Evaluation of three synchrony programs for pasture-based dairy heifers.

The objective was to evaluate the efficacy and economic benefits of three synchrony programs in 1137 heifers from 10 pasture-based dairy herds. Heifers were randomly assigned to one of three treatments within each herd on Day -13 (Day 0 = start of the breeding program). They were treated with: (1) PGF(2α) on Days -13 and -2, with AI after detection of estrus between Days 0 and 3 (Double PG); (2) GnRH, PGF(2α), and GnRH on Days -9, -2, and 0, respectively, with placement of an intravaginal progesterone (P4)-releasing device between Days -9 and -2, and set time AI on Day 1 (GPG + P4); or (3) same as the GPG + P4 group but with the set time AI on Day 0 (Cosynch + P4). Plasma P4 concentrations were determined on Days -20 and -13 to determine pubertal status. The Cosynch + P4 treatment had a higher (P < 0.05) conception rate to AI (57% vs. 47% vs. 48% for Cosynch + P4, GPG + P4, and Double PG, respectively), 21-day in-calf rate (76% vs. 72% vs. 63% for Cosynch + P4, GPG + P4, and Double PG), and a shorter median interval from the start of the breeding program to conception (0, 14, and 19 days for Cosynch + P4, GPG + P4, and Double PG). Heifers that had reached puberty before breeding, compared with those that had not, had higher (P < 0.05) in-calf rates to AI (53% vs. 47%) at 21 days (74% vs. 64%) and at 42 days (91% vs. 84%). Pubertal status was associated with herd, breed, age, and body condition score at the start of mating (P < 0.05). A partial budget model demonstrated that, compared with the Double PG program, there was an economic benefit from the Cosynch + P4 (mean, NZ$25.73; 95% confidence interval, 2.99-50.69), but not the GPG + P4 program (mean, NZ$-0.65; 95% confidence interval, -21.87 to 21.58). We concluded that the Cosynch + P4 program resulted in the highest fertility and economic benefit of the three programs evaluated, and that reproductive response was affected by pubertal status.

Invited review: New perspectives on the roles of nutrition and metabolic priorities in the subfertility of high-producing dairy cows.

Management, nutrition, production, and genetics are the main reasons for the decline in fertility in the modern dairy cow. Selection for the single trait of milk production with little consideration for traits associated with reproduction in the modern dairy cow has produced an antagonistic relationship between milk yield and reproductive performance. The outcome is a multi-factorial syndrome of subfertility during lactation; thus, to achieve a better understanding and derive a solution, it is necessary to integrate a range of disciplines, including genetics, nutrition, immunology, molecular biology, endocrinology, metabolic and reproductive physiology, and animal welfare. The common theme underlying the process is a link between nutritional and metabolic inputs that support complex interactions between the gonadotropic and somatotropic axes. Multiple hormonal and metabolic signals from the liver, pancreas, muscle, and adipose tissues act on brain centers regulating feed intake, energy balance, and metabolism. Among these signals, glucose, fatty acids, insulin-like growth factor-I, insulin, growth hormone, ghrelin, leptin, and perhaps myostatin appear to play key roles. Many of these factors are affected by changes in the somatotropic axis that are a consequence of, or are needed to support, high milk production. Ovarian tissues also respond directly to metabolic inputs, with consequences for folliculogenesis, steroidogenesis, and the development of the oocyte and embryo. Little doubt exists that appropriate nutritional management before and after calving is essential for successful reproduction. Changes in body composition are related to the processes that lead to ovulation, estrus, and conception. However, better indicators of body composition and measures of critical metabolites are required to form precise nutritional management guidelines to optimize reproductive outcomes. The eventual solution to the reduction in fertility will be a new strategic direction for genetic selection that includes fertility-related traits. However, this will take time to be effective, so, in the short term, we need to gain a greater understanding of the interactions between nutrition and fertility to better manage the issue. A greater understanding of the phenomenon will also provide markers for more targeted genetic selection. This review highlights many fruitful directions for research, aimed at the development of strategies for nutritional management of reproduction in the high-producing subfertile dairy cow.

Precalving effects on metabolic responses and postpartum anestrus in grazing primiparous dairy cows.

The effect of increased access to pasture feeding during the last 6 wk of gestation on metabolic responses and postpartum anestrous interval was investigated. Heifers with a body condition score (BCS) of 5.0 (BC5+FF; on a 1-to-10 scale, US = 1.5 + 0.32 x New Zealand) were offered unrestricted pasture, and those with BCS 4.0 were fed either pasture unrestricted (BC4+FF) or restricted (BC4+RES) for the last 6 wk of gestation. After calving, all groups were offered unrestricted pasture. Mean BCS at calving for BC5+FF, BC4+FF, and BC4+RES were 4.7 +/- 0.1, 4.3 +/- 0.1, and 3.5 +/- 0.1, respectively. At 35 d postpartum, LH pulse frequency was lower in BC4+RES than in BC4+FF and BC5+FF, which were similar. At 77 d after calving, 8% of BC4+RES cows had ovulated compared with 75% of BC4+FF and 69% of BC5+FF cows. Metabolic hormonal differences between BC4+FF and BC4+RES were not reflected in the differences between BC4+FF and BC5+FF for LH pulse frequency or ovulation. Unrestricted access to pasture during the final 6 wk of gestation for BC4 heifers reduced the risk of prolonged postpartum anestrus. Systemic factors, tissue sensitivity, and critical developmental set points are probably involved in the integrated control of ovulation by body condition.

Pregnancy loss in dairy cattle in the Waikato region of New Zealand.

AIM: To define the incidence rate of pregnancy loss and risk factors for those losses in pasture-fed dairy cattle in the Waikato region of New Zealand. METHODS: Cows (n=2,004) from 10 pasture-fed, spring-calving dairy herds in the Waikato were enrolled following confirmation of pregnancy 29-45 days after insemination, for inseminations that occurred within the first 16 days of the seasonal breeding period. Transrectal ultrasonographic examinations for pregnancy were conducted at approximately 6, 8, 10, 14 and 22 weeks gestation, and subsequent calving data were recovered. Pregnancy loss was defined as having occurred when a confirmed pregnancy was not re-diagnosed, when gross abortion was detected, or when a cow calved <265 days after the confirmed conception date. Data were analysed using reverse stepwise logistic regression and Cox's proportional hazards analysis. RESULTS: A total of 128 (6.4%) pregnancy losses were detected. The incidence rate was higher in early compared to late gestation (10.9 vs 2.8 losses/10,000 cow-days between Weeks 6-10 vs Weeks 10-14, respectively; p<0.001). Higher rates of loss were associated with the occurrence of clinical mastitis (Hazards ratio (HR)=1.57; p=0.071), being treated for anoestrus (HR=1.69; p=0.007), and in cows that had calving-to-conception intervals < or =63 days compared with those that had calving-to-conception intervals >92 days (HR=2.49; p=0.06). In addition, the rate of pregnancy loss differed between herds (p=0.05). CONCLUSIONS: The highest rate of pregnancy loss occurred in early gestation. Clinical mastitis, anoestrus and calving late in the calving season were risk factors for pregnancy loss. CLINICAL RELEVANCE: Pregnancy diagnosis using ultrasonography can be undertaken from 28 days post-insemination. However, due to the high rate of pregnancy loss at this stage of gestation, herdowners need to be warned of possible losses, and cows should be re-examined to confirm pregnancy before certification of pregnancy status is given.

Factors affecting conception and expression of oestrus in anoestrous cows treated with progesterone and oestradiol benzoate.

Nutrient balance affects the resumption of ovarian cyclic activity following calving in dairy cattle. However, few data are available about the relationships between nutrient balance and expression of oestrus or conception. It was hypothesised that previously anoestrous cows that conceived to first insemination and cows that expressed oestrus at the subsequent expected return to oestrus would be less likely to be in negative energy balance (i.e. would have higher body condition score, higher glucose, insulin-like growth factor (IGF), leptin or insulin concentrations, and lower non-esterified fatty acids (NEFA), blood urea nitrogen (BUN), beta hydroxy butyrate (BOH) concentrations 12-15 days after insemination) than herd mates not conceiving or expressing oestrus. Anoestrous cows were treated with progesterone and oestradiol benzoate (Day 0 = end of treatment period) and retrospectively categorised as conceiving (n = 108) or not conceiving (n = 108) to insemination. A subset of cows not conceiving to insemination were categorised as expressing (n = 44) or not expressing (n = 44) oestrus between Days 14 and 28 after initial insemination. Cows conceiving had a lower NEFA concentration (P = 0.014) than non-conceiving cows. Cows subsequently detected in oestrus had higher body condition scores (P = 0.016), IGF concentrations (P = 0.008) and milk protein percentages (P = 0.038), and lower BOH concentrations (P = 0.018) than cows not expressing oestrus. No difference in concentrations of leptin, insulin, glucose, blood urea nitrogen or milk yield were found between cows conceiving or not conceiving and those detected in oestrus or not detected in oestrus (P > 0.1). It is concluded that some measures of metabolic status at the time of pregnancy recognition affects the probability of pregnancy and of subsequent expression of oestrus in those treated, anoestrous cows not conceiving.

Invited review: Treatment of cows with an extended postpartum anestrous interval.

Cows with an extended interval from calving to first ovulation (PPI) have increased intervals from calving to conception and are more likely to be culled compared with cows with a short PPI. In year-round calving dairy herds, between 11 and 38% of cows are reported as anestrus by 50 or 60 d after calving. In seasonally calving dairy herds, between 13 and 48% of cows are diagnosed as anovulatory anestrus at the start of the breeding period. Ovulation and estrus after calving are delayed when the positive feedback effects of estradiol on release of LH from the pituitary, and circulating concentrations of metabolic hormones such as insulin and insulin-like growth factor-I, are reduced by a variety of environmental factors. The main factors are limited energy intake, lower body reserves, increased partitioning of energy to milk production, suckling, and peripartum disease. Treatment options for cows with an extended PPI include hormonal and management strategies. Hormonal treatments that include a period of progesterone supplementation result in the majority of treated animals displaying estrus with a subsequent luteal phase of normal duration and improved pregnancy rates compared with untreated controls. Hormonal interventions also tend to have more predictable outcomes compared with management changes, such as manipulating body condition or dietary intakes after calving, and usually have some estrous synchronization effect, thus facilitating the use of artificial insemination. However, responses to any treatment are variable and are related to those factors that influence duration of the PPI, such as body condition and parity.

Effect of dietary intake on steroid feedback on release of luteinizing hormone in ovariectomized cows.

This study tested the hypothesis that the decline in pulsatile release of luteinizing hormone (LH), resulting from steroid negative feedback, is greater in animals fed a low, compared with a high, plane of nutrition. Two-year-old cows were ovariectomized and six days later were fed diets to provide 1.5 x maintenance requirements (n = 6, supplemented) or 0.5 x maintenance requirements (n = 6, restricted) (Round 1). Pulsatile release of LH was measured over a 14-h period on the fifth day of feeding these diets (Day 1); at 6 h, all animals were treated with an intravaginal insert containing 1.38 g progesterone, which remained in place until the end of Day 3. Pulsatile release of LH was again measured for 14 h on Day 3; at 6 h, all animals were injected intramuscularly with oestradiol benzoate (ODB; 1 mg per 500 kg live weight). Three days later, this protocol was repeated, in a cross-over design, with cows that were previously restricted now being supplemented and those cows previously supplemented, now restricted (Round 2). Plasma concentrations of progesterone after intravaginal progesterone treatment were 1.01 ng mL(-1) higher in restricted cows compared with supplemented cows (P < 0.001) and were also higher in Round 1 than in Round 2 and on Day 1 than on Day 3 (P < 0.001). Plasma concentrations of oestradiol following injection with ODB did not differ between supplemented and restricted cows (P > 0.1). Dietary intake did not affect mean concentrations of LH, pulse frequency or amplitude during the 6-h period before steroid treatment or the change in these variables following steroid treatment; however, the slope of the decline in concentrations of LH following progesterone treatment was significantly more negative in cows fed restricted diets compared with those fed supplemented diets. In Round 2, mean concentrations of LH were higher preceding, and decreased more following, progesterone treatment compared with the decrease after ODB treatment. In conclusion, acute dietary restriction resulted in a more rapid decline in the release of LH following treatment with intravaginal progesterone, and was associated with higher concentrations of progesterone in plasma.

Effect of treatment with progesterone and oestradiol benzoate on ovarian follicular turnover in postpartum anoestrous cows and cows which have resumed oestrous cycles.

Two experiments were carried out to determine the effect of a low dose of progesterone (P) with and without the addition of an injection of oestradiol benzoate (ODB) on ovarian follicle dynamics, oestradiol production and LH pulsatility in postpartum anoestrous cows, compared with cows which had resumed oestrous cycles (cycling cows). In the first experiment, anoestrous Jersey cows were treated with (AN+P, n=8) or without (AN-3, n=3) a previously used intravaginal progesterone releasing (CIDR) device for 10 days, commencing 3 or 4 days after emergence of a new dominant follicle (DF1) as determined by transrectal ultrasonography. Contemporary cycling cows (CYC+P, n=8) were similarly treated with used CIDR devices and injected with prostaglandin F(2alpha) (PGF) at the time of device insertion. Follicle turnover was monitored by daily ultrasonography and pulsatile release of LH was measured on the ninth day after device insertion. During the period of CIDR device insertion, a second dominant follicle emerged in 4/8 of the CYC+P group and 7/8 of the AN+P group (P=0.14). Maximum diameter of DF1 was greater in cows in the CYC+P compared with the AN+P group (P=0.02), but did not differ between cows in the AN+P and AN-P groups (P>0.1). Frequency of LH pulses was greater in cows in the CYC+P than AN+P group (P=0.06), and in cows in the AN+P than AN-P group (P=0.02). In the second experiment, anoestrous (n=20) and cycling (n=11) Friesian cows were treated with a new CIDR device for 6 days commencing 3 days after emergence of a new dominant follicle (DF1). Cycling cows were also injected with PGF on the day of device insertion. Half of the cows in each group were injected with 2mg ODB on the day of device insertion. Daily ultrasonography was used to monitor follicular dynamics throughout the experimental period. Follicular turnover was increased by ODB in cycling (5/5 versus 1/6; P<0.05), but not anoestrous cows (5/9 versus 4/11). Persistence of DF1 was reduced by ODB treatment in both cycling and anoestrous cows (P<0.001). Maximum diameter of DF1 was influenced by ODB treatment and reproductive status (P<0.05). In anoestrous cows in which a second dominant follicle did not emerge during the period of device insertion, the interval from emergence of DF1 to emergence of a second dominant follicle was significantly delayed by treatment with ODB (P=0.04). In conclusion, P treatment of anoestrous cows increased pulsatile release of LH, but did not induce the development of persistent follicles. Injection of ODB in association with P treatment reduced the persistence of dominant follicles in both cycling and anoestrous cows, but delayed subsequent follicular development in a proportion of anoestrous cows.

Gonadotrophin responsiveness, aromatase activity and insulin-like growth factor binding protein content of bovine ovarian follicles during the first follicular wave.

The aim of this study was to examine the function of granulosa cells and hormone concentrations in follicular fluid in bovine ovarian follicles during selection of the first dominant follicle. Ovaries were obtained from beef heifers on days 1-5 after ovulation: follicles > 4 mm in diameter were dissected and follicular fluid and granulosa cells were collected from individual follicles. Oestradiol production by granulosa cells after culture with testosterone was used to determine aromatase activity and responsiveness to gonadotrophins was determined by cAMP production after culture with FSH or LH. Concentrations of oestradiol, progesterone and insulin-like growth factor binding proteins (IGFBPs)-4 and -5 were measured in follicular fluid. Follicles were classified as largest or smaller (days 1 and 2), or dominant or subordinate (days 3-5). Aromatase activity was greater in granulosa cells from the largest follicle than in granulosa cells from smaller follicles on days 1, 3, 4 and 5 (P < 0.05). Responsiveness to LH was not detected in granulosa cells on day 1, but from day 2 to day 5 cells from the largest follicle were significantly more responsive than cells from smaller follicles (P < 0.05). Responsiveness to FSH was detected in granulosa cells from all follicles from day 1 onwards and did not differ between cells from the largest follicle or smaller follicles on any day. Follicular fluid concentrations of oestradiol and the ratio of oestradiol:progesterone were greater and concentrations of IGFBP-4 and -5 were lower in the largest follicle than in smaller follicles from day 2 to day 5 (P < 0.05). In conclusion, selection of the dominant follicle is associated with increased granulosa cell aromatase activity followed by increased cAMP response to LH and follicular fluid oestradiol concentrations, and decreased follicular fluid concentrations of IGFBP-4 and -5 within 2 days after ovulation.

Fleeting foreskins: the misclassification of male circumcision status.

BACKGROUND: Errors in the classification of male circumcision status could bias studies linking infection to lack of circumcision. GOAL: To determine the frequency and factors associated with the reproducibility of reporting circumcision status. STUDY DESIGN: Secondary analysis of data using logistic regression modeling from a multicenter randomized controlled trial was performed. RESULTS: At follow-up assessment, 15.6% of clinician reports on circumcision status disagreed with baseline reports. Disagreement was more common if both clinicians were women than if both were men (odds ratio [OR], 2.8; 95% CI, 1.9-4.1). As compared with whites reported as circumcised (4%, 19/532 visits), the highest disagreement involved uncircumcised Hispanic (OR, 3.3; 95% CI, 1.7-6.3), white (OR, 12.2; 95% CI, 5.8-25.6), or black (OR, 17.1; 95% CI, 10.4-27.9) men. CONCLUSIONS: This is one study among a small number of studies examining the reproducibility of clinician-reported circumcision status by comparing multiple clinical examinations of the same patient. The magnitude of the misclassification discovered could bias results and indicates the need for greater accuracy in reporting circumcision status in future studies.

Using intervention theory to model factors influencing behavior change. Project RESPECT.

Project RESPECT was a multisite randomized trial comparing three clinic-based interventions' ability to increase condom use and prevent infection with HIV and sexually transmitted diseases. Because Project RESPECT had guiding concepts that determined the content of the sessions, the authors investigated how the intervention operated using these theoretical variables. Growth curve analysis and structural equation modeling estimated the correlation between intentions toward condom use and self-reports of condom use and isolated the treatment effects on mediating variables--attitudes, self-efficacy, and social norms--that predict intentions. The correlations between intentions and behavior exceeded .70 for both genders, justifying the emphasis on intentions. Project RESPECT was effective through changing attitudes and self-efficacy for females in both counseling interventions. For males, only enhanced counseling had significant effects on these two mediator variables.

Supplementing treated anoestrous dairy cows with progesterone does not increase conception rates.

AIM: To determine whether conception rates of anoestrous dairy cows treated with progesterone and oestradiol benzoate (ODB) could be increased by treating them with additional progesterone following insemination at the induced oestrus. METHODS: Cows which had not been detected in oestrus for at least 21 days after calving in 18 herds were confirmed anovulatory anoestrus (AA) by veterinary examination, due to the absence of a detectable corpus luteum in the ovaries. All cows were treated with intra-vaginal progesterone (CIDR insert) for 6 days and injected with 1 mg ODB 24 h after insert removal (Day 0). Only cows which were seen in oestrus on Days 0, 1 or 2 were enrolled in the trial. These cows were either treated with a second CIDR insert on Day 8, for 7 days (P4+; n=422), or remained untreated (Control; n=756). Milk progesterone concentrations were measured in a subset of enrolled cows (n=669) on Day 8 to determine the proportion of cows that ovulated following the induced oestrus. RESULTS: Conception rates to first insemination were similar in P4+ and Control cows (40.3% and 37.2%, p=0.59). Of cows which had milk progesterone concentrations measured on Day 8, 78.6% displayed oestrus and ovulated, (range: 53.8% to 94.6% among herds). Of the cows that ovulated, conception rate to first insemination was 46.8% and 43.5% in P4+ and Control cows, respectively (p=0.86). CONCLUSION: Conception rates to first insemination in AA cows treated with progesterone and ODB were not increased by progesterone supplementation using CIDR inserts following insemination.

Reproductive performance of dairy cows not detected in oestrus but with a detectable corpus luteum, in response to treatment with progesterone, oestradiol benzoate and prostaglandin F2alpha.

AIM: To determine if the reproductive performance of dairy cows not previously detected in oestrus but with a detectable corpus luteum before the planned start of mating (PSM), could be improved by treatment with progesterone, oestradiol benzoate (ODB) and prostaglandin F2alpha (PGF). METHODS: Cows in 18 herds which had not been detected in oestrus, but which had a detectable corpus luteum present at veterinary examination 7 days prior to the PSM (Day -7), were allocated to 1 of 2 groups. Treated cows (n=232) received an injection of 2 mg ODB and an intravaginal progesterone releasing device (CIDR insert) on Day -7, and an injection of PGF on the day of insert removal 7 days later (Treated group). The Control group (n=243) remained untreated. Cows were mated to detected oestrus from Day 0, and conception dates confirmed by manual palpation or transrectal ultrasonography. RESULTS: During the first 7 days of mating, 37.4% of Control cows and 65.9% of Treated cows were inseminated on detection of oestrus (p<0.001). Pregnancy rates for this period were 20.4% and 36.3%, respectively (p=0.001). Conception rates to first insemination, pregnancy rates after 21 days of mating and at the end of the mating period were similar between groups (p>0.1). Median interval from the PSM to conception did not differ between treatment groups (24 and 23 days for Control and Treated, respectively, p>0.1). CONCLUSION: Treating postpartum dairy cows which had not previously been detected in oestrus but which had a detectable corpus luteum, with progesterone, ODB and PGF did not significantly improve their reproductive performance compared with no hormonal intervention.

Treatment of anovulatory anoestrous postpartum dairy cows with a gonadotropin-releasing hormone (GnRH), prostaglandin F2 alpha, GnRH regimen or with progesterone and oestradiol benzoate.

AIM: To compare 2 treatments for anovulatory anoestrus (AA) in postpartum dairy cows. The treatments were combinations of gonadotropin-releasing hormone (GnRH) and prostaglandin F2 (PG) or progesterone (P4) and oestradiol benzoate (ODB). METHODS: Forty AA cows from each of 5 herds were blocked by age (2 or 2 years old) and randomly assigned to 1 of 2 treatments. The first group (GPG) were treated with 250 mug of a GnRH analogue, gonadorelin, followed 7 days later by 15 mg of the PG analogue, luprostiol. Two days later the cows were injected with 250 mug of gonadorelin. Cows were artificially inseminated 16-24 h after the second GnRH injection. The second group (P4+ODB) were treated with an intravaginal P4 releasing device for 6 days, followed 24 h after device removal by injection of 1 mg of ODB. Cows were pregnancy tested 35-40 days after the initial insemination and twice again at 6-8 week intervals thereafter. RESULTS: There was no significant difference between P4+ODB and GPG groups in the percentage of cows submitted for insemination in the first 7 days (94.0% vs 100% for P4+ODB vs GPG, respectively; p>0.3), in conception rate to first insemination within the first 7 days (43.6% vs 35.0% for P4+ODB vs GPG, respectively; p>0.2), in the percentage of cows conceiving in the first 28 days of the breeding period (68.0% vs 58.3%, P4+ODB vs GPG, respectively; p>0.1), or in median interval from the end of treatment to conception (20 vs 21 days; p>0.1). CONCLUSIONS: No differences in the reproductive performance of AA cows treated with either P4+ODB or GPG were detected. However, given the small number of animals enrolled, further data are required before the GPG protocol can be recommended for treatment of AA cows.

Structure of outcome beliefs in condom use. The Project RESPECT Study Group.

To study the structure of beliefs about condom use outcomes, the authors derived and tested 4 psychosocial hypothetical models: (a) a 2-factor model of the personal and social outcomes of condom use; (b) a 2-factor model of the pros and cons of the behavior; (c) a 3-factor model (i.e., physical, self-evaluative, and social) of outcome expectancies; and (d) a thematic 4-factor model of the protection, self-concept, pleasure, and interaction implications of the behavior. All 4 models were studied with a confirmatory factor analysis approach in a multisite study of 4,638 participants, and the thematic solution was consistently the most plausible. Self-concept and pleasure were most strongly associated with attitudes toward using condoms, intentions to use condoms, and actual condom use, whereas protection and interaction generally had little influence.

A model of follicular development and ovulation in sheep and cattle.

A dynamic model to describe ovarian follicular development following commitment has been developed. It identifies follicular growth with oestradiol production and assumes that this growth is the result of intra-ovarian stimulation, gonadotrophin stimulation, and inhibitory interactions among the follicles, where larger follicles suppress the growth of the smaller follicles. The variables of the model are the levels of oestradiol in each follicle at commitment, the rate of change of oestradiol production by individual follicles during follicular development, and the level of oestradiol that will induce luteinizing hormone (LH) surge. Changes in the variables of the model could be associated with both genetic and environmental effects. The behaviour of the model is consistent with experimental observations. The model can be expanded to include exogenous follicle-stimulating hormone (FSH) administration assuming that FSH is associated with advancing the maturation of gonadotrophin-dependent follicles without affecting the number of committed follicles. The use of the model to explore FSH administration strategies is demonstrated. The model confirms that the response to FSH administration depends on both the amount of FSH and the time of administration. The largest number of double ovulations occurred when FSH was given at the time of the deviation of the dominant and subordinate follicles.

Circumcision and STD in the United States: cross sectional and cohort analyses.

BACKGROUND: Male circumcision status has been shown to be associated with sexually transmitted disease (STD) acquisition in some, but not all, studies. Most studies have been cross sectional. OBJECTIVES: We examined the association between circumcision status and the prevalence and incidence of gonorrhoea, chlamydia, and syphilis. METHODS: We analysed cross sectional and cohort study data from a multicentre controlled trial in the United States. Between July 1993 and September 1996, 2021 men visiting public inner city STD clinics in the United States were examined by a clinician at enrolment and 1456 were examined at follow up visits 6 and 12 months later. At each visit, men had laboratory tests for gonorrhoea, chlamydia, and syphilis and were examined for circumcision status. We used multiple logistic regression to compare STD risk among circumcised and uncircumcised men adjusted for potentially confounding factors. RESULTS: Uncircumcised men were significantly more likely than circumcised men to have gonorrhoea in the multivariate analyses, adjusted for age, race, and site, in both the cross sectional (odds ratio (OR), 1.3; 95% confidence interval (CI), 0.9 to 1.7) and in the cohort analysis (OR, 1.6; 95% CI, 1.0 to 2.6). There was no association between lack of circumcision and chlamydia in either the cross sectional (OR, 1.0; 95% CI 0.7-1.4) or the cohort analysis (OR, 0.9; 95% CI 0.5-1.5). The magnitude of association between lack of circumcision and syphilis was similar in the cross sectional (OR, 1.4; 95% CI 0.6 to 3.3) and cohort analysis (OR, 1.5; 95% CI 0.4 to 6.1). CONCLUSION: Uncircumcised men in the United States may be at increased risk for gonorrhoea and syphilis, but chlamydia risk appears similar in circumcised and uncircumcised men. Our results suggest that risk estimates from cross sectional studies would be similar to cohort findings.

The inter-ovarian distribution of dominant follicles is influenced by the location of the corpus luteum of pregnancy.

The objective was to characterise the distribution of dominant ovarian follicles in the early post-partum period in relation to the side of the preceding pregnancy and its relationship with the left and right ovaries. Primiparous cows were enrolled over a 2-year period (n = 33 in Year 1 and n = 28 in Year 2). Ovarian follicles were observed daily by trans-rectal ultrasonography commencing within 9 days of calving. Dominant follicles (DF) were described as occurring on the ovary ipsilateral to the CL of preceding pregnancy (ipsilateral ovary of pregnancy, IOP) or contralateral to the CL of the preceding pregnancy (contralateral ovary of pregnancy, COP), and as occurring on the left or right ovary. Results in Year 1 were analysed for the effect of breed (Friesian n = 15; Jersey n = 18). There was a bias towards the COP for the first DF post-partum in both breeds (DF1; 70%; p<0.05). A breed interaction was observed with the second DF post-partum with a bias towards the COP in the Friesian (93%; p<0.05); but not the Jersey animals (50%). In Year 2, all cows were Friesians, and there was again a biased distribution of the DF1 towards the COP (89%; p<0.05) and for the combined distribution of the first three DF post-partum (76%; p<0.05) as well as the first ovulatory follicle (71%; p<0.05). A comparison of the pooled data for the location of the DF1 from both years showed that only one DF1 was observed on a left ovary in the 29 cases where the preceding pregnancy was also on the left side. This study demonstrated a bias in the distribution of DL in the early post-partum period towards the ovary on the side opposite that of the preceding pregnancy as well as towards the right side.

Monetary versus nonmonetary incentives for TB skin test reading among drug users.

BACKGROUND: In a prior study, we reported that monetary incentives were effective in increasing return for tuberculosis (TB) skin test reading. The purpose of this study was to compare the effects of monetary versus nonmonetary incentives and a theory-based educational intervention on return for TB skin test reading in a sample of newly recruited active injection and crack cocaine users, and to determine the prevalence of TB infection in this sample. METHODS: Active injection drug and/or crack cocaine users (n = 1,078), recruited using street outreach techniques, were skin tested for TB. They were randomly assigned to 1 of 5 experimental treatment conditions: $10 cash, grocery store coupons, bus tokens/fast-food coupons, motivational education, or usual encouragement to return. Nonmonetary incentives had a $10 value, and all incentives were provided at return for skin test reading. RESULTS: Ninety-five percent of those who received $10 returned for skin test reading compared to 86% of those who received grocery store coupons and 83% of those who received either bus tokens or fast-food coupons. In contrast, only 47% of those who received the educational session and only 49% of those who received usual encouragement returned for skin test reading. The prevalence of a positive tuberculin test was 21%, and was similar for crack cocaine and injection drug users. CONCLUSIONS: Nonmonetary and monetary incentives dramatically increased the return rate for TB skin test reading among drug users who are at high risk of TB infection. Nonmonetary incentives were somewhat less effective than monetary incentives.