A large population study to assess the magnitude of prenatal programming in dairy cattle

The performance of an adult dairy cow may be influenced by events that occur before her birth. The present study investigated potential effects of 2 prenatal groups of factors, Assisted Reproductive Techniques (ART) and maternal characteristics (e.g., dam parity), on offspring performance during their first lactation, in populations of 2 dairy cow breeds: French Holstein and Montbéliarde. The different ART studied included the type of semen (conventional or X-sorted) used for Artificial Insemination (AI) and the technology of conception used (AI, embryo transfer, or in vitro fertilization). Three maternal characteristics were considered: (1) the dam age at first calving, (2) dam parity number, and (3) indicators of dam udder health during gestation (somatic cell score and events of clinical mastitis). First, we investigated whether heifer survival from 3d to 18 mo old was associated with any of the prenatal factors considered. We then estimated the associations of these prenatal factors with 8 traits of commercial interest: (1) stature, (2-4) milk, fat, and protein yields, (5) somatic cell score, (6) clinical mastitis, and (7-8) heifer and cow conception rate, all measured on genotyped cows. Linear models were used for this study with the prenatal factors as covariates in the model, and for the 8 traits, phenotypes were adjusted for their corresponding genomic estimated breeding value. The results indicated that the survival rate of heifers born from embryo transfer was significantly higher than that of heifers born from AI (probably due to preferential management practices), while the other prenatal factors did not explain differences in heifer survival. Among the Montbéliarde cows born from AI, those born from X-sorted semen showed a lightly but significantly lower milk yield than those born without X-sorting of the semen (-52 kg of milk in the first lactation). Among the Holstein cows, those born from embryo transfer presented significantly lower milk performance than cows born from AI. Regarding the maternal characteristics, none or very weak associations were found between the dam age at first calving and the offspring performance in both breeds. Dam parity, on the other hand, was associated with offspring performance for milk, fat, and protein yield in both breeds, however not in the same direction. In the Holstein breed, an increase in dam parity was favorable for offspring performance for milk, fat, and protein yield, whereas in the Montbéliarde breed, an increase in dam parity was associated with lower milk and protein yield and no association was found for fat yield. The udder health of the dam during gestation was not or only weakly associated with the traits studied in the offspring. Although some significant associations were identified due to the large sample size, the effects were modest, typically less than 1% of the phenotypic mean, and were not consistently observed across the 2 breeds.

Short communication: Correlation of methane production, intensity, and yield with residual feed intake throughout lactation in Holstein cows

The environmental impact of dairy production can be reduced in several ways, including increasing feed efficiency and reducing methane (CH4) emissions. There is no consensus on their relationship. This study aimed at estimating the correlations between residual feed intake (RFI) and CH4 emissions expressed in g/d methane production (MeP), g/kg of fat- and protein-corrected milk methane intensity (MeI), or g/kg of DM intake methane yield (MeY) throughout lactation. We collected CH4 data using GreenFeed devices from 107 Holstein cows, as well as production and intake phenotypes. RFI was predicted from DM intake, fat- and protein-corrected milk, BW, and body condition score. Five-trait random regression models were used to estimate the individual variance components of the CH4 and production traits, which were used to calculate the correlations between RFI and CH4 traits throughout lactation. We found positive correlations of RFI with MeP and MeI ranging from 0.05 to 0.47 throughout the lactation. Correlations between RFI and MeY are low and vary from positive to negative, ranging from -0.18 to 0.17. Both MeP and MeI are favorably correlated with RFI, as is MeY during the first half of lactation. These correlations are mostly favorable for genetic selection, but the confirmation of these results is needed with genetic correlations over a larger dataset.

A Scoping Review of the Predictive Qualities of Walking Speed in Older Adults

BACKGROUND AND PURPOSE

Walking speed (WS) is an easily assessable and interpretable functional outcome measure with great utility for the physical therapist providing care to older adults. Since WS was proposed as the sixth vital sign, research into its interpretation and use has flourished. The purpose of this scoping review is to identify the current prognostic value of WS for the older adult.

METHODS

A scoping review was conducted using PubMed, CINAHL, and SPORTDiscus to find relevant articles highlighting the predictive capabilities of WS for older adults. Titles and abstracts were reviewed to identify relevant articles. Articles were excluded based on the following criteria: sample included both younger and older adults without separate analyses, sample was focused on a particular disease, if the study was published before 2017, or if the study did not report relevant cut points for interpretation of WS. The search returned 1064 results. Following removal of articles not meeting inclusion criteria and critical appraisal, relevant cut points were extracted from 47 original research publications.

RESULTS AND DISCUSSION

A preliminary review of the included articles showed that WS is a valuable prognostic tool across many health domains, including mental health, mortality, disability, pain, bone and joint health, falls, cognition, physical activity, metabolic health, risk for cardiovascular disease, socialization, and metabolic health. The fastest WS of 1.32 meters per second (m/s) served as a cutoff for decreased risk for incident development of type 2 diabetes, while the slowest WS of less than 0.2 m/s was associated with increased duration of hospitalization. Multiple studies reported on the prognostic value of WS slower than 1.0 m/s.

CONCLUSION

Although the reported range of predictive WS values was broad, multiple studies found WS of approximately 1.0 m/s to be a useful marker for delineating risk or decline across a variety of health domains. Clinicians may find it useful to use a WS slower than 1.0 m/s as a "yellow flag" to guide evaluation and intervention for their older adult clients.

Comparison of methane production, intensity, and yield throughout lactation in Holstein cows

Genetic selection to reduce methane (CH4) emissions from dairy cows is an attractive means of reducing the impact of agricultural production on climate change. In this study, we investigated the feasibility of such an approach by characterizing the interactions between CH4 and several traits of interest in dairy cows. We measured CH4, dry matter intake (DMI), fat- and protein-corrected milk (FPCM), body weight (BW), and body condition score (BCS) from 107 first- and second-parity Holstein cows from December 2019 to November 2021. Methane emissions were measured using a GreenFeed device and expressed in terms of production (MeP, in g/d), yield (MeY, in g/kg DMI), and intensity (MeI, in g/kg FPCM). Because of the limited number of cows, only animal parameters were estimated. Both MeP and MeI were moderately repeatable (>0.45), whereas MeY presented low repeatability, especially in early lactation. Mid lactation was the most stable and representative period of CH4 emissions throughout lactation, with animal correlations above 0.9. The average animal correlations of MeP with DMI, FPCM, and BW were 0.62, 0.48, and 0.36, respectively. The MeI was negatively correlated with FCPM (<-0.5) and DMI (>-0.25), and positively correlated with BW and BCS. The MeY presented stable and weakly positive correlations with the 4 other traits throughout lactation, with the exception of slightly negative animal correlations with FPCM and DMI after the 35th week. The MeP, MeI, and MeY were positively correlated at all lactation stages and, assuming animal and genetic correlations do not strongly differ, selection on one trait should lead to improvements in all. Overall, selection for MeI is probably not optimal as its change would result more from CH4 dilution in increased milk yield than from real decrease in methane emission. Instead, MeY is related to rumen function and is only weakly associated with DMI, FPCM, BW, and BCS; it thus appears to be the most promising CH4 trait for selection, provided that this would not deteriorate feed efficiency and that a system of large-scale phenotyping is developed. The MeP is easier to measure and thus may represent an acceptable alternative, although care would need to be taken to avoid undesirable changes in FPCM and BW.

Opportunities for genomic selection of cheese-making traits in Montbéliarde cows

As part of the From'MIR project, traits related to the composition and cheese-making properties (CMP) of milk were predicted from 6.6 million mid-infrared spectra taken from 410,622 Montbéliarde cows (19,862 with genotypes). Genome-wide association studies of imputed whole-genome sequences highlighted candidate SNPs that were then added to the EuroG10K BeadChip, which is routinely used in genomic selection. In the present study, we (1) assessed the reliability of single-step genomic BLUP breeding values (ssEBVs) for cheese yields, coagulation traits, and casein and calcium content generated from test-day records of the first 3 lactations, (2) estimated realized genetic trends for these traits over the last decade, and (3) simulated different cheese-making breeding objectives and estimated the responses for CMP as well as for other traits currently selected in the Montbéliarde breed. To estimate the reliability of ssEBVs, the available data were split into 2 independent training and validation sets that respectively contained cows with the oldest and the most recent lactation data. The training set included 155,961 cows (12,850 with genotypes) and was used to predict ssEBVs of 2,125 genotyped cows in the validation set. We first tested 4 models that included either lactation (LACT) or test-day (TD) records from the first (1) or the first 3 (3) lactations, giving equal weight to all 50K SNP effects. Mean reliabilities were 61%, 62%, 63%, and 64% for the LACT1, LACT3, TD1, and TD3 models, respectively. Using the most accurate model (TD3), we then compared the reliabilities of 3 scenarios with: SNPs from the Illumina BovineSNP50 BeadChip only, equally weighted (50K); 50K SNPs plus additional candidate SNPs, equally weighted (50K+); and 50K and candidate SNPs with additional weight given to 7 to 14 candidate SNPs, depending on the trait (CAND). The 50K+ and CAND scenarios led to similar mean reliabilities (67%) and both outperformed the 50K scenario (64%), whereas the CAND scenario generated the less biased ssEBVs. To assess genetic trends, SNP effects were estimated with a single-step GBLUP based on the TD3 model and the 50K scenario applied to the whole population (2.6 million performance records from 190,261 cows and 423,348 animals in the pedigree, of which 21,874 were genotyped) and then applied to 50K genotypes of 21,171 males and 311,761 females. We detected a positive genetic trend for all CMP during the last decade, probably due to selection for an increase in milk protein and fat content in Montbéliarde cows. Finally, we compared the selection responses to 3 different breeding objectives: the current Montbéliarde total merit index (TMI) and 2 alternative scenarios that gave a weight of 70% to TMI and the remaining 30% to either milk casein content (TMI-COMP) or a combination of 3 CMP (TMI-Cheese). The TMI-Cheese scenario yielded the best responses for all the CMP analyzed, whereas values in the TMI-COMP scenario were intermediate, with a slight effect on other traits currently included in TMI. Based on these results, a program of genomic evaluation for CMP predicted from mid-infrared spectra was designed and implemented for the Montbéliarde breed.

Active Participation of Care Partners in a Physical Activity Intervention Alongside People with Stroke: A Feasibility Study

Purpose: This study investigated the feasibility of a physical activity intervention for people with stroke and their care partners and the role social support plays in physical activity adherence. Method: The study used a single-group, pretest-posttest design with follow-up. Participants were adults with chronic stroke and their care partners. The intervention consisted of 8 weeks of structured, group-based physical activity classes, followed by 19 weeks of self-directed physical activity. Recruitment, adherence, safety, and retention were assessed. Familial social support was assessed before and after the 8-week structured portion and again 19 weeks later. Results: A total of 21 participants (15 people with stroke, 6 care partners), mean age 67.6 (SD 11.6) years, were recruited; 19 (90.5%) completed the 19-week assessment. No adverse events were experienced during the programme. Attendance during the 8-week portion was better than during the 19-week portion (mean difference 0.95; p < 0.001; 95% CI: 0.71, 1.19 visits/wk). No relationship was found between social support and physical activity adherence (p > 0.05). Conclusions: Involvement of care partners in a physical activity intervention is feasible and safe. Both people with stroke and their care partners may require ongoing support to participate in long-term physical activity. The relationship between social support and physical activity adherence requires further study.

Cultural Adaptation of the Reducing Disability in Alzheimer's Disease (RDAD) Protocol for an Intervention to Reduce Behavioral and Psychological Symptoms of Dementia in Thailand

BACKGROUND

The Reducing Disability in Alzheimer's Disease (RDAD) program is an evidence-based intervention found to be feasible for implementation in community settings in the United States, and effective in reducing depression, one of the major behavioral and psychological symptoms of dementia (BPSD).

OBJECTIVE

The goal of the study is to culturally adapt the RDAD for persons with dementia living in community settings of Thailand.

METHODS

Key adaptation steps included: 1) assess the community, 2) understand/select the intervention, 3) consult with experts/stakeholders, 4) decide what needs to be adapted, 5) adapt the original program, 6) train staff, and 7) pilot test the adapted materials.

RESULTS

Modifications to the original RDAD protocol included changes in number of sessions, mode of delivery, and the specific pleasant activities targeted. The pilot test demonstrated the feasibility and acceptance of the adapted RDAD intervention protocol. Implementers were able to comprehend and implement the core components of the intervention, while family members demonstrated ability to follow instructions, gain knowledge about dementia, and improve skills for setting up realistic goals.

CONCLUSION

Following the key adaptation steps outlined above, we were able to successfully modify the RDAD for the Thai cultural context, maintaining core components of the original protocol. Program implementers demonstrated their ability to supervise family caregivers and help them gain the knowledge and skills needed to provide care for older adults with dementia. Findings from the pilot studies were incorporated into final training and intervention protocols currently being implemented and evaluated in a randomized implementation trial in Thailand.

Implementation Science in Thailand: Design and Methods of a Geriatric Mental Health Cluster-Randomized Trial

BACKGROUND

Thailand has a rapidly aging population yet lacks evidence for effective and scalable evidence-based psychosocial interventions to support persons living with dementia and their family caregivers. In this study of a culturally adapted and evidence-based clinical program (Reducing Disabilities in Alzheimer's Disease [RDAD]), designed to reduce behavioral and psychological symptoms of dementia in older adults, the authors test the hypothesis that an implementation support strategy, Getting To Outcomes (GTO), would produce better implementation and clinical outcomes compared with usual implementation of RDAD in Thailand.

METHODS

The study uses a hybrid type III cluster-randomized design to compare eight geographical districts that receive training on both implementing the RDAD clinical intervention and on GTO implementation support strategies (intervention arm) with eight other districts that receive the same RDAD training but without training in GTO implementation support strategies (control arm). GTO is an evidence-based intervention designed to support implementers to better plan, implement, and evaluate innovative intervention programs in a novel setting. Primary outcomes, including implementation and clinical outcomes, will be assessed at baseline, month 3 (posttreatment), and month 6 (3-month follow-up).

RESULTS

The research team anticipates that there will be significantly more improvements in the delivery of the RDAD intervention program in the experimental group than in the control group.

NEXT STEPS

If clinical trial findings are positive, the authors plan to replicate and scale up the proposed implementation science approach across Thailand to enhance and expand mental health services for older adults with dementia.

Physical Activity in De Novo Parkinson Disease: Daily Step Recommendation and Effects of Treadmill Exercise on Physical Activity

OBJECTIVE

People with Parkinson disease (PD) have low physical activity (PA) levels and are at risk for cardiovascular events. The 3 purposes of this study were to determine a step threshold that corresponds to meeting aerobic PA guidelines, determine effects of treadmill exercise on PA, and quantify the relationship between changes in daily steps and fitness.

METHODS

This was a secondary analysis of the Study in Parkinson's Disease of Exercise trial, which randomized participants to high-intensity treadmill exercise, moderate-intensity treadmill exercise, or usual care for 6 months. Daily steps and moderate- to vigorous-intensity PA (MVPA) were assessed at baseline and once each month using an activity monitor. Fitness was assessed via graded exercise test at baseline and at 6 months. A step threshold that corresponds to meeting PA guidelines was determined by receiver operating characteristic curves. The effect of treadmill exercise on PA was examined in those below the step threshold (ie, the least active participants). Pearson r correlations determined the relationship between daily steps and fitness.

RESULTS

Individuals with de novo PD (n = 110) were included. Those with ≥4200 steps were 23 times more likely (95% CI = 7.72 to 68) to meet PA guidelines than those with <4200 steps. For those with <4200 steps at baseline (n = 33), only those in the high-intensity exercise group increased daily steps (median of differences = 1250 steps, z = -2.35) and MVPA (median of differences = 12.5 minutes, z = -2.67) at 6 months. For those with <4200 steps, changes in daily steps were not associated with changes in fitness (r = .183).

CONCLUSION

In people with PD and <4200 daily steps at baseline, high-intensity treadmill exercise increased daily steps and MVPA, but these changes were not associated with changes in fitness.

IMPACT

People with PD should be encouraged to take ≥4200 daily steps to meet PA guidelines through walking.

Feasibility of integrating survivors of stroke into cardiac rehabilitation: A mixed methods pilot study

Background

Survivors of stroke are often deconditioned and have limited opportunities for exercise post-rehabilitation. Cardiac Rehabilitation (CR), a structured exercise program offered post-cardiac event in the United States (U.S.), may provide an opportunity for continued exercise.

The purpose of this study was to examine the feasibility of integrating survivors of stroke into an existing, hospital-based CR program through an assessment of (1) recruitment, uptake and retention, (2) adherence and fidelity, (3) acceptability and (4) safety.

Methods

A mixed methods design combined a single group, pre-post design, pilot feasibility study with an imbedded qualitative inquiry. Survivors of stroke were recruited into a standard 12-week, 36 visit CR program.

Results

Fifty-three survivors were referred, 29 started and 24 completed the program. Program uptake rate was 55% and completion rate was 83%. Eleven completers and one non-completer participated in the qualitative interviews. Program completers attended an average of 25.25 (SD 5.82) sessions with an average of 38.93 (SD 5.64) exercise minutes per session while reaching targeted rate of perceived exertion levels. Qualitative themes included perceived benefits of an individualized program in a group setting, positive interactions with qualified staff, opportunities for socialization, and regular monitoring and staff attentiveness promoting feelings of safety.

Conclusions

Survivors of stroke were able to meet Medicare standard dosage (frequency and session duration) and rate of perceived intensity goals, and perceived the program as needed regardless of their mobility limitations or previous exercise experience. Primary challenges included managing referrals and uptake. Results support feasibility and benefit for survivors to integrate into U.S. CR programs.

A missense mutation in the FZD7 gene is associated with dilution of the red areas of the coat in Montbéliarde cattle

Recently, a new genetically autosomal recessive color phenotype emerged in the red pied bovine Montbéliarde breed. It is characterized by a dilution of the red areas of the coat and was denominated 'milca'. A genome-wide homozygosity scan of 106 cases followed by haplotype analysis revealed a candidate region within BTA2 between positions 89.95 and 91.63 Mb. Analysis of whole-genome sequence data generated from milca animals identified a strong candidate variant within the coding region of the Frizzled-7 gene (FZD7). This gene encodes for a G-protein coupled receptor for Wnt signaling proteins. The variant induces a glycine to alanine substitution in the second extracellular loop, p.(Gly414Ala). Cross-species amino acid alignments revealed that this glycine is conserved among orthologs and most paralogs, suggesting that it plays an important role in FZD function. In addition, genotyping data revealed that the mutant allele is restricted to the Montbéliarde breed, at a 3.7% frequency. All homozygous cows for the mutant allele exhibited the milca phenotype whereas all heterozygotes had no coat color defects. In conclusion, this study strongly suggests that, in cattle, a mutation of FZD7 alone is sufficient to cause a coat color phenotype without any strong other adverse effect.

Abstract P198: Daily Step Count at Two Months is the Strongest Predictor of Daily Steps at One Year Post-Stroke

For survivors of stroke, walking can improve endurance, community participation and decrease risk of subsequent stroke. Unfortunately, survivors take 4000 fewer steps per day compared to other adults. Early identification of survivors prone to long-term inactivity would be valuable, as interventions could be implemented to improve physical activity (PA) levels and reduce subsequent stroke risk.

Secondary data from the Locomotor Experience Applied Post Stroke (LEAPS) trial was used. Included participants had walking speeds of <0.80 m/s at 2 months post-stroke. Daily steps were assessed at 2 months and 1 year post-stroke using an activity monitor. Stepwise regression was used to predict daily step counts at 1 year based on modifiable (walking speed, endurance, balance, balance confidence, daily step counts) and nonmodifiable (age at time of stroke, gender, race, ethnicity, initial stroke severity, side of stroke and LEAPS intervention group) factors.

Data was available for 206 survivors, mean age=63 (13) years, 43% female (88/206), mean walking speed=.41 (.22) m/s, mean step count=2922 (2749) steps per day. The strongest predictor of daily steps at 1 year was daily steps at 2 months (p=<0.001, adjusted R 2 =.34). For every 1-step increase at 2 months, there was an increase of .54 (95% CI .38, .71) steps at 1 year. The next strongest predictor was walking endurance (Six Minute Walk), which significantly increased adjusted R 2 by .02 (p=.009). For every 1-meter increase in Six Minute Walk distance at 2 months, there was an increase of 8 (95% CI 2, 14) steps at 1 year. Together, baseline steps and Six Minute Walk distance explained 36% of the variance in daily steps at 1 year. No other factors significantly added to the prediction model.

Daily steps at 2 months post-stroke was the strongest predictor (explaining 34% of the variance) of steps at 1 year. Survivors with low daily steps early after stroke may benefit from targeted walking interventions to increase PA and long term health outcomes.

Integrating Survivors of Stroke Into Exercise-Based Cardiac Rehabilitation Improves Endurance and Functional Strength

Background

Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception.

Methods and Results

Subacute and chronic survivors of stroke were integrated into a standard 12‐week, 3 sessions per week, exercise‐based CR program. A total of 29 began the program, 24 completed the program, and 18 were available for 6‐month follow‐up. Quantitative measures were compared preprogram with postprogram with t‐test or equivalent, and preprogram with postprogram to 6‐month follow‐up with ANOVA or equivalent. Semistructured interviews were completed with 11 participants postprogram. Exercise‐based CR had significant impacts on cardiovascular endurance preprogram to postprogram, with maintenance at 6‐month follow‐up. The participants improved on the 6‐minute walk test on average by 61.92 m(95% CI, 33.99–89.84 m), and maximum metabolic equivalents improved by a median of 3.6 (interquartile range, 2.35). Five times sit to stand (functional strength) improved preprogram to postprogram by a median of 2.85 s (interquartile range, 4.03 s). Qualitative findings highlight additional health improvements. Most participants (83% [15/18]) reported continued exercise at follow‐up.

Conclusions

Exercise‐based CR has the potential to improve cardiovascular endurance, health status, and quality of life for survivors of stroke.

Registration

URL: https://www.clinicaltrials.gov; Unique identifier: NCT03706105.

Walking speed measurement technology: A review

Purpose of review

This article presents an overview of the main technologies used to estimate gait parameters, focusing on walking speed (WS).

Recent findings

New wearable and environmental technologies to estimate WS have been developed in the last five years. Wearable technologies refer to sensors attached to parts of the patient's body that capture the kinematics during walking. Alternatively, environmental technologies capture walking patterns using external instrumentation. In this review, wearable and external technologies have been included.From the different works reviewed, external technologies face the challenge of implementation outside controlled facilities; an advantage that wearable technologies have, but have not been fully explored. Additionally, systems that can track WS changes in daily activities, especially at-home assessments, have not been developed.

Summary

Walking speed is a gait parameter that can provide insight into an individual's health status. Image-based, walkways, wearable, and floor-vibrations technologies are the most current used technologies for estimating WS. In this paper, research from the last five years that explore each technology's capabilities on WS estimation and an evaluation of their technical and clinical aspects is presented.

Frequencies of milk protein variants and haplotypes estimated from genotypes of more than 1 million bulls and cows of 12 French cattle breeds

Due to their major effects on milk composition and cheese-making properties and their putative effects on human health, there is a great deal of interest in bovine milk protein variants. The objectives of this study were to estimate frequencies of milk protein variants and haplotypes in 12 cattle breeds as well as their trends over time to assess the effect of selection on milk traits. Milk protein variants and haplotypes were identified from SNP genotype data from more than 1 million animals from 12 dairy, beef, or dual-purpose cattle breeds that had been genotyped for genomic selection. We examined a total of 15 loci in the genes that encode β-lactoglobulin (β-LG) and 3 caseins (α_S1-CN, β-CN, and κ-CN); genotypes were directly called from customized SNP chips (50.6%) or imputed (49.4%). Variants A and B of β-LG were frequent in the 12 breeds. For the caseins, we found 3 variants for α_S1-CN (B, C, and D), 6 for β-CN (A1, A2, A3, B, C, and I), and 5 for κ-CN (A, B, C, D, and E). For α_S1-CN, the B variant was the most frequent in all breeds except Jersey. For β-CN, the A2 variant was the most abundant in all breeds except Tarentaise, although in Normande animals, the I variant (30.9%) was almost as common as A2 (39.7%). The C variant was very rare except in the Tarentaise sample (4.8%). The most frequent variant for κ-CN was A in 5 breeds (including Holstein), and B in the 7 other breeds. The B variant was present at a particularly high frequency in Jersey (82.6%) and Normande (85.5%) animals. The C and E variants of κ-CN appeared to be particularly frequent in the Tarentaise (12.7%) and Holstein (9%) breeds, respectively. We found 20 haplotype combinations of α_S1-β-κ CN that were present at a frequency >0.1% in at least one breed; however, only 6 to 9 haplotypes were found in any given breed, demonstrating a strong degree of linkage disequilibrium. The most frequent haplotypes were B-A1-A, B-A2-A, B-A2-B, B-I-B, C-A2-A, and C-A2-B. Some alleles were predominantly found in only one haplotype, such as the E and C variants of κ-CN and the I variant of β-CN, which were mainly found in the B-A1-E, B-A1-C, and B-I-B haplotypes, respectively. We observed changes in the frequency of certain variants over time in several breeds, such as an increase in the frequency of variants A of β-LG, I of β-CN, and B of κ-CN. With these results, we update and complete frequency data that were first estimated 30 to 50 yr ago, and, for the first time in these breeds, we assess the effect of selection on milk protein variants.

Yoga for everyone: a qualitative study of a community yoga class for people with disability

Background and Objective: People with mobility impairments face increased barriers to physical activity. The study aimed to understand the lived experiences of individuals with disability who are regular participants in the Yoga for Everyone class to inform future research, intervention and community programs.Methods: A phenomenological qualitative approach utilized semi-structured interviews and class observations. Data was analyzed through iterative inductive thematic analysis.Results: Six people of varied mobility limitations participated. Thematic analysis revealed themes on influential environmental and personal factors, a holistic-focused class environment, physical improvements, mental/emotional impact, and a sense of belonging to community.Conclusion: The Yoga for Everyone class fostered multi-faceted outcomes for people with diverse movement impairments. Focusing on community-clinical partnerships, utilizing a class structure with volunteers, and fostering an ongoing inclusive social environment are potential strategies for success in other community programs for those with disability.

Stepping After Stroke: Walking Characteristics in People With Chronic Stroke Differ on the Basis of Walking Speed, Walking Endurance, and Daily Steps

BACKGROUND

What contributes to free-living walking after stroke is poorly understood. Studying the characteristics of walking may provide further details that guide interventions.

OBJECTIVE

The objectives of this study were to examine how the walking characteristics of bouts per day, median steps per bout, maximum steps per bout, and time spent walking differ in individuals with various walking speeds, walking endurance, and daily steps and to identify cutoffs for differentiating ambulators who were active versus inactive.

DESIGN

This study involved a cross-sectional analysis of data from the Locomotor Experience Applied Post-Stroke trial.

METHODS

Participants were categorized by walking speed, walking endurance (via the 6-minute walk test), and daily steps (via 2 consecutive days of objective activity monitoring). Differences in walking characteristics were assessed. Linear regression determined which characteristics predicted daily step counts. Receiver operating characteristic curves and areas under the curve were used to determine which variable was most accurate in classifying individuals who were active (≥5500 daily steps).

RESULTS

This study included 252 participants with chronic stroke. Regardless of categorization by walking speed, walking endurance, or daily steps, household ambulators had significantly fewer bouts per day, steps per bout, and maximum steps per bout and spent less time walking compared with community ambulators. The areas under the curve for maximum steps per bout and bouts per day were 0.91 (95% confidence interval = 0.88 to 0.95) and 0.83 (95% confidence interval = 0.78 to 0.88), respectively, with cutoffs of 648 steps and 53 bouts being used to differentiate active and inactive ambulation.

LIMITATIONS

Activity monitoring occurred for only 2 days.

CONCLUSIONS

Walking characteristics differed based on walking speed, walking endurance, and daily steps. Differences in daily steps between household and community ambulators were largely due to shorter and fewer walking bouts. Assessing and targeting walking bouts may prove useful for increasing stepping after stroke.

Demographic and Admission Predictors of Students with Perceived Difficulty in Entry-Level Doctor of Physical Therapy Programs

BACKGROUND

Admission committees have the difficult task of selecting candidates with the greatest likelihood of success for their programs and the profession. Because of limitations in defining the successful candidate, we attempted to predict who will become a "student with perceived difficulty" within a doctor of physical therapy (DPT) program using data available during the time of application.

METHODS

A retrospective analysis of 479 students from three entry-level DPT programs. The dependent variable was student with perceived difficulty status. Student characteristics were compared using unpaired t-tests (or non-parametric equivalent) and chi-squared tests. Receiver operating characteristic curves were constructed for variables significantly associated with student status to compare the predictive capabilities of the student characteristics and identify cutpoints that maximized sensitivity and specificity. We examined the predictive capabilities of clusters of characteristics that differed significantly between groups by calculating likelihood ratios and estimating odds ratios from logistic regression.

RESULTS

The cluster of characteristics that best identified students with perceived difficulty was prerequisite GPA <3.7, Analytical Writing GRE <4, and attended >2 undergraduate institutions. Twenty students met these criteria and 8 (40%) were identified as students with perceived difficulty. The positive likelihood ratio for this cluster of characteristics was 6.9 and the odds ratio was 8.7 (95% CI: 3.2, 23.0).

CONCLUSIONS

These results suggest that this cluster of variables, available at the time of admission, can be used to identify students whose progress in the program may need to be more closely monitored and who may benefit from additional services to minimize difficulties for the student and faculty.

Short communication: A splice site mutation in CENPU is associated with recessive embryonic lethality in Holstein cattle

A genome scan for homozygous haplotype deficiency coupled with whole-genome sequence data analysis is a very effective method to identify embryonic lethal mutations in cattle. Among other factors, the power of the approach depends on the availability of a greater amount of genotyping and sequencing data. In the present study, we analyzed the largest known panel of Illumina BovineSNP50 (Illumina Inc., San Diego, CA) genotypes, comprising 401,896 Holstein animals, and we report the mapping of a new embryonic lethal haplotype on chromosome 27, called HH7. We fine mapped the locus in a 2.0-Mb interval using an identical-by-descent approach and analyzed genome sequence data from 4 carrier and 143 noncarrier Holstein bulls to identify the causative mutation. We detected a strong candidate variant in the gene encoding centromere protein U (CENPU), a centromere component essential for proper chromosome segregation during mitosis. The mutant allele is a deletion of 4 nucleotides located at position +3 to +6 bp after the splicing donor site of exon 11. Cross-species nucleotide alignment revealed that the nucleotide at position +3 is entirely conserved among vertebrates, suggesting that it plays an important role in the regulation of CENPU splicing. For verification, we genotyped the candidate variant in 232,775 Holstein individuals and did not observe any homozygotes, whereas 16 were expected (Poisson P-value = 1.1 × 10^-7; allele frequency = 0.8%). In addition, genotyping of 250,602 animals from 19 additional breeds revealed that the mutant allele is restricted to animals of Holstein descent. Finally, we estimated the effect of the candidate variant on 2 fertility traits in at-risk mating (i.e., between carrier bulls and daughters of carrier bulls) versus non-risk mating. In agreement with a recessive lethal inheritance pattern, we observed a marked reduction in both conception rate and 56-d nonreturn rate in heifers and cows. The effect on 56-d nonreturn rate suggests that a substantial proportion of homozygous mutants die before 35 d after insemination, which is consistent with the early embryonic death previously reported in CENPU^-/- mouse embryos. In conclusion, we demonstrate that with more than 400,000 genotypes, we can map very rare recessive lethal mutations segregating at a frequency below 1% in the population. We recommend performing new analyses regularly as data are accumulating.

Intrarater and interrater reliability of a hand-held dynamometric technique to quantify palmar thumb abduction strength in individuals with and without carpal tunnel syndrome

STUDY DESIGN

Clinical measurement.

INTRODUCTION

Individuals with carpal tunnel syndrome (CTS) sometimes exhibit weakness of palmar abduction strength (TAS). Reliable assessment of this strength in both subjects with and without CTS with the commonly available Microfet 2 is not known.

PURPOSE OF THE STUDY

The purpose of this study was to determine the intrarater and interrater reliabilities of a handheld dynamometric (HHD) method to assess TAS in individuals with and without CTS using the commercially available MicroFET2 and to examine the association between TAS in individuals with CTS and the Carpal Tunnel Symptom Questionnaire (CTSQ) scores.

METHODS

In 2 different study phases, individuals with and without CTS were assessed for TAS by 2 different examiners. The CTSQ was administered to the individuals with CTS.

RESULTS

Intrarater and interrater reliability coefficients (0.89-0.93 and 0.82-0.90, respectively) were excellent in individuals with and without CTS. Weak negative correlations were found between TAS and overall CTSQ and symptom severity subscale scores, and a moderate negative correlation was found between TAS and functional Status Subscale score.

DISCUSSION

This HHD method of reliably assessing TAS better quantifies deficits and progress than traditional manual muscle testing for muscle grades greater than 3/5.

CONCLUSION

This method of HHD reliably quantifies TAS but is more reliable with the same than different raters.

The six-minute walk test as a fall risk screening tool in community programs for persons with stroke: a cross-sectional analysis

Background and Purpose: Persons with stroke have increased risk for recurrent stroke. Group exercise programs like cardiac rehabilitation might reduce this risk. These programs commonly use the six-minute walk test to measure aerobic capacity. However, failure to assess fall risk may compromise safety for persons with stroke. The study aim was to determine the association between the six-minute walk test and fall risk in persons with stroke.Methods: Cross-sectional analysis measured the association between the six-minute walk test and fall risk in 66 persons with stroke with a mean age of 66 years (SD 12) and median stroke chronicity of 60.9 months (range 6.0-272.1). The six-minute walk test was evaluated using logistic regression. The best fit model was used in Receiver Operating Characteristic analysis. Likelihood ratios and post-test probabilities were calculated.Results: Lower six-minute walk test distance was associated with increased fall risk in logistic regression (p = .002). The area under the curve for the univariate six-minute walk test model (best fit) was 0.701 (p = .006). The cutoff for increased fall risk was six-minute walk test <331.65 m. The post-test probability of fall risk increased to 74.3% from a pre-test probability of 59.1%.Discussion: The moderate association between fall risk and six-minute walk test suggests that in addition to assessing capacity, the six-minute walk test provides insight into fall risk/balance confidence.Conclusion: Using the six-minute walk test cutoff to screen fall risk in community exercise programs may enhance safety for persons with stroke without additional testing required.

Abstract OT1-11-01: The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors

Background:

Further progress in the treatment of breast cancer will likely come from contributions of molecular biology and immunologic approaches. The search for druggable molecular aberrations may enable treatment based on the molecular profile. A better identification of patients with a high risk of relapse facilitates the selection of these pts for clinical trials investigating early therapeutic molecular-based interventions.

Trial Design:

The BRandO BiO Registry is a multi-center regional registry to record clinical, epidemiological, and biological data from patients with newly diagnosed breast and ovarian cancer at the University of Ulm, Dept. of Gynecology and 19 affiliated network hospitals and practices in the Alb-Allgäu Bodensee region (outreach area of the Comprehensive Cancer Center Ulm). Longitudinal biobanking is included with collection of paraffin-embedded samples of the primary tumor as well as blood samples at first diagnosis, after 6 and 12 months and at first relapse to isolate and investigate cell-free and germline DNA. Epidemiological, life style and quality of life (QOL) questionnaires are collected at first diagnosis, after 12, 36 and 60 months. The follow up is planned for 10 years.

Eligibility criteria:

Patients with primary newly diagnosed untreated breast or ovarian cancer of ≥ 18 years are eligible; primary metastatic untreated disease is allowed. Exclusion criteria comprise severe neurological or psychiatric disorders interfering with the ability to give an informed consent, no consent for registration, storage and processing of the individual disease characteristics and bio samples, and any malignant tumor in the last 3 years (except in situ disease).

Specific aims:

To register the majority of patients with newly diagnosed breast or ovarian cancer in all BRandO-BiO participating centers of a well-defined geographical area. To assess clinical characteristics and outcome data (event-free survival, overall survival) of these patients. To evaluate the primary tumor of all patients for mutational (druggable) aberrations. Further to assess cell-free DNA in the serial blood samples at baseline, 6 and 12 months and correlate these results with clinical outcome data as well as tumor and patient characteristics to look for early markers predicting relapse. To perform a longitudinal assessment of the patients' sociodemographic factors, comorbidities, lifestyle and QOL factors by analyzing serial questionnaires collected at recruitment and at 12, 36 and 60 months.

Present accrual and target accrual:

The BRandO BiO Registry started January 2016 in the Dept. of Gynecology, University of Ulm and February 2017 at the network hospitals and practices. Until June 2018, 1180 patients with primary breast or ovarian cancer have been enrolled. The current adherence to serial blood testing and serial questionnaires is good with a return rate of 90%. A sample size of 3000 patients is planned.

Contact information:

Jens Huober, University of Ulm, Dept of Gynecology, Breast Center, jens.huober@uniklinik-ulm.de

Amelie de Gregorio, University of Ulm, Dept of Gynecology, Breast Center, Amelie.de Gregorio@uniklinik-ulm.de

Citation Format: Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-11-01.

Abstract TP166: The Six Minute Walk Test as a Predictor for Fall Risk in Persons With Stroke

Introduction: Persons with stroke have increased risk for recurrent stroke, other chronic health conditions and falls. One option to reduce the risk of worsening health conditions is to increase physical activity by engaging in group medical fitness programs like cardiac rehabilitation (CR). CR programs utilize clinical measures for functional capacity, commonly exercise stress testing or the six-minute-walk test (6MWT). Absent is measurement and focus on balance or balance confidence. Supervising staff may be unaware of fall risk which is an important safety factor for persons with stroke. The purpose of this study was to determine the degree to which the 6MWT is associated with fall risk in community-dwelling persons with stroke.

Methods: A cross-sectional analysis measured association between the 6MWT and fall risk in 66 persons with stroke. Fall risk is defined as a score on the Activities Balance Confidence Scale (ABC) of < 81.1 based on a study by Beninato et al. (2009) which found significant accuracy of fall prediction with this cutoff (Sensitivity = 1.00, Specificity = 0.72(0.51-0.93)). The 6MWT and the 6MWT combined with other data differing between fall risk groups (e.g. walking speed, Berg Balance Scale and time since stroke) were evaluated using univariate logistic regression to determine influence on fall risk. The best fit model was used in Receiver Operating Characteristic (ROC) analysis to determine the area under the curve (AUC) to detect an increased risk of falls. Likelihood ratios and post-test probabilities were calculated.

Results: The 6MWT was associated with fall risk in logistic regression (p=0.002) with an odds ratio (OR) of 0.995 (0.991,0.999), p=0.007). The AUC for the univariate 6MWT ROC model (best fit) was 0.701 (p=0.006). The cutoff for increased fall risk was 6MWT < 331.65 meters. The post-test probability of fall risk was 74.3%, increased from a pre-test probability of 59.1%.

Conclusion: The association between fall risk and 6MWT suggests that in addition to aerobic capacity and motor components, the 6MWT includes a fall risk/balance confidence component. In conclusion, utilizing the 6MWT to screen fall risk in CR and other community exercise programs can enhance safety for persons with stroke without additional testing burden.

Determining Risk of Falls in Community Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability

BACKGROUND

Falls and their consequences are significant concerns for older adults, caregivers, and health care providers. Identification of fall risk is crucial for appropriate referral to preventive interventions. Falls are multifactorial; no single measure is an accurate diagnostic tool. There is limited information on which history question, self-report measure, or performance-based measure, or combination of measures, best predicts future falls.

PURPOSE

First, to evaluate the predictive ability of history questions, self-report measures, and performance-based measures for assessing fall risk of community-dwelling older adults by calculating and comparing posttest probability (PoTP) values for individual test/measures. Second, to evaluate usefulness of cumulative PoTP for measures in combination.

DATA SOURCES

To be included, a study must have used fall status as an outcome or classification variable, have a sample size of at least 30 ambulatory community-living older adults (≥65 years), and track falls occurrence for a minimum of 6 months. Studies in acute or long-term care settings, as well as those including participants with significant cognitive or neuromuscular conditions related to increased fall risk, were excluded. Searches of Medline/PubMED and Cumulative Index of Nursing and Allied Health (CINAHL) from January 1990 through September 2013 identified 2294 abstracts concerned with fall risk assessment in community-dwelling older adults.

STUDY SELECTION

Because the number of prospective studies of fall risk assessment was limited, retrospective studies that classified participants (faller/nonfallers) were also included. Ninety-five full-text articles met inclusion criteria; 59 contained necessary data for calculation of PoTP. The Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) was used to assess each study's methodological quality.

DATA EXTRACTION

Study design and QUADAS score determined the level of evidence. Data for calculation of sensitivity (Sn), specificity (Sp), likelihood ratios (LR), and PoTP values were available for 21 of 46 measures used as search terms. An additional 73 history questions, self-report measures, and performance-based measures were used in included articles; PoTP values could be calculated for 35.

DATA SYNTHESIS

Evidence tables including PoTP values were constructed for 15 history questions, 15 self-report measures, and 26 performance-based measures. Recommendations for clinical practice were based on consensus.

LIMITATIONS

Variations in study quality, procedures, and statistical analyses challenged data extraction, interpretation, and synthesis. There was insufficient data for calculation of PoTP values for 63 of 119 tests.

CONCLUSIONS

No single test/measure demonstrated strong PoTP values. Five history questions, 2 self-report measures, and 5 performance-based measures may have clinical usefulness in assessing risk of falling on the basis of cumulative PoTP. Berg Balance Scale score (≤50 points), Timed Up and Go times (≥12 seconds), and 5 times sit-to-stand times (≥12) seconds are currently the most evidence-supported functional measures to determine individual risk of future falls. Shortfalls identified during review will direct researchers to address knowledge gaps.

Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study

Background

Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.

Methods and Results

A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P <0.003; −5.3% risk for 10% higher 2,3 dinor‐8 iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments.

Conclusions

Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.

Clinical Trial Registration

URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.

67 Influence of Metabolic Status and Genetic Merit for Fertility on Proteomic Composition of Bovine Uterine Luminal Fluid

Intensive selection strategies focusing on increased milk yield over several decades has been associated with a decline in fertility in dairy cows. To study the effect of the genetic merit for fertility and the metabolic status of the female on the oocyte, early embryo and the maternal environment, 2 animal models were established. The genetic merit model involved Holstein heifers with a low (LFH) and high fertility (HFH) index and heifers from the Montbéliarde breed (MBD), known to have good reproductive performance. The metabolic model comprised samples from maiden heifers (MH), postpartum lactating cows (Lact), and non-lactating cows (dried off immediately after calving; Dry). A common pool of Day 7 embryos recovered from superovulated and artificially inseminated Holstein heifers were transferred into synchronised recipients (1/recipient) of the above-mentioned animal models and uterine lumen fluid (ULF) of confirmed pregnant animals was recovered on Day 19 post-oestrus. As communication between the conceptus and the uterine environment is crucial for the successful establishment of pregnancy, we analysed uterine luminal fluid of pregnant cows from both models using a holistic proteomic approach. Using nano-liquid chromatography-tandem mass spectrometry analysis combined with a label-free quantification approach, we analysed the uterine luminal fluid from the uterine horn ipsilateral to the corpus luteum (where the conceptus was located in all cases). A total of 2127 proteins were quantified in all samples of both models. Among this set of proteins, 458 were found to differ significantly (P-value < 0.05) in abundance between the groups of the genetic model, and 141 were altered in abundance in the metabolic model. The majority of proteome differences in ULF samples was found comparing HFH to the LFH group (358) and between Dry and Lact cows (70) in the metabolic model. Evaluation of this dataset using bioinformatic tools comprising DAVID GO and gene set enrichment analysis revealed that the affected proteins were predominantly assigned to the terms “translation”, “monosaccharide metabolic process”, “enzyme inhibitor activity”, “lipid binding”, and “response to oxidative stress”. Our study revealed that metabolic status and genetic merit for fertility lead to quantitative molecular differences at the level of proteins in uterine fluid of pregnant animals, thus altering the microenvironment for the early conceptus. This research was funded by European Union Seventh Framework Programme FP7/2007-2013 under grant agreement no. 312097 (‘FECUND’).

KIRREL is differentially expressed in adipose tissue from 'fertil+' and 'fertil-' cows: in vitro role in ovary?

We have previously shown that dairy cows carrying the 'fertil-' haplotype for one quantitative trait locus affecting female fertility located on the bovine chromosome three (QTL-F-Fert-BTA3) have a significantly lower conception rate and body weight after calving than cows carrying the 'fertil+' haplotype. Here, we compared by Tiling Array the expression of genes included in the QTL-F-Fert-BTA3 in 'fertil+' and 'fertil-' adipose tissue one week after calving when plasma non-esterified fatty acid concentrations were greater in 'fertil-' animals. We observed that thirty-one genes were overexpressed whereas twelve were under-expressed in 'fertil+' as compared to 'fertil-' cows (P < 0.05). By quantitative PCR and immunoblot we confirmed that adipose tissue KIRREL mRNA and protein were significantly greater expressed in 'fertil+' than in 'fertil-'. KIRREL mRNA is abundant in bovine kidney, adipose tissue, pituitary, and ovary and detectable in hypothalamus and mammary gland. Its expression (mRNA and protein) is greater in kidney of 'fertil+' than 'fertil-' cows (P < 0.05). KIRREL (mRNA and protein) is also present in the different ovarian cells with a greater expression in granulosa cells of 'fertil+' than 'fertil-' cows. In cultured granulosa cells, recombinant KIRREL halved steroid secretion in basal state (P < 0.05). It also decreased cell proliferation (P < 0.05) and in vitro oocyte maturation (P < 0.05). These results were associated to a rapid increase in MAPK1/3 and MAPK14 phosphorylation in granulosa cells and to a decrease in MAPK1/3 phosphorylation in oocyte. Thus, KIRREL could be a potential metabolic messenger linking body composition and fertility.

Genomic evaluation of regional dairy cattle breeds in single-breed and multibreed contexts

An important prerequisite for high prediction accuracy in genomic prediction is the availability of a large training population, which allows accurate marker effect estimation. This requirement is not fulfilled in case of regional breeds with a limited number of breeding animals. We assessed the efficiency of the current French routine genomic evaluation procedure in four regional breeds (Abondance, Tarentaise, French Simmental and Vosgienne) as well as the potential benefits when the training populations consisting of males and females of these breeds are merged to form a multibreed training population. Genomic evaluation was 5-11% more accurate than a pedigree-based BLUP in three of the four breeds, while the numerically smallest breed showed a < 1% increase in accuracy. Multibreed genomic evaluation was beneficial for two breeds (Abondance and French Simmental) with maximum gains of 5 and 8% in correlation coefficients between yield deviations and genomic estimated breeding values, when compared to the single-breed genomic evaluation results. Inflation of genomic evaluation of young candidates was also reduced. Our results indicate that genomic selection can be effective in regional breeds as well. Here, we provide empirical evidence proving that genetic distance between breeds is only one of the factors affecting the efficiency of multibreed genomic evaluation.

A novel computational model to probe visual search deficits during motor performance

Successful execution of many motor skills relies on well-organized visual search (voluntary eye movements that actively scan the environment for task-relevant information). Although impairments of visual search that result from brain injuries are linked to diminished motor performance, the neural processes that guide visual search within this context remain largely unknown. The first objective of this study was to examine how visual search in healthy adults and stroke survivors is used to guide hand movements during the Trail Making Test (TMT), a neuropsychological task that is a strong predictor of visuomotor and cognitive deficits. Our second objective was to develop a novel computational model to investigate combinatorial interactions between three underlying processes of visual search (spatial planning, working memory, and peripheral visual processing). We predicted that stroke survivors would exhibit deficits in integrating the three underlying processes, resulting in deteriorated overall task performance. We found that normal TMT performance is associated with patterns of visual search that primarily rely on spatial planning and/or working memory (but not peripheral visual processing). Our computational model suggested that abnormal TMT performance following stroke is associated with impairments of visual search that are characterized by deficits integrating spatial planning and working memory. This innovative methodology provides a novel framework for studying how the neural processes underlying visual search interact combinatorially to guide motor performance.

NEW & NOTEWORTHY

Visual search has traditionally been studied in cognitive and perceptual paradigms, but little is known about how it contributes to visuomotor performance. We have developed a novel computational model to examine how three underlying processes of visual search (spatial planning, working memory, and peripheral visual processing) contribute to visual search during a visuomotor task. We show that deficits integrating spatial planning and working memory underlie abnormal performance in stroke survivors with frontoparietal damage.

Mechanisms of Shoulder Range of Motion Deficits in Asymptomatic Baseball Players

BACKGROUND

Shoulder range of motion (ROM) deficits have been identified as injury risk factors among baseball athletes. Despite the knowledge surrounding these risk factors, there is a lack of consensus regarding the specific tissues responsible for these deficits in ROM.

PURPOSE/HYPOTHESIS

The purpose of this study was to elucidate the primary mechanisms of posterior shoulder tightness (capsular, musculotendinous, bony) by examining the tissue responses that occur with the application of an acute intervention in baseball players with ROM deficits. The hypothesis was that posterior rotator cuff stiffness, not glenohumeral joint mobility, would be primarily responsible for ROM gains observed within an acute treatment setting.

STUDY DESIGN

Controlled laboratory study.

METHODS

Through use of ultrasound elastography, electromagnetic motion analysis, and ultrasound imaging, posterior rotator cuff stiffness, glenohumeral joint translation, and humeral torsion were examined in 60 asymptomatic baseball players (age, mean ± SD, 19 ± 2 years) with shoulder ROM deficits. Tissue mechanisms were examined concurrently, with the ROM gains elicited by an acute application of instrument-assisted soft tissue mobilization plus self-stretching (n = 30) versus self-stretching only (n = 30). Separate 3-way analyses of variance (group × arm × time) and linear regression analyses were used to determine the treatment effects and relationships between tissue mechanisms and ROM gains.

RESULTS

ROM gains were associated with decreases in rotator cuff stiffness (internal rotation: r = 0.35, P = .034; horizontal adduction: r = 0.44, P = .008) and increased humeral retrotorsion (internal rotation: r = -0.35, P = .034), not joint translation (P > .05). Players receiving instrument-assisted soft tissue mobilization plus stretching displayed greater shoulder ROM gains (internal rotation, +5° ± 2° [P = .010]; total arc of motion, +8° ± 6° [P = .010]; horizontal adduction, +7° ± 2° [P = .004]; and decreased posterior rotator cuff stiffness, -0.2 ± 0.3 kPa [P = .050]) compared with players receiving self-stretching alone.

CONCLUSION

Decreases in rotator cuff stiffness were associated with acute ROM gains in baseball players. The study results show that changes in rotator cuff stiffness, not glenohumeral joint mobility or humeral torsion, are most likely associated with the ROM deficits observed in adolescent baseball players.

CLINICAL RELEVANCE

Reducing rotator cuff stiffness may be beneficial in improving the ROM deficits associated with injury risk in overhead athletes.

Genetic tools to improve reproduction traits in dairy cattle

Fertility is a major concern in the dairy cattle industry and has been the subject of numerous studies over the past 20 years. Surprisingly, most of these studies focused on rough female phenotypes and, despite their important role in reproductive success, male- and embryo-related traits have been poorly investigated. In recent years, the rapid and important evolution of technologies in genetic research has led to the development of genomic selection. The generalisation of this method in combination with the achievements of the AI industry have led to the constitution of large databases of genotyping and sequencing data, as well as refined phenotypes and pedigree records. These resources offer unprecedented opportunities in terms of fundamental and applied research. Here we present five such examples with a focus on reproduction-related traits: (1) detection of quantitative trait loci (QTL) for male fertility and semen quality traits; (2) detection of QTL for refined phenotypes associated with female fertility; (3) identification of recessive embryonic lethal mutations by depletion of homozygous haplotypes; (4) identification of recessive embryonic lethal mutations by mining whole-genome sequencing data; and (5) the contribution of high-density single nucleotide polymorphism chips, whole-genome sequencing and imputation to increasing the power of QTL detection methods and to the identification of causal variants.

Risk of pancreatic fistula after enucleation of pancreatic tumours

Background

Enucleation is used increasingly for small pancreatic tumours. Data on perioperative outcome after pancreatic enucleation, especially regarding the significance and risk factors associated with postoperative pancreatic fistula (POPF), are limited. This study aimed to assess risk-dependent perioperative outcome after pancreatic enucleation, with a focus on POPF.

Methods

Patients undergoing enucleation for pancreatic lesions between October 2001 and February 2014 were identified from a prospective database. A detailed analysis of morbidity was performed. Risk factors for POPF were assessed by univariable and multivariable analyses.

Results

Of 166 enucleations, 94 (56·6 per cent) were performed for cystic and 72 (43·4 per cent) for solid lesions. Morbidity was observed in 91 patients (54·8 per cent). Severe complications occurred in 30 patients (18·1 per cent), and one patient (0·6 per cent) died. Reoperation was necessary in nine patients (5·4 per cent). POPF was the main determinant of outcome and occurred in 68 patients (41·0 per cent): grade A POPF, 34 (20·5 per cent); grade B, ten (6·0 per cent); and grade C, 24 (14·5 per cent). Risk factors independently associated with POPF were: cystic tumour, localization in the pancreatic tail, history of pancreatitis and cardiac co-morbidity. Only cystic morphology was independently associated with clinically relevant POPF (grade B or C), occurring after enucleation in 25 (27 per cent) of 94 patients with cystic tumours versus nine (13 per cent) of 72 patients with solid tumours. Tumour size and distance to the main duct were not associated with risk of POPF.

Conclusion

Enucleation is a safe procedure in appropriately selected patients with a low rate of severe complications. POPF is the main determinant of outcome and is more frequent after the enucleation of cystic lesions.

The association between resistance exercise and cardiovascular disease risk in women

OBJECTIVES

The objective of this study was to examine the association between resistance exercise and cardiovascular disease risk, independent of body composition, physical activity and aerobic capacity, in healthy women.

DESIGN

A cross-sectional analysis including 7321 women with no history of heart disease, hypertension or diabetes was performed.

METHODS

Participation in resistance exercise was self-reported and body weight and height was measured. A single cardiovascular disease risk score was established via factor analysis including percent body fat, mean arterial pressure, fasting glucose, total cholesterol and triglyceride levels. Physical activity level was determined based on questionnaire data and aerobic capacity was assessed via a maximal treadmill exercise test.

RESULTS

Women reporting resistance exercise had lower total cardiovascular disease risk at any age. Specifically, resistance exercise was associated with lower body fat, fasting glucose and total cholesterol. The association between resistance exercise and cardiovascular disease risk, however, remained only in normal weight women after adjusting for physical activity and aerobic capacity.

CONCLUSION

Results of the present study underline the importance of resistance exercise as part of a healthy and active lifestyle in women across all ages. Our results suggest that resistance exercise may be particularly beneficial to independently improve cardiovascular disease risk profiles in women with normal weight. In overweight/obese women, total physical activity and aerobic capacity may have a stronger association with cardiovascular disease risk.

Reproductive technologies and genomic selection in dairy cattle

Genomic tools are now available for most livestock species and are used routinely for genomic selection (GS) in cattle. One of the most important developments resulting from the introduction of genomic testing for dairy cattle is the application of reasonably priced low-density single nucleotide polymorphism technology in the selection of females. In this context, combining genome testing and reproductive biotechnologies in young heifers enables new strategies to generate replacement and elite females in a given period of time. Moreover, multiple markers have been detected in biopsies of preimplantation stage embryos, thus paving the way to develop new strategies based on preimplantation diagnosis and the genetic screening of embryos. Based on recent advances in GS, the present review focuses on new possibilities inherent in reproductive technologies used for commercial purposes and in genetic schemes, possible side effects and beneficial impacts on reproductive efficiency. A particular focus is on the different steps allowing embryo genotyping, including embryo micromanipulation, DNA production and quality assessment.

Diagnosis and treatment of autoimmune pancreatitis types 1 and 2

Background

Autoimmune pancreatitis (AIP) is characterized by diffuse or focal swelling of the pancreas. AIP has been divided into types 1 and 2. The aim of the study was to evaluate and compare the clinicopathological characteristics, therapy and outcome of patients with AIP.

Methods

The medical records of patients diagnosed with AIP between January 2003 and July 2011 were reviewed. Characteristics of patients with AIP types 1 and 2 were compared with those of patients with pancreatic ductal adenocarcinoma (PDAC).

Results

AIP was classified as type 1 in 40 patients and type 2 in 32 according to the HISORt (Histology, Imaging, Serology, Other organ involvement, Response to therapy) criteria. Patients with histologically confirmed AIP type 2 were younger than those with type 1 (P = 0·005). Some 30 of 32 patients with AIP type 2 were found to have a localized tumour-like pancreatic mass and underwent pancreatectomy, compared with only 16 of 40 with type 1 (P &lt; 0·001). Three of 25 patients with AIP type 2 presented with raised serum levels of IgG4 compared with 21 of 38 with type 1 (P &lt; 0·001). There was no difference in symptoms and involvement of other organs between AIP types 1 and 2. Presentation with weight loss was more common among patients with PDAC than those with AIP, but there was no difference in pain or jaundice between the groups. Raised serum carbohydrate antigen 19-9 levels were more prevalent in patients with PDAC.

Conclusion

Patients with AIP type 2 frequently present with abdominal pain and a tumour-like mass. Differentiating AIP from PDAC is difficult, so making the clinical decision regarding operative versus conservative management is challenging.