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The particle size of the forage has been proposed as a key factor to ensure a healthy rumen function and maintain dairy cow performance, but little work has been conducted on ryegrass silage (GS). To determine the effect of chop length of GS and GS:maize silage (MS) ratio on the performance, reticular pH, metabolism and eating behaviour of dairy cows, 16 multiparous Holstein-Friesian cows were used in a 4×4 Latin square design with four periods each of 28-days duration. Ryegrass was harvested and ensiled at two mean chop lengths (short and long) and included at two ratios of GS:MS (100:0 or 40:60 dry matter (DM) basis). The forages were fed in mixed rations to produce four isonitrogenous and isoenergetic diets: long chop GS, short chop GS, long chop GS and MS and short chop GS and MS. The DM intake (DMI) was 3.2 kg/day higher (P<0.001) when cows were fed the MS than the GS-based diets. The short chop length GS also resulted in a 0.9 kg/day DM higher (P<0.05) DMI compared with the long chop length. When fed the GS:MS-based diets, cows produced 2.4 kg/day more (P<0.001) milk than when fed diets containing GS only. There was an interaction (P<0.05) between chop length and forage ratio for milk yield, with a short chop length GS increasing yield in cows fed GS but not MS-based diets. An interaction for DM and organic matter digestibility was also observed (P<0.05), where a short chop length GS increased digestibility in cows when fed the GS-based diets but had little effect when fed the MS-based diet. When fed the MS-based diets, cows spent longer at reticular pH levels below pH 6.2 and pH 6.5 (P<0.01), but chop length had little effect. Cows when fed the MS-based diets had a higher (P<0.05) milk fat concentration of C18 : 2n-6 and total polyunsaturated fatty acids compared with when fed the GS only diets. In conclusion, GS chop length had little effect on reticular pH, but a longer chop length reduced DMI and milk yield but had little effect on milk fat yield. Including MS reduced reticular pH, but increased DMI and milk performance irrespective of the GS chop length.
Improving access to tuberculosis (TB) care and ensuring early diagnosis are two major aims of the WHO End TB strategy and the Collaborative TB Strategy for England. This study describes risk factors associated with diagnostic delay among TB cases in England. We conducted a retrospective cohort study of TB cases notified to the Enhanced TB Surveillance System in England between 2012 and 2015. Diagnostic delay was defined as more than 4 months between symptom onset and treatment start date. Multivariable logistic regression was used to identify demographic and clinical factors associated with diagnostic delay. Between 2012 and 2015, 22 422 TB cases were notified in England and included in the study. A third (7612) of TB cases had a diagnostic delay of more than 4 months. Being female, aged 45 years and older, residing outside of London and having extra-pulmonary TB disease were significantly associated with a diagnostic delay in the multivariable model (aOR = 1.2, 1.2, 1.2, 1.3, 1.8, respectively). This study identifies demographic and clinical factors associated with diagnostic delay, which will inform targeted interventions to improve access to care and early diagnosis among these groups, with the ultimate aim of helping reduce transmission and improve treatment outcomes for TB cases in England.
Established methods of recruiting population controls for case–control studies to investigate gastrointestinal disease outbreaks can be time consuming, resulting in delays in identifying the source or vehicle of infection. After an initial evaluation of using online market research panel members as controls in a case–control study to investigate a Salmonella outbreak in 2013, this method was applied in four further studies in the UK between 2014 and 2016. We used data from all five studies and interviews with members of each outbreak control team and market research panel provider to review operational issues, evaluate risk of bias in this approach and consider methods to reduce confounding and bias. The investigators of each outbreak reported likely time and cost savings from using market research controls. There were systematic differences between case and control groups in some studies but no evidence that conclusions on the likely source or vehicle of infection were incorrect. Potential selection biases introduced by using this sampling frame and the low response rate are unclear. Methods that might reduce confounding and some bias should be balanced with concerns for overmatching. Further evaluation of this approach using comparisons with traditional methods and population-based exposure survey data is recommended.
Soil solarization is a process of soil disinfestation that involves solar heating of moist soil covered with transparent polyethylene film. This nonchemical approach to controlling soil-borne pests is being investigated as an alternative to methyl bromide fumigation. Summer solarization controlled annual weed species and suppressed purple nutsedge. Although some nutsedge tubers sprouted despite the solarization treatment, the resulting shoots were almost always trapped under the clear solarization film. Conversely, in rows that were mulched with black film, nutsedge rhizomes punctured the film so that leaf expansion occurred above the film. In controlled pot experiments conducted in darkness, yellow nutsedge rhizomes readily penetrated 19- and 30-μm clear films as effectively as opaque films. Thicker clear films and bubble film reduced nutsedge penetration. In the greenhouse and laboratory, nutsedge penetration of transparent polyethylene film was inversely related to irradiance levels when the film was in direct contact with the soil. However, when there was a 5- to 10-mm space between the soil and the film, the lowest irradiance level (30 μmol m−2 s−1) was as effective as 320 μmol m−2 s−1 in reducing penetration by purple nutsedge. The film penetration by nutsedge rhizomes appears to be linked to a light-dependent morphological change from rhizome growth to leaf development, which occurs before film penetration with clear mulch and after film penetration with opaque mulch. The alternate sprouting and foliar scorching of nutsedge shoots trapped under clear films could potentially be exploited to deplete nutsedge tubers that occur at soil depths that do not develop lethal temperatures under soil solarization.
Background: Cerebral palsy (CP) is a debilitating disorder (1). Based on neuromotor impairments it is divided to spastic, dyskinetic and ataxic types (2). Inborn Errors of Metabolism (IEMs), monogenic and chromosomal disorders mimic CP (3). We aimed to identify causal genetic variants in patients with atypical dyskinetic CP in whom known IEMs were ruled out. Timely diagnosis is essential for proper management, especially in conditions that mimic CP and are treatable. Methods: We enrolled 23 patients with unexplained atypical dyskinetic CP, for whole exome sequencing. Variants were filtered against public and in-house databases to identify variants predicted as damaging (in silico tools and ACMG criteria). We applied a virtual gene panel of known and suspected CP and movement disorder genes and investigated each sample. Results: The participants presented with symptoms including: spasticity, dystonia, choera-athetosis, ataxia and cognitive delays. We identified 23 diagnoses: 13 dominant,6 recessive and 4 X-linked. 12 patients had movement disorders. In 4, the diagnoses enabled targeted treatment (neurotransmitter supplements in Unverricht Lundborg diseases (CSTB) and PAK3 deficiency, deep brain stimulation in GNAO1 deficiency, medical diet in Glutaric Aciduria (GCDH). Conclusions: Whole Exome Sequencing contributes to establishing diagnosis in patients with atypical dyskinetic CP resulting in precision medicine and improved health outcomes.
Introduction: In Ottawa, STEMI patients are transported directly to percutaneous coronary intervention (PCI) by advanced care paramedics (ACPs), primary care paramedics (PCPs), or transferred from PCP to ACP crew (ACP-intercept). PCPs have a limited skill set to address complications during transport.The objective of this study was to determine what clinically important events (CIEs) occurred in STEMI patients transported for primary PCI via a PCP crew, and what proportion of such events could only be treated by ACP protocols. Methods: We conducted a health record review of STEMI patients transported for primary PCI from Jan 1, 2011-Dec 21, 2015. Ottawa has a single PCI center and its EMS system employs both PCP and ACP paramedics. We identified consecutive STEMI bypass patients transported by PCP-only and ACP-intercept using the dispatch database. A data extraction form was piloted and used to extract patient demographics, transport times, and primary outcomes: CIEs and interventions performed during transport, and secondary outcomes: hospital diagnosis, and mortality. CIEs were reviewed by two investigators to determine if they would be treated differently by ACP protocols. We present descriptive statistics. Results: We identified 967 STEMI bypass cases among which 214 (118 PCP-only and 96 ACP-intercept) met all inclusion criteria. Characteristics were: mean age 61.4 years, 78% male, 31.8% anterior and 44.4% inferior infarcts, mean response time 6 min, total paramedic contact time 29 min, and in cases of ACP-intercept 7 min of PCP-only contact time.A CIE occurred in 127 (59%) of cases: SBP<90 mmHg 26.2%, HR<60 30.4%, HR>100 20.6%, malignant arrhythmias 7.5%, altered mental status 6.5%, airway intervention 2.3%, 2 patients (0.9%) arrested, both survived. Of the CIE identified, 54 (42.5%) could be addressed differently by ACP vs PCP protocols (25.2% of total cases). The majority related to fluid boluses for hypotension (44 cases; 35% of CIE). ACP intervention for CIEs within the ACP intercept group was 51.6%. There were 6 in-hospital deaths (2.8%) with no difference in transport crew type. Conclusion: CIEs are common in STEMI bypass patients however a smaller proportion of such CIE would be addressed differently by ACP protocols compared to PCP protocols. The vast majority of CIE appeared to be transient and of limited clinical significance.
In October 2014, Public Health England (PHE) identified cases of Shiga toxin-producing Escherichia coli (STEC) serogroup O157 sharing a multiple locus variable-number tandem repeat analysis (MLVA) profile. We conducted a case-control study using multivariable logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) testing a range of exposures. Cases were defined as laboratory-confirmed STEC O157 with the implicated MLVA profile, were UK residents aged ⩾18 years with symptom onset between 25 September and 30 October 2014, and had no history of travel abroad within 5 days of symptom onset. One hundred and two cases were identified. Cases were mostly female (65%; median age 49, range 2–92 years). It was the second largest outbreak seen in England, to date, and a case-control study was conducted using market research panel controls and online survey methods. These methods were instrumental in the rapid data collection and analysis necessary to allow traceback investigations for short shelf-life products. This is a new method of control recruitment and this is the first in which it was a standalone recruitment method. The case-control study suggested a strong association between consumption of a ready-to-eat food and disease (aOR 28, 95% CI 5·0–157) from one retailer. No reactive microbiological testing of food items during the outbreak was possible due to the short shelf-life of the product. Collaboration with industrial bodies is needed to ensure timely traceback exercises to identify contamination events and initiate appropriate and focused microbiological testing and implement control measures.
Although only three antennas of the Australia Telescope Compact Array are currently operational, we have made use of the technique of bandwidth synthesis to make an image of the radio galaxy 2152 – 69. The three baselines were used to observe the source at three different frequencies, effectively resulting in nine baselines, which have been used to produce an image with a surprisingly high dynamic range, and with a slightly higher resolution than any existing image.
The production of such a worthwhile result, despite being made with a small subset of the capabilities of the Australia Telescope, bodes well for the future operation of the instrument.
A panel of emergency medicine (EM) leaders endeavoured to define the key elements of leadership and its models, as well as to formulate consensus recommendations to build and strengthen academic leadership in the Canadian EM community in the areas of mentorship, education, and resources.
Methods
The expert panel comprised EM leaders from across Canada and met regularly by teleconference over the course of 9 months. From the breadth of backgrounds and experience, as well as a literature review and the development of a leadership video series, broad themes for recommendations around the building and strengthening of EM leadership were presented at the CAEP 2015 Academic Symposium held in Edmonton, Alberta. Feedback from the attendees (about 80 emergency physicians interested in leadership) was sought. Subsequently, draft recommendations were developed by the panel through attendee feedback, further review of the leadership video series, and expert opinion. The recommendations were distributed to the CAEP Academic Section for further feedback and updated by consensus of the expert panel.
Results
The methods informed the panel who framed recommendations around four themes: 1) leadership preparation and training, 2) self-reflection/emotional intelligence, 3) academic leadership skills, and 4) gender balance in academic EM leadership. The recommendations aimed to support and nurture the next generation of academic EM leaders in Canada and included leadership mentors, availability of formal educational courses/programs in leadership, self-directed education of aspiring leaders, creation of a Canadian subgroup with the AACEM/SAEM Chair Development Program, and gender balance in leadership roles.
Conclusions
These recommendations serve as a roadmap for all EM leaders (and aspiring leaders) to build on their success, inspire their colleagues, and foster the next generation of Canadian EM academic leaders.
It is well-established that altering the proportion of starch and fibre in ruminant diets can alter ruminal and post-ruminal digestion, although quantitative evidence that this reduces enteric methane (CH4) production in dairy cattle is lacking. The objective of this study was to examine the effect of varying grass-to-maize silage ratio (70 : 30 and 30 : 70 DM basis), offered ad libitum, with either a concentrate that was high in starch or fibre, on CH4 production, intake, performance and milk composition of dairy cows. A total of 20 cows were allocated to one of the four experimental diets in a two-by-two factorial design run as a Latin square with each period lasting 28 days. Measurements were conducted during the final 7 days of each period. Cows offered the high maize silage ration had a higher dry matter intake (DMI), milk yield, milk energy output and lower CH4 emissions when expressed per kg DMI and per unit of ingested gross energy, but there was no difference in total CH4 production. Several of the milk long-chain fatty acids (FA) were affected by forage treatment with the most notable being an increase in 18:0, 18:1 c9, 18:2 c9 c12 and total mono unsaturated FA, observed in cows offered the higher inclusion of maize silage, and an increase in 18:3 c9 c12 c15 when offered the higher grass silage ration. Varying the composition of the concentrate had no effect on DMI or milk production; however, when the high-starch concentrate was fed, milk protein concentration and milk FAs, 10:0, 14:1, 15:0, 16:1, increased and 18:0 decreased. Interactions were observed for milk fat concentration, being lower in cows offered high-grass silage and high-fibre concentrates compared with the high-starch concentrate, and FA 17:0, which was the highest in milk from cows fed the high-grass silage diet supplemented with the high-starch concentrate. In conclusion, increasing the proportion of maize silage in the diets of dairy cows increased intake and performance, and reduced CH4 production, but only when expressed on a DM or energy intake basis, whereas starch-to-fibre ratio in the concentrate had little effect on performance or CH4 production.
The aim of the present study was to provide evidence of validity of the Brief Resilient Coping Scale for use in Spanish young population. A total of 365 university students responded to the Spanish version of the BRCS as well as to other tools for measuring personal perceived competence, life satisfaction, depression, anxiety, negative and positive affect, and coping strategies. Confirmatory factor analysis confirmed the unidimensional structure of the scale. Internal consistency reliability and temporal stability through Cronbach’s alpha and test-retest correlations, respectively, were comparable to those found in the initial validation of the tool. The BRCS showed positive and significant correlations with personal perceived competence, optimism, life satisfaction, positive affect (p < .01), and some coping strategies (p < .05). Significant negative correlations were observed with depression, anxiety and negative affect. (p < .01). Multiple regression analysis with stepwise method showed that positive affect, negative affect, optimism and problem solving explained 41.8% of the variance of the BRCS (p < .001). The Spanish adaptation of the BRCS in a young population is satisfactory and comparable to those of the original version and with the Spanish version adapted in an elderly population. This supports its validity as a tool for the assessment of resilient coping tendencies in young people who speak Spanish and offers researchers and professionals interested in this area of study a simple tool for assessing it.
In light of increasing global protein prices and with the need to reduce environmental impact of contemporary systems of milk production, the current review seeks to assess the feasibility of reducing levels of dietary CP in dairy cow diets. At CP levels between 140 and 220 g/kg DM there is a strong positive relationship between CP concentration and dry matter intake (DMI). However, such effects are modest and reductions in DMI when dietary CP is below 180 g/kg DM can be at least partially offset by improving the digestibility and amino acid profile of the undegradable protein (UDP) component of the diet or by increasing rumen fermentable energy. Level and balance of intestinally absorbable amino acids, in particular methionine and lysine, may become limiting at lower CP concentrations. In general the amino acid composition of microbial protein is superior to that of UDP, so that dietary strategies that aim to promote microbial protein synthesis in the rumen may go some way to correcting for amino acid imbalances in low CP diets. For example, reducing the level of NDF, while increasing the proportion of starch, can lead to improvements in nitrogen (N) utilisation as great as that achieved by reducing dietary CP to below 150 g/kg. A systematic review and meta-analysis of responses to rumen protected forms of methionine and lysine was conducted for early/mid lactation cows fed diets containing ⩽150 g CP/kg DM. This analysis revealed a small but significant (P=0.002) increase in milk protein yield when cows were supplemented with these rumen protected amino acids. Variation in milk and milk protein yield responses between studies was not random but due to differences in diet composition between studies. Cows fed low CP diets can respond to supplemental methionine and lysine so long as DMI is not limiting, metabolisable protein (MP) is not grossly deficient and other amino acids such as histidine and leucine do not become rate limiting. Whereas excess dietary protein can impair reproduction and can contribute to lameness, there is no evidence to indicate that reducing dietary CP levels to around 140 to 150 g CP/kg DM will have any detrimental effect on either cow fertility or health. Contemporary models that estimate MP requirements of dairy cows may require refinement and further validation in order to predict responses with low CP diets.
Digital signal processing is one of many valuable tools for suppressing unwanted signals or inter-ference. Building hardware processing engines seems to be the way to best implement some classes of interference suppression but is, unfortunately, expensive and time-consuming, especially if several miti-gation techniques need to be compared. Simulations can be useful, but are not a substitute for real data. CSIRO’s Australia Telescope National Facility has recently commenced a ‘software radio telescope’ project designed to fill the gap between dedicated hardware processors and pure simulation. In this approach, real telescope data are recorded coherently, then processed offline. This paper summarises the current contents of a freely available database of base band recorded data that can be used to experiment with signal processing solutions. It includes data from the following systems: single dish, multi-feed receiver; single dish with reference antenna; and an array of six 22 m antennas with and without a reference antenna. Astronomical sources such as OH masers, pulsars and continuum sources subject to interfering signals were recorded. The interfering signals include signals from the US Global Positioning System (GPS) and its Russian equivalent (GLONASS), television, microwave links, a low-Earth-orbit satellite, various other transmitters, and signals leaking from local telescope systems with fast clocks. The data are available on compact disk, allowing use in general purpose computers or as input to laboratory hardware prototypes.
The objectives of the study were to determine the effect of the partial replacement of soyabean meal and rapeseed meal with feed grade urea or a slow-release urea on the performance, metabolism and whole-tract digestibility in mid-lactation dairy cows. Forty-two Holstein–Friesian dairy cows were allocated to one of three dietary treatments in each of three periods of 5 weeks duration in a Latin square design. Control (C) cows were offered a total mixed ration based on grass and maize silages and straight feeds that included 93 g/kg dry matter (DM) soyabean meal and 61 g/kg DM rapeseed meal. Cows that received either of the other two treatments were offered the same basal ration with the replacement of 28 g/kg DM soyabean and 19 g/kg DM rapeseed meal with either 5 g/kg DM feed grade urea (U) or 5.5 g/kg DM of the slow-release urea (S; Optigen®; Alltech Inc., Kentucky, USA), with the content of maize silage increasing. There was no effect (P > 0.05) of dietary treatment on DM intake, which averaged 22.5 kg/day. Similarly, there was no effect (P > 0.05) of treatment on daily milk or milk fat yield but there was a trend (P = 0.09) for cows offered either of the diets containing urea to have a higher milk fat content (average of 40.1 g/kg for U and S v. 38.9 g/kg for C). Milk true protein concentration and yield were not affected by treatment (P > 0.05). Milk yield from forage and N efficiency (g milk N output/g N intake) were highest (P < 0.01) in cows when offered S and lowest in C, with cows receiving U having intermediate values. Cows offered S also tended to have the highest live weight gain (0.38 kg/day) followed by U (0.23 kg/day) and C (0.01 kg/day; P = 0.07). Plasma urea concentrations were higher (P < 0.05) at 2 and 4 h post feeding in cows when offered U and lowest in C, with animals receiving S having intermediate values. There was no effect (P > 0.05) of treatment on whole-tract digestibility. In conclusion, the partial replacement of soyabean meal and rapeseed meal with feed grade urea or a slow-release urea can be achieved without affecting milk performance or diet digestibility, with the efficiency of conversion of dietary N into milk being improved when the slow-release urea was fed.
Anthropogenic pollutants comprise a wide range of synthetic organic compounds and heavy metals, which are dispersed throughout the environment, usually at low concentrations. Exposure of ruminants, as for all other animals, is unavoidable and while the levels of exposure to most chemicals are usually too low to induce any physiological effects, combinations of pollutants can act additively or synergistically to perturb multiple physiological systems at all ages but particularly in the developing foetus. In sheep, organs affected by pollutant exposure include the ovary, testis, hypothalamus and pituitary gland and bone. Reported effects of exposure include changes in organ weight and gross structure, histology and gene and protein expression but these changes are not reflected in changes in reproductive performance under the conditions tested. These results illustrate the complexity of the effects of endocrine disrupting compounds on the reproductive axis, which make it difficult to extrapolate between, or even within, species. Effects of pollutant exposure on the thyroid gland, immune, cardiovascular and obesogenic systems have not been shown explicitly, in ruminants, but work on other species suggests that these systems can also be perturbed. It is concluded that exposure to a mixture of anthropogenic pollutants has significant effects on a wide variety of physiological systems, including the reproductive system. Although this physiological insult has not yet been shown to lead to a reduction in ruminant gross performance, there are already reports indicating that anthropogenic pollutant exposure can compromise several physiological systems and may pose a significant threat to both reproductive performance and welfare in the longer term. At present, many potential mechanisms of action for individual chemicals have been identified but knowledge of factors affecting the rate of tissue exposure and of the effects of combinations of chemicals on physiological systems is poor. Nevertheless, both are vital for the identification of risks to animal productivity and welfare.