Alimetrics (Finland)

Abstract Background Vomiting is a symptom of various gastrointestinal (GI) disorders and may invalidate gastric emptying tests. Body surface gastric mapping (BSGM) is a clinical test to assess motor vs . sensory contributors to GI symptoms. Aims While previous studies have observed myoelectrical dysrhythmias associated with vomiting, the effects of vomiting on BSGM testing have not been defined. Methods A large clinical database of de-identified BSGM tests was queried for vomiting events, noted by symptom markers via an integrated symptom reporting App. Tests with pre-meal or >2 vomiting events were excluded. Spectrograms and clinical reports were qualitatively assessed. Key BSGM metrics, including the Gastric Alimetry Rhythm Index (GA-RI) and BMI-adjusted amplitude, were interrogated in 5 min epochs for quantitative analysis. Results A total of 49 vomit events were included. Vomiting typically had little effect, though was sometimes characterised by small, temporary decreases in BMI-adjusted amplitude or GA-RI. Prolonged periods (> 10 mins) of low amplitude were observed in 4 cases (8%). A mixed effects model revealed a transient decrease in GA-RI in the 5 mins before (Δ = −0.27; p < 0.001) and after vomiting (Δ = −0.21; p = 0.014), but not in subsequent periods (all p > 0.05). Other metrics were unaffected. Nausea, bloating, and excessive fullness symptoms decreased following vomiting (all p < 0.05). Conclusions Transient amplitude and rhythm decreases were observed concurrent to vomiting, but subsequently normalised. While additional considerations may be required during test interpretation, the overall impact of vomiting on BSGM test interpretation is minimal.

ABSTRACTImportancePersistent upper gastroduodenal symptoms, such as nausea, vomiting, bloating, and abdominal pain, are widespread among pediatric patients. Multiple overlapping symptoms complicate the diagnostic process, necessitating the development of novel gastric function tests with actionable biomarkers. Body Surface Gastric Mapping (BSGM) has emerged as a promising diagnostic tool for gastroduodenal disorders, and this is the first detailed evaluation in adolescents.ObjectiveThis study aimed to assess the utility of BSGM in delineating specific patient phenotypes among adolescents with functional dyspepsia (FD) and gastroparesis in order to guide clinical decision-making.DesignA prospective cross-sectional study recruited adolescents aged 12 to 21 between 2022 and 2024.SettingControls were recruited from New Zealand (controls) and Patients from the Children’s Hospital of Philadelphia, USA.ParticipantsProspectively recruited participants included controls without gastroduodenal symptoms or motility-related medication usage and patients diagnosed with either gastroparesis (delayed gastric emptying test (GET)) or FD according to ROME IV criteria and a normal GET.ProceduresBSGM was performed using a standardized protocol, including simultaneous symptom reporting and the completion of validated symptom, psychometric and physical health questionnaires.Main OutcomeThe primary outcome was to evaluate if BSGM could delineate specific patient phenotypes and provide clinically meaningful distinctions between gastroparesis and FD diagnoses, utilizing BSGM spectral outcome data.ResultsFifty-six subjects were recruited (31 controls, 25 patients); median age 16; 96% of patients were female. Control data showed that adult reference intervals provided an acceptable interpretation framework. Patients with FD (n=10) and gastroparesis (n=15) had common symptoms, mental health, quality of life and functional disability (all p>0.05). Three distinct BSGM phenotypes were identified:BSGM Normal(n=10),BSGM Delay(n=8), andLow Stability/Low Amplitude(n=7), having spectral differences in BMI-Adjusted Amplitude 34.6 vs 39.1 vs 19.9 (p=.01) and Gastric Alimetry Rhythm Index: 0.45 vs 0.45 vs 0.19 (p=.003).BSGM phenotypes demonstrated differences in symptoms (nauseap=0.04), physical health (p=.04) and psychometrics (anxietyp=.03).Conclusion and RelevanceAdolescent patients with FD and gastroparesis have overlapping clinical profiles, making individualized treatment challenging. Conversely, employing BSGM to categorize patients into distinct phenotypes revealed clinically relevant differences, offering potential avenues for individualized therapeutic pathways.

Abstract Introduction The dim light melatonin onset (DLMO) is the gold-standard for estimating sleep timing and is recognized as a reliable diagnostic tool for circadian rhythm sleep-wake disorders (CRSWD). Its assessment may help optimize treatment of various sleep disorders. The DLMO is usually assessed in a research laboratory or clinic, which presents significant barriers. Thus, there is a need to further evaluate the ecological validity of self-directed collection at home. Salimetrics, Inc. recently introduced a circadian phase assessment kit that allows for self-collection of saliva at home accompanied by laboratory assessed DLMOs. This is a preliminary report of a limited dataset identifying normal (typical) and abnormal (atypical) melatonin profiles. Methods Sleep clinic patients (N = 197) utilized one of four different protocols that varied in the number and timing of saliva collection based on their provider’s suggestion. Despite different protocols, the actual sampling protocol was performed under the same guidance for all assessments. A typical profile was determined as an expected onset (estimated ~2.5-1.5 hours before bedtime) with a baseline of < 10 pg/ml and a sleep onset of >10 pg/ml. An atypical profile fell outside these parameters. Routine medication usage was also analyzed to determine if there was a correlation between melatonin modulating medications and resulting profiles. Only sex and age were recorded as the participants collected samples as part of the clinical care protocol. Results Findings indicate 22% typical profiles vs. 78% atypical profiles. With regards to medication use: 26% of typical profiles vs 19% of atypical profiles had no medications listed, 53% vs 68% used a melatonin modulator, respectively, 14% vs 54% used a psychiatric medication, 21% vs 25% used 2+ psychiatric medications, and 9% vs 14% used a melatonin supplement within 10 days of assessment. Conclusion These data corroborate earlier investigations by Burgess and colleagues and suggest that the use of a self-directed, at-home DLMO assessment is feasible and accurate. It further suggests that medication use, or an underlying psychiatric disorder can modulate melatonin secretion exaggerating the CRSWD. Data indicates that this diagnostic tool can accurately identify many clinical sleep patients with an existing CRSWD or significant sleep wake misalignment. Support (if any) Salimetrics

ABSTRACTIt was hypothesized that dietary inclusion of Bacillus subtilis DSM 32315 could inhibit Clostridium perfringens induced necrotic enteritis (NE), thereby improving broiler performance. Male, d 0 chicks were randomly assigned 14 birds/pen, 11 pens/treatment in 3 treatments: a basal diet (control), a coccidiostat fed control (Narasin), and a direct fed microbial (DFM) B. subtilis DSM 32315 treatment. Necrotic enteritis was induced in all birds by oral inoculation of Eimeria maxima oocysts on d 12 and a virulent C. perfringens on d 16. Mortality was reduced (P < 0.001) in DFM and Narasin compared to control. DFM reduced (P < 0.001) feed conversion ratio (FCR) compared to control. Furthermore, DFM and Narasin reduced (P < 0.001) footpad lesions. The DFM was shown to increase (P < 0.05) Bacillus spp. and decrease (P < 0.05) C. perfringens in the ileum and cecum at several time points. To investigate microbiome changes in the cecum, digesta samples were analyzed with % guanine and cytosine (%G+C) microbial profiling which fractionates bacterial chromosomes based on the %G+C in DNA. The method revealed treatment profile peaks in low (27.0 to 34.5%), mid (40.5 to 54.0%), and high (59.0 to 68.0%) G+C fractions. 16S rRNA gene amplification and high throughput sequencing was conducted on each of these fractions in order to elucidate specific bacterial population differences. In the low and mid %G+C fractions, DFM had greater abundance of Lactobacillaceae family members (P = 0.03 and P = 0.01, respectively) and Lactobacillus salivarius (P = 0.04 and P = 0.01, respectively) than control or Narasin. Lactobacillus johnsonii was also greater in the low %G+C fraction compared to control and Narasin (P = 0.01). Lachnospiraceae (P = 0.04) and Ruminococcaceae (P < 0.01) in the mid %G+C fraction were reduced in the DFM compared to control. Positive alterations to the microbial populations in the gut of broilers may at least be a partial mechanism by which B. subtilis DSM 32315 reduced pathology and improved performance of broilers in the NE challenge.

ABSTRACT1. The objective of this study was to evaluate the effect of ferric tyrosine on the reduction of Campylobacter spp. and zootechnical performance in broilers exposed to Campylobacter spp. using a natural challenge model to simulate commercial conditions. Additionally, the minimum inhibitory concentrations (MICs) of ferric tyrosine against common enteropathogens were evaluated.2. At the start of the trial, 840 healthy male 1-d-old birds (Ross 308) were randomly allocated to 6 replicate pens of 35 birds each and fed diets containing different concentrations of ferric tyrosine (0, 0.02, 0.05 and 0.2 g/kg) in mash form for 42 d.3. Broilers fed diets containing ferric tyrosine showed significantly higher body weight at d 42 and weight gain compared to the control group. However, birds fed ferric tyrosine ate significantly more than the control birds so significant improvements in feed conversion rate were not observed.4. Microbiological analyses of caecal samples collected on d 42 of the study showed, per gram of sample, 2–3 log10 reduction in Campylobacter spp. and 1 log10 reduction in Escherichia coli in the groups fed diets containing ferric tyrosine compared to the control.5. The MICs of ferric tyrosine was >400 mg/l for C. jejuni and >200 mg/l for E. coli and Salmonella enterica, indicating that ferric tyrosine did not exert antimicrobial activity.6. The results showed that birds fed ferric tyrosine grew faster and consumed more feed compared to the control group, indicating potential benefits of faster time to reach slaughter weight with no significant reduction on feed efficiency. Moreover, ferric tyrosine significantly reduced caecal Campylobacter spp. and E. coli indicating potential as a non-antibiotic feed additive to lower the risk of infections transmitted through the food chain.

The omega-3 fatty acid (n-3 FA) content of broiler tissues can be increased through dietary supplementation of hens with n-3 FA-rich microalgae. The aim of this study was to evaluate the effect of three different dietary inclusion levels of a docosahexaenoic acid (DHA)-rich microalgae (AURA) on broiler performance and the enrichment of tissues with n-3 FA. The randomized study was conducted using 352 birds, housed in 32 pens with 11 birds per pen. Pens were randomly assigned to one of four treatments, with each treatment replicated 8 times. The treatments included one unsupplemented control (0%) and three wheat-soya based experimental diets supplemented with AURA at a level of 0.5%, 1.5% and 2.5% for the starter, grower and finisher periods. Birds were weighed on days 0, 10, 24, 35 and 41, and feed intake was recorded per pen. On day 41, five birds per treatment were euthanized and individually weighed. Thigh muscle, breast muscle, liver, kidney and skin samples were taken post-mortem, freeze dried and DHA content quantified, following fat extraction and methylation, by GC-FID (AOAC 996.06 method). Performance and tissue data were analyzed by ANOVA with Dunnett’s (2-sided) post-hoc test to determine the differences between the mean values for each treatment. Dietary supplementation with AURA had no effect on body weight or feed intake during any period of the study. For thigh muscle, kidney and skin the DHA increased linearly (P < 0.05) with increasing level of dietary AURA, whilst there was a quadratic response in uptake of DHA in breast muscle and liver. The study demonstrated the potential of efficiently enriching broiler meat and organs with DHA by feeding AURA.