Welcome to this webinar, looking at what's new in the world of Yoni's disease. I'm going to start by taking you through some of the latest research. This is by no means exhaustive, as several new Yoni's papers come out every single day.

I've just picked out some that I think are of particular interest and relevance. All papers are referenced on each slide should you want to read the full paper at your leisure. I'll then move on to an update on what's happening globally and how this scheme is perceived by the rest of the world, and we'll end up with a roundup on the NJMP and Action Yoni.

So, onto the research update. I'm going to cover a wide range of papers, most of which are pretty recent publications, but also some older papers which sought to address questions which are still frequently asked today. The papers sit in 3 broad categories and will go through each in turn.

So starting off with testing. First up, we're going to look at a study published last month in the Irish Veterinary Journal, where they wanted to see if environmental sampling could be used to establish the prevalence of map on cattle farms in Ireland. This was just a pilot study on 157 farms, 81 dairy, and 76 beef, using samples collected by veterinary inspectors at routine inspection visits.

Two samples were collected from each farm, and they were taken from indoor areas, such as collecting yards and feeding areas to give pooled environmental samples. It's testing and the other by PCR. In total, 10.2% of samples were found to be positive.

Only 5 samples were positive on culture, all of which were also PCR positive, and a further 11 were positive on PCR alone. So overall, map was detected in 16 of 157 farms. Now you can see there is a significant difference there between the culture and PCR results.

These samples were frozen for up to 6 months prior to testing, which may have reduced the quantity of viable map in the faeces. And this may account for some of the differences between culture and PCR results. It's interesting to compare this to work done in the USA in 2007.

There they only used culture, no PCR, but they took 6 samples from each farm, with over 70% of farms testing positive on at least 1 sample. And it would seem looking at the distribution of their results, that taking more samples increases your likelihood of finding map. So rather, the more you look, the more you find.

Now the US likely has a significantly higher prevalence of map than Ireland. But perhaps had more samples been taken in the Irish study, they may have found more too. Hopefully this pilot will lead to a larger study in Ireland with more farms and more samples being analysed.

As it looks like environmental sampling could provide a simple and cost effective way to assess farms. Continuing the theme of assessing prevalence using environmental samples, some interesting work was carried out in two large Californian dairies and reported last November. Here, collectors used a large 2 litre container and collected a hand grab of slurry using a rectal glove at 1 metre intervals along passageways in dry lock pens.

Once full, the container of slurry was thoroughly mixed, and a 25 mL aliquat was sent for PCR testing. This was repeated daily for 3 days in each pen, by 2 independent collectors. Each passageway was cleaned using a water flush system between daily collections, and there was no movement of cows between pens, so there should have been stability of groups.

This study allows for assessment of the agreement, both between collectors, which was shown to be very good, and also between days of collection in each pen, which showed quite significant variability of around 25%. Again, demonstrating the need for repeated sampling. The consistency shown between operators is likely a product of the thorough mixing of the sample and the large initial volume collected from multiple sites in each dry lot.

Which is a good thing to note if you're going to use environmental sampling as a method to determine if a herd is infected or not. Moving on to map shedding. We know that the level of map shedding faeces varies widely between different cows, and that shedding is often intermittent.

Two distinct shedding patterns have been documented, and these probably relate to how the animal is dealing with the infection and may also be influenced by the strain of map. These two distinct patterns are defined as progression and non-progression. Progressors are recognised as cows that shed continuously and progressively worsen, shedding higher and higher levels.

While nonprogressors have patterns of low and intermittent shedding. Often in the present, in the absence of a strong antibody response. So low and intermittent shedding, but no strong antibody response.

So these progresses are high map shedders. They usually Elis are positive and they may become clinical if they're not called. They're high risk animals, likely to be shedding large amounts of map into the environment.

Now none progresses, on the other hand. Could be thought of as disease tolerant. So they have little or no antibody response, despite low grade intermittent shedding.

So whilst infected and at times shedding, they're producing no immune response to the disease. This is backed up by a recent French study published in October 19. This was a longitudinal study looking at temporal patterns of faecal shedding and its relationship to serology.

They found a large variation in shedding patterns, as well as a high variability between herds in the proportion of animals showing a given pattern. They showed that almost 20% of the study cows had at least one faecal sample with low or no detectable map. Interspersed with positive samples.

However, animals that shed at least twice consecutively or that shed large amounts, rarely reverted back to negative samples. So again, here we can see the difference between those progressors and non-progressors. They also found that although a portion of animals which were low positive intermittently on PCR were missed by the antibody elizer testing.

There was a strong relationship between having more than 2 antibody ellier positives and persistent shedding. So we can see that antibody elizer can be used, particularly over the course of multiple tests, to identify animals most likely to contribute to the contamination of the farm environment and onward transmission. We know that there are differences in shedding between experimentally and naturally infected animals, with high progressive rates seen in experimental infection models.

And that may be because of the high inoculum doses that they're given in the first place. But in naturally infected animals, it's thought that less than 10% will become progressors or heavy shedders. This leads us nicely onto the concept of super shedders, which is not new, but there is a growing body of research pointing to their role in Yoni's disease transmission.

It's been shown that approximately 1 in 10 faecal PCR positive cows or heavy shedding cows will be a super shedder. So what is a super shedder? Well, they're defined as cows shedding more than 10 million colony forming units of map per gramme of faeces, which, to be frank, is a pretty eye-watering number.

This is especially important in large herds where just given the maths, several super shedders could be present at any one time. The level of map shedding in individual animals has been shown in modelling work to be one of the most important factors in the spread of infection. And research supports the observation of clusters of infection.

So that's cohorts of animals that became infected together at the same time. And this may be the result of exposure to a super shredder. All of this reinforces the need to manage high risk cows effectively, but also to recognise the value of culling.

Supershedders will be part of your pool of repeatedly antibody ellizer positive cows, and by prioritising this group for culling, you reduce the chance of retaining a super shedder on farm. Using this, we now move on to an interesting case study from New Zealand. Traditionally, there's been little engagement in Yoni's management in New Zealand unless a high prevalence of clinical disease has been present.

As pasture management of multiple groups to facilitate segregation of positive cows is really quite complex in those systems, and waste milk feeding is commonplace. However, there is evidence of increasing prevalence, especially on the South Island, so maybe we will see greater engagement in future. This particular case study took place over a 4 year period on a single 1200 cow dairy, where they had a high clinical disease incidence.

They chose to screen all cows using blood antibody elizer annually before calving, and then to follow up any ELISA positives with faecal PCR. The PCR they used was semi-quantitative and so they were able to define these PCR results into not detected, moderate and high shedding. The culling of high PCR positives and higher LISA positives was prioritised.

Now, just to give you a bit of context. The herd was culling around 350 animals per year, and in the first year of this study, 123 of these were Yonies positive. So a big proportion of those animals that they call out were for Yoni's reasons.

Now limited management changes were implemented, these included not retaining offspring of Yoni's positive cows for breeding and separation of calves from cows within 24 hours of birth. However, separation of Yoni's positive cows during calving wasn't possible. The results showed that the apparent prevalence, so those that were EISA antibody positive, decreased from 26% in year one to just 2.3% in year four.

And the proportion of cows culled, the suspected clinical yoni's cases, also decreased. From 5% in the year before the study commenced to just 0.4% in year four.

Now, although this was a one-off case study on a single herd, it does demonstrate that you can decrease infection pressure by pulling out the heavy shedders, even with limited management changes. So for me, the take home for this would be that it validates the importance of removing the most infectious animals from a herd, to decrease the disease prevalence and the possibility of onward transmission. However, as always, there is a note of caution, because firstly, boy it was this expensive.

So with a bit of rudimentary maths, I estimate the testing alone will have cost around 40,000 pounds. Also, while it's obviously decreased the number of clinicals and reduced the overall environmental load, we don't know what the new infection rates will be. So we need to see if the downward trend can be maintained as experience generally shows that you can't just call your way out of yoni.

Now, moving away from testing and looking at the consequences of Yoni's disease on cow health and welfare, we come to a recent study from Harper Adams. In this study, they followed 22 Yoni's positive cows. Now for their definition of a positive cow, they used cows that were repeatedly positive on milk Eliza and were classified as red J5s on the quarterly testing scheme.

And then they matched these with 22 Yoni's negative cows. And again, their classification for this was that they needed to be repeatedly negative on quarterly testing and classified as green J zeros. The cows were also matched for the same lactation number and age.

So we had 22 matched pairs of cows. And each cow was fitted with an accelerometer and monitored from carving to week 20 of lactation. At peak lactation they noted that the yoni's positive cows demonstrated differences in their lying behaviour with at week 8 of lactation, the most marked difference with a 2 hour reduction in lying time per day compared to their yoni's negative matches.

They also demonstrated fewer lying bouts per day over a 4 week period from week 7 to 11. Now, this is really interesting and poses the question why? Why would cows with yonis be lying less and why would they have fewer lying bouts?

Perhaps they're experiencing some discomfort when they lie down due to pressure on the abdomen or the act of getting up and lying down is painful. Or are they spending less time lying down because they're spending more time eating in an effort to maintain nutrition. Often with these studies, they give us some answers, but they also pose us more questions.

A similar study design of matched pairs of Yoni's positive and negative cows was used in a recent RVC study to look at Yoni and lameness. Now their case definition was slightly different as they used a single antibody elizer positive rather than repeats. And they then categorise those antibody levels as high positive or medium positive.

In this study of 98 matched pairs, they found that Yoni's positive cows became lame on average 3 months earlier, and that they are lame 2.7 times more often than their Yoni's negative counterparts. They also found a difference between high Eliser positive and medium Eliser positive cows.

With those high ELISA positive cows, 2.8 times more likely to develop lameness after a Yoni's diagnosis than those cows that only had a medium EISer positive result. Again, this study poses more questions, and it's very chicken and egg.

We know that there is an association between yoni and lameness. But we still don't quite know what's happening. But these two studies nicely show the impact of having Yoni's disease on cow health, welfare, and also on farm profitability.

We're now going to move on to looking at risk factors for transmission. So firstly, damned calf transmission. Here we're thinking about the risk of transmission from the calf's dam alone.

So this is a 1 to 1 risk rather than the risk infection from exposure to other infected adults. It obviously makes biological sense that a calf born to a Yoni's positive dam is more likely to become Yoni positive itself. Either through in utero transmission or exposure to dam faeces or colostrum.

This has been shown in the research to be around a 6 times greater risk. This particular study also showed that within their population of cows, that the Yoni's positive status of approximately 35% of their animals was attributable to having a dam who was zero positive at the time of their birth. Recent UK work from a longitudinal study of commercial dairy farms has taken this a little bit further forward.

It found that as in the previous study, there was a significant risk associated with having a dam that was 0 positive at the time of the subject calf's birth. But it also demonstrated a risk if the dam became zero positive after the birth of that subject calf. Adam zero converting in the 12 months after the birth of the subject calf increased that calf's risk of becoming zero positive by 3.6 times.

And even if the sero conversion happened more than 12 months after the birth of the subject calf, it's risk of becoming sero positive was still 2.8 times higher. Now, at present we don't know the reason for this, although it may relate to a periparuran relaxation of immunity, allowing in utero transmission or perhaps a brief period of shedding at calving.

Which might be insufficient to produce a detectable antibody response. Interestingly, a recent publication explores this thought a bit further, albeit looking at yoni in sheep rather than in cows. When they looked, they found little difference in Yoni's antibody results pre and post lambing.

But the ewes were more likely to be faecal PCR positive immediately postpartum, even if they remained Eliza negative. So is this another indicator of periparer and relaxation of immunity, leading to short periods of map shedding. This work demonstrates the need to consider dam's status more carefully, and not just dams status at the time of the calf's birth.

So when a cow becomes sero positive, we need to think about looking back at her previous calves and deciding if we want to be breeding replacements from them. Now, whilst adult cow to calf infection is likely to be the most important route of transmission on most farms, we know that calf to calf transmission can occur. In calves experimentally infected with map at 3 and 12 weeks of age, they were shown to shed map in their faeces for several weeks post infection.

Now obviously that is experimental infection and whether the doses are higher in those in ocular, we don't know, but it does demonstrate the ability of calves to shed map. Work in Canada in 2017 detected map in calf pens in 9 of 17 farms investigated and found 3% of calves on these farms to have MAP positive faeces. So even in a non-experimental infection model, so these calves were naturally infected, they were still finding calves shedding map.

Further work was then done to look at whether these infected calves could infect other intact calves. And it was found that all calves within this study, both experimentally infected and the intacts, shed mapping their faeces at some point in the trial. And it demonstrated the ability of one shedding calf to infect up to 3 other intact calves.

We don't quite know how important this route of transmission is in Yoni's disease. And it's it's possible that it's not anywhere near as important as adult cow to calf transmission, given the level of infection that's likely to be within that calf faeces. However, it could be a cause of low grade persistence of Yoni's disease in some herds, and it very much highlights the need for replacement calves to be reared away from any high risk calves.

So any calves that are born out of animals that are known to be yonies positive should again be treated as a transmission risk. So in essence, we need to create not only a green maternity or calving line where we prevent positive adults from being able to spread to calves, but also a green calf line where we prevent calf to calf spread. A question I get asked every now and again is about Yoni's disease in bulls and whether they pose a risk.

The stock answer, if you'll excuse the pun, is always yes. They can shed mapping faeces and contaminate the environment just the same as any cow can. So they shouldn't be allowed to spread map into calving or calf areas.

But what about the risk to the car, to the cows, via natural service or AI? We know that map is found in semen from infected bulls, although usually at low numbers. But there's only really been one study that's looked into the consequences of this for cows being served, and that was way back in 1982.

It was a very small study, and they used quite large inoculums of map directly into the uterus. So perhaps the data from there needs to be looked at again and possibly with more animals, and maybe with a more realistic level of infection. However, Map was recovered from the body and horns of the uterus directly after inoculation and for up to 7 days.

And there was also evidence of a transitory tissue necrosis in the superficial mucosa of the uterus. Now we don't quite know why that happened. We can't say whether for sure this was map infection or whether it was a localised hypersensitivity.

And this necrosis was short-lived and resolved quickly and didn't have any impact on pregnancies. MAP was not recovered from any tissues or blood on postmortem examination of these animals. And so the author's conclusion was that the small numbers of MAP that could be introduced into the uterus with semen would likely be destroyed rather than leading to any systemic infection.

Now we have to remember that oral infection is the preferred route of infection for map. And also that adult animals are significantly less susceptible to map infection than calves. So realistically, it's the wrong route and it's the wrong age of animals.

Now we don't have all the answers, and as I said, it was a small study that would probably bear repeating. But it seems unlikely that map in semen poses any significant risk in Yoni's transmission. So now moving on to milk, which is another thing that I get asked about a lot when it comes to on-farm control of MAP.

So one of the things that we wonder about is how MAP gets into bulk milk. And this question is important when we think about transmission to calves who are being fed whole milk, but also from a public health perspective, if map is ever proven to be zoonotic. And there are 2 studies which modelled the risks, and both found that the level of faecal contamination was the most important means by which map gets into raw milk.

With the number of high shedding or clinical cows and the efficiency of teat prep and parlour washing also coming up as important. Another study in the Netherlands looked at how much dirt gets into milk at milking, and by this they mean muck, soil and bedding. And the variation between the amount of muck that gets into there was actually quite amazing.

With some farms producing very clean milk and some with 100 times more contamination. So this demonstrates that we need to focus minds on good hygiene practises at milking. So if you think about how much of that dirt is getting into that milk, then if there is a yoni's problem on farm, the map is certainly going to be part of that.

So by removing heavy shdders through culling, maximising hygiene at milking, the number of map ending up in the bulk tank can be minimised, and that gives pasteurisation the very best chance of working effectively. Whole milk feeding of calves can have many benefits in terms of calf health, it can also be a good economic win for farms, if it's done well. A recent study on Chilean dairy farms looked at just how much map was present in the milk being fed to dairy calves and what the risk factors were.

They found some eye-watering levels of map present in the milk used for calf feeding on some of these farms, with the highest being 1 million bacteria per mL of milk, a dose that's certainly capable of successful infection, and it's being hand delivered to these calves twice a day. Worse still, in this study, this highly contaminated milk was often being delivered to many calves at once, using the amazing yoni spreaders pictured here, wonderfully named Cafeterias. This study also demonstrated that as zero prevalence in the herd increased, so, perhaps unsurprisingly, did the level of map in the milk being fed.

So in high prevalence herds, mapping calf milk can be a highly effective method of Yoni's transmission if precautions aren't taken. So we need to be careful that the benefits of feeding whole milk to calves are not outweighed by the risk of yonis. This leads quite nicely on to talking about pasteurisation.

On-farm pasteurisation of milk to feed calves has become much more commonplace in the last few years. However, the recommended 60 degrees for 60 minutes is time consuming and it can be inconvenient. A recent study in Germany looked at whether high temperature short time pasteurisation could provide an alternative on farm.

So with an HTST of 73.5 degrees C, held for 20 to 25 seconds, they achieved a significant reduction in the viable map in the milk. But.

Around about 1000 viable map cells per mill still remained. So it would appear that HTST is not currently a viable alternative if we want to achieve a 100% map kill. With 60 degrees C for 60 minutes still being the most effective route.

So, the answer would seem to be that the best map kill is achieved. When you have high temperature, long time, and putting the minimum number of map in to begin with. Again, continuing on the theme of pasteurisation.

There have been many reports in recent years regarding the presence of viable map in retail pasteurised milk. So why are some mat bacteria capable of surviving commercial, high temperature short time pasteurisation? A recent review by William Mullen looked for some of the answers.

The top theory, which may explain why most maps seem to be killed and only low numbers survive, would be the presence of a heat resistant subpopulation. So most map are sensitive to the temperature of HTST but a small number are resistant and survive. Another theory involves map's propensity to form clumps and thus be not uniformly distributed in milk.

And this may make survival of bacteria at the centre of the clumps more likely. There's also evidence that much of the map found in raw milk may be within somatic cells. We know it's an intracellular organism, so I guess that makes sense.

And it's possible that this affords the map a degree of protection from pasteurisation, allowing some to survive. And lastly comes the pasteurizer itself, and it may be that in some older models there's the potential for leakage of small amounts of the raw milk into the pasteurised milk. So rather than surviving pasteurisation, some map may actually be missing it altogether.

So moving away from the latest research, we'll now take a quick look at what's happening with Yoni's Disease Control globally and how the National Yoni's Management plan fits in, along with an update on the NJMP progress and requirements for 2020, including the new red tractor farm assurance standards. A review paper was published in 2019 looking at Yoni's control across 48 countries globally. And whilst it did include the UK, it unfortunately only looked at check schemes and did not consider the NJMP.

However, it provides some really useful insights into how Yoni's is considered globally and the efforts that people are taking to control it. Of the 48 countries surveyed, 22 had formal control programmes in place, and these tended to be the more developed countries. 60% of programmes were voluntary, although these were often supported by incentives or penalties for farmers.

And it's interesting to note that 73% of these schemes were considered a success when measured against their stated objectives. With further programmes too newly established to yet answer that question. Across all programmes were the common drivers of animal health, market protection and public health.

Although public health reasons were less overtly stated in many countries due to fears of consumer confidence and perception. It was noted that voluntary programmes supported by initial funding often struggled to survive once that funding ended, unless they became compulsory or government led. This has been seen in the US, Canada, and several European countries.

Legislation is used in several countries to make programmes compulsory, for example, the Netherlands, where they have compulsory screening of all adult cows. And also in Sweden and Norway where they consider themselves to be yoni free and only carry out ongoing surveillance. The effort to manage Yoni and GB is being led by Action Yoni, a cross industry group which was formed 10 years ago.

Membership includes Dairy UK, AHDB, the NFU, milk processors, and VETs. The group is concentrating on the dairy sector currently, but hopes to engage with the beef sector going forwards. The National Yonies Management Plan is the framework provided by this group to facilitate robust and credible Yoni control across GB.

This was rolled out through milk processors in 2016 as the most efficient way to engage dairy farmers. The NJMP is structured around 3 pillars. Firstly, knowing the risk of introduction and spread of yoni through a formal risk assessment.

Secondly, knowing the farm's yoni status through appropriate surveillance. And lastly, using all of this information to choose one of the 6 management strategies outlined by Action Yonies to build a robust and appropriate management plan. This must all be done with a BCVA accredited journey's vet and reviewed at least annually.

This is documented by both farmer and vet signing the National Yoni's Management Plan certificate, a copy of which should be submitted to their milk buyer, and another retained on farm. Now, please note this is a veterinary certificate, and as such it is subject to the RCVS rules of certification. In order to sign it, you must be confident that you've carried out all of the steps and have a credible plan in place.

You can also only sign if you are a BCVA accredited vet who's passed the training. If you've not done it, details are available on the BCVA website. You don't need to be a BCVA member to complete the training, although obviously we'd really love you to be.

I mentioned 6 strategies, and here they are. I don't have time to go into them all in detail now, but they are fully covered in the BCVA training, and you can also find out more on the Action News website. The address will be at the end.

But we're really comfortable that every dairy farmer in GB will be able to sit comfortably within one of these 6 management strategies. The management strategy they choose with their vet may change over time. But this will provide a good framework for building a really good plan.

The National Yoni's Management Plan is now well recognised across the world, and it's seen as an innovative and collaborative way of engaging dairy farmers in credible Yoni's control. With no external funding for farmers, it's unusual amongst global programmes, but in this way is protected from the common drop off of engagement once funding stops. It's also quite different in approach to lots of other schemes, with no set testing requirement other than a minimum to assign herd status, and a choice of management strategies.

This allows farmers and vets to use their judgement and choose a strategy that will work on each farm rather than a one size fits all approach. This is well supported by over 1100 BCVA accredited vets, providing excellent advice and guidance to their farmers. So a big thank you to them for helping to make the NJMP work.

October 31st, 2018 was the first deadline for the NJMP and we were really pleased with the results. Declarations were received from almost 6000 dairy farms across GB and this is continued into the 2019 deadline, with 24 milk purchasers participating. These milk bars between them represent around 75% of GB milk production.

Which is an amazing level of engagement for a voluntary scheme. Over 80% compliance was achieved across these milk buyers, with many getting 100% of their farmers engaged. Overall, this means that we've seen over 50% of GB dairy farms compliant with the NJMP providing an amazing platform to build on in future years.

So we gather data on which strategies the farmers are using, and we can see this presented in the table here. So the first column shows you the six strategies and then you can see the percentage of farmers that are choosing those strategies, firstly in 2018, and secondly in 2019. And we see a fairly predictable split of strategies employed and little has changed over the two years for which we have data.

Improved farm management and testing strategies account for just over 75% of farms. So that's numbers 3 and 4. Smaller numbers using improved farm management alone or breed to terminal sire.

We see less than 1% of farms engaged are vaccinating, and just 10% are considered low risk and adopting for biosecurity protect and monitor. The split that we see across these supports the methodology of providing a choice of strategies to enable all farms to participate. We don't want to disengage any farms by having too stringent rules.

The deadline is October 31st each year for farmers to have their completed declarations back to their milk buyer. So be proactive and make sure you don't have them all coming to you at the last minute. This process does take time and needs to be done properly.

All forms are available in the vet portal of the Action Yoni's website. 2019 saw a breakthrough. With an update of the red tractor farm assurance standards.

Having demonstrated that we were able to get over 50% engagement, we were actually then able to show Red Tractor that we had a sustainable scheme and they were prepared to get on board. So compliance with the NJMP is now a requirement of farm assurance from October 1, 2019. And a current signed declaration must be shown to the inspector at each audit.

This has to be accompanied by test results demonstrating that they've completed the testing stated on the declaration. This means that over 95% of GB dairy farms are now going to have to be part of the NJMP. So all of those who didn't do it before because their milk buyer wasn't part of the scheme, are going to have to step up if they want to pass their farm assurance audit.

For clarification, farms in Northern Ireland have until October 2020 to comply with this part of the red tractor farm assurance. This is to allow time for Northern Ireland to launch its Yoni scheme, which will likely be more aligned with Southern Ireland. However, in the meantime, any farmer in Northern Ireland can choose to engage with the National Yoni's Management Plan now.

So, what's next for Action Yonies? We're gonna continue to work further engagement and further enfuse new and existing milk purchaser and farmer members and provide resources for vets to use with clients to improve yoni's management on farm, and that's always going to be a priority for action yoni. Continue to look for ways to include the beef industry in the NJMP, and that's again, always going to be a goal.

It's a lot more tricky without the structure we have in the dairy industry, as we found the milk purchases were integral to the success of the NJMP, but nothing is impossible, and it's just going to take a little thinking outside the box. There's now a specific vet portal on the website with extra resources which all BCVA accredited vets have access to. So I'd encourage you to visit the website and to contact the team at the email address shown on here if you have questions about Action Yonies or the MJMP.

And another plea, anyone who hasn't completed the BCVA training, please sign up. It'll take about an hour and a half, and then it also gives you access to the full technical manual. As well as being able to work with your clients on the NJMP and sign the declarations.

So, just like to acknowledge everyone for their contributions to the content of this webinar. Firstly, action yoni, especially the technical group. The authors of the research papers I've discussed, sadly only one of which was anything to do with me.

The BCVA accredited vet advisors for flying the flag for Yoni's management so ably and BCVA for supporting their training. And finally to the webinar vet for this opportunity to speak to you all. Thank you very much for listening.