Johne's disease (JD; paratuberculosis) control programs have been regionally implemented across the globe, but few have successfully eradicated the pathogen (Mycobacterium avium ssp. paratuberculosis (MAP)) causing this disease. The limited success may partly be attributed to excluding young stock (calves and replacement heifers or bulls) from testing strategies aimed at identifying MAP-infected cattle. Young stock can shed MAP in feces and can have detectable MAP-specific antibodies in blood, as confirmed in experimentally and naturally infected cattle. Furthermore, MAP transmission causes new infections in young stock. Calves and heifers are often included in JD management strategies on dairy farms but excluded from conventional diagnostic tests due to a presumed lag between infection and detection of MAP shedding and/or MAP-specific serum antibodies. We summarize evidence of MAP shedding early in the course of infection and discuss promising diagnostics, testing and management strategies to support inclusion of young stock in JD control programs. Improvements in fecal Polymerase Chain Reaction, interferon-gamma release assay (IGRA), and enzyme-linked immunosorbent assay (ELISA) enable earlier detection of MAP and specific early immune responses. Studies on IGRA and ELISA have focused on evaluation of new antigens and optimal age of testing. There are new diagnostics, including phage-based tests to detect viable MAP, and gene expression patterns and metabolomics to detect MAP-infected young stock. In addition, refinements in testing and management of calves and heifers may enable reductions in MAP prevalence. We provide recommendations for dairy farmers, researchers, veterinarians, and other stakeholders that may improve JD control programs with an objective to control and potentially eradicate JD. Additionally, we have identified the most pressing gaps in knowledge that currently hamper inclusion of young stock in JD prevention and control programs. In summary, transmission among young stock may cause new MAP infections, and appropriate use of new diagnostic tests, testing and management strategies for young stock may improve the efficacy of JD control programs.
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http://dx.doi.org/10.3168/jds.2024-24643 | DOI Listing |
Background: There is a lack of evidence to suggest that outcomes of adolescent and adult-onset glomerular disease differ. Still, most glomerular disease trials include adults but exclude adolescents.
Methods: We designed a retrospective study using the CureGN database to compare individuals with adolescent-onset glomerular disease relative to individuals with older and younger age at onset.
Lancet Digit Health
January 2025
Biomedical Engineering Department, Duke University, Durham, NC, USA; Biostatistics and Bioinformatics Department, Duke University, Durham, NC, USA. Electronic address:
Background: Longitudinal digital health studies combine passively collected information from digital devices, such as commercial wearable devices, and actively contributed data, such as surveys, from participants. Although the use of smartphones and access to the internet supports the development of these studies, challenges exist in collecting representative data due to low adherence and retention. We aimed to identify key factors related to adherence and retention in digital health studies and develop a methodology to identify factors that are associated with and might affect study participant engagement.
View Article and Find Full Text PDFJ Patient Rep Outcomes
December 2024
Institute of Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Paul-Ehrlich-Haus, Hindenburgdamm 30, 12203, Berlin, Germany.
Objective: A key component of determining that a patient-reported outcome (PRO) measure is fit-for-purpose is to ensure that respondents understand its instructions and items. Any modification to a measure should be evaluated for relevance and understandability. The objective of the study was to assess comprehension of the adapted Urticaria Activity Score (UAS) questionnaire among adolescents aged populations with chronic spontaneous urticaria (CSU) and the modification to UAS question 2 to include patient-friendly terminology "wheals (hives).
View Article and Find Full Text PDFNeurology
January 2025
AbbVie, North Chicago, IL; and.
Background And Objectives: Three phase 3 trials demonstrated the efficacy and safety of atogepant in episodic migraine (EM) and chronic migraine (CM) across 12-week treatment periods. This analysis evaluates improvements in efficacy and functional outcomes in the first 4 weeks of treatment with the oral calcitonin gene-related peptide receptor antagonist, atogepant, for the preventive treatment of migraine.
Methods: ADVANCE, ELEVATE, and PROGRESS were phase 3, multicenter, randomized, double-blind, placebo-controlled 12-week trials.
Arthrosc Tech
November 2024
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A.
Lateral patellar dislocations represent a common orthopaedic condition in young, active individuals who experience patellar instability. Despite increasing interest in re-creating the natural biomechanics and native knee anatomy when performing medial patellar soft-tissue reconstructive procedures, there is no consensus among surgeons regarding the best techniques to use when reconstructing the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament. This article details a method to reconstruct the medial patellofemoral ligament and medial quadriceps tendon-femoral ligament using a single graft and a single all-suture knotless anchor on the patella.
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