Conventional knowledge, general attitudes and risk perceptions towards zoonotic diseases among Maasai in northern Tanzania.

Understanding factors influencing conventional medical knowledge (CMK), general attitudes and risk perceptions of zoonotic diseases among rural residents who face risk of exposure to such diseases is important for human, livestock, and wildlife health. Focusing on Maasai from Makame, Kiteto District (Tanzania) who largely maintained a semi-nomadic lifestyle, we evaluated respondents' CMK of causes, symptoms, treatments, and prevention methods of rabies, brucellosis, and anthrax. In addition, we identified socio-demographic correlates of CMK with respect to the target zoonoses. Finally, we assessed the relative frequency of practices that increase the risk of pathogen transmission, and compared the risk perception of the three diseases. We conducted structured interviews with Maasai respondents (n = 46) in six sub-villages of Makame and considered education, gender, age, and wealth (indicated by standardized number of livestock) as potential correlates of CMK. Respondents had greater CMK of rabies and anthrax, but feared anthrax the most. Receiving formal education increased rabies CMK (p ≤ 0.05). The CMK of anthrax and brucellosis was not associated with any of the tested variables (p > 0.05). Risk perceptions were correlated with knowledge scores for rabies and anthrax (p ≤ 0.05), and multiple interviewees reported engaging in practices that potentially enhance pathogen transmission. Specific socio-demographic attributes (i.e., formal education) may explain the observed variation in CMK of zoonotic diseases. This information can be used to develop and tailor health education programs for specific at-risk groups.

Management of type 2 diabetes using non-insulin glucose-lowering therapies: a critical appraisal of clinical practice guidelines with the AGREE II instrument.

AIM: Type 2 diabetes is a major global epidemic affecting over 400 million people worldwide. The objective of this systematic review was to provide an overview of recommendations from clinical practice guidelines (guidelines) addressing non-insulin based pharmacological management of among non-pregnant adults in an outpatient setting, and critically appraise their methodological development. METHODS: We systematically searched MEDLINE and Embase databases, for relevant guidelines using the Ovid interface. We scanned the bibliographies of all eligible guidelines for additional relevant citations. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility and appraised the reporting quality of guidelines using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE II) instrument. RESULTS: Our search yielded 11264 unique citations, of which 124 were retrieved for full-text review; 17 guidelines proved eligible. The highest scoring AGREE domain was 'clarity of presentation' (66%; range 7-92%), followed by 'scope and purpose' (58%; range 25-92%), 'editorial independence' (55%; range 0-91%), 'stakeholder involvement' (45%; range 11-90%) and 'rigour of development' (43%; range 4-92%). The poorest domain was 'applicability' (37%; range 6-84%). The guidelines authored by the World Health Organization group achieved the highest AGREE overall score. CONCLUSIONS: Most of the guidelines provided recommendations with a local jurisdictional focus and showed significant variation in the quality. Nevertheless, only a small number of those scored well overall.

SGLT2 inhibition increases serum copeptin in young adults with type 1 diabetes.

AIMS: Copeptin, a surrogate of vasopressin, is elevated in type 1 diabetes (T1D) and predicts kidney disease and cardiovascular mortality. Given the cardiorenal protective effects of SGLT2 inhibition (SGLT2i), our aim was to examine: 1) the relationship between serum copeptin, metabolic, renal and systemic hemodynamic parameters in adults with T1D; and 2) serum copeptin after SGLT2i with empagliflozin. MATERIALS AND METHODS: In this post-hoc, exploratory analysis, serum copeptin, glomerular filtration rate (GFRInulin), effective renal plasma flow (ERPFPAH), plasma renin angiotensin aldosterone system markers, HbA1c, 24-hour urine volume and sodium excretion were measured in 40 participants with T1D (24.3±5.1 years) during eu- and hyperglycaemia before and after 8 weeks of 25mg of daily empagliflozin. RESULTS: Higher baseline copeptin correlated with higher HbA1c, lower 24-hour urine volume and sodium excretion, after correcting for age, sex, systolic blood pressure, and HbA1c. Copeptin concentrations increased in response to empagliflozin under euglycaemia (4.1±2.1 to 5.1±2.8pmol/L, P=0.0053) and hyperglycaemia (3.3±1.4 to 5.6±2.8pmol/L, P<0.0001). The rise in copeptin in response to empagliflozin correlated with change in 24-hour urine volume, but was independent of changes in fractional excretion of sodium and haematocrit. CONCLUSIONS: Elevated serum copeptin was associated with worse glycaemic control and lower diuresis and natriuresis. SGLT2i increased serum copeptin in adults with T1D, and the rise correlated with change in diuresis, but not natriuresis and hemo-concentration. Further work is required to evaluate the clinical implications of elevated copeptin with SGLT2i, including whether it is simply a marker of diuresis or may contribute to cardiorenal disease long-term.

Distinct Oral Neutrophil Subsets Define Health and Periodontal Disease States.

Neutrophils exit the vasculature and swarm to sites of inflammation and infection. However, these cells are abundant in the healthy, inflammation-free human oral environment, suggesting a unique immune surveillance role within the periodontium. We hypothesize that neutrophils in the healthy oral cavity occur in an intermediary parainflammatory state that allows them to interact with and contain the oral microflora without eliciting a marked inflammatory response. Based on a high-throughput screen of neutrophil CD (cluster of differentiation) marker expression and a thorough literature review, we developed multicolor flow cytometry panels to determine the surface marker signatures of oral neutrophil subsets in periodontal health and disease. We define here 3 distinct neutrophil subsets: resting/naive circulatory neutrophils, parainflammatory neutrophils found in the healthy oral cavity, and proinflammatory neutrophils found in the oral cavity during chronic periodontal disease. Furthermore, parainflammatory neutrophils manifest as 2 distinct subpopulations-based on size, granularity, and expression of specific CD markers-and exhibit intermediate levels of activation as compared with the proinflammatory oral neutrophils. These intermediately activated parainflammatory populations occur in equal proportions in the healthy oral cavity, with a shift to one highly activated proinflammatory neutrophil population in chronic periodontal disease. This work is the first to identify and characterize oral parainflammatory neutrophils that interact with commensal biofilms without inducing an inflammatory response, thereby demonstrating that not all neutrophils trafficking through periodontal tissues are fully activated. In addition to establishing possible diagnostic and treatment monitoring biomarkers, this oral neutrophil phenotype model builds on existing literature suggesting that the healthy periodontium may be in a parainflammatory state.

Plasma uric acid effects on glomerular haemodynamic profile of patients with uncomplicated Type 1 diabetes mellitus.

AIMS: Increased plasma uric acid (PUA) levels are associated with impaired renal function in patients with Type 1 diabetes, but the mechanisms are not well understood. Our aim was to evaluate whether higher PUA levels are associated with increased afferent arteriolar resistance in patients with Type 1 diabetes vs. healthy controls, thereby influencing renal function. METHODS: PUA, GFR (inulin) and effective renal plasma flow (ERPF; para-aminohippurate) were measured in 70 otherwise healthy patients with Type 1 diabetes and 60 healthy controls. Gomez's equations were used to estimate afferent (RA ) and efferent (RE ) arteriolar resistances, glomerular hydrostatic pressure (PGLO ) and filtration pressure (ΔPF ). The relationships between PUA and glomerular haemodynamic parameters were evaluated by univariable linear regression correlation coefficients. RESULTS: In patients with Type 1 diabetes, higher PUA correlated with lower PGLO (P = 0.002) and ΔPF (P = 0.0007), with higher RA (P = 0.001), but not with RE (P = 0.55). These associations were accompanied by correlations between higher PUA with lower GFR (P = 0.0007), ERPF (P = 0.008), RBF (P = 0.047) and higher RVR (P = 0.021). There were no significant correlations between PUA and renal haemodynamic parameters in the healthy controls. CONCLUSIONS: The association between higher PUA with lower GFR and lower ERPF in patients with Type 1 diabetes is driven by alterations in the estimated RA . PUA-mediated RA may be caused by increased tone or thickening of the afferent renal arteriole, which might potentiate renal injury by causing ischaemia to the renal microcirculation.

Glomerular haemodynamic profile of patients with Type 1 diabetes compared with healthy control subjects.

AIMS: To evaluate the glomerular haemodynamic profile of patients with Type 1 diabetes with either renal hyperfiltration (GFR ≥ 135 ml/min/1.73 m2 ) or renal normofiltration (GFR 90-134 ml/min/1.73 m2 ) during euglycaemic and hyperglycaemic conditions, and to compare this profile with that of a similar group of healthy control subjects. METHODS: Gomez's equations were used to derive afferent and efferent arteriolar resistances, glomerular hydrostatic pressure and filtration pressure. RESULTS: At baseline, during clamped euglycaemia, patients with Type 1 diabetes and hyperfiltration had lower mean ± sd afferent arteriolar resistance than both those with Type 1 diabetes and normofiltration (914 ± 494 vs. 2065 ± 597 dyne/s/cm5 ; P < 0.001) and healthy control subjects (1676 ± 707 dyne/s/cm(5) ; p < 0.001). By contrast, efferent arteriolar resistance was similar in the three groups. Patients with Type 1 diabetes and hyperfiltration also had higher mean ± sd glomerular hydrostatic pressure than both healthy control subjects and patients with Type 1 diabetes and normofiltration (66 ± 6 vs. 60 ± 3 vs. 55 ± 3 mmHg; P < 0.05). Similar findings for afferent arteriolar resistance, efferent arteriolar resistance, glomerular hydrostatic pressure and filtration pressure were observed during clamped hyperglycaemia. CONCLUSION: Hyperfiltration in Type 1 diabetes is primarily driven by alterations in afferent arteriolar resistance rather than efferent arteriolar resistance. Renal protective therapies should focus on afferent renal arteriolar mechanisms through the use of pharmacological agents that target tubuloglomerular feedback, including sodium-glucose cotransporter 2 inhibitors and incretins.

The effect of renal hyperfiltration on urinary inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes mellitus.

AIMS/HYPOTHESIS: High intraglomerular pressure causes renal inflammation in experimental models of diabetes. Our objective was to determine whether renal hyperfiltration, a surrogate for intraglomerular hypertension, is associated with increased excretion of urinary cytokines/chemokines in patients with type 1 diabetes mellitus. METHODS: Blood pressure, renal haemodynamic function (inulin and para-aminohippurate clearances for glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), respectively) and urine samples were obtained during clamped euglycaemia in individuals with type 1 diabetes with either hyperfiltration (GFR determined using inulin [GFRINULIN] ≥ 135 ml min⁻¹ 1.73 m⁻², n = 28) or normofiltration (n = 21) and healthy control individuals (n = 18). RESULTS: Baseline clinical characteristics, dietary sodium and protein intake and blood pressure levels were similar in the diabetic and healthy control groups. In addition, HbA1c levels were similar in the two diabetic groups. As expected baseline GFR was higher in hyperfilterers than either normofiltering diabetic patients or healthy control patients (165 ± 9 vs 113 ± 2 and 116 ± 4 ml min⁻¹ 1.73 m⁻², respectively, p < 0.01). ERPF and renal blood flow were also comparatively higher and renal vascular resistance was lower in hyperfiltering patients (p < 0.01). Hyperfiltering diabetic patients had higher excretion rates for eotaxin, IFNα2, macrophage-derived chemokine, platelet-derived growth factor (PDGF)-AA, PDGF-AB/BB and granulocyte-macrophage colony-stimulating factor (p ≤ 0.01). Urinary monocyte chemoattractant protein (MCP)-1 and RANTES (regulated on activation, normal T expressed and secreted) excretion was also higher in hyperfiltering vs normofiltering diabetic individuals (p < 0.01) and fibroblast growth factor-2, MCP-3 and CD40K excretion was elevated in hyperfiltering diabetic individuals vs healthy controls (p < 0.01). CONCLUSIONS/INTERPRETATION: Renal hyperfiltration is associated with increased urinary excretion of inflammatory cytokines/chemokines in patients with uncomplicated type 1 diabetes.

Free ferulic acid uptake in lactating cows.

Ferulic acid (FRA), a phenolic compound with antioxidant and anticancer activities, naturally occurs in plants as a lignin precursor. Many veins of research have been devoted to releasing FRA from the lignin complex to improve digestibility of ruminant feeds. Thus, the objective of this research was to investigate the transfer of a given dosage of the free form of FRA into the milk of dairy cattle. Six mid- to late-lactation Holstein cows at the Cornell Research Farm (Harford, NY) were given 14-d adaptation to diet and stall position. Ad libitum access to a total mixed ration based on haylage and maize silage (31.1% neutral detergent fiber containing 5.52 mg of FRA/g) was provided during the study. A crossover design was implemented so that each cow alternated weekly between FRA-dosed and control. On d 1, jugular cannulas and urine catheters were placed in all cows. On d 2, FRA-dosed cows received a single dosage of 150 g of pure FRA powder at 0830 h via their fistula (n=4) or a balling gun for nonfistulated cows (n=2). Plasma, urine, feces, feed, orts, milk, and rumen fluid were sampled intensively for the next 36 h and analyzed for FRA concentration. On d 8, the cows crossed over and the experiment was repeated. When compared with the control, FRA administration did not have an effect on dry matter intake, milk yield, milk fat yield, milk protein yield, somatic cell count, or neutral detergent fiber content of orts and feces. The concentration of FRA in the feces did not change as a result of FRA dosage. As expected, FRA concentration increased dramatically upon FRA dosage and decreased over time until returning to basal levels in rumen fluid (4 h after dosage), plasma (5.5 h after dosage), urine (10 h after dosage), and milk (14 h after dosage). Baseline values for FRA in urine and rumen fluid were variable among cows and had an effect on FRA concentration in FRA-dosed cows. From this study, it is observed that orally ingested FRA can be transported into the milk and that the physiological transfer of FRA occurs from rumen to milk within 6.5 h or the first milking after dosage. Ferulic acid may affect the functionality of milk due to its antioxidant, anticancer, and antibacterial activities. Future research will be required to elucidate whether FRA in milk is bioavailable and bioactive, and to evaluate the complete sensory and microbiological effects of increased FRA and FRA degradation products in milk.

Short communication: Antioxidant activity of calf milk replacers.

A calf milk replacer (CMR) is designed to replace whole, saleable milk as a lower cost nutrient source for calves while striving to nourish a newborn calf, reduce calf mortality, strengthen immunity, and increase animal life span and productivity. Antioxidants (AO) can enhance immune defense by reducing oxidative damage, but CMR are traditionally not formulated for AO activity. The objective of this study was to compare total AO activities of bovine milk and 6 CMR (A to F) that vary in the amount and source of fat and protein. Calf milk replacers were donated by Milk Products LLC (Chilton, WI). Milk was obtained from the Cornell Dairy Research Farm bulk tank, representing milk produced within 24h by 455 cows. Milk replacers were mixed to 150 g/L with 40°C purified water. All samples were extracted in triplicate. Following hexane lipid extraction, both milk and CMR samples were extracted 5 times with ethyl acetate and then evaporated and reconstituted with 70% methanol:water. Samples were assessed for total AO activity using the peroxyl radical scavenging capacity assay where each sample was diluted to 5 descending concentrations, plated in triplicate. Ascorbic and gallic acids were standards for each plate. Type of protein (soy) had a positive effect on AO activity for CMR A, which exhibited the highest total AO activity. Natural bovine milk had the second highest AO activity. Many factors may explain the difference in AO activity between natural milk and formulated CMR, including fat, vitamin, and mineral contents, enzymatic AO, phenolics, flavonoids, fatty acid profile, and AA composition. When comparing AO activity of CMR, it is important to consider the diversity in feeding recommendations, which will alter the vitamin and mineral content, thus influencing AO activity. The opportunity exists to enhance AO activity of CMR to more closely mimic that of bovine milk. Future research is warranted to compare a broader range of CMR using methods that account for total lipophilic and hydrophilic AO activities, as well as to investigate the effect of additional compounds in milk that may affect AO activity.

Urinary markers of renal inflammation in adolescents with Type 1 diabetes mellitus and normoalbuminuria.

AIMS: Patients with the highest albumin:creatinine ratio within the normal range are at an increased risk for developing microalbuminuria. The mechanistic basis for this is unknown, but may be related to renal inflammation. Our goal was to characterize the urinary excretion of cytokines/chemokines in normoalbuminuric adolescents with Type 1 diabetes to determine whether higher range normoalbuminuria is associated with evidence of renal inflammation. METHODS: Forty-two urinary cytokines/chemokines were measured in subjects who were screened for the Adolescent Type 1 Diabetes Cardio-Renal Intervention Trial. Urinary cytokines/chemokines were compared across low (n = 50), middle (n = 50) or high (n = 50) albumin:creatinine ratio tertile groups. RESULTS: At baseline, participants in the upper tertile were younger and had shorter diabetes duration compared with the other groups. Other clinical characteristics were similar. Urinary levels of interleukin 6, interleukin 8, platelet-derived growth factor-AA and RANTES differed across albumin:creatinine ratio tertiles, with higher values in patients in the middle and high tertiles compared with the lower tertile (ANCOVA P ≤ 0.01). CONCLUSIONS: Within the normal albumin:creatinine ratio range, higher urinary albumin excretion is associated with elevated urinary levels of inflammatory markers. Ultimately, this may provide mechanistic insights into disease pathophysiology and stratify the risk of nephropathy in Type 1 diabetes.

Free ferulic acid uptake in ram lambs.

The objective of this research was to investigate the fate of free ferulic acid (FA) in sheep. Ferulic acid is normally present in plants, bound to the indigestible cell wall. If the FA present in a ruminant diet is released from the cell wall with feed pretreatment methods, FA may be released into the rumen for digestion or absorption into the bloodstream or both. Eight male Dorset × Finn lambs were randomly assigned to 1 of 4 treatment (trt) concentrations, 0 (control), 3, 6, or 9 g/d free FA as part of a replicated 4 × 4 Latin square design. Lambs were housed individually and consumed chopped alfalfa hay (Medicago sativa; 22.8% CP, 39.3% NDF, 0.73 Mcal/kg NE(g)) ad libitum and 350 g corn grain (Zea mays L.; 9.1% CP, 11.2% NDF, 1.52 Mcal/kg NE(g)) once daily at 0800 h. Basal concentrations of FA in hay, grain, blood, feces, and urine were established following a 14-d adjustment to diet and housing. An oral dose of free FA was administered for 5 d via bolus after each morning feeding, after which hay, grain, blood, feces, and urine were sampled. Body weights were recorded at the beginning and end of each trt, and DMI was measured daily during trt periods. In addition to trt, each lamb ingested a daily average of 3.78 g FA in its bound form via the offered hay (2.67 mg/g FA; 1.0 kg/d DMI) and corn (3.17 mg/g FA; 0.35 kg/d DMI). The FA administered had a quadratic effect on average hay DMI (1.25, 1.41, 1.41, and 1.29 kg/d for 0, 3, 6, or 9 g/d FA trt; P < 0.01; SE = 58.9 g), but lamb BW did not change as a result of FA trt (P = 0.28). The NDF content and amount of FA in refusals were not affected by trt, (P = 0.30; P = 0.82, respectively). Fecal FA did not differ among trt or when compared with basal FA (P = 0.53), while urine FA increased as FA dose increased (P < 0.01), indicating that free FA was absorbed and transferred into urine. No free FA was found in the plasma analyzed, suggesting that disappearance from the blood of absorbed free FA occurred within the 5 h that passed between bolus dosage and blood collection. An in vitro analysis was conducted to assess the degree of inhibition of microbial NDF digestion caused by FA supplementation. In vitro, NDF disappearance was not inhibited as a result of FA treatment (P = 0.80). These data in combination with the results of the lamb study indicate that free FA as 0.24, 0.43, and 0.70% of DMI in lambs is absorbed and excreted in the urine as opposed to the feces with no apparent effects on rumen microbial NDF digestion.

Ability of cystatin C to detect acute changes in glomerular filtration rate provoked by hyperglycaemia in uncomplicated Type 1 diabetes.

AIMS: Systematic study of hyperfiltration in diabetic nephropathy has been hindered by the lack of a simple glomerular filtration rate (GFR) measure that is accurate in this range of renal function. Serum cystatin C (GFR(CYSTATIN C) ) reflects long-term trends in GFR in normal or elevated ranges. To test whether it can reflect acute changes, we examined the impact of clamped hyperglycaemia on GFR(CYSTATIN C) and GFR(INULIN) in subjects with Type 1 diabetes. METHODS: GFR(INULIN) and GFR(CYSTATIN C) were measured in 32 normotensive, normoalbuminuric subjects during clamped euglycaemia and hyperglycaemia. For comparison, GFR(MDRD) was estimated according to the four-variable equation. RESULTS: During clamped euglycaemia, agreement between GFR(CYSTATIN C) and GFR(INULIN) was excellent, with mean bias +1.9 (90% distribution -29 to +31) ml min(-1) 1.73 m(-2), while GFR(MDRD) had mean bias +11.4 (-45 to +51) ml min(-1) 1.73 m(-2). With exposure to clamped hyperglycaemia, the mean increase in GFR(CYSTATIN C) (+17.5 ± 13.5 ml min(-1) 1.73 m(-2) ) reflected that observed with GFR(INULIN) (+15.3 ± 28.1 ml min(-1) 1.73 m(-2), P = 0.74), while GFR(MDRD) demonstrated a mean decline of -4.4 ± 33.6 ml min(-1) 1.73 m(-2) (P = 0.01). In all 24 subjects in whom GFR(INULIN) increased in response to hyperglycaemia, GFR(CYSTATIN C) reflected a concordant change (sensitivity, 100%) while GFR(MDRD) increased in 10/24 (sensitivity, 42%). In the eight remaining subjects, specificity was 25 and 75% for GFR(CYSTATIN C) and GFR(MDRD), respectively. CONCLUSION: GFR(CYSTATIN C) reflects normal and elevated renal function better than GFR(MDRD) even under the acute influences of hyperglycaemia, suggesting a role for cystatin C in clinical practice and research for the study of early renal function changes in Type 1 diabetes.

The effect of oral contraceptives on the nitric oxide system and renal function.

We have demonstrated that oral contraceptive (OC) users exhibit elevated angiotensin II levels and angiotensin II type 1 receptor expression, indicative of renin-angiotensin system (RAS) activation, yet the renal and systemic consequences are minimal, suggesting that there is increased vasodilatory activity, counteracting the effect of RAS activation. We hypothesized that the nitric oxide (NO) system would be upregulated in OC users and that this would be reflected by a blunted hemodynamic response to l-arginine infusion. All subjects were studied after a 7-day controlled sodium and protein diet. Inulin and para-aminohippurate clearance techniques were used to assess renal function. l-Arginine was infused at 100, 250, and 500 mg/kg, each over 30 min. Skin endothelial NO synthase mRNA expression was assessed by real-time PCR. While OC nonusers exhibited significant increases in effective renal plasma flow (670.8 +/- 35.6 to 816.2 +/- 59.7 ml.min(-1).1.73 m(-2)) and glomerular filtration rate (133.4 +/- 4.3 to 151.0 +/- 5.7 ml.min(-1).1.73 m(-2), P = 0.04) and declines in renal vascular resistance (81.1 +/- 6.1 to 63.5 +/- 6.2 mmHg.ml(-1).min, P = 0.001) at the lower l-arginine infusion rates, the responses in OC users were blunted. While l-arginine reduced mean arterial pressure at the 250 and 500 mg/kg doses in OC nonusers, OC users only exhibited a decrease in mean arterial pressure at the highest infusion rate. In contrast, tissue endothelial NO synthase mRNA levels were higher in the OC users (P = 0.04). In summary, these findings suggest that the NO system is upregulated by OC use in young, healthy women. Increased activity of the NO pathway may modulate the hemodynamic effects of RAS activation in OC users.

Fermentation characteristics of corn forage ensiled in mini-silos.

To evaluate numerous experimental variables and their interactions involving different corn (Zea mays, L.) silage hybrids, scaled down mini-silos are necessary. Objectives of this study were to evaluate the influence of sample size on pH, NH3, and volatile fatty acid profile of 8 corn silage hybrids, selected to vary in fiber digestibility and ensiled in vacuum-sealed polyethylene bags for 90 d, and to assess the suitability of these mini-silos for detecting differences among corn silage samples. Hybrids were grown at the Cornell Teaching and Research Center located near Harford, NY, and harvested at a dry matter content of about 32% in the fall of 2002. Samples from 3 field replications of each hybrid were chipper-shredder chopped and vacuum-ensiled in bags with sample sizes of 50, 100, 200, 400, and 600 g. Increasing sample size resulted in decreased lactic acid, acetic acid, total acids, and NH3. Most of the difference among sample sizes occurred between the 50- and 100-g sample sizes. Lactic acid:acetic acid ratio (3.1 +/- 0.13) and pH (3.9 +/-0.08) did not vary among sample sizes. There was no detectable butyric acid in the samples. Fermentation characteristics suggested that all samples were well ensiled but that the fermentation profile of the 50-g samples differed the most from other sample sizes. Hybrids did vary in lactic acid, acetic acid, lactic acid:acetic acid, and pH. Differences among hybrids were also noted for dry matter and crude protein. Field-chopped corn hybrids that were ensiled using mini-silos had higher acids than corresponding field-chopped corn hybrids ensiled in Ag-bags, in part due to no effluent escaping from the mini-silos. It is possible to use vacuum-sealed plastic bags to ensile corn, with samples as small as 200 g, and to use these mini-silos to assess differences among corn silage samples. Caution should be used when extrapolating mini-silo data to field-scale ensiling.

Lactation performance of holstein cows fed fescue, orchardgrass, or alfalfa silage.

Perennial grasses are increasingly being used as an integral part of nutrient management plans, but fescue (Festuca arundinacea Schreb.) is often overlooked because of perceived intake problems. A 30-d study was conducted to evaluate the lactation performance of cows fed a fescue silage-based total mixed ration (TMR) compared with orchardgrass (Dactylis glomerata L.) and alfalfa (Medicago sativa L.) silage-based TMR, when forages are harvested at recommended neutral detergent fiber (NDF) levels. Holstein cows (body weight [BW] = 627 +/- 66.0 kg, milk yield = 40.9 +/- 6.93 kg/d, parity = 2.6 +/- 1.44, days in milk = 152 +/- 24.5) were randomly assigned to treatment. Statistical design was a randomized complete block with 10 cows per treatment. The 5 treatments consisted of TMR using first-cutting alfalfa, and first- and second-cutting orchardgrass and tall fescue silage. Diets were formulated to provide 0.95% of BW as forage NDF and contained approximately 18% CP and 1.6 mcal/kg. This resulted in diets of about 30% NDF; for a 612-kg cow, approximately 5.8 kg/d of forage NDF was fed. Second-cutting, grass-based TMR had lower intake than alfalfa and first-cutting forage TMR. Cows consuming second-cutting orchardgrass had lower milk production than did cows consuming other forage TMR. Cows fed fescue TMR had higher milk production than those fed orchardgrass. Indigestible residues were higher, and NDF digestibilities were lower, in second-cutting forages vs. first-cutting forages, likely contributing to the differences observed in intake and resulting differences in milk production. Dairy cows consumed the first-cutting fescue TMR readily and performed as well as those on alfalfa or first-cutting, orchardgrass-based TMR in terms of lactation performance, but fescue and orchardgrass rations will require more concentrate in the ration than alfalfa.

Western Coordinating Committee-204 goals and why they are important to the future of animal production systems.

There are scientists who believe that science is value-free and that social and ethical issues are not their concern. The birth of Dolly, the cloned lamb, greatly increased public and scientific awareness of ethical issues raised by molecular biology as they intersect with human experience. There are many other issues involving animal production systems, including animal welfare, rural community issues, and environmental concerns. Last year Germany became the first European nation to grant animals a constitutional right. Several European nations ban the use of traditional battery cages for laying hens and gestation crates for sows. In the US, 37 states have recently passed animal anticruelty laws. Times are changing, and if animal production systems are to be part of the future, animal scientists must join with society to solve these ethical issues. The Western Coordinating Committee-204 (WCC-204), Animal Bioethics, has as its goals to 1) create a forum in which animal scientists and nonanimal scientists may work together to examine and discuss contentious social issues, 2) provide a means of encouraging the development of research projects dealing with bioethics of the animal sciences, 3) develop mechanisms of outreach that would allow animal scientists to respond directly to consumers and critics, and 4) provide the means for ongoing critical analysis of the animal science professions in the context of their ability to address moral and sociopolitical issues. Animal scientists can no longer ignore social ethics, and by realizing the goals of Western Coordinating Committee-204, we can help maintain the future of animal production systems.

Influence of dietary nonfiber carbohydrate concentration and supplementation of sucrose on lactation performance of cows fed fescue silage.

There is interest in knowing if the source of nonfibrous carbohydrates (NFC) influences milk production and composition. Our objective was to determine the effects of source (starch or sugar) and level of NFC in the diet on these parameters. A 4 x 4 Latin square replicated five times using early-lactation (56 +/- 9 DIM) Holstein cows was used; cows were offered one of two levels of NFC and either no added sucrose or sucrose substituting for 10% of the corn. Diets were balanced to meet National Research Council requirements for total protein, energy, and minerals. Tall fescue silage was included at one of two levels (0.95 or 1.25% of BW as forage NDF), resulting in diets with 40 and 30% NFC. The remaining ingredients consisted of high-moisture corn, soybean meal, SoyPlus, minerals, and vitamins. Megalac (0.45 kg) was used in the low NFC diets. High NFC diets were lower (P < 0.01) in neutral detergent fiber (NDF; 31.5%) and crude protein (CP; 19.6%) than the low NFC diet (35.8% NDF and 21.0% CP). Sucrose containing diets were somewhat lower (P < 0.01) in NDF (33.1%) than the no sucrose added diets (34.3%), but diets did not differ in CP%. Cows offered the high NFC level produced more milk (39.6 kg/d; P < 0.05) than those offered the low level (38.3 kg/d), primarily due to higher dry matter intake (P < 0.05). Cows consuming the high NFC diet also had lower (P < 0.05) milk fat (3.25%) and milk urea nitrogen (MUN; 13.7 mg/dl), and higher (P < 0.05) milk protein (2.58%) and milk lactose (4.81%) concentrations than cows offered the low NFC level (3.46% milk fat, 17.5 mg/dl MUN, 2.51% milk protein, and 4.74% milk lactose). Fat yield was higher (P < 0.05) for cows fed low NFC diets than cows fed high NFC diets, whereas protein and fat yield were lower (P < 0.05) for cows fed low NFC diets than those fed high NFC diets. The NFC source did not influence dry matter intake or milk production or milk component yield (P > 0.05). Milk lactose (4.79%) and MUN (16.0 mg/dl) concentrations were higher (P < 0.05) for cows offered sucrose as a portion of the NFC compared with those not offered sucrose (4.76% milk lactose and 15.2 mg/dl MUN). Results suggest that cows fed sucrose may utilize diet nitrogen less efficiently than those not fed sucrose, when sucrose is replacing a portion of the high-moisture corn in the diet.

Acute hyponatraemia and 'ecstasy': insights from a quantitative and integrative analysis.

A 20-year-old woman attended a 'rave party' where she took the drug 3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'). She had used this drug previously without serious adverse effects. On this occasion, while both she and her friends drank a large quantity of water, only she became seriously ill. The initial manifestation was an altered sensorium; several hours later she had a grand mal seizure. In the Emergency Department, the most striking features were the severe degree of hyponatraemia (112 mmol/l) and cerebral oedema. To explain the basis for this life-threatening clinical presentation, an imaginary consultation was sought with Professor McCance. Using both a deductive and a quantitative analysis that involved several medical subspecialties, he illustrated that a simple story of water ingestion and vasopressin release was not sufficient to explain her hyponatraemia. It was only after events in her gastrointestinal tract were analysed that a plausible hypothesis could be constructed.

A physiological analysis of hyponatremia: implications for patients on peritoneal dialysis.

The basis for hyponatremia is a negative balance for sodium (Na+) plus potassium (K+) and/or a positive balance for water. In patients with normal renal function, vasopressin is needed to prevent the excretion of electrolyte-free water. Vasopressin is not important when there is little residual renal function. If hyponatremia is accompanied by a quantitatively appropriate gain in weight, this implies that a gain of electrolyte-free water was the basis for hyponatremia. In the absence of this weight gain, a loss of salts is to be suspected. If the extracellular fluid (ECF) volume is obviously low, hyponatremia is due to a deficit of NaCl, unless there is a deficit of K+. With a KCl deficit and a contracted ECF volume, there should also be a large shift of Na+ into cells, so metabolic alkalosis would not be an expected finding. In contrast, those patients with no change in weight who have a normal or expanded ECF volume are subdivided into those with a gain of solutes restricted to the ECF compartment (glucose, mannitol), or those with a deficit of solutes of intracellular fluid origin, which implies that a catabolic state (malnutrition) may be present.