Impact of animal density on cattle nutrition in dry Mediterranean rangelands: a faecal near-IR spectroscopy-aided study.

In the context of determining the sustainable carrying capacity of dry-Mediterranean herbaceous rangelands, we examined the effect of animal density on cattle nutrition, which is fundamental to animal performance and welfare. The effects on dietary components of low (0.56 cows/ha; L) and high (1.11 cows/ha; H) animal densities were monitored for three consecutive years in grazing beef cows. In the dry season (summer and early autumn), cows had free access to N-rich poultry litter (PL) given as a dietary supplement. In each season, near-IR spectroscopy (NIRS) was used to predict the chemical composition of herbage samples (ash, NDF, CP, in vitro dry matter digestibility (IVDMD) and metabolizable energy (ME) content from IVDMD). Near-IR spectroscopy was applied also to faecal samples to determine the chemical composition of the diet selected by the animal, as well as the contents of ash, NDF and CP in the faeces themselves. A faecal-NIRS equation was applied to estimate the dietary proportion of PL. Seasonal categories were green, dry without PL supplementation and dry with it. We found no effects of animal density on nutrition during the green season but effects were apparent when cows consumed dry pasture. Ash content predicted by faecal NIRS was higher in the diet than in plant samples clipped from pasture, which infers that cows ingested soil. Dietary and faecal ash contents were higher (P<0.05) at the H, implying greater soil intake in these animals. During the dry period, dietary contents of ME were higher in L than in H (P<0.05). Poultry litter supplementation was associated with a marked increase (P<0.01) in dietary and faecal CP contents. Poultry litter represented 0.45 and 0.59 of the diet in treatments L and H, respectively (P<0.05). Consequently, treatment H had higher faecal protein (P<0.05). A tendency of higher dietary protein (P=0.08) and lower dietary NDF (P=0.10) in treatment H was probably related to greater PL ingestion. Given that high and sustained rates of poultry litter consumption are detrimental to animal health, the above results cast doubts on the long-term sustainability of the higher of the animal densities tested. Although it may be sustainable vis-à-vis the vegetation, treatment H may have exceeded the boundaries of what is acceptable for cow health. Chemical information revealed with NIRS can be used to evaluate whether animal densities are compatible with animal health and welfare standards and can play a role in determining the carrying capacity of Mediterranean rangelands.

Faecal near-IR spectroscopy to determine the nutritional value of diets consumed by beef cattle in east Mediterranean rangelands.

Rapid assessment of the nutritional quality of diets ingested by grazing animals is pivotal for successful cow-calf management in east Mediterranean rangelands, which receive unpredictable rainfall and are subject to hot-spells. Clipped vegetation samples are seldom representative of diets consumed, as cows locate and graze selectively. In contrast, faeces are easily sampled and their near-IR spectra contain information about nutrients and their utilization. However, a pre-requisite for successful faecal near-infrared reflectance spectroscopy (FNIRS) is that the calibration database encompass the spectral variability of samples to be analyzed. Using confined beef cows in Northern and Southern Israel, we calibrated prediction equations based on individual pairs of known dietary attributes and the NIR spectra of associated faeces (n=125). Diets were composed of fresh-cut green fodder of monocots (wheat and barley), dicots (safflower and garden pea) and natural pasture collected at various phenological states over 2 consecutive years, and, optionally, supplements of barley grain and dried poultry litter. A total of 48 additional pairs of faeces and diets sourced from cows fed six complete mixed rations covering a wide range of energy and CP concentrations. Precision (linearity of calibration, R2cal, and of cross-validation, R2cv) and accuracy (standard error of cross-validation, SEcv) were criteria for calibration quality. The calibrations for dietary ash, CP, NDF and in vitro dry matter digestibility yielded R2cal values >0.87, R2cv of 0.81 to 0.89 and SEcv values of 16, 13, 39 and 31 g/kg dry matter, respectively. Equations for nutrient intake were of low quality, with the exception of CP. Evaluation of FNIRS predictions was carried out with grazing animals supplemented or not with poultry litter, and implementation of the method in one herd over 2 years is presented. The potential usefulness of equations was also established by calculating the Mahalanobis (H) distance to the spectral centroid of a calibration population of 796 faecal samples collected throughout 2 years in four herds. Seasonal trends in pasture quality and responses to management practices were identified adequately and H<3.0 for 98% of faecal samples collected. We conclude that the development of FNIRS equations with confined animals is not only unexpensive and ethically acceptable, but their predictions are also sufficiently accurate to monitor dietary composition (but not intake) of beef cattle in east Mediterranean rangelands.

Foraging behavior of two cattle breeds, a whole-year study: II. Spatial distribution by breed and season.

Spatial distributions of 22 mature large-framed Beefmaster × Simford (BS) cross cows and 16 mature small-framed Baladi (BA) cows were determined. Cows were allocated to the same paddock of a Mediterranean pasture and monitored during 6 consecutive seasons: spring (April 2006), summer (June 2006), autumn (September 2006), winter (February 2007), early spring (March 2007), and summer (June 2007). The locations of the cows were determined at 5-min intervals for 3 to 4 d during each season by using Global Positioning System (GPS) collars. The distances between consecutive locations and the average locations of each breed at each hour of the day in each season were calculated. The Lateral Foraging Index (LFI) was calculated as the ratio between the average distance per day travelled by the cows of each breed and the perimeter of the diurnal itinerary of that breed, which was calculated from its hourly average locations. The 2 breeds maintained similar diurnal patterns of foraging and resting, characterized by morning and afternoon foraging, and resting at midday and during the night. In summer this pattern was more distinctive, with longer resting periods and more intense foraging periods than in winter, when the noon rest was shorter and only partial. The diurnal routes differed (P < 0.001) between the breeds in all seasons, in their locations, their travelling time, or both. The BA cows were more active than the BS cows in all seasons: they travelled longer distances (P < 0.001) and foraged for more hours during the day (P < 0.001). For both breeds the LFI was numerically greater in winter and spring (February, and March) than in summer (June and September), and it was numerically greater for BA than for BS cows in most seasons.

Foraging behavior of two cattle breeds, a whole-year study: I. Heat production, activity, and energy costs.

The foraging behavior and energy costs of activity of 19 large-frame Beefmaster × Simford (BS) cross mature cows and 14 small-frame Baladi (BA) mature cows was determined. Cows were allocated to the same paddock of a Mediterranean pasture and were monitored during 5 seasons throughout 2006 and 2007: spring (April 2006), summer (June 2006), autumn (September 2006), winter (February 2007), and early spring (March 2007). Cows were given poultry litter (25% CP, DM basis) as supplemental feed during autumn only. The cows were fitted for 3 to 4 d in each season with global positioning system (GPS) monitors, activity monitors attached to 1 of their hind legs, and heart rate (HR) monitors harnessed to their chests. Oxygen consumption per heart beat was determined for each cow during each season to enable conversion of the diurnal HR patterns to heat production (HP) units. All GPS data of cattle locations and activity and the HR and HP data were synchronized to produce simultaneous 5-min interval records; step length also was calculated for each record. These records provided summaries of partitioning among activities: lying down, standing, foraging, and walking without foraging as well as horizontal and vertical distances walked per day and number of steps taken per day. These attributes were analyzed using multiple regression models to relate these activities to HP and to estimate specific HP costs per unit of each activity. Accordingly, the daily energy costs of activity were calculated for the 2 cattle types in each season as the product of the specific activity and the number of units of each activity per day. The HP level of the large-frame BS cows was greater than that of the small-frame BA cows in winter and lower in spring (P < 0.001); however, the respective HP levels were much closer in summer and autumn, with BA cows having values greater by 3% than those of BS cows. The BA cows were more active than the BS cows during all seasons: they foraged for more hours per day (P < 0.001) and walked longer distances (P < 0.001). The mean specific costs of activity of BA cows were 20% less than those of BS cows (P < 0.001). The BA cows took longer steps during foraging and walking idle compared with BS cows despite their much smaller frame. The BA cows were more efficient in conditions of low herbage quality whereas metabolic rate of BS cows was greater in conditions of high herbage quality.

Energy cost of activities and locomotion of grazing cows: a repeated study in larger plots.

We determined the energy costs associated with the activities of beef cows grazing on Mediterranean foothill rangeland covered with herbaceous vegetation. Our central aim was to compare the energy cost coefficients obtained in this study, using relatively large plots, with those obtained in a previous study conducted on smaller plots. Measurements were performed in 3 seasons: in March on nursing cows grazing a 135-ha plot of high quality herbage (11.4 MJ/kg of ME), and in May and September on nonlactating cows grazing a 78-ha plot of low quality herbage (6.2 MJ/kg of ME). Poultry litter manure was given as a supplement in September. Stocking rates on the respective plots were 2.25 and 1.95 ha/cow; 5, 5, and 7 cows were monitored in the respective months. Heat production was determined by continuous monitoring of the heart rate and measurement of the oxygen consumption per heartbeat. Animal location was tracked with global positioning system (GPS) collars equipped with motion sensors. Activity was determined for 5-min intervals using suitable calibration equations. Horizontal and vertical distances traveled were computed by integrating GPS data and plot maps in a geographic information system. Three models were used to estimate the energy cost coefficients of engaging in a given activity and locomotion. Total daily heat production ranged from 644 (September) to 1,014 kJ.kg of BW(-0.75).d(-1) (March; P = 0.04). Estimates of the energy cost coefficients for activity states (kJ.kg of BW(-0.75).d(-1)) ranged from 42.7 to 46.2 for standing, from 84.5 to 92.4 for walking idle, and from 89.4 to 103.2 for grazing; those for locomotion (kJ.kg of BW(-0.75).d(-1).km(-1)) ranged from 2.8 to 2.9 for horizontal locomotion and from 21.4 to 27.9 for vertical locomotion. Estimated cost coefficients of standing, grazing, and horizontal locomotion derived in the present study from animals on relatively larger plots were similar to those of the previous study based on data from smaller plots, but the energy costs of walking idle and of vertical locomotion were greater in the present study than in the previous one. The differences found are associated with the fact that cows in the present study walked for longer periods of time and traveled longer distances in single uninterrupted bouts of locomotion than those in the previous study.

Strategy for increasing detection rates of drug and alcohol abuse in paediatric emergency departments.

AIM: To determine whether implementation of criteria for performing a toxicology screen and increasing staff awareness improve detection of substance abuse among adolescents presenting to the emergency department. METHODS: Patients 12 to 18 years of age presenting to one of three emergency departments in Israel were included in a prospective cohort study. In the 'study' hospital, a set of criteria for urine toxicology screen and measurements of ethanol serum level were implemented. No specific interventions were implemented in the two other hospitals. The main outcome measure was the rate of substance abuse detection. RESULTS: The number of adolescents seen in the participating centres was 3200 at the study hospital, and 3493 and 2792 at the two other hospitals. High blood ethanol concentrations were found in 49 patients at the study hospital compared with 30 and 19 patients at the two other hospitals (p < 0.001). Illicit drugs were detected in 13, 4 and 1 patients, respectively (p = 0.002). CONCLUSIONS: Introducing structured guidelines for ordering toxicological screening increases the detection of alcohol and drug of abuse among adolescents presenting to paediatric emergency departments.

Grazing behavior and energy costs of activity: a comparison between two types of cattle.

The grazing behavior, diet intake, and energy costs of activity of 2 types of cows grazing a Mediterranean pasture were compared. Fifteen large-frame Beefmaster x Simford (BM) cross cows and 13 small Baladi (Ba) mature cows were allocated to the paddock and monitored during 3 seasons throughout 2006; spring (April), summer (June), and autumn (September). Cows were not given supplemental feed during the spring and summer, but had free access to a poultry litter supplement (25% CP, DM basis) during the autumn. Fecal output and digesta kinetics and feed intake were estimated using indigestible double-marker technique. Cows were fitted for 3 to 4 d in each season with global positioning system (GPS) monitors, with activity monitors attached to one of their hind legs, and with heart rate (HR) monitors harnessed to their chests. Oxygen consumption per heart beat was determined for each cow during each season to enable conversion of the diurnal HR patterns to heat production (HP) units. All the GPS data of cattle locations and the activity, HR, and HP data were synchronized to produce a simultaneous record at 5-min intervals. Partition of time spent by the cows lying down, standing, grazing, and walking without grazing, the horizontal and vertical distances walked per day, and the number of steps taken per day were summed from these records. Multiple regression models were adjusted to refer these activities to the HP and to estimate the specific HP costs per unit of each activity. Accordingly, the daily energy costs of activity were calculated for the 2 cattle breeds on each season as the product of the specific activity and the number of units of each activity per day. Feed intake by Ba cows per unit of metabolic BW was greater (P < 0.001) than that of BM cows in both spring and summer and their apparent selection of greater-quality herbage in spring was greater (P < 0.1) than that of BM cows. The smaller framed Ba cows grazed more hours per day and walked longer distances than the BM cows among all seasons. The specific costs for locomotion were less for the Ba cows.

Energy cost of cows' grazing activity: Use of the heart rate method and the Global Positioning System for direct field estimation.

This study with grazing beef cows on the range was designed to explore the possibility of determining incremental energy expenditure (EE) in standing, traveling, and grazing relative to that in lying down, by means of continuous monitoring of EE, location, and activity by the heart-rate method, with Global Positioning System (GPS) collars, and by motion sensors in the GPS collars, respectively. Cows were observed on Mediterranean foothill rangeland covered with herbaceous vegetation through 4 seasons of the year. There were 2 stocking rate treatments, and 14 statistical models were evaluated, including one that was a stepwise model. Total daily EE (TEE) was affected by many interdependent factors apart from activity, including season, stocking rate, herbage quality, standing biomass, and reproductive state of the cow. Each model included all activity variables, plus some of the other factors. Across seasons and treatments TEE, in kJ/(kg of BW(0.75) . d), ranged from 469 in densely stocked, nonlactating cows in June to 1,092 in sparsely stocked, lactating cows in April. The cows' daily vertical and horizontal movements ranged from 75 to 174 m and from 1.5 to 4.2 km, respectively. Within a day, time spent traveling (without grazing) ranged from 0 to 32 min, and grazing time ranged from 4.4 to 12.1 h. Cows spent less time grazing (P < 0.001) in the summer, when herbage quality was low, than in winter and spring. Relative to the baseline EE while lying down, the daily increment incurred by grazing ranged from 13 to 48 kJ/(kg of BW(0.75) . d), and that incurred by grazing, standing, and traveling combined ranged from 38 to 74 kJ/(kg of BW(0.75) . d) or 5.8 to 11.4% of TEE. In conclusion, the estimates of activity costs yielded by 11 of the models were similar to one another, whereas those yielded by the stepwise model and the remaining 2 models were 20% smaller. The cost of grazing activity was estimated to be 6.14 J/(kg of BW(0.75) . m), and that of locomotion during grazing was 6.07 J/(kg of BW(0.75) . m), which agree with values obtained for animals and humans by means of a treadmill. The experimental and statistical approach tested here yielded fairly reliable estimations of energy costs of activities in grazing cows.

EMLA cream prior to digital nerve block for ingrown nail surgery does not reduce pain at injection of anesthetic solution.

BACKGROUND: Needle penetration and local anesthetic infiltration are painful steps of digital ring block. The objective of this study was to evaluate the efficacy of EMLA cream application prior to digital ring block for surgery for ingrown big toenail. METHODS: We conducted a prospective, double-blinded, placebo-controlled, randomized clinical trial with 81 patients (range: 12-75 years, mean +/- SD: 30.3 +/- 17.5 years), who underwent big toenail surgery. Prior to the digital block, EMLA cream (Group E) or a placebo cream (Group P) was applied. A visual analog scale (VAS) and a verbal rating score (VRS) from 1 to 10, 10 being most severe pain, were used for assessment of pain during the skin needle penetration and during the infiltration of the anesthetic product. RESULTS: Data of the VAS and of the VRS during the two steps, respectively, show no significant difference in pain rating between the two groups. In Group E, the gender of the patients had a significant effect on pain perception. Male patients reported less pain than female patients, both during the needle skin penetration and during the infiltration step (P < 0.005). In Group P, reported pain did not differ by gender in either step of the procedure. CONCLUSIONS: We found no clinical benefit in using EMLA during digital nerve block. Although the digital nerves are not deeply located in the small subcutaneous space of the digit, topical anesthesia may not reach them. Moreover, swelling due to injection of the anesthetic product in this small space may also amplify the sensation of pain.

Does the size of nasogastric tubes affect gastroesophageal reflux in children?

BACKGROUND: To evaluate the effects of nasogastric tube insertion and different nasogastric tube sizes on gastroesophageal reflux in children. METHODS: During a prospective randomized study, 29 patients aged 1 month to 4 years (median, 9 months) underwent 24 hours of continuous esophageal pH monitoring to rule out gastroesophageal reflux as the cause of severe pulmonary problems. Each patient was monitored without nasogastric tube for 16 hours (baseline), and thereafter the first nasogastric tube, small (8-Fr) or large (10-Fr or 12-Fr), was placed. Four hours later, the original nasogastric tube was replaced by a new one of large (instead of small) size or of small (instead of large) size. We selected the times of wakefulness in these study periods and compared the number of reflux episodes (NREs), the number of reflux episodes that lasted more than 5 minutes (NRE>5), and the percentage of time with esophageal pH less than 4 (PTP<4). RESULTS: The 12-Fr group in comparison with the 8-Fr group and baseline showed significant difference (P<0.05) in the NRE>5 and PTP<4 parameters. No significant differences were found when comparing 8-Fr versus 10-Fr groups and baseline. In children with (n = 20) and without (n = 9) gastroesophageal reflux, comparison of the various reflux parameters between baseline and the different sizes of nasogastric tubes showed the same results. CONCLUSIONS: Size of the nasogastric tubes is a significant factor in predisposing the child to gastroesophageal reflux. Large nasogastric tubes interfere with the clearance of the refluxed acid from the esophagus.

Alkalinizing local anesthetic does not decrease pain during injection for dorsal penile nerve block.

STUDY OBJECTIVE: To evaluate whether alkalizing local anesthetic with sodium bicarbonate reduces pain related to infiltration of local anesthetic during dorsal penile nerve block for circumcision. DESIGN: Prospective, randomized, double-blind, controlled study. SETTING: E. Wolfson Medical Center, Holon, Israel. PATIENTS: 144 patients aged 15 to 54 years (mean +/- SD = 22.7 +/- 8.8 years), randomized before the block into four groups of 36 patients each. INTERVENTIONS: Group A (control) received a standard solution of 1 mg/kg lidocaine 2% mixed with 0.5 mg/kg bupivacaine 0.5% without epinephrine (pH = 6.3). Patients in Group B, Group C, and Group D received this mixture added with 8.4% sodium bicarbonate for a mean final pH of 6.90, 7.16, and 7.43, respectively. Penile block was performed using a 23-gauge needle by an anesthetist who was blinded to the pH of the solution. MEASUREMENTS AND MAIN RESULTS: Patients were questioned regarding pain suffered during injection of the anesthetic solutions by another physicians who also was blinded to the drug used. Pain was rated by a previously reported subjective pain scale. Mean pain scales were 2.0 +/- 0.17, 2.3 +/- 0.15, 2.2 +/- 0.16, and 1.94 +/- 0.15 for Groups A to D, respectively. The differences between these results were not statistically significant. CONCLUSION: Alkalinizing the acidic local anesthetic solution by sodium bicarbonate does not decrease pain related to infiltration during penile nerve block for circumcision.

Detecting psychological distress among patients attending secondary health care clinics. Self-report and physician rating.

A study was conducted to determine the prevalence of psychological distress, as reported by patients and their physicians, in orthopedic, neurology, dermatology, and ophthalmology clinics; to study their accuracy in detecting psychological distress; and to determine if there is any connection among psychological distress, accuracy of detecting distress, and use of mental health and primary health care physicians' prognosis for the somatic complaints. Five hundred and fifty-six patients, ages 18-21, responded to the Psychiatric Epidemiology Research Interview Demoralization Scale (PERI-D), a measure of psychological distress, and to questions about their mental health and use of mental health and primary health services. Physicians, who were blind to patients' responses, were asked to what extent they thought the cause of patients' complaints was physical and to what extent they thought it was psychological in nature, and to prognosticate. Based on the PERI-D, about 25% of patients were distressed, this was less for females than males and varied between clinics. Based on self-reporting, about 14% of patients (males and females) were distressed. Based on physician reporting, about 17% (males less) were distressed. Physicians identified 35% of the PERI-D-distressed cases and 79% of nondistressed cases. About 66% of patients identified their distress and 83% their lack of distress. Increased use of primary health care and mental health care was related to distress. The prognosis was negatively related to distress. Based on this study, there is a need for more attention to psychological distress among secondary health care patients. Patients' ability to identify their distress suggests the importance of involving the patient in the diagnostic process. Correct detection of distress alone does not appear to decrease the use of primary medical and mental health services.

Early and long-term effects of electroconvulsive therapy and depression on memory and other cognitive functions.

Twenty-seven medication-free, depressed patients (Research Diagnostic Criteria, endogenous subtype) were administered a comprehensive battery testing memory and other cognitive functions before and after a series of bilateral, brief-pulse electroconvulsive therapy (ECT) administered according to a dosage-titration procedure (8.9 +/- 1.981 treatments). A subset of patients (N = 14) were reexamined at 1 month and 6 months after the conclusion of the treatment. Anterograde (verbal and visuospatial tasks), as well as retrograde (famous and personal events), memory function was significantly impaired at the end of the ECT series. By 1 month follow-up, performance had improved to pre-ECT (depression) levels on both anterograde and retrograde tasks and exceeded these by 6 months. The memory deficits induced by ECT were not a consequence of generalized cognitive impairment. Furthermore, depression and ECT were shown to independently affect memory, and recovery from depression was not a consequence of the amnestic action of the treatment. The results generally confirm previous reports regarding the nature of ECT-induced memory impairment, in a different language and culture. They suggest that long-term effects of the treatment on memory are even less prominent than previously observed.