Behavioural response to gastrointestinal parasites of yearling dairy calves at pasture.

AIMS: To investigate the association between gastrointestinal parasites (GIP) and animal behaviour in dairy calves under New Zealand pastoral conditions, using animal-mounted, accelerometer-based sensors. METHODS: Thirty-six, 5-6-month-old, Friesian-Jersey, heifer calves fitted with animal activity sensors to track behaviour were randomly allocated to one of two treatment groups. Half the animals were challenged with an oral dose of 20,000 larvae of Ostertagia ostertagi and Cooperia oncophera once a week for 3 weeks and half were unchallenged. Five weeks after the last dose, seven infected and nine uninfected animals were treated with an oral anthelmintic (AHC) and data collected for a further week. Accelerometer data were classified into minutes per day eating, ruminating, in moderate-high activity or in low activity. Live weight and faecal egg counts (FEC) were recorded weekly over the study period. All animals co-grazed a newly sown pasture not previously grazed by ruminants and were moved every week to fresh grazing. Treatment status was blinded to those managing the animals which were otherwise treated identically. RESULTS: Complete behavioural records were available from 30/36 calves, (13 challenged and 17 unchallenged). Before treatment with AHC, FEC increased in infected and un-treated calves over the study, while uninfected animals maintained a near zero FEC. There was no difference in live weight gain between the two groups over the study period. Bayesian, multinomial regression predicted differences in animal behaviour between infected and uninfected animals that were not treated with AHC over the 7 weeks following initial infection. Parasitised calves not treated with AHC were less active and spent up to 6 (95% highest density interval (HDI) = 1-11) minutes/day less in low level activity and up to 15 (95% HDI = 7-20) minutes/day less in moderate to high level activity. They ruminated up to 9 (95% HDI = 2-15) minutes/day more and ate up to 10 (95% HDI = 2-19) minutes/day more than control calves that were not treated with AHC. The effect of AHC on time spent in each behaviour differed between infected and uninfected calves and increased the coefficient of dispersion of the behavioural data. CONCLUSIONS AND CLINICAL RELEVANCE: Small differences in animal behaviour can be measured in calves with GIP. However, to use this to target treatment, further validation studies are required to confirm the accuracy of behavioural classification and understand the complex drivers of animal behaviour in a dynamic and variable pasture-parasite-host environment.

Retention of internal teat sealants over the dry period and their efficacy in reducing clinical and subclinical mastitis at calving.

Internal teat sealants (ITS) reduce the risk of new intramammary infections over the dry period by forming a physical barrier to pathogen ingress. As the first and last 2 wk of the dry period are high-risk periods for new infections, maintaining an effective barrier in this period is a key requirement. Few studies have systematically examined sealant retention and none have done so under New Zealand pastoral conditions, where cows frequently move to separate grazing for dry periods, typically 80 to 90 d long. This multi-herd study was a split-udder equivalence trial comparing 2 ITS formulations for retention and efficacy in preventing periparturient clinical and subclinical mastitis. Both ITS contained 65% (2.6 g) bismuth salts, which contribute to the barrier within the teat canal, emulsified in ≤1.4 g of mineral oil. However, one ITS additionally contained <10% amorphous silica. At dry-off, treatment was randomly allocated to diagonal teat-pairs within 409 cows on 4 farms. All cows met industry best practice criteria for ITS treatment alone. The study unit was quarter within cow and farm. Outcomes included clinical mastitis (CM) incidence for the last 7 d of the dry period and first 42 d of lactation, subclinical mastitis (SCM) incidence 96 h after calving, and quantity of residual after centrifuging 50 mL of colostrum collected from each quarter within 24 h of calving. Proportional outcomes were analyzed using Bayesian mixed models with a binomial distribution and logit link function, whereas the quantity of residual was analyzed using Bayesian finite mixture models and cluster bootstrapping. We set a region of probable equivalence (ROPE) of ±2.5% between proportions and ±0.2 g for residual weight. Records were available for 1,596 quarters (399 cows). We detected no meaningful difference in incidence of CM or SCM attributable to differences in sealant: the model predicted treatment differences of 0.00 with a 95% highest density interval (HDI) of ±1.00%. Across all cows and farms, the marginal difference in the percentage of quarters with CM was 0.11% (95% HDI: -2.11 to 2.49%), and for SCM 0.00 (95% HDI: -1.98 to 1.94%). Including the quantity of residual recovered at calving did not improve fit or predictive ability of the models predicting CM or SCM, and the coefficient spanned the null value. The distribution of the weight of material recovered at calving was multi-modal; for 25% of quarters, more residual was recovered than inserted. When the residual weight was less than or equal to the median residual weight (2.06 g; range: 0.19-6.03 g), there was a ≥90% probability that any treatment difference in residual was ≤0.2 g. When the residual weight was between the median and 75th percentile (4.40 g; 95% HDI: 4.00 to 4.75 g), there was no clear difference in residual between products. Above the 75th percentile, there was a 90% probability that the residual from quarters differed by product type (difference = 0.36 g, 90% HDI: 0.20 to 0.54 g). In conclusion, both products had equivalent efficacy for SCM and CM. As the quantity of residual increased, the difference in residual weight recovered increased but this may represent increases in debris rather than indicating a more effective barrier.

A new method of administering local anesthesia for calf disbudding: Findings from a comparative on-farm study in New Zealand.

Anesthesia of the horn bud for calf disbudding commonly is attained by injection of local anesthetic over branches of the cornual nerve, with anesthesia achieved in 3 to 20 min. With experienced and trained staff, this method is effective in 88 to 100% of calves. Variability in response and time of onset can compromise calf welfare if calves are disbudded before anesthesia is attained. Proposed legislative reliance on effective local anesthetic as the minimal method of pain relief for calves at disbudding means that administration of local anesthetic must achieve a repeatable level and rapid onset of analgesia. We describe an alternative method of local anesthesia administration that uses local site infiltration of anesthetic over the horn bud. However, this method has not yet been scientifically validated. This study assessed differences between disbudding using the cornual nerve block and disbudding with local anesthesia administered by local site infiltration. Efficacy of local anesthesia was assessed at 30-s intervals after administration by absence of reaction to 3 consecutive needle pricks over the horn buds. Behavior indicating pain was assessed during disbudding and scored from 0 to 3. Calf behavior was also recorded for 3 h after disbudding. Accelerometer data loggers were fitted to each calf for 24 h before and after disbudding to assess lying and standing times. Median time to cutaneous desensitization for local infiltration was 60 s compared with 225 s for cornual nerve block, and the variance in time to desensitization was less with local infiltration. Calves disbudded under cornual block had a larger behavioral response (indicated by a graded aversive body reaction) than calves disbudded under local infiltration. A multivariable model predicted that the mean body reaction score would be 0.6 for calves disbudded under local infiltration and 1.2 for calves disbudded under cornual block. There was no difference in any behaviors between the treatment groups in the 3 h after disbudding. Method of analgesia had no effect on lying time over the 24 h after disbudding. In this study, local infiltration was at least as effective in providing analgesia for disbudding as the cornual nerve block. Our results suggest that a more consistent, effective level of analgesia during disbudding was achieved using local infiltration and that there was no difference in postoperative expressions of pain.

Effect of treatment with an internal teat sealant at drying-off in cows wintered on forage crops in New Zealand on clinical mastitis and somatic cell counts.

AIMS: To determine the impact of treatment with internal teat sealant (ITS) compared to no treatment at drying-off on the incidence of clinical mastitis (CM) during the dry period and 84 days after calving, and the prevalence of cows with somatic cell counts (SCC) ≥200,000 cells/mL at the first lactation herd test, for cows wintered on forage crops. METHODS: In four dairy herds in the South Island of New Zealand, cows with no history of CM or individual SCC >100,000 cells/mL during the 2015-16 season were randomly assigned to treatment with ITS in each quarter (ITS group) at drying-off or no treatment (Control group). Cows were otherwise treated similarly, wintered on forage crops and transferred to pasture for calving and lactation. Cows were monitored over the dry period and for 84 days after calving, and any case of CM recorded. Individual SCC were recorded at the first herd test after calving. RESULTS: Between drying-off and 84 days after calving 36/470 (7.7%) cows in the ITS groups and 73/442 (16.5%) cows in the Control group were diagnosed with CM (RR=0.46; 95% CI=0.26-0.73). The final multivariable logistic regression model included an interaction between treatment group and length of dry period. For a Friesian/Jersey cow, aged 4-8 years, with a dry period of 30-80 days, dried off without ITS, the probability of CM in the study period was 0.12 (95% CI=0.09-0.16), and for such a cow treated with ITS the probability was 0.07 (95% CI=0.05-0.10). For an equivalent cow, with a dry period of 81-140 days, which was untreated, the probability was 0.21 (95% CI=0.14-0.29), and for such a cow treated with ITS it was 0.05 (95% CI=0.02-0.11). At the first herd test after calving 77/383 (20.1%) cows in the Control group and 57/425 (13.4%) cows in the ITS group had SCC ≥200,000 cells/mL (RR=1.51; 95% CI=1.10-2.06). CONCLUSIONS AND CLINICAL RELEVANCE: For these farms, treatment of cows with no history of elevated SCC or CM with ITS at drying-off halved the incidence of CM between drying-off and 84 days after calving, and reduced by 33% the proportion of cows with SCC≥200,000 at the first herd test after calving, compared with untreated cows. Treatment with ITS reduced the risk of CM proportionally more for cows with a dry period of 81-140 days than for cows with a shorter dry period.

Effect of using an internal teat sealant at drying-off in cows wintered on forage crops in New Zealand on culling in the dry period and early lactation.

AIMS: To determine the impact of treatment with internal teat sealant (ITS) compared to no treatment at drying-off on culling during the dry period and 90 days after calving, for cows wintered on forage crops. METHODS: In four dairy herds in the South Island of New Zealand, cows with no history of clinical mastitis or somatic cell counts >100,000 cells/mL during the 2015-16 season were randomly assigned to treatment with ITS in each quarter (ITS group) or no treatment (Control group). Cows were otherwise treated similarly, wintered on forage crops and transferred to pasture for calving and lactation. Culling was defined as an unplanned exit from the herd, including cows sold for slaughter, cows slaughtered for salvage value and cows that died on farm. Culls and cull dates were recorded between drying-off and 90 days after calving. RESULTS: Between drying-off and 90 days after calving 24/491 (4.9%) cows in the ITS group and 45/473 (9.5%) cows in the Control group were culled (RR=0.51; 95% CI=0.75-0.83), and between 30 days before calving and 90 days after calving 20/491 (4.1%) cows in the ITS group and 40/473 (8.5%) cows in the Control group were culled (RR=0.48; 95% CI=0.29-0.81). In the final multivariable logistic regression model, adjusting for dry-period length, cow age, breed and farm, the OR for culling in the study period was 0.43 (95% CI=0.23-0.81) for cows in the ITS compared with the Control group. For a Friesian/Jersey cow, aged 4-8 years, with a dry period of 30-80 days, dried-off without ITS, the probability of culling in the study period was 0.10 (95% CI=0.06-0.16), and for such a cow treated with ITS the probability was 0.05 (95% CI=0.03-0.08). CONCLUSIONS AND CLINICAL RELEVANCE: In these four herds, the use of ITS at drying-off reduced the incidence of culling between drying-off and 90 days after calving. The use of ITS at drying-off in cows prior to wintering on forage crops may provide additional benefit to farmers through reduced incidence of culling and should be considered in any cost-benefit analysis of its use.

Unusual case of suspected recurrent scarlet fever in a UK serviceman.

The UK prevalence of scarlet fever, a Group A streptococcal infection, is increasing. We present an unusual case of suspected recurrent scarlet fever in a member of the UK Armed Forces. Treatments, occupational implication and public health measures to mitigate the risk of disease spread.

Attitudes of farm consultants in the South Island of New Zealand towards the role of veterinarians in farm businesses.

AIMS: To assess the attitude of dairy farm consultants to the role of veterinarians on dairy farms and whether they viewed veterinary advice as impartial, free from commercial bias and central to farm productivity and profitability. METHODS: A telephone survey was commissioned in September 2014 of 36 full-time farm consultants in the Canterbury and Otago region of New Zealand using a pre-prepared questionnaire to explore their attitudes towards the veterinary profession. Of those approached, 25 completed the survey. RESULTS: The consultants surveyed agreed or strongly agreed (21/23) that they were the custodians of animal health expenditure on farms, which was seen as an expense to be controlled (19/25 agreed or strongly agreed). This view was held more strongly (9/9 agreed or strongly agreed) by consultants with >5 years' professional experience, compared to 10/16 consultants with ≤5 years' experience. Most consultants (24/25) disagreed that they did not respect veterinary advice, but agreed (24/25) that veterinarians almost always had a vested interest in the advice that they gave. The role of veterinarians was seen by respondents to be mainly treatment of sick animals (22/25) and provision of animal health products (24/25), but not in maximising farm profitability (selected by 8/25 respondents). Consultants viewed their own roles as providing advice on the influence of animal health on farm profitability (21/25), nutrition (22/25) and reproduction (20/25). Most respondents (21/25) stated that reducing disease and animal health issues was important, but they (21/25) also identified a reduction in farm animal health expenditure as a measure of success. Only 7/25 consultants felt that they should work in partnership with veterinarians. CONCLUSIONS: This was a small scale study from one region of New Zealand but it indicates that consultants are ambivalent about the role and value of working more closely with veterinarians, and about the benefit that veterinary intervention may bring to a farm's profitability. CLINICAL RELEVANCE: More successful veterinary involvement on dairy farms will follow from a better understanding of how other rural professionals are involved in the farm's management and in meeting the individual farmer's goals and motivations.

The effect of different combinations of local anaesthesia, sedative and non-steroidal anti-inflammatory drugs on daily growth rates of dairy calves after disbudding.

AIM: To assess the effect of sedation and local anaesthesia (LA) at disbudding, and the addition of meloxicam or ketoprofen treatment, on weight gain in dairy calves following disbudding. METHODS: Friesian-Jersey cross calves, from four dairy farms, were enrolled when 3-6 weeks old. All calves (n=271) were disbudded by veterinary personnel and randomly assigned to six groups: 136 were disbudded without sedation or LA, of which 31 received 20 mg meloxicam S/C and 75 received 150 mg ketoprofen I/M. A further 135 were disbudded with sedation (0.25 mg/kg xylazine I/M) and LA, of which 30 also received meloxicam and 75 received ketoprofen. Calves were weighed 3 days before, and 15 and 30 days after, disbudding (Day 0). Daily weight gain was analysed using mixed models and ANOVA. RESULTS: Complete results were obtained from 263 calves. From Day -3 to Day 15, the growth rate of calves disbudded without pain relief (0.53 (95% CI=0.47-0.60) kg/day) was less that of calves disbudded with some form of pain relief (0.65 (95% CI=0.62-0.68) kg/d; p=0.004). There was no difference between the effect of meloxicam or ketoprofen (p=1.00). An interaction between use of sedation and LA and additional non-steroidal anti-inflammatory drugs (NSAID) meant that NSAID treatment did not increase growth rates in calves disbudded with sedation and LA but did increase growth rates for calves disbudded without pain relief (p<0.05). From Day 16 to Day 30 there was no effect of NSAID treatment on growth rate, but calves receiving LA and sedation grew faster (0.74 (95% CI=0.69-0.80) kg/day) than calves disbudded without LA and sedation (0.66 (95% CI=0.61-0.71) kg/day; p=0.018). From Day -3 to Day 30, calves disbudded with sedation and LA grew faster (0.71 (95%CI=0.64-0.77) kg/day) than calves disbudded without sedation and LA (0.60 (95% CI=0.55-0.65) kg/day; p=0.011). However, addition of NSAID to sedation and LA made no further difference to growth rates (p=0.69). CONCLUSIONS: Dairy calves disbudded with no pain relief had slower growth rates than calves receiving pain relief. From Day 15 to 30 calves given no pain relief, or NSAID alone, grew more slowly than those receiving sedation and LA at disbudding. The addition of NSAID treatment to sedation and LA did not further increase growth rates. CLINICAL RELEVANCE: This study adds to the evidence that pain management when disbudding is beneficial for calf productivity as well as calf welfare.

Resynchronising returns to service in anoestrous dairy cows in the South Island of New Zealand.

AIMS: To investigate the effect of targeted resynchronisation of cows treated for non-observed oestrus before the planned start of mating (PSM), that were not detected in oestrus or pregnant 23 days after treatment (phantom cows), on the proportion pregnant at 42 days after PSM and the end of mating. METHODS: Farm staff from eight herds in two regions of the South Island of New Zealand identified 1,819 cows not showing oestrus by 10 days before PSM. These cows were treated with intravaginal progesterone for 7 days, and I/M gonadorelin 10 days and 1 day before PSM. Three days before PSM they were injected with cloprostenol and equine chorionic gonadotrophin, with fixed time artificial insemination (FTAI) at PSM. By 23 days after PSM, 1,218 cows had not returned to oestrus. Of these, 161 cows confirmed not pregnant by transrectal ultrasonography were randomly assigned to no treatment (control group; n=74) or were resynchronised 25 days after PSM using the same treatment programme as above, with FTAI 35 days after PSM (n=87). All cows that returned to oestrus were artificially inseminated until 42 days after PSM, when natural mating was used. All cows were examined using transrectal ultrasonography 80 to 90 days after PSM to confirm conception dates. RESULTS: Of the 1,819 anoestrous cows treated before PSM, 526 (29 (95% CI=23.1-34.0)%) had not been observed in oestrus by 23 days after PSM and had not conceived, so were diagnosed as phantoms cows. For resynchronised cows, 42/87 (48 (95% CI=37.8-58.8)%) were pregnant by 42 days after PSM compared to 21/74 (28 (95% CI=18.1-38.7)%) control cows (p=0.009). At the end of mating 58/87 (67 (95% CI=56.6-76.7)%) cows in the resynchronised group were pregnant and 46/74 (62 (95% CI=50.9-73.2)%) in the control group (p=0.554). The hazard of conception from 21 to 42 days after PSM was 1.9 (95% CI=1.07-3.12) times greater for resynchronised than control cows (p=0.026). CONCLUSION: In cows not observed in oestrus and treated before PSM, resynchronisation increased the proportion pregnant by 42 days after PSM. CLINICAL RELEVANCE: The benefit of resynchronisation depends on the number of anoestrous cows before PSM and the number of phantom cows after PSM. However at the herd-level it is likely that providing advice to reduce the known risk factors for cows not being observed in oestrus before the PSM may well be more cost effective than identifying and treating a sub-population of phantom cows.

Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study.

In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs.

Banning smoking at Army Foundation College, Harrogate: a military phase I training establishment's experience of introducing a smoking ban.

In September 2019, Harrogate Army Foundation College (AFC) introduced what is believed to be the British Army's first smoking ban. AFC, the British Army's only training college for junior soldiers (JS) aged 16-18 years, had identified the possibility of JS adopting a smoking habit during training and introduced positive steps to mitigate this risk. The smoking ban for JS was part of a phased approach, with a complete ban being implemented in January 2020, which extended to all personnel on camp. A historically strong smoking culture in the military meant introducing a ban had inherent challenges, but the potential benefits from doing so made it worth considering. The introduction of the ban coincided with an intake of around 1070 new JS. Intakes are a busy period for the medical centre, with each JS requiring an Initial Medical Assessment. The added requirement to provide smoking cessation therapy at this time resulted in an increased workload. Medical challenges during this period included staffing numbers, dispensary stock levels for nicotine replacement therapy and disruption to routine clinics. However, experience gained from the September 2019 intake resulted in modifications that allowed the next intake in March 2020 to be optimised. Success when introducing a smoking ban in a military establishment is dependent on early planning and clear communication between the chain of command and the medical centre. As the military moves towards a larger scale smoking ban, lessons from AFC's experience may help guide other military establishments with the implementation process.

Parenteral medications at Role 1: do doctors in the British Army require improved training and experience?

Role 1 doctors in the British Army work predominantly in primary healthcare, but also provide prehospital emergency care and administer potent parenteral medications in the field. Role 1 doctors have theoretical training in the use of these medications on short courses but then have little refresher training and use them infrequently in their routine practice, introducing the risk of skill fade. This may lead to higher rates of medication errors in an environment where the consequences may be significant. This article explores the current training of Role 1 doctors, the threat of skill fade and how the safety of drug administration can be improved. This includes recommendations for the development of training competencies, bespoke courses and clinical placements, e-learning and the use of new technology. Application of these recommendations has the potential to improve patient safety and the confidence of doctors in the use of parenteral analgesia.

The effect of pre-calving injection of trace mineral supplements on periparturient disease incidence in pasture based dairy cows.

Trace minerals, have a role in immune function and a trace mineral supplement (TMS) can improve animal health in dairy herds. This prospective randomised clinical study assessed whether subcutaneous injection of 5.5 mL of TMS (40 mg zinc, 10 mg manganese, 5 mg selenium, 15 mg copper per mL), 14-28 days before planned start of calving (PSC) reduced clinical mastitis (CM), subclinical mastitis (SCM) and purulent vaginal discharge (PVD). From four farms, half of 1700 cows stratified on somatic cell count, age and breed were randomly allocated to treatment or no treatment. Occurrence of CM from - 7 to PSC + 100 days, SCM at PSC + 60 days and PVD at PSC + 24 days was analysed using survival analysis and Bayesian generalised mixed multivariable models. From -7 to PSC +30 days, TMS reduced the adjusted hazard ratio (HR) for CM at quarter and cow level (P < 0.001), with no evidence for an effect beyond 30 days. The adjusted OR (and 95% highest density interval, HDI) for the effect of TMS on CM from -7 to PSC +30 days was 0.40 (95% HDI, 0.26-0.63) at quarter level, 0.51 (95% HDI, 0.38-0.69) at cow level and for SCM, 0.72 (95% HDI, 0.54-0.95). The difference in CM incidence from TMS at the cow level was -2.0% (95% HDI, -3.4 to -1.1%) and -1.2% (95% HDI, -3.2 to - 0.6%) at quarter level. No clear effect was identified of TMS on cumulative incidence of PVD.

Global climate-driven trade-offs between the water retention and cooling benefits of urban greening.

Urban greening can potentially help mitigate heat-related mortality and flooding facing the >4 billion urban population worldwide. However, the geographical variation of the relative combined hydrological and thermal performance benefits of such interventions are unknown. Here we quantify globally, using a hydrological model, how climate-driven trade-offs exist between hydrological retention and cooling potential of urban greening such as green roofs and parks. Using a Budyko framework, we show that water retention generally increases with aridity in water-limited environments, while cooling potential favors energy-limited climates. Our models suggest that common urban greening strategies cannot yield high performance simultaneously for addressing both urban heat-island and urban flooding problems in most cities globally. Irrigation, if sustainable, may enhance cooling while maintaining retention performance in more arid locations. Increased precipitation variability with climate change may reduce performance of thinner green-infrastructure more quickly compared to greened areas with thicker soils and root systems. Our results provide a conceptual framework and first-order quantitative guide for urban development, renewal and policymaking.

A comparison of machine learning and logistic regression in modelling the association of body condition score and submission rate.

The effect of body condition score (BCS) on reproductive outcomes is complex, dynamic and non-linear with interaction and confounding. The flexibility inherent in machine learning algorithms makes them attractive for analysing complex data. This study was designed to compare the ability of a range of machine learning techniques in estimating the probability of service within 21 days of the planned start of mating. We hypothesised that if there were complex and unknown interactions or non-linearity in the data, some machine learning algorithms would result in superior model performance compared to regression models. For a period of six months from the planned start of calving, BCS was visually assessed once a month for 6127 cows on 8 commercial New Zealand dairy farms by a trained veterinarian using the DairyNZ 10-point range for every cow in the herd. Cow, lactation and reproductive data was extracted from the national herd database. This data was used to predict probability of service within 21 days of planned start of mating (PSM) using mixed multivariable logistic regression and decision tree, k-nearest neighbour, random forest and neural network analysis. Models were adjusted for herd, cow age, breed, days in milk, BCS at calving, BCS change between calving and mating, BCS change after mating, volume adjusted milk protein and fat concentration pre-mating. Models were constructed on a training data set using 10-fold cross validation repeated 10 times and evaluated on a test data set using discrimination and calibration techniques. In all models, days calved at PSM was the most important variable for predicting submission rate, followed by BCS at PSM. Factors associated with an increased probability of insemination were calving at a BCS of 5.0, losing less BCS after calving, having a higher BCS at nadir, losing BCS rapidly after calving, nadir occurring before PSM and calving early. All the models except for the decision tree had an area under the receiver operating characteristic curve (AUC) in the range 0.68-0.73 indicating good overall discriminatory power, but calibration analysis suggested all models were better at predicting cows that got inseminated than correctly identifying animals that did not get inseminated. Overall, the machine learning techniques were no better than a generalised logistic regression model. These results highlight the importance of BCS targets at calving and indicate BCS loss, milk characteristics and days calves may be useful indicators identifying cows at risk of poor reproductive outcomes.

Epidemiological study of emergency ambulance activation in the British Eastern Sovereign Base Area of Cyprus, September 2013 to August 2016.

OBJECTIVES: To record the activation and use of the Eastern Sovereign Base Area (ESBA) emergency ambulance service of British Forces Cyprus between 1 September 2013 and 31 August 2016. To reflect on these findings in light of data from 1995 to 1998 to identify current treads and areas of development. METHOD: Retrospective epidemiological study of all activations of the ESBA emergency ambulance service within the study period. RESULTS: 812 patients were treated over 3 years, an 80% increase in workload, of which 41% were entitled personnel. Forty-two per cent of activations were for medical complaints compared with 41% for trauma. The number of deaths remained static (n=15). Road traffic incidents (RTI) remain the top activation by type, but accounting for a smaller proportion of workload. RTI mortality has declined by 50%. CONCLUSION: The ESBA emergency ambulance service responded to double the activations, when compared with 18 years ago, with a significant shift to medical cases over trauma. This ESBA emergency ambulance provides a varied and vital service for the local community that also benefits Defence Medical Services personnel interested in the Pre-Hospital Emergency Medicine environment in order to maintain clinical skills and currency for the benefit of future deployments, both humanitarian and kinetic in nature.

Computational fluid dynamics benchmark dataset of airflow in tracheas.

Computational Fluid Dynamics (CFD) is fast becoming a useful tool to aid clinicians in pre-surgical planning through the ability to provide information that could otherwise be extremely difficult if not impossible to obtain. However, in order to provide clinically relevant metrics, the accuracy of the computational method must be sufficiently high. There are many alternative methods employed in the process of performing CFD simulations within the airways, including different segmentation and meshing strategies, as well as alternative approaches to solving the Navier-Stokes equations. However, as in vivo validation of the simulated flow patterns within the airways is not possible, little exists in the way of validation of the various simulation techniques. The data presented here consists of very highly resolved flow data. The degree of resolution is compared to the highest necessary resolutions of the Kolmogorov length and time scales. Therefore this data is ideally suited to act as a benchmark case to which cheaper computational methods may be compared. A dataset and solution setup for one such more efficient method, large eddy simulation (LES), is also presented.

Risk factors for peri-parturient farmer diagnosed mastitis in New Zealand dairy herds: findings from a retrospective cohort study.

Risk factors associated with the development of clinical mastitis (CM) in multiparous cows, defined as detection of abnormalities in the milk by farm staff in the 30days before and 90days after calving were studied using a retrospective longitudinal cohort study of 18,162 cows on 30 South Island commercial New Zealand dairy farms. Risk factors studied included age, breed, length of dry period, farm, herd size, yield and individual somatic cell count (ISCC) status 30-60days before the end of the previous lactation, rainfall at calving and number calving on the same day. A modified Cox Proportional hazards model with time varying effects for breed, age, length of dry period and ISCC was used to identify which factors were significantly associated with an increased hazard of CM after calving Rainfall at calving >10mm increased the hazard ratio (HR) by 1.14 (95%CI=1.01-1.30) for 30days before to 90days after calving. Milk production >1.5kgMS/cow/day in the 30-60days before the end of lactation increased the HR for CM by 1.36 (95%CI=1.21-1.52) for the same period. The effects of breed, age, length of dry period and ISCC 30-60days before the end of lactation varied with time around calving. The HR decreased as the proportion of Friesian genetics decreased. Compared to animals >75% Friesian the HR for animals that were <25% Friesian was 0.50 (95%CI=0.26-0.99) in the 30days before calving, 0.81 (95%CI=0.60-1.08) in the 20days after calving and 0.28 (95%CI=0.18-0.62) from 21 to 90days after calving. HR increased with age, with the largest effect seen 21-90days after calving. Compared to cows <4 years of age, cows that were 4-8 years of age had a HR of 2.18 (95%CI=1.71-2.76) and those >8 years old had a HR of 4.09 (95%CI=3.06-5.46) for this period. Dry periods >112days had a HR of 1.46 (95%CI=1.24-1.73) in the 20days after calving but a decreased HR (0.73, 95%CI=0.57-0.94) 21-90days after calving. Cows with ISCC >150,000 cells/ml 30-60days before the end of lactation had a HR of 1.60, (95%CI=1.39-1.84) 0-20days after calving and 1.96 (95%CI=1.67-2.27) 21-90days after calving. Neither number of animals calving per day, nor herd size was associated with an increased hazard of CM and there was a significant difference in the hazard across farms.

Comparison of cephalonium alone and in combination with an internal teat sealant for dry cow therapy in seasonally calving dairy cows.

AIM: To assess the effect of combining an internal teat sealant (ITS) and a long-acting cephalonium-based dry cow therapy (DCT) on the prevalence of cows with a somatic cell count (SCC) >150,000 cells/mL 60-80 days after calving, and the incidence of clinical mastitis diagnosed by farm staff in the first 100 days after calving. METHODS: Cows from a spring-calving, pasture-based, dairy farm in the South Canterbury region of New Zealand were randomly allocated to receive cephalonium DCT (n=289) or cephalonium and internal teat sealant (n=304) at the end of lactation. Cows were inspected twice daily by farm staff during the dry period and following calving for signs of mastitis. Individual SCC were determined from herd tests conducted in the previous lactation and following calving. Logistic regression models were used to determine relationships with the prevalence of cows with a SCC >150,000 cells/mL after calving, and survival analysis was used to model time to the first case of clinical mastitis following calving at the cow and quarter level. RESULTS: The OR for a cow with a SCC >150,000 cells/mL after calving, including age and individual SCC in the preceding lactation in the model, was 0.53 (95% CI=0.32-0.89) for cows treated with combination therapy compared to cows receiving cephalonium (p=0.017). At the cow level, including age and preceding SCC in the model, the hazard ratio for diagnosis of clinical mastitis by farm staff in the first 100 days of lactation was 0.60 (95% CI=0.39-0.98) for cows treated with combination therapy compared to cows receiving cephalonium (p=0.04). At the quarter level, the hazard ratio for diagnosis of clinical mastitis, with age included in the model, was 0.41 (95% CI=0.23-0.74) for the combination therapy compared to cephalonium alone (p<0.001). CONCLUSIONS: The combination of internal teat sealant and cephalonium DCT was more effective than cephalonium alone at reducing clinical mastitis diagnosed by farm staff in the 100 days after calving, and the prevalence of cows with a SCC >150,000 cells/mL 60-80 days after calving. CLINICAL RELEVANCE: This study adds to the evidence that the prevention of intra mammary infections throughout the dry period and up to calving by using combination therapy is important in reducing the incidence of farmer-diagnosed clinical mastitis and prevalence of cows with a SCC >150,000 cells/mL 60-80 days after calving.

The effects of curvature and constriction on airflow and energy loss in pathological tracheas.

This paper considers factors that play a significant role in determining inspiratory pressure and energy losses in the human trachea. Previous characterisations of pathological geometry changes have focussed on relating airway constriction and subsequent pressure loss, however many pathologies that affect the trachea cause deviation, increased curvature, constriction or a combination of these. This study investigates the effects of these measures on tracheal flow mechanics, using the compressive goitre (a thyroid gland enlargement) as an example. Computational fluid dynamics simulations were performed in airways affected by goitres (with differing geometric consequences) and a normal geometry for comparison. Realistic airways, derived from medical images, were used because idealised geometries often oversimplify the complex anatomy of the larynx and its effects on the flow. Two mechanisms, distinct from stenosis, were found to strongly affect airflow energy dissipation in the pathological tracheas. The jet emanating from the glottis displayed different impingement and breakdown patterns in pathological geometries and increased loss was associated with curvature.