Milk production declines as dairy cows enter late lactation, resulting in reduced milk quality and negatively impacting milk processability, such as rennet coagulation time (RCT), milk pH and ethanol stability (ES), leading to seasonality issues for milk processors. Multispecies forages, containing grass, legume and herb species, require lower N inputs and are of interest to dairy farmers. However, little is known about the effect of grazing multispecies forages on milk processability characteristics in late lactation dairy cows. Forty-five autumn-calving dairy cows in late lactation were allocated to 1 of 3 grazing forages; perennial ryegrass (PRG; Lolium perenne), perennial ryegrass and white clover (Trifolium pratense) (PRGWC), and a 6 – species multispecies forage (MULTI) containing perennial ryegrass, timothy (Phleum pratense), white clover, red clover (Trifolium repens), chicory (Cichorium intybus) and plantain (Plantago lanceolata). Cows were allocated 12 kg DM grazed forage and supplemented with a grass – silage TMR and concentrate. Forage DMI was significantly lower for cows grazing PRG. Milk yield increased when cows grazed PRGWC (18.07 kg/d) and MULTI (17.84 kg/d) compared to PRG (16.08 kg/d). Milk RCT (mins) and ES (%) were unaffected by treatment. However, offering cows PRGWC and MULTI increased the concentration of C18:2 cis – 9, 12 and C18:3 cis – 9, 12, 15 in milk compared to PRG. Compared to PRG, grazing forages containing clover and herb species improved milk yield and beneficially altered milk fatty acid profile in late lactation dairy cows without negatively impacting milk processability.

To provide comprehensive information on the epidemiology and burden of respiratory syncytial virus hospitalisation (RSVH) in preterm infants, a pooled analysis was undertaken of seven multicentre, prospective, observational studies from across the Northern Hemisphere (2000–2014). Data from all 320–356 weeks' gestational age (wGA) infants without comorbidity were analysed. RSVH occurred in 534/14 504 (3.7%) infants; equating to a rate of 5.65 per 100 patient-seasons, with the rate in individual wGA groups dependent upon exposure time (P = 0.032). Most RSVHs (60.1%) occurred in December–January. Median age at RSVH was 88 days (interquartile range (IQR): 54–159). Respiratory support was required by 82.0% of infants: oxygen in 70.4% (median 4 (IQR: 2–6) days); non-invasive ventilation in 19.3% (median 3 (IQR: 2–5) days); and mechanical ventilation in 10.2% (median 5 (IQR: 3–7) days). Intensive care unit admission was required by 17.9% of infants (median 6 days (IQR: 2–8) days). Median overall hospital length of stay (LOS) was 5 (IQR: 3–8) days. Hospital resource use was similar across wGA groups except for overall LOS, which was shortest in those born 35 wGA (median 3 vs. 4–6 days for 32–34 wGA; P < 0.001). Strategies to reduce the burden of RSVH in otherwise healthy 32–35 wGA infants are indicated.

Introduction: Acute pharyngitis is a common emergency department (ED) presentation. The Centor (Modified/McIsaac) score uses five criteria (age, tonsillar exudates, swollen tender anterior cervical nodes, absence of a cough, and history of fever) to predict Group A Streptococcus (GAS) infection. The recommendation is patients with a Centor score of 0-1 should not undergo testing and should not be given antibiotics, patients with a score of 2-3 may warrant throat cultures, and for patients with a score ≥ 4, empiric antibiotics may be appropriate. Associated pain is often first managed with acetaminophen or non-steroidal anti-inflammatory drugs, however recent evidence suggests a short course of low-to-moderate dose corticosteroids as adjunctive therapy may reduce inflammation and provide pain relief. The objective of this study was to describe the ED management of acute pharyngitis for adult patients presenting to an academic ED over a two-year study period. Methods: This was a retrospective chart review of all adult (> 17 years) patients presenting to Mount Sinai Hospital ED with a discharge diagnosis of acute pharyngitis (ICD-10 code J02.9) from January 1st 2016 to December 31st 2018. Trained research personnel reviewed medical records and extracted data using a computerized, data abstraction form. Results: Of the 638 patients included in the study, 286 (44.8%) had a Centor score of 0-1, 328 (51.4%) had a score of 2-3, and 24 (3.8%) had a score of ≥ 4. Of those with a Centor score of 0-1, 83 (29.0%) had a throat culture, 88 (30.8%) were prescribed antibiotics, 15 (5.2%) were positive for GAS and 74 (25.9%) were given corticosteroids in the ED or at discharge. Of those with a Centor score of 2-3, 156 (47.6%) had a throat culture, 220 (67.1%) were prescribed antibiotics, 44 (13.4%) were positive for GAS, and 145 (44.2%) were given corticosteroids. Of those with a Centor score ≥ 4, 14 (58.3%) had a throat culture, 18 (75.0%) were prescribed antibiotics, 7 (29.2%) were positive for GAS and 12 (50.0%) were given corticosteroids. Conclusion: As predicted, a higher Centor score was associated with higher risk of GAS infection, increased antibiotic prescribing and use of corticosteroids. Many patients with low Centor scores were prescribed antibiotics and also had throat cultures. Further work is required to understand clinical decision making for the management of acute pharyngitis.

A two-year (2015 and 2016) grazing study was established to compare ewe and lamb performance when grazed on a perennial ryegrass only sward compared to more diverse sward types. In that study four sward types were investigated: a perennial ryegrass (Lolium perenne) only sward receiving 163 kg nitrogen per hectare per year (N/ha/yr) (PRG); a perennial ryegrass and white clover (Trifolium repens) sward receiving 90 kg N/ha/yr (PRGWC); a six species sward (two grasses (perennial ryegrass and timothy (Phleum pratense)), two legumes (white and red clover (Trifolium pratense)) and two herbs (ribwort plantain (Plantago lanceolata) and chicory (Cichorium intybus)) receiving 90 kg N/ha/yr (6S); and a nine species sward containing cocksfoot (Dactylis glomerata), greater birdsfoot trefoil (Lotus pedunculatus) and yarrow (Achillea millefolium) in addition to the six species listed above, receiving 90 kg N/ha/yr (9S). Each sward type was managed as a separate farmlet and stocked with 30 twin-rearing ewes at a stocking rate of 12.5 ewes/ha under rotational grazing management from turnout post-lambing until housing. Lamb live weight was recorded fortnightly and lambs were drafted for slaughter at 45 kg. Ewe live weight and body condition score (BCS) were recorded on five occasions annually. Lamb faecal egg count (FEC) was recorded fortnightly and lambs were treated with anthelmintics when mean lamb FEC per sward type was above 400 eggs per gram. Ewes grazing the 6S and 9S swards had heavier (P < 0.01) live weights and BCS throughout the study than the ewes grazing the PRG sward. Lambs grazing the 6S sward were heavier than lambs grazing all other sward types of 14 weeks old (P < 0.05). Lambs grazing the PRG sward required more days to reach slaughter weight than lambs grazing all other sward types (P < 0.001). Lambs grazing the 6S and 9S swards required fewer anthelmintic treatments than lambs grazing the PRG or PRGWC swards. In conclusion, grazing multispecies swards improved ewe and lamb performance and reduced the requirement for chemical anthelmintics.

During the Skylab period from June 1973 to January 1974 approximately 1500 type III metre-wave radio bursts or burst groups were reported (Solar Geophysical Data Prompt Reports). The longitudinal distribution of these type III bursts closely resembles that of sunspots and of the coronal transients observed above 2 R⊙ by the white-light coronagraph on Skylab. White light ejection transients appear as large loop or blob-like structures which carry material outward from the Sun and rearrange the corona. In front of the main, bright structures there are weak enhancements of brightness, termed forerunners (Jackson and Hildner 1978; Jackson 1978). In this paper we enquire into whether or not type III bursts are in any way related to the onset of solar mass ejections indicated by coronal transients.

Studies of coronal transients observed in white-light (Gosling et al., 1976) have shown that fast-moving events (≤ 400 km s-1) are closely associated with flares and with type II and IV radio bursts while slow-moving events are not. We now report the first detection of the radio counterpart of a slow-moving transient. The event of 1974 January 21 is shown to be visible on maps of the quiet Sun made at a frequency of 80 MHz.

We compare observations of a large coronal streamer made with the 80 MHz Culgoora radioheliograph, the Kcoronameter on Mauna Loa and the white light coronagraph on Skylab. The various measurements are not in agreement, and this raises fundamental questions about the nature of the corona and wave propagation through a streamer structure. The comparisons also indicate how precise data from the heliograph may contribute to a better understanding of these processes.

Most if not all metre-wave Type III bursts appear to be associated with solar active regions (e.g. Duncan 1977). There is a well-known association of Type III bursts and flares within a few minutes of the onset of the brightenings seen in Hα (Wild et al. 1954). Early descriptions of these observations were given by Malville (1961) (or see Kundu (1965) for review). More recently Jackson et al. (1978) have reported the occurrence of a broad maximum of Type III bursts 10 to 5 h prior to mass ejection transients seen by the white light coronagraph on Skylab.

Local food systems are comprised of networks of actors that work to ensure the sustainability of food supplies within communities. While local food has typically been promoted through direct marketing strategies such as farmers' markets and community-supported agriculture (CSA), retail stores are increasingly carrying and marketing local foods in response to consumer demand and market potential. Given the frequency with which consumers shop at grocery stores, as well as the portion of consumers' food purchases made at these locations, these stores may play a significant role in the success of local agriculture and the shaping of ideology about what is ‘local’. We conducted 27 semi-structured interviews with representatives of food retailers known to source and market local foods in the four major urban centers of Oregon's Willamette Valley. Our results reveal that grocers' perceptions of local food vary significantly from one another. Additionally, our results differed in comparison to the published literature on consumers' and producers' ideas of what constitutes local. Food retailers identified varying distances (frequently a region including several states) that they consider local, as well as diverse reasons for choosing to source and market local foods (most commonly supporting the local economy). Some trends in the variation of responses relate to how the size and form of ownership of the grocery stores influence the level at which decisions are made. These wide-ranging perceptions outline many of the realities of the local food movement, as well as opportunities for change.

The influence of a strong low-level temperature inversion on the occurrence of lee waves, rotors and hydraulic jumps has been investigated using high resolution numerical model simulations. The aim of the work is to develop tools for forecasting hazardous winds downstream of mountains. Two-dimensional simulations were conducted for a range of inversion heights and strengths and a fixed hill shape; lee waves, rotors and hydraulic jumps were found to occur. The flow type depends largely on the ratio of mountain height to inversion height and the upstream Froude number. A flow regime diagram based on these two parameters has been constructed and suggests that rotors could be forecast using upstream profiles, which are generally readily available from numerical weather prediction models.

The applicability of the regime diagram for two-dimensional flow to flows over real terrain has been tested using three-dimensional simulations of flows over East Falkland, South Atlantic, under a range of upstream conditions. The flow type is found to be determined largely by the upstream profiles of wind and temperature, and the maximum height of orography directly upstream, indicating that the flow regime diagram can be used to predict flow type downstream of such terrain. Various three-dimensional flow phenomena occur, such as flow channelling through gaps, and could be taken into account to improve the information available from the regime diagram.

The ability of the heart to function as an efficient pump is critically dependent on an adequate blood supply to the myocardium. When myocardial blood supply is reduced (ischaemia), contractile function of the heart is impaired and its cellular electrophysiological properties are profoundly altered. Prolonged ischaemia may result in cell necrosis which, if irreversible, leads to cell death (infarction) and predisposes the heart to ventricular arrhythmias, which in turn may be fatal. In man, myocardial ischaemia is the consequence of narrowing or occlusion of a coronary artery and is usually a manifestation of coronary artery disease which is often associated with thrombosis.