Long-Term Follow-up of a Randomized Controlled Trial Evaluating a Mobile Health Intervention for Self-Management in Lung Transplant Recipients.

Mobile health interventions may help transplant recipients follow their complex medical regimens. Pocket Personal Assistant for Tracking Health (Pocket PATH) is one such intervention tailored for lung transplant recipients. A randomized controlled trial showed Pocket PATH's superiority to usual care for promoting the self-management behaviors of adherence, self-monitoring and communication with clinicians during posttransplant year 1. Its long-term impact was unknown. In this study, we examined associations between Pocket PATH exposure during year 1 and longer term clinical outcomes-mortality and bronchiolitis obliterans syndrome (BOS)-among 182 recipients who survived the original trial. Cox regression assessed whether (a) original group assignment and (b) performance of self-management behaviors during year 1 predicted time to outcomes. Median follow-up was 5.7 years after transplant (range 4.2-7.2 years). Pocket PATH exposure had no direct effect on outcomes (p-values >0.05). Self-monitoring was associated with reduced mortality risk (hazard ratio [HR] 0.45; 95% confidence interval [CI] 0.22-0.91; p = 0.027), and reporting abnormal health indicators to clinicians was associated with reduced risks of mortality (HR 0.15; 95% CI 0.04-0.65; p = 0.011) and BOS (HR 0.27; 95% CI 0.08-0.86; p = 0.026), regardless of intervention group assignment. Although Pocket PATH did not have a direct impact on long-term outcomes, early improvements in self-management facilitated by Pocket PATH may be associated with long-term clinical benefit.

Genetic parameters for the prevalence of osteochondrosis in the limb joints of South German Coldblood horses.

Heritabilities were estimated for osteochondrosis (OC) in fetlock and hock joints and palmar/plantar osseous fragments in fetlock joints of South German Coldblood (SGC) horses using Residual Maximum Likelihood (REML) under a linear animal model. The analyses were based on the results of a standardized radiographic examination of 167 SGC horses with a mean age of 14 months. The heritabilities linearly estimated and transformed onto the liability scale were for OC in fetlock joints 0.16 and for OC in hock joints 0.04. Considering fetlock and hock OC together, results in a heritability of 0.17. Palmar/plantar osseus fragments of the fetlock joints showed a heritability of 0.48. We concluded that there is most likely a genetic component in the variation of the development of osteochondrosis in fetlock and hock joints as well as for palmar/plantar osseus fragments of fetlock joints of the investigated population of SGC horses.

Mapping quantitative trait loci for osteochondrosis in fetlock and hock joints and palmar/plantar osseus fragments in fetlock joints of South German Coldblood horses.

The aim of this study was to identify quantitative trait loci (QTL) for osteochondrosis (OC) and palmar/plantar osseous fragments (POF) in fetlock joints in a whole-genome scan of 219 South German Coldblood horses. Symptoms of OC and POF were checked by radiography in 117 South German Coldblood horses at a mean age of 17 months. The radiographic examination comprised the fetlock and hock joints of all limbs. The genome scan included 157 polymorphic microsatellite markers. All microsatellite markers were equally spaced over the 31 autosomes and the X chromosome, with an average distance of 17.7 cM and a mean polymorphism information content (PIC) of 63%. Sixteen chromosomes harbouring putative QTL regions were further investigated by genotyping the animals with 93 additional markers. QTL that had chromosome-wide significance by non-parametric Z-means and LOD scores were found on 10 chromosomes. This included seven QTL for fetlock OC and one QTL on ECA18 associated with hock OC and fetlock OC. Significant QTL for POF in fetlock joints were located on equine chromosomes 1, 4, 8, 12 and 18. This genome scan is an important step towards the identification of genes responsible for OC in horses.

Prevalence of osteochondrosis in the limb joints of South German Coldblood horses.

This study aimed to quantify the factors associated with the prevalence of the radiological signs of osteochondrosis (OC) and osteochondrosis dissecans (OCD) in South German Coldblood (SGC) horses. The prevalence of OC and OCD in fetlock and hock joints was analysed in 167 young coldblood horses with a mean age of 14 months. The presence of at least one osteochondrotic lesion (OC) in fetlock or hock joints was documented for 61.7% of the horses and 26.9% of the horses had osseus fragments. Osteochondrotic findings at the dorsal aspect of the sagittal ridge of the third metacarpal/metatarsal bone were seen in 53.9% of the horses and palmar/plantar osseous fragments in fetlock joints in 16.2% of the horses. Hock joint OC was found in 40.1% of the horses and hock OCD in 0.6%. Osteochondrotic findings in the distal part of the tibia were prevalent in 28.1% and in the lateral trochlea tali in 17.4% of the horses. The sex of the investigated horses significantly influenced the prevalence of OC in fetlock and hock joints, as well as the findings in the distal part of the tibia and lateral trochlea tali. Age at radiological examination was significant for the prevalence of OC in hock joints, palmar/plantar osseous fragments in fetlock joints and osteochondrotic findings in the distal part of the tibia. Female horses showed a 2-fold higher risk for OC in fetlock and hock joints than male horses. The distribution of the affected horses by age classes showed that radiographic signs of OC in fetlock and hock joints significantly increased at an age of about 1 year. We can conclude from our study that fetlock and hock OC is a prevalent radiographic finding in more than 1-year-old female and male SGC horses.

Risk factors for congenital umbilical hernia in German Fleckvieh.

Risk factors for congenital umbilical hernias were investigated in German Fleckvieh calves up for sale at livestock markets. Data from 53,105 calves were collected from 77 livestock auctions in 1996 and 1997. The overall incidence of congenital umbilical hernia was 1.8%. A significant influence on incidence was exerted by the sex of the calf, the occurrence of multiple births, the market place/market date, the sire and the sire line. The proportion of Red Holstein blood in the calf, the dam's lactation number, gestation length, 305 day milk performance and the herd milk level were not significant factors. Herdmate averages for calves differed significantly in their incidence. Heritability estimates on the liability scale for congenital umbilical hernia were about 0.4 and progeny groups of sires at risk for congenital umbilical hernia were in the range 0.1% to 14.2%. The segregation pattern could not be explained either by an autosomal recessive or by an autosomal dominant monogenic model. It seems likely that more than one gene locus is involved in the underlying genetic mechanism. Breeders should be aware of the genetic implications of congenital umbilical hernias.

[Occurrence and economic importance of congenital hernia in German Fleckvich calves]. / Vorkommen und wirtschaftliche Bedeutung des angeborenen Nabelbruchs beim Deutschen Fleckvieh.

The frequency of congenital hernia was investigated in German Fleckvieh calves being driven up for sale on livestock markets for breeding and fattening calves in Miesbach and Traunstein. Data were collected on 77 livestock auctions in the years 1996 and 1997. Altogether 53,105 calves were examined and 1.8% of these calves showed a congenital umbilical hernia. The incidence of umbilical hernia was significantly influenced by the sex of the calf, the occurrence of multiple births, the market place/market date, the sire and the sire line. Red Holstein blood proportion, lactation number, duration of pregnancy and 305 day milk performance were not of significant importance. Herd milk level did not influence the incidence of congenital umbilical hernia, however, herdmate averages for calves differed significantly in their incidence. The average difference of the market price between male calves affected by congenital umbilical hernia and not affected male calves amounted to 75 DM, in female calves, however, only to 38 DM. The risk, that a congenital umbilical hernia is not closing within an age of 15 months, depends on the width of the hernial opening in the newborn calf. An opening of 4 cm and more has only a healing chance of 50% and less. However, negative effects on fattening and carcass traits could be not found. The genetic influence on congenital umbilical hernia was obvious. The analyses indicated that the incidence of congenital umbilical hernia observed could not be explained by one autosomal recessive gene locus, but it seemed much more likely that more than one gene locus is involved or a mixed multifactorial monogenic mode of inheritance may be the underlying genetic mechanism. Breeders should be aware of the implications of congenital hernias and thus, congenital hernia should get more attention in the selection process of young sires.