Evaluating GreenFeed and respiration chambers for daily and intraday measurements of enteric gaseous exchange in dairy cows housed in tie-stalls.

The objective of this study was to evaluate the GreenFeed (GF) and respiration chambers (RC) for daily and intraday measurements of the enteric gaseous exchange, as well as the metabolic heat production, lying behavior, and feed intake (FI) rate of dairy cows at these 2 respective housing conditions [tie-stall barn (TS) vs. RC] during the summer periods. Sixteen multiparous lactating dairy cows were recruited and arranged in a randomized complete block design with a baseline period established for each cow. Cows were given a basal diet (CON) for a baseline period of 7 d and were then fed a 3-nitrooxypropanol (3-NOP)-containing feed for the subsequent 26 d as experimental period. During both the baseline and the last 7 d of treatment period, gaseous exchanges of each animal were measured in the TS using GF for 8 6-hourly staggered measurements over 3 d, immediately followed by the measurement in RC for 2 d. Corresponding DMI, milk yield, and behavior parameters (e.g., lying behavior and FI rate) in TS and RC were recorded. The correlation coefficients of CH4 and H2 using raw data were 0.84 and 0.85, respectively. For all gases, correlation coefficients between GF and RC on individual cow level decreased when the marginal fixed effects (e.g., inhibitor and breed) were corrected by a mixed model. There were no differences in daily CH4 production or intensity between GF and RC (442 vs. 443 g CH4/d or 16.6 vs. 16.2 g CH4 /kg MY). However, greater CH4 yield was measured by GF than RC (19.0 vs. 17.8 g CH4/kg DMI), driven by a lower DMI (23.3 vs. 24.6 kg/d) when cows were housed in TS sampled by GF compared with cows being housed and sampled in RC. The correlations for CO2 production and O2 consumption were moderate and expected due to the variation associated with the mild heat stress condition during GF measurements in the TS (Thermal humidity index (THI) 56 vs. 68), as indicated by the reduced lying time (-2.1 h/d). At the intraday level, there was an interaction between techniques and hour-of-day for CH4 production, as indicated by the discrepancies in post-prandial CH4 emissions between techniques. In summary, this set of results showed that there were strong positive correlations for CH4 and H2 emissions between GF and RC based on individual cow data. However, such relationship should be interpreted with caution, given the data clustering resulting from the use of inhibitor 3-NOP. On treatment level, these 2 techniques detected similar inhibitor effect on the estimated daily CH4 emissions. The intraday patterns of CH4 and H2 production captured by GF provided a close approximation for those measured by RC. Nevertheless, potential underestimation may occur, especially following fresh feed delivery. For measuring CO2 production and O2 consumption, the GF captured similar intraday variations to those in the RC. However, the estimated daily production and consumption were not directly comparable, which was expected due to the variable thermal conditions during the summer. Further evaluations under the same weather conditions are warranted.

Effects of 3-nitrooxypropanol (Bovaer10) and whole cottonseed on milk production and enteric methane emissions from dairy cows under Swiss management conditions.

The objective of this study was to determine the potential effect and interaction of 3-nitrooxypropanol (3-NOP; Bovaer, DSM-Firmenich Nutrition Products Ltd.) and whole cottonseed (WCS) on lactational performance and enteric methane (CH4) emission of dairy cows. A total of 16 multiparous cows, including 8 Holstein Friesian (HF) and 8 Brown Swiss (BS; 224 ± 36 DIM, 26 ± 3.7 kg milk yield, mean ± SD), were used in a split-plot design, where the main plot was the breed of cows. Within each subplot, cows were randomly assigned to a treatment sequence in a replicated 4 × 4 Latin square design with 2 × 2 factorial arrangements of treatments with four 24-d periods. The experimental treatments were as follows: (1) control (basal TMR), (2) 3-NOP (60 mg/kg TMR DM), (3) WCS (5% TMR DM), and (4) 3-NOP + WCS. The treatment diets were balanced for ether extract, crude protein, and NDF contents (4%, 16%, and 43% of TMR DM, respectively). The basal diets were fed twice daily at 0800 and 1800 h. Dry matter intake and milk yield were measured daily, and enteric gas emissions were measured (using the GreenFeed System, C-Lock Inc.) during the last 3 d of each 24-d experimental period when animals were housed in tiestalls. There was no difference in DMI on treatment level, whereas the WCS treatment increased ECM yield and milk fat yield. No interaction of 3-NOP and WCS occurred for any of the enteric gas emission parameters, but 3-NOP decreased CH4 production (g/d), CH4 yield (g/kg DMI), and CH4 intensity (g/kg ECM) by 13%, 14%, and 13%, respectively. Further, an unexpected interaction of breed by 3-NOP was observed for different enteric CH4 emission metrics: HF cows had a greater CH4 mitigation effect compared with BS cows for CH4 production (g/d; 18% vs. 8%), CH4 intensity (g/kg milk yield; 19% vs. 3%), and CH4 intensity (g/kg ECM; 19% vs. 4%). Hydrogen production was increased by 2.85-fold in HF and 1.53-fold in BS cows receiving 3-NOP. Further, a 3-NOP × time interaction occurred for both breeds. In BS cows, 3-NOP tended to reduce CH4 production by 18% at approximately 4 h after morning feeding, but no effect was observed at other time points. In HF cows, the greatest mitigation effect of 3-NOP (29.6%) was observed immediately after morning feeding, and it persisted at around 23% to 26% for 10 h until the second feed provision, and 3 h thereafter, in the evening. In conclusion, supplementing 3-NOP at 60 mg/kg DM to a high-fiber diet resulted in 18% to 19% reduction in enteric CH4 emission in Swiss HF cows. The lower response to 3-NOP by BS cows was unexpected and has not been observed in other studies. These results should be interpreted with caution due to the low number of cows per breed. Finally, supplementing WCS at 5% of DM improved ECM and milk fat yield but did not enhance the CH4 inhibition effect of 3-NOP of dairy cows.

Equipment for pre-hospital airway management on Helicopter Emergency Medical System helicopters in central Europe.

BACKGROUND: For advanced out-of-hospital airway management, skilled personnel and adequate equipment are key prerequisites. There are little data on the current availability of airway management equipment and standards of medical staff on Helicopter Emergency Medical System (HEMS) helicopters in central Europe. METHODS: An internet search identified all HEMS helicopters in Austria, Switzerland and Luxembourg. We identified 15 HEMS helicopter bases in Switzerland, 28 in Austria and three in Luxembourg. A questionnaire was sent to all bases, asking both for the details of the clinical background and experience of participating staff, and details of airway management equipment carried routinely on board. RESULTS: Replies were received from 14 helicopter bases in Switzerland (93%), 25 bases in Austria (89%) and all three bases in Luxembourg. Anaesthesiologists were by far the most frequent attending physicians (68-85%). All except one bases reported to have at least one alternative supraglottic airway device. All bases had capnometry and succinylcholine. All bases in the study except two in Austria had commercial pre-packed sets for a surgical airway. All helicopters were equipped with automatic ventilators, although not all were suitable for non-invasive ventilation (NIV; Switzerland: 43%, Austria: 12%, Luxembourg: 100%). Masks for NIV were rarely available in Switzerland (two bases; 14%) and in Austria (three bases; 12%), whereas all three bases in Luxembourg carried those masks. CONCLUSION: Most HEMS helicopters carry appropriate equipment to meet the demands of modern advanced airway management in the pre-hospital setting. Further work is needed to ensure that appropriate airway equipment is carried on all HEMS helicopters.

Protamine-1 represents a sperm specific gene transcript: a study in Callithrix jacchus and Bos taurus.

Spermatozoa are transcriptionally inactive cells, but contain acetylated histones, normally a characteristic of transcriptionally active cells. Acetylgroups are thought to represent epigenetic marks that are transmitted to the oocyte and are involved in starting gene expression in the zygote and in regulating gene expression during early embryogenesis. We performed reverse transcription polymerase chain reaction (RT-PCR) in the common marmoset monkey (Callithrix jacchus) and in bovine spermatozoa, oocytes, zygotes, two- and four-cell embryos to evaluate the presence of specific transcripts known to play a role during fertilisation and early embryo development, namely protamine-1 (PRM1), protamine-2 (PRM2), histone H1 (H1), histone H3 (H3), histone H4 (H4), cAMP-responsive element modulator (CREM), DNA methyltransferase-1 (DNMT1), TATA box-binding protein (TBP). All transcripts tested were present in spermatozoa of the common marmoset, while bull spermatozoa lack PRM2. Marmoset oocytes exhibited transcripts for H1, H3, H4 and TBP, whereas bovine oocytes revealed H1, H3, H4, CREM, DNMT and TBP mRNAs. In zygotes, we amplified H1, H4, TBP (marmoset) and PRM1, H1, H3, H4, CREM, DNMT1 and TBP (bovine). Two-cell embryos showed PCR products for H1, H3 and TBP in the marmoset. In the bovine, all transcripts could be observed except PRM2. In four-cell embryos, PCR signals were obtained for PRM1, H1, H3, H4 and TBP in the marmoset. In the bovine, all transcripts were detected except PRM2. Our data suggest that, in both C. jacchus and Bos taurus, PRM1 transcripts are delivered by the spermatozoon to the oocyte.

Gastrointestinal nematode and Eimeria spp. infections in dairy cattle along a rural-urban gradient.

Endoparasite infections can lead to considerable economic losses in dairy cattle due to decreases in milk yield and quality. Environmental and host-related factors contribute to endoparasite infection intensity and probability. Moreover, advancing urbanization influences parasite infection dynamics in livestock due to close human-animal cohabitation and changes in animal housing conditions. The aim of the present study was to investigate social-ecological effects on gastrointestinal nematode (GIN) and Eimeria spp. infections in dairy cattle along a rural-urban gradient in the emerging Indian megacity Bangalore. In this regard, 726 faecal samples from 441 dairy cattle of different ages and physiological stages were collected from 101 farms and examined at three visits between June 2017 and April 2018. Based on a survey stratification index (SSI) comprising built-up density and distance to the city center, we assigned the farms to urban, mixed and rural areas. GIN eggs were identified in the faeces of 243 cattle (33.5%; 95% confidence interval [CI]: 30.1-36.9%), and Eimeria spp. oocysts in the faeces of 151 cattle (20.8%; 95% CI: 17.9-23.7%). Co-infection rates of GIN and Eimeria spp. were 8.5 to 12.2% higher in rural compared to urban and mixed areas. The SSI effect significantly influenced Eimeria spp. infection probability and oocyst per gram of faeces (OpG; P < 0.001) with an infection probability and OpG higher than 26% and 40% for cattle kept in rural areas compared to cattle from urban areas. However, the SSI effect was not significant for the infection probability of GIN and for GIN eggs per gram of faeces (EpG). Infection probabilities and EpG/OpG were significantly higher in calves and heifers compared to lactating and dry cows. Moreover, we estimated significantly lower OpG values in summer compared to the other seasons. No differences were estimated for GIN and Eimeria spp. infection probabilities and EpG/OpG with regard to pasture access and breed. The variations in endoparasite infection intensity and probability observed along the rural-urban gradient of Bangalore reflect the variability in dairy husbandry systems governed by the social-ecological context.

Promoting normalcy in chronically ill children.

Chronic orthopaedic conditions or orthopaedic conditions associated with other chronic conditions affect an estimated 150,000 children in the United States. The ultimate cost in human and financial resources depends upon the success of habilitation efforts throughout childhood. This article identifies major areas of concern to the continuing care of the child and family who must cope with chronic problems and proposes nursing approaches to resolve them.

Screening children with myelodysplasia for readiness to learn self-catheterization.

The purpose of this research study was to develop and test a screening tool to determine the readiness of children with myelodysplasia to self-catheterize. The tool was developed after identifying requisite skills for self-catheterization. Twenty-five clients with myelodysplasia who required intermittent catheterization for bladder management--all under 18 years of age--were screened using the tool. Based on their previously demonstrated ability to self-catheterize, the children were divided into two groups: those who did self-catheterize and those who did not. The 18 children who self-catheterized all passed each item on the screening tool. The 7 children who did not self-catheterize failed one or more items on the screening tool. Based on this small sample, the tool offers a simple, safe way to judge readiness to learn self-catheterization.

Phenotyping chronic pelvic pain based on latent class modeling of physical examination.

Introduction. Defining clinical phenotypes based on physical examination is required for clarifying heterogeneous disorders such as chronic pelvic pain (CPP). The objective of this study was to determine the number of classes within 4 examinable regions and then establish threshold and optimal exam criteria for the classes discovered. Methods. A total of 476 patients meeting the criteria for CPP were examined using pain pressure threshold (PPT) algometry and standardized numeric scale (NRS) pain ratings at 30 distinct sites over 4 pelvic regions. Exploratory factor analysis, latent profile analysis, and ROC curves were then used to identify classes, optimal examination points, and threshold scores. Results. Latent profile analysis produced two classes for each region: high and low pain groups. The optimal examination sites (and high pain minimum thresholds) were for the abdominal wall region: the pair at the midabdomen (PPT threshold depression of > 2); vulvar vestibule region: 10:00 position (NRS > 2); pelvic floor region: puborectalis (combined NRS > 6); vaginal apex region: uterosacral ligaments (combined NRS > 8). Conclusion. Physical examination scores of patients with CPP are best categorized into two classes: high pain and low pain. Standardization of the physical examination in CPP provides both researchers and general gynecologists with a validated technique.

Enhanced proapoptotic gene expression of XAF1, CASP8 and TNFSF10 in the bovine endometrium during early pregnancy is not correlated with augmented apoptosis.

Bovine trophoblast cells release interferon-tau (IFNT), a type I IFN, as the pregnancy recognition signal. Since type I IFNs exert growth inhibitory and proapoptotic actions, the effect of the conceptus on components of the apoptosis pathways was determined in the bovine endometrium during the periimplantation period. Uteri of Simmental heifers were flushed post mortem at days 12, 15, and 18 of cycle or pregnancy for the recovery of conceptuses and the sampling of ipsilateral endometrial tissue at slaughter for quantitative RT-PCR, immunohistochemistry, caspase activity and TUNEL assays. Endometrium samples of pregnant animals revealed increased transcript levels for the proapoptotic genes XAF1 (day 15: 2.9-fold; day 18: 15.1-fold; p=0.005) and CASP8 (day 18: 2.4-fold; p=0.007). The mRNA expression increased significantly with the day of the cycle for the proapoptotic genes FASLG, TNFSF10, TNF and TNFSF1A (p=0.004, p=0.006, p=0.001 and p=0.007) and the antiapoptotic gene BIRC4 (p=0.03). We detected high amounts of FASLG transcripts in day 18 conceptuses (16-fold higher than day 18 endometria). This finding was validated at the protein level by immunohistochemistry. To further analyse the endometrial activation of the caspase cascade, the activities of initiator caspase 8 and effector caspases 3/7 were determined luminometrically. No difference between pregnant and cyclic animals was found for either caspase activity. Additionally, a TUNEL assay showed no increase of apoptotic cells in the pregnant endometrium. In conclusion, although the bovine conceptus induces the expression of proapoptotic genes, neither an activation of a caspase cascade nor an increase of apoptotic cells was noticed. These results suggest inhibitory mechanisms preventing endometrial cells from programmed cell death.

A framework for the nature and development of health beliefs in children.

The framework uses the social cognitive perspective that health is personally defined in relation to an object of emotional attachment. Thought related to this person/object parallels, but is distinct from, the process of cognitive development. The framework suggests that cognitive operations will vary according to situational differences.

[Expertises on growth disturbances in children seen from the aspect of private accident insurance (author's transl)]. / Die Begutachtung von Wachstumsstörungen bei Kindern in der privaten Unfallversicherung.

In private accident insurance, a degree of disability established for the insured and the insuring party for the first time in a binding manner, cannot be established as a new fact if more than 3 years have elapsed since the accident occurred. In private accident insurance for children, the right to confirm the disability as a new fact, is limited to a period of 5 years, but not beyond the age of 18. If post-traumatic disturbances in young children (following injuries of the epiphyseal cartilage, bone and articular infections etc..) do not supply sufficient pointers towards the possible or probable findings at the termination of growth, the physician writing the expertise should draw attention to this fact and should state that as far as the medical situation is concerned, determination of the first occurrence cannot be made now and is possible at the stage of termination of growth only.

[Reproducibility and seasonal dependence of specific intranasal provocation tests in birch pollen allergy patients]. / Untersuchungen zur Reproduzierbrakeit und jahreszeitlichen Abhängigkeit von spezifischen intranasalen Provokationstests bei Birkenpollenallergikern.

BACKGROUND: The intranasal allergen Provocation test (INT) is the standard procedure to verify the effect of an allergen when a nasal allergy is suspected. It may be especially useful if results from skin tests or in vitro tests conflict with those from the history. In the clinical and research setting, INT may be used to study the efficacy of different treatment modalities such as pharmacotherapy or immunotherapy. The technique of INT has not been well standardized in the past. Variations exist in planning the optimum time for testing, especially in seasonal allergies. METHODS: We examined influences of different test dates with regard to the pollen season on the result of INT. A total of 19 patients (eight females, 11 males, aged 26.1 +/- 4.8 years) with a history of at least two years of allergic rhinitis to birch pollen, positive skin prick test, and RAST (> or = CAP class II) to birch pollen. INT was performed during the winter-period after approximately six months without natural pollen exposition (V1), during the birch pollen season (V2) and six weeks after the birch pollen season (V3). Allergens were applied using a pump spray (0.1 ml) in concentrations of 10, 50, 100, 500, 1000, 5000, 10,000, 50,000, and 100,000 SQ units per ml (SQ/ml). RESULTS: The threshold concentrations were significantly lower at V2 (100 SQ/ml) and V3 (500 SQ/ml) if compared to V1 (1000 SQ/ ml). CONCLUSIONS: Seasonal influences should be taken into account when performing INT in birch pollen allergy.

[Lymph node metastasis in head-neck tumors]. / Lymphknotenmetastasierung bei Kopf-Hals-Tumoren.

BACKGROUND: One of the most important criteria of malignancy of head and neck cancer are the cervical lymph metastases. Being significant for the therapeutical plan is how tumor depending parameters like T-stage, degree of differentiation and tumor localisation will influence the N-stage and therefore the extension of neck dissection. METHOD: To evaluate the pattern of formations of metastases and the success of therapy a retrospective study was performed on 405 patients with carcinoma of the oral cavity (n = 47), the oropharynx (n = 117), the hypopharynx (n = 47) and the larynx (n = 193). RESULTS: By the time of surgery carcinoma of the hypopharynx were most frequently accompanied by cervical metastases (80%), followed by carcinoma of the oropharynx (70%), the oral cavity (52%) and the larynx (26%). Occurrence and extension of regional lymph node metastases correlated well with T-stages and degree of differentiation. After surgical therapy locoregional recurrence could be observed in 5.2% of the patients. Five-year-survival rate was reduced to 50% on patients with positive lymph nodes. The different tumour sites showed preferred patterns of metastatic spread, without complete avoidance of certain levels. CONCLUSION: For the decision on indication and extent of neck dissection the preoperative diagnostic (ultrasound, CT-scan, MRI), localisation of tumour, T-stage, degree of differentiation and the knowledge of typical metastatic spread must be considered.

[Comparison of 2 endoscopic surgery techniques for reliable therapy of Zenker diverticulum]. / Vergleich zweier endoskopischer Operationstechniken für eine sichere Therapie des Zenkerschen Divertikels.

BACKGROUND: A mediastinitis or intraoperative bleeding are the most feared complications of the transoral laser assisted diverticulotomy of Zenker's diverticulum. To reduce these complications we developed a new endoscopic surgical technique and compared the results of this new method with the results of patients who we treated earlier. PATIENTS AND METHODS: At the department of Otorhinolaryngology, Head and Neck Surgery, University of Luebeck 68 patients suffering from a hypopharyngeal diverticulum have been treated since 1987. In 64 patients we performed an endoscopic diverticulotomy using a CO2-Laser and the Weerda distending diverticuloscope. Four of the Zenker's diverticulua had to be removed by an external approach. From 1987 to 1994 a five millimeter bar between pouch and hypopharynx after diverticulotomy was left and sealed with fibrin glue in the first 38 patients. From 1995 to 1999 the spur of the hypopharyngeal pouch of the other 26 patients was completely separated. Afterwards we sutured the mucosa between the pouch and the hypopharynx to close the opened mediastinal space and sealed the former spur with fibrin glue. RESULTS: Comparing both endoscopic methods we had to observe concerning our first method one mediastinitis, a rise of body temperature in 29 patients (76%) and we had to perform a revision diverticulotomy in three patients (8%). Our modified technique didn't cause any mediastinitis, a rise of body temperature did only occur in five patients (18%) and no patient had to undergo revision surgery. CONCLUSIONS: The transoral complete separation of the spur of the hypopharyngeal pouch with suturing the mucosa of the pouch and the hypopharynx causes good functional results and means a further reduction of complications and a further improvement of the endoscopic diverticulotomy. Our new instruments (Fa. K. Storz, Tuttlingen) will be demonstrated.