation cephalosporins. There was an association between the increased use of high-importance antimicrobials and wound severity (P < .001), antimicrobial polytherapy (P < .001) and year (P < .001). The odds of the clinic with specialists prescribing high-importance antimicrobials compared to those of medium importance for DBW was 82% less than that of a semi-rural, mixed and general practice. Culture and susceptibility (C&S) testing was performed in 1.8% of dogs. CONCLUSION AND CLINICAL IMPORTANCE: Empirical use of amoxicillin-clavulanic acid was common for DBW. Increasing wound severity was associated with greater use of high-importance antimicrobials. While C&S testing was rarely performed, routine susceptibility profiles are recommended to optimize antimicrobial stewardship.

Dietary choices after a cancer diagnosis: A narrative review.

Individuals with cancer may be motivated to make lifestyle changes and informed dietary choices, but are exposed to conflicting and erroneous nutrition information, particularly from online and social media sources. Changes to dietary choices that stem from a diagnosis of cancer are not fully understood. Thus, we conducted a narrative review to summarize the literature focused on dietary choices after a cancer diagnosis, and highlighted influential factors. Postdiagnosis dietary changes have been studied primarily in female patients with breast cancer in European countries. Reported changes typically included decreased red and processed meat intake and increased consumption of fruits and vegetables. These changes align with the recommendations for cancer prevention but were implemented after diagnosis, and may not meet nutrition guidelines for patients with cancer. Age and time since diagnosis were among the influential factors that affected these postdiagnosis changes. Data on dietary changes implemented after a diagnosis of varying cancer types in the North American population are lacking, and would provide practitioners with an enhanced understanding of patient information needs and reasons for dietary choices.

Effect of leukoreduction on inflammation in critically ill dogs receiving red blood cell transfusions: A randomized blinded controlled clinical trial.

BACKGROUND: Prestorage leukoreduction of red blood cell (RBC) bags prevents accumulation of pro-inflammatory mediators and experimentally attenuates post-transfusion inflammation in healthy dogs. However, the effect of leukoreduction on post-transfusion inflammation in critically ill dogs is unclear. HYPOTHESIS: Dogs transfused with leukoreduced (LR) RBC will have lower concentrations of leukocytes, interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP) within 24 hours of post-transfusion compared to dogs transfused with nonleukoreduced (NLR) RBC. ANIMALS: Sixty-one RBC-transfused dogs (LR = 34, NLR = 27). METHODS: Randomized, blinded, controlled preliminary clinical trial. Blood bag processing was randomized to create identically appearing LR and NLR bags. Group allocation occurred with transfusion of the oldest compatible RBC bag. Blood samples were collected pretransfusion and at 8 and 24 hours post-transfusion for leukocyte count, IL-6, IL-8, MCP-1, and CRP. Data were analyzed on an intention-to-treat basis using linear mixed effects models. Significance was set at P < .05. RESULTS: No significant differences were found between groups in concentrations of leukocytes (P = .93), IL-6 (P = .99), IL-8 (P = .75), MCP-1 (P = .69), or CRP (P = .18) over time. Eleven LR dogs (32%) and 4 NLR dogs (15%) were euthanized in the hospital (P = .14). No natural deaths occurred. CONCLUSIONS AND CLINICAL IMPORTANCE: No differences in inflammation biomarker concentrations were detected over time between dogs transfused with LR or NLR RBC, but heterogeneity likely hampered the ability to detect a difference with this sample size. The novel randomization and enrollment protocol was successfully implemented across 2 participating institutions and will be easily scaled up for a future multicenter clinical trial.

The impact of yoga on components of energy balance in adults with overweight or obesity: A systematic review.

Background: Yoga may reduce body weight in individuals with overweight or obesity, but whether this occurs through decreased energy intake (EI) or increased energy expenditure (EE)/physical activity (PA) is unclear. Methods: A systematic search of PubMed, Web of Science, Embase, and PsychINFO was conducted from inception until April 26, 2021. Eligible studies included randomized controlled trials or single-arm pre-post studies with any type and duration of yoga intervention in adults with overweight or obesity. Studies with measures related to EI , EE, or PA were eligible. The review initially identified 1,373 articles. Results: Of the 10 included studies, one used indirect calorimeter measures of resting EE, while nine used self-reported measures of EI and PA. Of the seven studies measuring parameters related to EI, only one found greater decreases in EI relative to the control group, although three other investigations reported trends toward improved dietary intake. Of the eight studies measuring PA, two reported greater increases in resting EE or PA in the yoga group relative to the control group. Two reported significant within-group increases in PA from pre-post intervention, and four studies reported a trend for increased PA with no p-values reported. Conclusions: Limited evidence suggests yoga may reduce EI and increase PA in adults with overweight or obesity. Additional studies that investigate the effects of yoga interventions on energy balance parameters using objective techniques are warranted.

A Proposed Guideline for Performance of Emergency Surgical Airways in Small Animals: Analysis of Five Unsuccessfully Managed Cannot Intubate, Cannot Oxygenate Cases.

Objective-To describe three dogs and two cats diagnosed with a cannot intubate, cannot oxygenate (CICO) condition, and discuss the appropriateness and timing of emergency front-of-neck airway access (eFONA). The authors aim to increase awareness of CICO events and effective management strategies, which may result in faster airway access and improve patient outcomes. Case series summary-Three dogs and two cats could not be easily intubated resulting in the inability to deliver oxygen and contributing to their death. Emergency front-of-neck airway access was attempted in three cases, it could not be performed in one when indicated, and it was not considered in managing another. Conclusions-This is the first report of small animals suffering CICO emergencies and tracheostomy attempts without a concurrently secured airway. Cannot intubate, cannot oxygenate events and eFONA attempts were managed sub-optimally in all cases, which likely contributed to the poor outcomes. Rapid diagnosis of CICO and early eFONA using appropriate techniques has the potential to improve the management of difficult airways in small animals.

Effect of Morning and Evening Exercise on Energy Balance: A Pilot Study.

The purpose of this study was to evaluate the feasibility and acceptability of randomizing adults with overweight and obesity (BMI 25-40 kg/m2) to morning (06:00-10:00) or evening (15:00-19:00) aerobic exercise. Participants completed four exercise sessions per week in the morning (AM, n = 18) or evening (PM, n = 15). The exercise program was 15 weeks and progressed from 70 to 80% heart rate maximum and 750-2000 kcal/week. Bodyweight, body composition, total daily energy expenditure (TDEE), energy intake (EI), sleep, sedentary behavior (SB), non-exercise physical activity (NEPA), and maximal aerobic capacity were assessed at baseline and week 15. Study retention was 94% and adherence to the supervised exercise program was ≥90% in both groups. Weight change was -0.9 ± 2.8 kg and -1.4 ± 2.3 kg in AM and PM, respectively. AM and PM increased TDEE (AM: 222 ± 399 kcal/day, PM: 90 ± 150 kcal/day). EI increased in AM (99 ± 198 kcal/day) and decreased in PM (-21 ± 156 kcal/day) across the intervention. It is feasible to randomize adults with overweight and obesity to morning or evening aerobic exercise with high levels of adherence. Future trials are needed to understand how the timing of exercise affects energy balance and body weight regulation.

A VetCompass Australia Study of Antimicrobial Use in Dog-to-Dog Bite Wounds (1998-2018).

Although dog-to-dog bite wounds (DBW) are a common presentation to veterinary clinics, antimicrobial prescribing habits of Australian clinics have not been reported. This study determined the frequency and results of DBW cultures; antimicrobial selection; and importance class of antimicrobials prescribed relative to wound severity, geographic location, or year. A systematic sample of 72,507 patient records was retrieved from the VetCompass Australia database. Records for 1713 dog bite events involving 1655 dogs were reviewed for presenting signs, results of culture and susceptibility testing (C&S), antimicrobial treatment, geographical location, and outcome. A crossed random effects multivariable logistic regression model was used to determine if antimicrobial importance was associated with wound severity, year, and location, and to assess the differences in antimicrobial prescription between geographical locations, clinics, and veterinarians. Antimicrobials were prescribed in 86.1% of DBW. Amoxicillin-clavulanic acid was prescribed in 70% (1202/1713) with underdosing in 15.8% (191/1202). High-importance antimicrobial use was associated with wound severity (p < 0.001), year category (p = 0.007), and surgery (p = 0.03). C&S testing was recorded as having been performed in only one case. Differences in individual veterinarian prescribing habits were stronger than the clinic culture, suggesting that education utilizing clinic-wide antimicrobial guidelines may aid in improving antimicrobial stewardship.

Acute cerebral compression caused by an epidural hematoma associated with cryptococcosis in a dog.

OBJECTIVE: To describe acute cerebral compression caused by an epidural hematoma (EDH) in a dog with cryptococcal infection. CASE SUMMARY: An 18-month-old neutered male Neapolitan Mastiff was found comatose with no preceding clinical signs apart from a mild forelimb lameness. A CT scan of the head revealed a lesion within the right caudal nasal cavity that traversed the cribriform plate in addition to a right epidural lesion resulting in compression of the right cerebrum. Assessment of brain death was made based on the presence of coma, apnea, and absence of brain stem reflexes and included assessment of the vestibulo-ocular reflex. Postmortem identified a large EDH causing marked compression of the right frontal lobe. A nasal biopsy cultured Cryptococcus gattii. NEW OR UNIQUE INFORMATION PROVIDED: EDH formation in a dog secondary to cryptococcosis has not been previously reported. This is also the first time a caloric vestibulo-ocular reflex assessment has been reported in a dog.