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BMJ Open Ophthalmology Aug 2023To evaluate effectiveness of dexamethasone intravitreal implant 0.7 mg (DEX) monotherapy in the AUSSIEDEX study non-responder subgroup, defined by diabetic macular... (Observational Study)
Observational Study
AIM
To evaluate effectiveness of dexamethasone intravitreal implant 0.7 mg (DEX) monotherapy in the AUSSIEDEX study non-responder subgroup, defined by diabetic macular oedema (DME) refractory to anti-vascular endothelial growth factor (anti-VEGF) agents.
METHODS
This prospective, open-label, observational, real-world study included pseudophakic and phakic (scheduled for cataract surgery) eyes that did not achieve a ≥5-letter best corrected visual acuity (BCVA) gain and/or clinically significant central subfield retinal thickness (CRT) improvement after 3-6 anti-VEGF injections for DME (N=143 eyes), regardless of baseline BCVA and CRT. After an initial DEX injection (baseline visit), reinjection was permitted at ≥16-week intervals.
PRIMARY ENDPOINTS
changes in mean BCVA and CRT from baseline to week 52. Safety assessments included adverse events.
RESULTS
Of 143 eyes, 53 (37.1%) and 89 (62.2%) switched to DEX after 3-6 (early) and >6 (late) anti-VEGF injections, respectively; 1 (0.7%) had missing information. With 2.3 injections (mean) over 52 weeks, the change in mean BCVA from a baseline of 57.8 letters was not significant at week 52. Mean CRT improved significantly from a baseline of 417.8 μm at week 52 (mean change -60.9 μm; p<0.001). Outcomes were similar in eyes switched to DEX early and late. No unexpected adverse events were reported; no filtration surgeries were required.
CONCLUSION
To date, AUSSIEDEX is the largest prospective, real-world study of DEX monotherapy for treatment-naïve or anti-VEGF-refractory DME. Following early or late switch from anti-VEGF agents, DEX significantly improved anatomic outcomes at 52 weeks without new safety concerns, supporting use in anti-VEGF-refractory DME.
TRIAL REGISTRATION NUMBER
NCT02731911.
Topics: Humans; Macular Edema; Glucocorticoids; Dexamethasone; Prospective Studies; Vascular Endothelial Growth Factor A; Drug Implants; Intravitreal Injections; Diabetic Retinopathy; Vascular Endothelial Growth Factors; Diabetes Mellitus
PubMed: 37541745
DOI: 10.1136/bmjophth-2022-001224 -
JDS Communications May 2023Feed is often offered to a cow in the milking unit of an automated milking system. This offering provides nutrients but also acts as a reward to the cow for entering the...
Feed is often offered to a cow in the milking unit of an automated milking system. This offering provides nutrients but also acts as a reward to the cow for entering the unit. To complement the partial total mixed ration and to enable handling, flow, and delivery within this mechanized system, this offering is usually a mix of feeds that are combined and manufactured into a feed pellet. The objective of this experiment was to compare 4 different pelleting formulation strategies and measure the effects of feed preference in lactating Jersey cattle. To test the objective, a taste preference experiment was conducted with 8 multiparous lactating Jersey cattle (289 ± 25.3 d in milk, 26.0 ± 2.45 kg of milk yield, 19.36 ± 1.29 kg of dry matter intake). Four formulation strategies were tested including (1) a pellet containing feeds commonly included in the concentrate mixture of a total mixed ration, including 43.1% corn grain, 26.3% dried distillers grains, 3.18% soybean meal, and 5.6% vitamin and mineral premix (CMIX), (2) a pellet of dry corn gluten feed (CGF), (3) a pellet including feedstuffs that are considered to be highly palatable (53.2% wheat middling, 15.7% dried corn distillers grains and solubles, 15.2% cane molasses, and 1.81% oregano (FLVR), and (4) a high-energy pellet (ENG) consisting of 61% corn grain and 26.2% wheat middlings. Cows were offered 0.50 kg of each in a randomized arrangement within the feed bunk for 1 h or until the feed was fully consumed. According to the procedure, cows were offered all 4 treatments for the first 4 d, then the most preferred feed for each cow was removed, and the remaining 3 feeds were offered for 3 d. The process was repeated for the last 2 d. Feed preference was ranked from 1 to 4 with 1 being the most preferred and 4 the least. The resulting preference ranking was CGF (1.25 ± 0.463), FLVR (2.5 ± 0.926), CMIX (2.88 ± 0.835), and ENG (3.13 ± 0.991). These results were subsequently examined utilizing the Plackett-Luce analysis to examine the probability animals would choose a given pellet first based on the current data set. The analysis determined probabilities of first choice as 78.6 ± 0.601% CGF, 9.38 ± 0.438% FLVR, 4.94 ± 0.453% ENG, and 7.11 ± 0.439% CMIX. A -test was also conducted to determine if the percentage a treatment will be chosen first differed from the mean value of no preference at 25%. Corn gluten feed and ENG differed from the mean value while no difference was observed for FLVR and CMIX. Results suggest that animals exhibit a high degree of preference for CGF pellets and that this preference is greater than pellets containing other feed ingredients. Alternatively, cows appeared to exhibit the lowest preference for a high-energy pellet containing mostly corn and wheat middlings.
PubMed: 37360119
DOI: 10.3168/jdsc.2022-0318 -
Translational Animal Science Oct 2020This experiment determined the effects of die thickness and conditioning temperature on pelleting and starch characteristics in diets containing conventional or Enogen...
This experiment determined the effects of die thickness and conditioning temperature on pelleting and starch characteristics in diets containing conventional or Enogen Feed corn (Syngenta Seeds, LLC). Treatments were arranged as a 2 × 2 × 3 factorial of corn type [conventional (CON) and Enogen Feed corn [EFC]), die thickness [5.6 and 8 length:diameter (L:D)], and conditioning temperature (74, 79, and 85 °C). Diets were steam conditioned (Wenger twin staff preconditioner, Model 150) and pelleted (CPM, Model 1012-2) with a 4- × 22.2-mm (L:D 5.6) or 4- × 31.8-mm (L:D 8) pellet die. Conditioner retention time was set at 30 s and production rate was set at 15 kg/min. All treatments were represented within three replicate days. Pellets were composited and analyzed for gelatinized starch and pellet durability index (PDI). Conditioning temperature, hot pellet temperature, production rate, and pellet mill energy consumption were recorded throughout each processing run. Data were analyzed using the GLIMMIX procedure in SAS (v. 9.4, SAS Institute Inc., Cary, NC) with pelleting run as the experimental unit and day as the blocking factor. Pelleting with a larger die L:D improved PDI ( = 0.01) and increased ( = 0.02) pellet mill energy consumption. Increasing conditioning temperature from 74 to 85 °C increased (linear, < 0.03) PDI and tended to decrease energy consumption (quadratic, = 0.07). There was a corn × conditioning temperature interaction ( = 0.01) for gelatinized starch in conditioned mash. Enogen Feed corn diets steam conditioned at 85 °C had the greatest quantity of gelatinized starch. Cooked starch in conditioned mash and pellets was greater ( < 0.01) for EFC diets compared to CON diets and increased (linear, < 0.01) with increasing conditioning temperature in conditioned mash. Similarly, starch gelatinization was greater ( < 0.01) in pelleted EFC diets compared to CON diets and was increased (linear, = 0.05) by increasing conditioning temperature from 74 to 85 °C. In conclusion, increasing die L:D and increasing conditioning temperature improved PDI. Starch gelatinization was increased when diets were pelleted at the highest conditioning temperature of 85 °C, and EFC diets resulted in greater starch gelatinization than conventional corn.
PubMed: 33241191
DOI: 10.1093/tas/txaa189 -
Animals : An Open Access Journal From... Apr 2022The objective of this study was to study the effect of pelleting and long-term high-temperature stabilization on the retention of vitamin A, vitamin E, vitamin B2, and...
The objective of this study was to study the effect of pelleting and long-term high-temperature stabilization on the retention of vitamin A, vitamin E, vitamin B2, and vitamin B6 in swine feed. Piglet diets (diet 1 and 3) were pelleted after conditioning at 83 °C for 120 s, and were high-temperature stabilized at 90 °C for 8.5 min after pelleting; the finishing pig diets (diet 2, 4, and 5) were pelleted after conditioning at 82 °C for 90 s, and were high-temperature stabilized at 85 °C for 9 min after pelleting; the samples were obtained before condition, after condition, after pelleting, and after cooling. The contents of vitamin A and vitamin E in diets 1−5 and vitamin B2, and vitamin B6 in diets 3−5 were detected. The results showed that: (1) the conditioning process had no significant effect on the retention of vitamin A, vitamin E, vitamin B2, and vitamin B6 in all experimental diets (p > 0.05); (2) the pelleting process and high-temperature stabilization process after pelleting had different degrees of influence on vitamins, among which the stabilization process had a more significant effect on the retention of vitamins. After pelleting and long-term high-temperature stabilization, the retention of vitamin A, vitamin E, and B2, and vitamin B6 were 68.8−77.3%, 56.9−90.1%, 63.8−70.3%, and 60.1−67.0%, respectively. In the process of pelleting and long-term high-temperature stabilization, the retention of vitamin A, vitamin E, vitamin B2, and vitamin B6 in the feed were significantly reduced (p < 0.05). Therefore, vitamin loss during high temperature and over a long period of time is worth considering, and vitamins must be over-supplemented.
PubMed: 35565485
DOI: 10.3390/ani12091058 -
Current Medical Mycology 2020This study was conducted to evaluate the presence of aflatoxigenic strains and level of aflatoxin in poultry feed. Aflatoxigenic strains were investigated in corn and...
BACKGROUND AND PURPOSE
This study was conducted to evaluate the presence of aflatoxigenic strains and level of aflatoxin in poultry feed. Aflatoxigenic strains were investigated in corn and soybean meal as the ingredients of poultry feed, as well as in two types of commercial feed, namely pellet and mash. The gene sequencing was performed to identify the species of section
MATERIALS AND METHODS
All samples were randomly collected from feed storage silos located in Iran in 2018. The samples were cultured on specialized media for 2 weeks at 28ºC. Identification of section isolates was based on macro- and microscopic morphological criteria and molecular analysis. The thin-layer chromatography (TLC) was applied to confirm the aflatoxigenic isolates. In addition, the level of aflatoxin B (AFB) produced by these isolates was determined by high-performance liquid chromatography. The strains were subjected to sequence analysis, and Bt2 PCR products were purified by the QIAquick PCR purification kit. At the final stage, the phylogenetic tree was built.
RESULTS
Among 54 isolates identified as section 20 (37%) isolates were found to produce aflatoxin at a range of 11.28±1.18 to 2239.92±92.26 µg/g fungal dry weight. The aflatoxigenic isolates had the frequencies of 45%, 40%, 10%, and 5% in the corn, pellet, soybean meal, and mash samples, respectively. Furthermore, the mean concentrations of AFB were significantly higher in the corn samples (707.04±39.05) than that of other poultry feed samples (). A total of 34 (63%) isolates were detected as non-aflatoxigenic on the yeast extract-sucrose broth in TLC analysis. The toxigenic isolates produced the highest (2232.62±55.49) and lowest (11.28±1.18) levels of AFB in the corn samples, compared to other feedstuffs. Furthermore, the mean level of AFB in mash product was 554.09±10.36 µg/g, compared to a mean level of 229.22±11.09 µg/g in pellets. The isolates were randomly selected, sequenced, and then analyzed. Subsequently, the phylogenetic tree of section was plotted.
CONCLUSION
The process of converting raw ingredients to compound poultry feed is more hazardous when there is not enough time and temperature provided to eliminate aflatoxigenic isolates. Therefore, section in poultry feed can pose a threat to the poultry industry and poultry products, thereby affecting the health status of humans. Unprocessed/processed materials, such as corns and pelleted feed, need further monitoring, especially when conditions are not optimal for destroying the fungus.
PubMed: 32420504
DOI: 10.18502/cmm.6.1.2504 -
Turkish Journal of Ophthalmology Apr 2020We present patient characteristics and follow-up results of cases with anterior chamber dexamethasone implant migration. The common feature of all six presented cases...
We present patient characteristics and follow-up results of cases with anterior chamber dexamethasone implant migration. The common feature of all six presented cases was vitrectomized eyes. Four of the patients had sutured intraocular lens (IOL) implantation due to complicated cataract surgery, one had combined retinal detachment surgery with sutured IOL implantation, and one had vitrectomy for diabetic intravitreal hemorrhage cleaning and uncomplicated cataract surgery. Anterior chamber implant migration caused corneal edema in all cases and elevated intraocular pressure in three cases. In two cases, the dexamethasone implant was directed into the vitreous cavity after maximum pupillary dilation and corneal manipulation with cotton tip applicator with the patient in reverse Trendelenburg position. There was no other complication until dexamethasone implant degradation, with clear cornea at final examination. In two cases, the implant was removed from the anterior chamber by aspiration, but keratoplasty surgery was planned due to endothelial cell loss and persistent corneal edema during follow-up. In the last two cases, the dexamethasone implant was redirected into the vitreous chamber with a 23-gauge catheter and anterior chamber maintainer but they migrated into the anterior chamber again. In one of these patients, the implant was aspirated by catheter and corneal transplantation was performed due to corneal edema, while the other patient's implant was redirected into the vitreous chamber with no further anterior migration. The risk of dexamethasone implants migrating into the anterior chamber of vitrectomized eyes and those with sutured IOL implantation should be kept in mind and the patient should be informed and advised to see an ophthalmologist immediately before permanent corneal endothelial damage occurs.
Topics: Anterior Chamber; Dexamethasone; Drug Implants; Foreign-Body Migration; Humans; Macular Edema; Male; Middle Aged; Tomography, Optical Coherence
PubMed: 32367704
DOI: 10.4274/tjo.galenos.2019.43778 -
Engineering in Life Sciences Mar 2021Filamentous microorganisms are main producers of organic acids, enzymes, and pharmaceutical agents such as antibiotics and other active pharmaceutical ingredients. With... (Review)
Review
Filamentous microorganisms are main producers of organic acids, enzymes, and pharmaceutical agents such as antibiotics and other active pharmaceutical ingredients. With their complex cell morphology, ranging from dispersed mycelia to dense pellets, the cultivation is challenging. In recent years, various techniques for tailor-made cell morphologies of filamentous microorganisms have been developed to increase product formation and have been summarised under the term . These techniques, namely microparticle-enhanced cultivation, macroparticle-enhanced cultivation, and alteration of the osmolality of the culture medium by addition of inorganic salts, the salt-enhanced cultivation, are presented and discussed in this review. These techniques have already proven to be useful and now await further proof-of-concept. Furthermore, the mechanical behaviour of individual pellets is of special interest for a general understanding of pellet mechanics and the productivity of biotechnological processes with filamentous microorganisms. Correlating them with substrate uptake and finally with productivity would be a breakthrough not to be underestimated for the comprehensive characterisation of filamentous systems. So far, this research field is under-represented. First results on filamentous pellet mechanics are discussed and important future aspects, which the filamentous expert community should deal with, will be presented and critically discussed.
PubMed: 33716605
DOI: 10.1002/elsc.202000060 -
Poultry Science Jun 2020This study aimed to assess the effect of preprocessing of corn and of physical form of diets on growth performance, carcass yield, and nutrient digestibility in broilers...
This study aimed to assess the effect of preprocessing of corn and of physical form of diets on growth performance, carcass yield, and nutrient digestibility in broilers and also the influence of corn processing on pellet quality. A total of 1,080 male Cobb chicks from 1 to 35 D were evaluated. Birds were distributed according to a completely randomized design in a 3 × 2 factorial arrangement, with 3 types of corn processing (unprocessed, pelleted, or expanded), and 2 diet physical forms (mash or pelleted), totaling 6 treatments and 9 replicates with 20 birds. The data were submitted to ANOVA, and means were compared by Tukey's test (P < 0.05). There was no interaction between the physical form and preprocessing of corn for any of the studied variables (P > 0.05). The use of expanded corn in the diets before pelleting resulted in higher pellet durability index and lower amount of fines (P < 0.05) when compared with unprocessed corn. Broilers fed pelleted diets had higher feed intake (FI) and weight gain (WG; P < 0.001), higher amounts of abdominal fat (P < 0.05), and lower ileal digestible energy (IDE, P = 0.05) than those fed mash. There was no effect of the feed form on nutrient digestibility (P > 0.05). Broilers fed diets with unprocessed corn had higher FI when compared to those fed diets with expanded or pelleted corn (P < 0.001). The use of pelleted corn resulted in lower WG than the other processing methods (P < 0.01). The corn expansion process improved feed conversion ratio and adjusted feed conversion ratio (P < 0.001). Inclusion of expanded corn improved the coefficient of apparent ileal digestibility of DM, CP, starch, and IDE (P < 0.05) in comparison with unprocessed corn. It is concluded that pelleted diets improve broiler performance. The corn expansion can be used to improve physical quality of the diets and broilers growth performance and nutrient digestibility.
Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Chickens; Diet; Digestion; Food Handling; Male; Meat; Nutrients; Random Allocation; Zea mays
PubMed: 32475455
DOI: 10.1016/j.psj.2020.01.027 -
PloS One 2021The innovative Pratt pouch could optimize dispensing nevirapine prophylaxis to HIV-exposed infants in pre-measured single dose pouches to increase completion of the full...
INTRODUCTION
The innovative Pratt pouch could optimize dispensing nevirapine prophylaxis to HIV-exposed infants in pre-measured single dose pouches to increase completion of the full 6 week infant nevirapine regimen.
MATERIALS AND METHODS
Nineteen health facilities with highest HIV positivity rates among pregnant women across 9 districts in southwest and central Uganda were assigned to control and intervention groups. HIV-positive women enrolled at intervention facilities received pouches filled with premeasured single doses of nevirapine using Uganda national guidelines, which were integrated into the existing drug distribution system. During antenatal care (ANC) women received 14 pouches to cover time until the 6 day postpartum visit, with an additional 8 pouches if women were delayed in returning to the facility, and 28 pouches after delivery. Women enrolled at control facilities received standard nevirapine syrup following delivery for postnatal infant prophylaxis. In a select number of intervention facilities, during ANC, women received all 42 pouches needed to complete the 6 weeks regimen. Medical record data from enrolled women were extracted; interviews with HIV-positive women during postnatal care visits were conducted. Data were collected January to August 2018 (control sites) and October 2019 to February 2020 (intervention sites). Unadjusted and adjusted logistic regression models were used to identify factors associated with facility delivery, postnatal care follow-up visit, and completion of the full 6 weeks infant nevirapine regimen.
RESULTS
Significantly more women in the intervention (n = 320) versus control (n = 340) group had facility delivery (292/316, 92.4% versus 169/340, 49.7%, p<0.0001), postnatal visits within 2 weeks postpartum (295/297, 99.3% versus 133/340, 39.1%, p<0.0001) and reported their infants completing the full 6 weeks infant prophylaxis regimen (299/313, 95.5% versus 210/242, 86.8%, p = 0.0002). Dispensing 42 versus 14 pouches during ANC did not have negative effects on these outcomes. Among out-of-facility deliveries, a higher proportion of infants received nevirapine within 72 hours of birth in the intervention versus control group, 95.8% versus 77.9%. In multivariate models, the intervention group was the only significant factor associated with facility delivery or completion of the full 6 weeks infant prophylaxis.
CONCLUSIONS
Use of the Pratt pouch resulted in an increase in HIV-exposed infants completing the full 6weeks prophylaxis regimen and associated benefits including increasing facility delivery and women's adherence to postnatal care services.
Topics: Adult; Anti-HIV Agents; Drug Implants; Drug Packaging; Female; HIV Infections; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Nevirapine; Postnatal Care; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Surveys and Questionnaires; Uganda; Young Adult
PubMed: 33690610
DOI: 10.1371/journal.pone.0247507 -
The Science of the Total Environment Oct 2020Emissions from solid-fuel burning cookstoves are associated with 3 to 4 million premature deaths annually and contribute significantly to impacts on climate....
Emissions from solid-fuel burning cookstoves are associated with 3 to 4 million premature deaths annually and contribute significantly to impacts on climate. Pellet-fueled gasifier stoves have some emission factors (EFs) approaching those of gas-fuel (liquid petroleum gas) stoves; however, their emissions have not been evaluated for biological effects. Here we used a new International Organization for Standardization (ISO) testing protocol to determine pollutant- and mutagenicity-EFs for a stove designed for pellet fuel, the Mimi Moto, and for two other forced-draft stoves, Xunda and Philips HD4012, burning pellets of hardwood or peanut hulls. The Salmonella assay-based mutagenicity-EFs (revertants/megajoule) spanned three orders of magnitude and correlated highly (r = 0.99; n = 5) with EFs of the sum of 32 particle-phase polycyclic aromatic hydrocarbons (PAHs). The Mimi Moto/hardwood pellet combination had total-PAH- and mutagenicity-EFs 99.2 and 96.6% lower, respectively, compared to data published previously for the Philips stove burning non-pelletized hardwood, and 100 and 99.8% lower, respectively, compared to those of a wood-fueled three-stone fire. The Xunda burning peanut hull pellets had the highest fuel energy-based mutagenicity-EF (revertants/megajoule) of the pellet stove/fuel combinations tested, which was between that of diesel exhaust, a known human carcinogen, and a natural-draft wood stove. Although the Mimi Moto burning hardwood pellets had the lowest fuel energy-based mutagenicity-EF, this value was between that of utility coal and utility wood boilers. This advanced stove/fuel combination has the potential to greatly reduce emissions in contrast to a traditional stove, but adequate ventilation is required to approach acceptable levels of indoor air quality.
Topics: Air Pollutants; Cooking; Environmental Pollutants; Humans; Mutagens; Particulate Matter; Wood
PubMed: 32526531
DOI: 10.1016/j.scitotenv.2020.139488