bluuebunny/crossref_metadata_2025 huggingface dataset:
Bi-Institutional Analysis of Microbiological Spectrum and Therapeutic Management of Parotid Abscesses
Authors: Mayer Marcel , Esser Julia , Walker Sarah , Shabli Sami , Lechner Axel , Canis Martin , Klussmann Jens Peter , Nachtsheim Lisa , Wolber Philipp
Published: May 2024

Background. A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting.
Methods. A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables.
Results. Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n=23), followed by Staphylococcus aureus (n=6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin +/- beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%) or obstructive, immunosuppressive, or tumorous (each 11.8%). Patients with a dental focus (p=0.007) had a longer duration of hospitalization. Chronic parotitis was associated with recurrence (p<0.001).
Conclusion. The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.
Electronic patient-reported outcome monitoring system for sarcoma patients undergoing drug treatment: A development and feasibility study
Authors: Toki Shunichi , Nishisho Toshihiko , Yamashita Natsumi , Numoto Kunihiko , Sugihara Shinsuke , Kidani Teruki , Kawasaki Motohiro , Nishimura Hideki , Muramatsu Shudai , Namba Hirofumi , Tanioka Hiroki , Fujibuchi Taketsugu , Fukuoka Natsuko , Shiko Yuki , Taira Naruto , Sairyo Koichi
Published: May 2024

Background: Symptom and quality of life monitoring using electronic patient-reported outcomes has been widely adopted for common cancers. However, there are few such systems and studies for rare cancers such as sarcoma in Japan. We herein report a development and feasibility study of a novel system for monitoring electronic patient-reported outcomes.
Methods: Our study group, which included members from industry and academia, conducted weekly electronic patient-reported outcome monitoring for sarcoma patients during the administration of anti-tumor agents. This prospective study was conducted from 2021 to 2023, with each patient monitored for 12 weeks to 1 year.
Results: Twenty-three patients were included in this study. The weekly response rate and missing rate of the electronic patient-reported outcome system were 95.7% and 0.12%, respectively. The median time required to answer the items for Performance Status, EuroQol 5-Dimension 5-Level, and 14 symptoms from the Patient-Reported Outcome-Common Terminology Criteria for Adverse Events was 11 s, 46 s, and 123 s, respectively. In a comparison between electronic and paper-based patient-reported outcomes, the intraclass correlation coefficient of the EuroQol index score was 0.92 (95%CI: 0.89-0.94) and the weighted kappa coefficient was >0.6 for items in the weekly evaluations. The items that showed the highest rate of moderate or severe grade (at least once in each case) in the whole cohort were general pain (82.6%), fatigue (78.3%), decreased appetite (73.9%) and pain/discomfort (73.9%).
Conclusions: The novel electronic patient-reported outcome monitoring system for Japanese sarcoma patients undergoing drug treatment is found to be feasible and showed excellent compliance. For the application of the system in clinical practice, an update to implement an alert function based on a precise predictive model, is warranted.
Are we there yet? AI on traditional blood tests efficiently detects common and rare diseases
Authors: Németh Ákos , Tóth Gábor , Fülöp Péter , Paragh György , Nádró Bíborka , Karányi Zsolt , Paragh György , Horváth Zsolt , Bagyó Gábor , Édes István , Kappelmayer János , Harangi Mariann , Daroczy Balint
Published: May 2024

Chronic workforce shortages, unequal distribution, and rising labor costs are crucial challenges for most healthcare systems. The past years have seen a rapid technological transition to counter these pressures. We developed an AI-assisted software with ensemble learning on a retrospective data set of over one million patients that only uses routine and broadly available blood tests to predict the possible presence of major chronic and acute diseases as well as rare disorders. We evaluated the software performance with three main approaches that are 1) statistics of the ensemble learning focusing on ROC-AUC (weighted average: 0.9293) and DOR (weighted average: 63.96), 2) simulated recall by the model-generated risk scores in order to estimate screening effectiveness and 3) performance on early detection (30–270 days before established clinical diagnosis) via creating historical anamnestic patient timelines. We found that the software can significantly improve three important aspects of everyday medical practice. The software can recognize patterns associated with both common and rare diseases, including malignancies, with outstanding performance. It can also predict the later diagnosis of selected disease groups 1–9 months before the establishment of clinical diagnosis and thus could play a key role in early diagnostic efforts. Lastly, we found that the tool is highly robust and performs well on data from various independent laboratories and hospitals on widely available routine blood tests. Compared to decision systems based on medical imaging, our system relies purely on widely available and inexpensive diagnostic tests.
Biallelic mutations in SUPV3L1 cause an inherited neurodevelopmental disorder with variable leukodystrophy due to aberrant mitochondrial double stranded RNA processing
Authors: Green Lydia , Hamilton Noémie , Elpidorou Marilena , Maroofian Reza , Douglas Andrew G.L. , Õunap Katrin , Rose Ailsa M.S. , Harris Erica L. , Elworthy Stone , Renshaw Stephen A. , Low Elizabeth C. , Dockrell David H. , Tveten Kristian , Wells Geoffrey , Harris Sarah A. , Al-Maawali Almundher , Al-Thihli Khalid , Al-Zuhaibi Sana , Futaisi Amna Al , Calame Daniel , Chinn Ivan , Fisher Kristen S. , Sa Mario , Warren Daniel , Zamani Mina , Sadeghian Saeid , Azizimalamiri Reza , Galehdari Hamid , Shariati Gholamreza , Seifi Tahere , Zaki Maha S. , Afzal Erum , Tarnopolsky Mark A. , Brady Lauren , Zuchner Stephan L. , Efthymiou Stephanie , Scardamaglia Annarita , Houlden Henry , Wakeling Emma , Prabhakar Prab , Roca-Bayerri Carla , Rice Gillian I. , Prouteau Clément , Bris Céline , Tessarech Marine , Sandvig Inger , Sheridan Eamonn G. , Johnson Colin A. , Livingston John H. , Crow Yanick J. , Poulter James A.
Published: May 2024

We describe eighteen individuals from twelve families with an autosomal recessive neurodevelopmental disorder and variable leukodystrophy harbouring biallelic variants in SUPV3L1. SUPV3L1 encodes the RNA helicase SUV3 (also known as SUPV3L1), with previous studies demonstrating a role for the protein as part of the mitochondrial degradosome. Patient mutations result in an accumulation of mitochondrial double stranded RNAs in human cells. An assessment of supv3l1 knock-out zebrafish confirmed the role of supv3l1 in neurodevelopment, with gross defects identified in mitochondrial biogenesis and microglial function. Zebrafish displayed a significant activation of the type 1 interferon pathway, which was supported by qPCR of blood RNA from four patients with biallelic SUV3 mutations. Altogether, we describe a clinico-radiological spectrum associated with biallelic SUPV3L1 mutations, demonstrating that loss of SUV3 function results in altered mitochondrial biogenesis, increased mitochondrial double stranded RNA, dysplastic microglia and activation of the type 1 interferon innate immune pathway.
Reducing the Percent of Surviving Infants with Acute Symptomatic Seizures Discharged on Anti-Seizure Medication
Authors: Sewell Elizabeth , Nangle Anne Marie , He Zhulin , Bhalla Sonam , Bullock Jessica , Carlson Alyssa , Dutt Monideep , Hamrick Shannon , Jones Passion , Piazza Anthony , Vale Allison
Published: May 2024

Objective: To evaluate the impact of inclusion of an ASM weaning protocol in a neonatal seizure pathway on the percent of infants discharged on ASMs.
Study Design: This cohort study included surviving infants with acute symptomatic seizures treated with ASMs. We evaluated infants in 2 epochs, pre- and post-implementation of the ASM weaning protocol. The primary outcome was discharge on ASM.
Results: Of 116 included infants, the percent of infants discharged on ASMs was 69% in epoch 1 versus 34% in epoch 2 (p<0.001). There was no significant difference between epochs in recurrence of seizures after discharge by 1 year of age (p=0.125). There was an annual decrease in the percent of infants discharged on ASM for both delivery and referral NICUs.
Conclusion: Inclusion of a formal ASM weaning protocol as part of an institutional seizure pathway reduced percent of infants with acute symptomatic seizures discharged on ASM.
Diverse Clinical and Immunological Profiles in Patients with IPEX Syndrome: A Multicenter Analysis
Authors: Bozkurt Hayrunnisa Bekis , Catak Feyza Bayram , Sahin Ali , Gungoren Ezgi Yalcin , Karaarslan Betul Gemici , Yakici Nalan , Altunbas Melek Yorgun , Catak Mehmet Cihangir , Can Salim , Amirov Razin , Bozkurt Selcen , Ozturk Necmiye , Eltan Sevgi Bilgic , Kasap Nurhan , Cetinkaya Fatma Bal , Orhan Fazil , Arga Mustafa , Cavkaytar Ozlem , Kiykim Ayca , Karakoc-Aydiner Elif , Ozen Ahmet , Baris Safa
Published: May 2024

Purpose: Immunodysregulation, Polyendocrinopathy, Enteropathy, and X-linked syndrome (IPEX), caused by FOXP3 mutations, is a rare autoimmune disorder with diverse clinical features, including early-onset diabetes, eczema, and enteropathy. Atypical cases show milder symptoms and unique signs, requiring different treatments. Therefore, there are ambiguities in the accurate diagnosis and management of IPEX. We sought to present clinical, genetic, and immunological assessments of 12 IPEX patients with long-term follow-up to facilitate the diagnosis and management of the disease.
Methods: Clinical findings and treatment options of the patients were collected over time. Lymphocyte subpopulations, protein expressions, regulatory T (Treg) and circulating T follicular helper (cTFH) cells, and T-cell proliferation were analyzed. Results: Predominant presentations included chronic diarrhea (75%), failure to thrive (66.7%), and eczema (58.3%). There were four classical and eight atypical IPEX individuals. Strikingly, the classical triad of IPEX was observed only in one patient. Allergic manifestations were more common in atypical patients. Notably, infections and chronic diarrhea demonstrated heightened severity compared to other manifestations. Four patients (33.3%) demonstrated eosinophilia, and nine (75%) showed high serum IgE levels. Most patients showed normal percentages of Treg cells with reduced CD25, FOXP3, and CTLA-4 expressions. Compared to healthy controls, the TH2-like skewing accompanied by reduced TH17-like responses was observed in cTFH and Treg cells of patients. The impaired immune responses were corrected after hematopoietic stem cell transplantation (HSCT). Overall, nine patients (75%) received immunosuppressants (ISs), and six (50%) underwent HSCT, which was the only treatment revealing sustained control. Commonly used ISs included corticosteroids and sirolimus, but severe side effects led to therapy discontinuation in six patients.
Conclusions: This comprehensive analysis of clinical features and treatment responses contributes valuable insights for the improved diagnosis and management of IPEX syndrome, particularly emphasizing the atypical presentations and the efficacy of HSCT in achieving sustained control.
Correlation of Bone Age Development with Overweight and Obesity in 23305 Children from Beijing
Authors: Zhou Bo , Qu Xia , Li Minjun , Wang Xi , Xu Qi , Wang Jianhong , Liu Xiaoli , Zhang Lili , Zhang Ting , Gu Jialu , Zhou Lijun , Peng Nan , Niu Wenquan , Wang Lin
Published: May 2024

Purpose
The aim was to observe the influence of different nutritional status on bone age change according to BMI and analyze the risk of advanced bone age in overweight and obese children.
Methods
Total 23305 children from Beijing in this cross-section study were analyzed. Childhood overweight and obesity are defined according to the China and WHO growth criteria. Data are analyzed by STATA software and the R language version 4.3.0.
Results
Under China criteria, 29%, 15% and 4% of overweight boys, 33%, 33% and 3% of obese boys, while 39%, 25% and 2% of overweight girls, 37%, 42% and 1% of obese girls had advanced, significantly advanced and delayed BA. After adjustment, overweight (odds ratio, 95% confidence interval, P under China criteria: 2.52, 2.30 to 2.75, < 0.001 and 4.54, 4.06 to 5.09, < 0.001) and obesity (4.31, 3.85 to 4.82, < 0.001 and 14.01, 12.39 to 15.85, < 0.001) were risk factors of both advanced BA and significantly advanced BA.
Conclusions
Different nutritional status leads to different children's BA development, overweight and obese children have a higher rate of advanced BA under two growth criteria, and girls are more obvious than boys. Overweight and obesity were risk factors of advanced BA.
Explainable Machine Learning Model for Predicting the Risk of Significant Liver Fibrosis in Patients with Diabetic Retinopathy
Authors: zhu gangfeng , Yang Na , Yi Qiang , Xu Rui , Zheng Liangjian , Zhu Yunlong , Li Junyan , Che Jie , Chen Cixiang , Lu Zenghong , Huang Li , Xiang Yi , Zheng Tianlei
Published: May 2024

Background: Diabetic retinopathy (DR), a prevalent complication in patients with type 2 diabetes, has attracted increasing attention. Recent studies have explored a plausible association between retinopathy and significant liver fibrosis. The aim of this investigation was to develop a sophisticated machine learning (ML) model, leveraging comprehensive clinical datasets, to forecast the likelihood of significant liver fibrosis in patients with retinopathy and to interpret the ML model by applying the SHapley Additive exPlanations (SHAP) method.
Methods: This inquiry was based on data from the National Health and Nutrition Examination Survey 2005-2008 cohort. Utilizing the Fibrosis-4 index(FIB-4), liver fibrosis was stratified across a spectrum of grades (F0-F4). The severity of retinopathy was determined using retinal imaging and segmented into four discrete gradations. A ten-fold cross-validation approach was used to gauge the propensity towards liver fibrosis. Eight ML methodologies were used: Extreme Gradient Boosting (XGBoost), Random Forest, multilayer perceptron, Support Vector Machines, Logistic Regression, Plain Bayes, Decision Tree, and k-nearest neighbors. The efficacy of these models was gauged using metrics, such as the area under the curve (AUC). The SHAP method was deployed to unravel the intricacies of feature importance and explicate the inner workings of the ML model.
Results: The analysis included 5363 participants, of whom 2116 (39.45%) exhibited notable liver fibrosis. Following random allocation, 3754 individuals were assigned to the training set and 1610 were allocated to the validation cohort. Twelve variables were curated for integration into the ML model. Among the eight ML models scrutinized, the XGBoost model attained zenith in both AUC (0.977, 95% CI: 0.974-0.981) and F1 score (0.896, 95% CI: 0.885-0.907). In internal validation, this model sustained its superiority, with an AUC of 0.969 and an F1 score of 0.885, surpassing all other ML models. The SHAP methodology unveils the six foremost factors through importance ranking.
Conclusion: Sophisticated ML models were crafted using clinical data to discern the propensity for significant liver fibrosis in patients with retinopathy and to intervene early.
Decision for elective surgery - how well informed are patients and how easy is the decision for them?
Authors: Prediger Barbara , Könsgen Nadja , Schlumberger Fabian , Heinen Lena , Schlimbach Anna , Hess Simone , May Susann , Bruch Dunja , Liersch Sebastian , Sehlen Stephanie , Pieper Dawid
Published: May 2024

Background: Decisions for elective surgery are difficult for many patients and some regret them afterwards. The aim of this survey of patients who have undergone elective tonsillectomy/tonsillotomy (TE/TT), hysterectomy (HE) or shoulder arthroscopy (SA) was to investigate the decision process, need for information and need for second opinion.
Methods: In October 2020, n=8,862 persons insured at AOK Nordost who had undergone TE/TT, HE and SA were invited by post to participate. A reminder was sent in November 2020. Results were analysed descriptively.
Results: A total of n=1,633 responses were received (participation rate 18%). Around half (54 %) of the participants felt that the decision to undergo surgery was (very) easy. Overall, the participants felt (very) well informed about the benefits of surgery (79%), the disease (76%), treatment alternatives (66%) and the risks/ side effects of surgery (67%) after the consultation with the physician recommending surgery, 29 % sought a second opinion.
Conclusion: The majority of respondents seemed well informed after the consultation with the physician recommending surgery. Information about treatment alternatives and risks/ side effects of the surgery might be improvable. Prospective studies looking at the decision process before surgery would allow a clearer statement about contribution of aspects to an informed decision.
Stress Relaxation, another cause of “Pseudo Auto-Peep”?
Authors: Marchal Manuel Valdivia , Izurieta José Ricardo Naranjo , Carmona Ashlen Rodríguez , Pérez José Castaño , Centeno Guillermo Besso , Simón José Manuel Serrano
Published: May 2024

In critically ill patients receiving mechanical ventilation, a positive end-expiratory pressure greater than the applied externally (auto-PEEP) reflects dynamic hyperinflation of the lungs. The term “Pseudo Auto-Peep” (Bilen & Cohen, 1993) 1 was coined to describe a progressive increase in expiratory plateau pressure in prolonged occlusion, attributed to a retrograde flow of extraluminal gas into the airways. However, the mechanism has not been studied closely. We intend to describe another mechanism for this phenomenon, explained by stress relaxation due to inequalities in expiratory time constant (τE), manifested in inspiration and expiration.
Enhancing Competitive Advantage through a Strategic Product Portfolio and Design for Variety in Weather Radar Products
Authors: Azami Marzieh , Karbasian Mahdi , yousefian Sareh
Published: May 2024

In today's competitive industrial landscape, corporations must develop products with a wide range of options to stay ahead. High product quality and mass customization trends have driven industries to adopt product portfolio strategies, enhancing customer satisfaction and optimizing resource use. The design for variety (DFV) technique is crucial for managing product variety impact on costs. This abstract introduces a model for improving weather radar product design by integrating various methodologies for an optimal product structure. By carefully considering competitive advantages and expanding product portfolios, corporations can enhance market share and meet customer needs effectively
Fine-Tuning for Accuracy: Evaluation of GPT for Automatic Assignment of ICD Codes to Clinical Documentation
Authors: Nawab Khalid , Fernbach Madalyn , Atreya Sayuj , Asfandiyar Samina , Khan Gulalai , Arora Riya , Hussain Iqbal , Hijjawi Shadi , Schreiber Richard
Published: May 2024

Background:
Assignment of International Classification of Disease (ICD) codes to clinical documentation is a tedious but important task that is mostly done manually. This study evaluated the widely popular OpenAI’s Generative Pretrained Model (GPT) 3.5 Turbo in facilitating the automation of assigning ICD codes to clinical notes.
Methods:
We identified the 10 most prevalent ICD-10 codes in the Medical Information Mart for Intensive Care (MIMIC-IV) dataset. We selected 200 notes for each code, and then split them equally into two groups of 100 each (randomly selected) for training and testing. We then passed each note to GPT 3.5 Turbo via OpenAI’s API, prompting the model to assign ICD-10 codes to each note. We evaluated the model’s response for the presence of the target ICD-10 code. After fine-tuning the GPT model on the training data, we repeated the process with the test data, comparing the fine-tuned model’s performance against the default model.
Results:
Initially the target ICD-10 code was present in the assigned codes by the default GPT 3.5 Turbo model in 29.7% of the cases. After fine-tuning with 100 notes for each top code, the accuracy improved to 62.6%.
Conclusions:
Historically, GPT’s performance for healthcare related tasks is sub-optimal. Fine-tuning as in this study provides great potential for improved performance, highlighting a path forward for integration of Artificial Intelligence (AI) in healthcare for improved efficiency and accuracy of this administrative task. Future research should focus on expanding the training datasets with specialized data and exploring the potential integration of these models into existing healthcare systems to maximize their utility and reliability.
Designing strategies to reach the maximum number of women for comprehensive knowledge of Human Immunodeficiency Virus (HIV)
Authors: Sarkar Jaimini , Sarkar Chiradeep
Published: May 2024

Introduction:
Globally women are the major victims of socio-economic and political inequalities. This applies equally to stigma and discrimination related to HIV awareness and treatment. India has the second largest HIV epidemic in the world with 2.467 million people living with HIV in 2023. India shares 6.3% of global cases of people living with HIV. The biggest challenge is not only to reach all HIV-infected people but also to reach the maximum number of people for counseling and testing to avoid future transmission. There is a need to frame cost-effective, rapid, and confidential awareness strategies that will eventually encourage people to HIV testing.
Design:
Anonymized, publicly available data of the India National Family Health Survey (NFHS-5) and ASHAs per state is collected from the Ministry of Health and Family Welfare, India. The sample consisted of 724,115 women of 15–49 years of age and were sub-grouped as urban and rural women. Descriptive statistical analysis, linear regression analysis, and Pearson correlation coefficient analysis were done for the data.
Results:
The multiple linear regression equation for women with comprehensive HIV knowledge (%) Y is ŷ = -0.19433X1 + 0.32387X2 + 12.32505 where X1 is the percentage of ASHAs per state and X2 is the percentage of women with Internet access. It shows an R square value of 0.2338 for an overall p-value of 0.0123. Pearson correlation indicated that there is a non-significant medium negative relationship between ASHAs per state (%) and women with knowledge of HIV (%) (r = -0 .315, p = 0.061). Whereas, the results of the Pearson correlation indicated that there is a significant medium-positive relationship between the percentage of women with internet access and the percentage of women with comprehensive knowledge of HIV, (r = 0 .481, p = 0.003).
Conclusion:
More urban women have access to the Internet as compared to rural women, which may be the reason why the knowledge of HIV is higher in urban women as compared to their rural counterparts. Internet access to women is more beneficial in states where the rate of literacy is high. In areas where internet access and understanding content in English is an issue, community health workers can provide better support to spread awareness about HIV.
I’d Rather Bite My Tongue Off Than Stand with Them: Paralysis of Political Engagement in Serbia
Authors: Nikolić Sara , Zejnulahović Damir , Janković Miloš
Published: May 2024

The text analyses how the discursive paralysis of political engagement in Serbia is triggered and manifested, as well as how the elements connected with this paralysis are reproduced and reinforced. We begin with the premise that the discursive paralysis of political engagement interacts with two elements: understanding politics as an inherently immoral field of activity, and the importance placed upon personal moral integrity as an essential personal resource for citizens of Serbia. Based on the empirical data from Facebook comments made on a Serbian news portal, the text analyses and presents two types of strategies used to trigger paralysis, as well as how these comments reproduce and reinforce the very perception of politics as a field of immorality and the significance of moral integrity as a personal resource. Finally, we show how these elements are reproduced independently of one another, outside their particular context of “defence” from attack and “precaution.”
Intangible Cultural Heritage and Tourism - Sketches on Identity
Authors: Stojanović Marko
Published: May 2024

Intangible Cultural Heritage (ICH) within the cultural tourism framework has opened up space for reconsideration of the ways in which living heritage, the tourist market, and target tourist groups are intertwined, and how their interaction affects the identity constructs of members of local communities. By including specific domains of living cultural practices in tourist offers, a kind of seesaw has emerged, with economic interests leading to the improved existence of practiced heritage on one side and the fact that ICH becomes a commodity primarily driven by the need of every tourist to literally experience heritage in the same way, becoming an exceedingly marketable commodity, on the other. The living tissue of tourism and ICH, in any case, represents one of the significant resources within which it is possible to realize UNESCO's guiding idea of heritage as a global point of encounter for different cultures. Both of these concepts are in constant processes of reconsidering what has been achieved and are attempting, through upcoming activities, to avoid dead ends and poorly implemented solutions.
A partnership for success: Tips for retaining associates and tips on getting the most out of your first year in practice
Authors: Bartholomew Amy
Published: May 2024

Large animal practices have historically had a difficult time recruiting new veterinarians into the profession. Recently, the data on retention has shown that veterinarians are leav­ing large animal practice for other sectors of clinical practice. Onboarding new associates is different in ambulatory prac­tice when compared with companion animal practice. Setting up the new associate for success will benefit both the existing practitioners as well as the new veterinarian. Spelling out ex­pectations, communicating these expectations, and flexibility will help retain the new associate. This paper gives some tips on ways to increase the retention of associates as well as tips for the new graduate veterinarian on how to make the first year in practice a success.
Caregiver impact on cattle health, performance and well-being
Authors: Noffsinger Tom , Morrissey Lucy
Published: May 2024

Animal well-being is founded on positive interactions and building trusting relationships between caregivers and cattle. Trusting relationships between animals and caregivers result in positive performance levels providing the foundation for a holistic system which benefits the whole internal supply chain i.e., from conception to harvest.
The positive effect of handling livestock with methods based on handler understanding of cattle behavior inclusive of accli­mation and exercise techniques is seen predominately in quali­tative measures resulting in quantitative results in health and performance.
Every human intervention such as calving, processing, wean­ing, pasture rotation, transportation and address change is an opportunity to build cattle confidence, health, performance and well-being.
Cow-calf vaccinations – when it comes to immunology what makes sense and what doesn’t
Authors: Chase Chris
Published: May 2024

Vaccination is an important component for the prevention and control of disease in cattle. However, too often vaccines are viewed as a catch all solution for management and nutrition er­rors; the “best” vaccine can never overcome these deficiencies. Proper vaccination in the young and developing heifer is the key to long term development of that animal as a reproductive unit in the herd. Modified live vaccines (MLV) have been used because of the good antibody response, longer duration of im­munity, fewer doses needed per animal and lower cost. Howev­er, non-adjuvanted MLV vaccines fail to booster well vaccinated animals as active vaccine induced immunity neutralizes vac­cine virus preventing the MLV from replicating and preventing a booster immune response. Improved adjuvants have increased the scope and duration of both MLV and inactivated virus immu­nity. Each vaccine program needs to be based designed based on animal flow, actual “disease” threats and labor on the farm.
Validation of genomic tools to improve production efficiency, health resilience and the carbon footprint of beef production
Authors: Basarab John , Valente Tiago , Wang Yining , Vinsky Michael , Li Changxi , Plastow Graham
Published: May 2024

Genomic tools and accuracy of molecular breeding values (MBVs) for economically important traits continue to improve and are being applied in commercial crossbred beef cattle. Ge­nomic breed composition and retained heterozygosity of an individual animal can be used to further improve female fertil­ity, stayability, lifetime productivity and calf health resilience. But this is just the first step. Within specific crossbred popula­tions, researchers at Livestock Gentec have used large numbers of cattle phenotypes and genotypes, combined with advanced statistical genomic analyses to generate MBVs for 18 traits with moderate to moderately-high accuracy (0.35 to 0.60). This accu­racy is equivalent to 10 to 20 progeny records. These MBVs are economically balanced into multi-trait profit indices such as the Replacement Heifer Profit Index Score and the Feeder Profit In­dex. The use of these genomic tools will improve the sustainabil­ity of beef production by improving profitability, lowering the carbon footprint, and improving an animal’s ability to adapt to changing environments. The following paper outlines the valida­tion of these genomic tools and their potential benefits.
Cow-calf chute side data collection in the field and its role in cow-calf consultation
Authors: Folsom J.D.
Published: May 2024

Cattle Health and Reproduction LLC is a private vet practice located in the Snake River valley of Idaho servicing east Idaho and southwest Montana. It primarily serves beef cattle produc­ers with a major focus on large cow-calf operations with herds of 250 to 3,500 mother cows. The practice also services stocker/ yearling/feedlot operators and has a growing embryo transfer division. The practice retains a strong service-oriented approach with significant involvement in the herd management of its cli­ents. Data collection and information management has been a focus of the practice over the past couple of years and has aided in the development of a consultation leg of the practice.
Bloodborne pathogens in beef herds – a Kansas practitioner’s perspective
Authors: Schrag Nora
Published: May 2024

Management options for bloodborne diseases depend on preva­lence (herd level and geographic), disease stage and production class. Opportunities to manage disease can be classified ac­cording to disease stage. Newer studies show that, in contrast to older studies, there is not currently a known legal way to clear animals of anaplasmosis. The only currently labeled products for treatment of acute clinical anaplasmosis are injectable oxy­tetracyclines. For a time, an enrofloxacin product (Baytril-CA) was marketed with a label for treatment of anaplasmosis, but the conditional approval application has been withdrawn. Op­portunities for leukosis management are limited to exposure control as there are no effective treatments for animals in the clinical stage and no effective methods to clear infected non-clinical animals. Due to the relatively high prevalence in beef herds, a strict test-and-cull strategy is not practical. Instead identifying animals with high pre-viral load who are most infectious provides an option to decrease disease levels with reasonable economics at the farm level. More research is neces­sary to fully quantify production effects for carrier animals of both bovine leukosis and anaplasmosis.
Prescription platform and autogenous vaccines – what are they and what is the difference?
Authors: Chase Chris
Published: May 2024

Autogenous vaccines – farm- and ranch-specific – have been used for decades to prevent and control diseases where com­mercial vaccines have not been effective. Since the 1970s, the United States Department of Agriculture’s Center for Veterinary Biologics (CVB) has regulated the production of autogenous vaccines that are produced for interstate and intrastate use. In 2018, CVB extended this “autogenous” production to platform technology which allows an opportunity for a wider number of agents to have “prescription” vaccines developed. These “pre­scription” platform (RxP) vaccines can express the important immunizing antigens rather than the whole organism in tradi­tional inactivated autogenous vaccines There is a difference in the specificity and safety of autogenous and RxP vaccines, but both need to be administered with an adjuvant. They each have their advantages and disadvantages. These vaccines are tested for safety and purity, but there is no guarantee of efficacy.
Calf Care & Quality Assurance program – best management guidelines for the calf raising sector
Authors: Herman Julia
Published: May 2024

The cattle raising sector has played an important role for devel­oping male or female calves with dairy genetics destined for the dairy breeding herd or the beef production system. Quality as­surance programs have become commonplace for food produc­ing enterprises to build consumer confidence that food is ethi­cally and responsibly produced. Calf raisers are a critical piece to this. Healthy calves are the cornerstone of every beef, dairy and veal facility. As no single organization or program covers all calves to ensure optimal health and welfare throughout the supply chain, the Calf Care and Quality Assurance program (CCQA; funded by the Beef Checkoff) was created through the collaboration of 4 industry groups. The National Dairy Farm­ers Assuring Responsible Management (FARM), Beef Checkoff-funded Beef Quality Assurance (BQA), Veal Quality Assurance (VQA), and the Dairy Calf and Heifer Association (DCHA) are na­tional recognized programs that collaborated to create the CCQA program. Included in the program are science-based guidance for calf raisers covering employee training, continuing educa­tion, emergency preparedness, calf health, animal handling and stockmanship, and management and care. Producers and veterinarians are encouraged to review the tools and resources, get certified in CCQA, and ensure they are following best man­agement practices for calves in their care. It is important that the education that producers, veterinarians and transporters receive is current and up to date, and adapts to this changing industry.
The evolution of dairy cattle welfare
Authors: Cook Nigel , Von Keyserlingk Marina , Walker Jennifer
Published: May 2024

In this article we discuss the evolution of dairy cattle welfare, the approaches being taken to improve welfare in other coun­tries and the recent changes that have been taking place in the U.S. and Canada. The role of the veterinarian as a leader in the animal welfare discussion is addressed, along with the grow­ing list of concerns for the dairy industry in maintaining public trust, and the changes that we predict are needed in current au­diting procedures.
The evolution of lameness on North American dairies: Addressing current industry challenges and exploring new and existing approaches to reduce lameness
Authors: Shepley Elise
Published: May 2024

Lameness is a key issue on commercial dairy farms, impacting productivity, profitability, sustainability, and overall welfare. As the causes of the disorder are multifactorial the persistence of lameness requires more complex approaches that take into account the existing knowledge we have on risk factors and management strategies and couples these with more novel ap­proaches to the issue. With hoof lesions being the source of the overwhelming majority of lameness cases, improving our understanding of what makes for a successful hoof trimming strategy on farms is a first step in addressing lameness. Howev­er, it is our ability to detect and provide early intervention that is proving increasingly vital to overall success in reducing on-farm lameness. Technology, especially when integrated with existing sources of routinely collected herd data, is one such emerging tool that may hold considerable promise for earlier, more accurate, and low labor lameness detection to allow for earlier intervention. Stakeholders, such as hoof trimmers, vet­erinarians, and nutritionists, can serve as effective and trusted facilitators of the adoption of new lameness management prac­tices and technologies, highlighting the need for their involve­ment in the industry pursuit for lower lameness prevalence.
The evolution of down cow management
Authors: Winder Charlotte
Published: May 2024

While improvements have been made in how non-ambulatory cattle cared for over the past 35 years, they remain a challenge to manage on farm. Cows that are down, even for several hours, are at risk of developing secondary complications, further exac­erbated by poor management and care, which impacts both their welfare and potential for recovery. Good nursing care results in better recovery rates and ensures compliance with quality assur­ance programs. Developing standard operating procedures for managing these animals, including euthanasia decision-making, is an essential step towards improving animal welfare on farm.
The evolution of calf nutrition
Authors: Drackley James
Published: May 2024

The milk-feeding period is a front and center welfare concern, as well as a huge economic opportunity for producers and veteri­narians alike. Calf nutrition has progressed from a simple, one-size-fits-all approach to a more sophisticated understanding of the role that early nutrition has in health and future productivity. Still, calves are the only age group where it is not routine to have a nutritionist who formulates the diet, provides feedback and evaluation of animal performance, and is responsible for out­comes of the program. Veterinarians could step in to provide this service. In this presentation, I discuss what incorporating calf nutrition into a dairy practice might look like, as well as some tools available to help accomplish it. Topics discussed include the role and economic value of improving early feed efficiency; research on the value of early nutrition for health and future pro­ductivity; and tips and strategies to implement increased milk feeding programs, including starter and weaning management.
Leading from the bottom up: Improving leadership on your farms and in your practice
Authors: Rooney Barnhardt Tera
Published: May 2024

Embracing bottom-up leadership concepts on farms and within practices replaces aged practices of top-down management with a more inclusive and empowering strategy. Utilizing bot­tom-up concepts fosters a culture of shared responsibility and understanding because the individuals are motivated to achieve success because they fully understand the “why” behind every­thing we are asking of them.
Organizing milk harvest: A producer perspective on infrastructure and human resources
Authors: Warvrin William J.
Published: May 2024

One of the major considerations in operating a dairy production enterprise is the development and execution of a strategy for milk harvest. The production of milk as a business enterprise is generally governed by commodity based financial consid­erations. That is, the price of the final product is driven by the relationship between supply and demand. Both price and cost associated with the final product will be cyclical, and producers with lowest cost will, on average, gain market share over time just as those with high cost will lose market share over econom­ic cycles and may exit the business. Thus, the major consider­ation in organizing milk harvest is how strategic decisions will affect the final cost of the product. Some of the costs associated with the milking center can be considered direct costs while other aspects of the strategy can be considered indirect costs or opportunities. There are still other less tangible aspects of the harvest strategy that may not impact costs directly or indirectly at the milking center, but nonetheless have a bearing on what may be considered success in dairy production on a broader hu­man scale.
Future vet: Current trends in demand for veterinary services on dairy farms
Authors: Warvrin William J.
Published: May 2024

The industry that is served by the dairy veterinarian is dy­namic and operates under conditions where the value of its end products decrease in real dollar value over time. This exerts pressure on that industry toward constant improvements in operating efficiencies and cost reductions. It is no surprise then that as part of the service sector to this industry, the practicing dairy veterinarian will need to be as dynamic and constantly striving to improve and increase the value of its offerings to this ever-evolving sector. The veterinary work force is highly select­ed and highly trained. It has been an integral part of advance­ment in the production of dairy foods. With a forward-looking attitude striving for constant discovery of new and useful ideas for advancing cow health and productivity, it will be possible to assure that this remains true. Conversely, lacking this outlook, there is the real risk that the veterinarian becomes less relevant on dairy farms over time as those farms compete on a global level for market share.
The veterinarian’s role in reducing GHG emissions from beef and dairy production
Authors: Beal Colin M.
Published: May 2024

The beef and dairy industries make significant contributions to sustainability objectives by providing our society with nutri­tious food, supporting farmers’ livelihoods, generating billions of dollars in economic activity, and contributing to healthy ecosystems. However, cattle production also generates negative environmental impacts, including greenhouse gas (GHG) emis­sions. Veterinarians have a unique opportunity to interface with beef and dairy farmers to assist with the implementation of products and practices that reduce GHG emissions, such that their clients can be more profitable and more sustainable. In general, the GHG intensity of beef and dairy production can be reduced by increasing output yields of beef and milk, while re­ducing inputs and maximizing efficiency. Some of the specific interventions include: early entry of feeder cattle to a feedlot, dry manure management, optimized inorganic nitrogen fertil­izer use, increased fat in the ration, use of anti-methane feed additives and ionophores, sourcing low-carbon corn, select­ing genetics for high feed efficiency, raising moderate/small mature beef cows and feed efficient dairy cows, improving pregnancy rate and reducing dystocia, conducting pregnancy checks, implementing artificial insemination, promoting herd health products and practices to reduce death loss, using growth-promoting implants, and utilizing SOP Lagoon®. As a trusted source of scientific information, veterinarians can be a conduit of information for producers and contribute to the ongoing effort to improve the resiliency of the beef and dairy industries.
Beef on dairy: A case study of sustainable animal protein production
Authors: Moreno Juan F.
Published: May 2024

Human society has evolved over thousands of years, but in the last 35 years we have gained access to multiple advanced tech­nologies that can change how animal protein is produced. As members of society, we all have a responsibility to ourselves, our families, our neighbors, our friends and our fellow citizens to utilize the available technologies to provide a sustainable fu­ture. The word “sustainability” has been used freely by many, but I believe that it truly has only two meanings in our industry. For the producers of animal protein, it is the economic sustain­ability of the farmer producers. For the consumers of animal proteins, it is the production of that protein in a manner that derives in a highly nutritious product that is produced in an en­vironmentally friendly system.
Hoof trimming: The steps to success
Authors: Cramer Gerald
Published: May 2024

Hoof trimming plays a pivotal role in both the treatment and prevention of lameness. The role of veterinarians in hoof trim­ming can vary, from treating lame animals to actively par­ticipating in the delivery and assessment of hoof trimming practices. Consequently, it is important for veterinarians to un­derstand the prerequisites for proper hoof trimming. Success­ful hoof trimming entails selecting the right animal, and using the correct equipment and method. When these things are in place, hoof trimming becomes an intervention that safeguards both the animal and the person conducting the hoof trimming.
On-farm calf assessment and practical fluid therapy
Authors: Lear Andrea
Published: May 2024

Large animal practitioners are faced with varying levels of dehydration in neonatal cattle. The goal of this talk will be to describe and formulate fluid therapy plans using intravenous catheter placement in varying circumstances in an ambulatory setting. Determining route of fluid administration and intrave­nous catherization techniques will be reviewed. Following this presentation, the practitioner will be able to identify the proper use intravenous catherization and fluid therapy plans in clini­cal cases to be administered on farm.
The do’s and don’ts of bovine euthanasia
Authors: Gilliam John
Published: May 2024

The goal of humane euthanasia is to produce a “good death” by inducing a rapid, ideally instantaneous, loss of conscious­ness followed quickly by respiratory and cardiac arrest. Bovine euthanasia often presents significant challenges due to the size and nature of the animal, limited options for euthanasia methods, facility limitations and operator experience among many others. In particular, euthanasia under field conditions may present unique challenges. Developing a plan, or standard operating procedure, can reduce the risk of adverse events and help ensure both the welfare of the animal being euthanized and the personnel performing the task. However, the varied circumstances under which bovine euthanasia may be needed can require adaptability and flexibility. Veterinarians and other individuals performing euthanasia should be familiar with standard euthanasia practices and be comfortable with a variety of euthanasia methods to allow adaptability to ensure the welfare of animals requiring euthanasia under a variety of circumstances. The purpose of this paper is to provide practical tips on the do’s and don’ts of humane bovine euthanasia under a variety of circumstances.