Ovine abortion and stillbirth investigations in Australia.

Fetal loss and lamb mortality between mid-pregnancy and weaning are important economic and welfare issues for the Australian sheep industry. The aim of this study was to determine common causes of ovine abortion and stillbirths based on submissions to veterinary laboratories and identify factors that impact the determination of an aetiological diagnosis. Data for 529 investigations on abortion or stillbirth between 2000 and 2018 were retrieved from four state veterinary laboratories in Western Australia, South Australia, Victoria and Tasmania. An aetiological diagnosis was made for 57% of investigations. Investigations that included placental tissue samples were more than twice as likely to have an aetiological diagnosis compared to investigations without placenta (P = 0.017, 95% confidence interval 1.1, 4.5). Of the investigations where an aetiological diagnosis was made, 81% involved infectious abortion, with Campylobacter spp. (32%), Listeria spp. (25%) and Toxoplasma gondii (9%) being the three most common abortigenic pathogens implicated. The remaining 19% of investigations with an aetiological diagnosis included a wide range of infectious and non-infectious diseases. Diagnoses made varied year to year and between states. No evidence of exotic abortigenic pathogens were reported. Veterinary practitioners can improve the probability of an aetiological diagnosis by emphasising to farmers the importance of collecting any aborted material, especially placenta, and appropriate storage of the tissues until they can be submitted to the laboratory. Some diseases that cause abortion in Australian sheep have zoonotic potential, and veterinary practitioners play an important role in educating clients about appropriate hygiene when handling pregnant and lambing ewes or any aborted material.

Findings in cattle consigned to Victorian knackeries between 2009 and 2018.

OBJECTIVE: To describe the causes of death or culling in cattle in Victoria, Australia, through surveillance at knackeries. METHODS: Data were collected from 2797 adult cattle consigned to four Victorian knackeries over a 10-year period (2009-2018, inclusive). Cattle were sampled either at the point of collection or at a knackery. A single best-fit diagnosis was assigned to each case to describe the cause of loss. RESULTS: Sampled cattle were predominantly female dairy cattle originating from the three main dairying regions in Victoria. The most commonly diagnosed conditions were calving paralysis (6.8%), followed by mastitis (6.4%), hypocalcaemia (6.4%) and dystocia (5.9%). "Unknown" accounted for 24.2% of the cattle examined. CONCLUSION: This study provides a unique insight into the causes of death and culling in cattle consigned to Victorian knackeries. The periparturient period was identified as a high risk period for knackery consignment in adult female cattle.

Suboptimal outcomes in patients with PKU treated early with diet alone: revisiting the evidence.

BACKGROUND: The National Institute of Health (NIH) published a Consensus Statement on the screening and management of Phenylketonuria (PKU) in 2000. The panel involved in the development of this consensus statement acknowledged the lack of data regarding the potential for more subtle suboptimal outcomes and the need for further research into treatment options. In subsequent years, the approval of new treatment options for PKU and outcome data for patients treated from the newborn period by dietary therapy alone have become available. We hypothesized that a review of the PKU literature since 2000 would provide further evidence related to neurocognitive, psychosocial, and physical outcomes that could serve as a basis for reassessment of the 2000 NIH Consensus Statement. METHODS: A systematic review of literature residing in PubMed, Scopus and PsychInfo was performed in order to assess the outcome data over the last decade in diet-alone early-treated PKU patients to assess the need for new recommendations and validity of older recommendations in light of new evidence. RESULTS: The majority of publications (140/150) that contained primary outcome data presented at least one suboptimal outcome compared to control groups or standardized norms/reference values in at least one of the following areas: neurocognitive/psychosocial (N=60; 58 reporting suboptimal outcomes); quality of life (N=6; 4 reporting suboptimal outcomes); brain pathology (N=32; 30 reporting suboptimal outcomes); growth/nutrition (N=34; 29 reporting suboptimal outcomes); bone pathology (N=9; 9 reporting suboptimal outcomes); and/or maternal PKU (N=19; 19 reporting suboptimal outcomes). CONCLUSIONS: Despite the remarkable success of public health programs that have instituted newborn screening and early introduction of dietary therapy for PKU, there is a growing body of evidence that suggests that neurocognitive, psychosocial, quality of life, growth, nutrition, bone pathology and maternal PKU outcomes are suboptimal. The time may be right for revisiting the 2000 NIH Consensus Statement in order to address a number of important issues related to PKU management, including treatment advancements for metabolic control in PKU, blood Phe variability, neurocognitive and psychological assessments, routine screening measures for nutritional biomarkers, and bone pathology.

The effective life of ivermectin on Western Australian sheep farms--a survival analysis.

A mail survey of 235 Western Australian sheep farmers who had performed faecal egg count reduction tests for anthelmintic resistance in 1999 or 2000 was conducted, with some telephone follow-up. A response of 56% was achieved. Resistance to ivermectin, a member of the macrocyclic lactone class of anthelmintics, had developed on 44% of the farms surveyed. We used time to occurrence of resistance to ascertain factors that contributed to extending the time ivermectin remained an effective drench on these farms (median time=10.5 years). This time was significantly longer when farmers implemented more worm control practices on their farms (P=0.003). We developed a multivariable survival model that contained the following main effects: reduced winter drenching frequency, 0-2 flock treatments in 5 years (hazard ratio (HR) 0.52); availability of alternative effective anthelmintic classes on the farm (HR 0.30); always using safe pastures (HR 0.23); and veterinarians as the primary source of worm control advice (HR 0.58). The relationship of these findings to the understanding of anthelmintic resistance is discussed.

Sheep-farm risk factors for ivermectin resistance in Ostertagia circumcincta in Western Australia.

On-farm risk factors associated with ivermectin resistance on sheep farms in Western Australia were identified from data derived from a postal survey of 235 farmers who had conducted a fecal egg-count-reduction test in 1999, 2000, or both years. A response of 54% was achieved. We developed a logistic-regression model. Contributory main effects in the final model were selling 10% more sheep in 2000 than is the usual policy (OR = 4.00), farm purchased since 1975 (OR = 2.34), and number of winter flock anthelmintic treatments in the previous 5 years (OR = 1.04). A secondary logistic-regression model assessed risk factors for farms selling 10% more sheep than usual in 2000; these farmers appeared less committed to their sheep enterprises than other farmers. These results are discussed in relation to current hypotheses of anthelmintic resistance. This is the first time that the farmer's management of the flock has been implicated in the development of anthelmintic resistance.

Protective immunogenicity of Haemophilus influenzae type b polysaccharide-tetanus protein conjugate vaccine in children who failed to respond to prior invasive H. influenzae type b disease.

UNLABELLED: A polyribosylribitol phosphate (polysaccharide)-tetanus protein conjugate vaccine (PRP-T) against Haemophilus influenzae type b (Hib) was evaluated for protective immunogenicity in 25 previously PRP-unimmunized children who had failed to develop protective PRP antibody levels (< 1 microg/ml) after prior invasive Hib disease at median age 10 months. Children under 21 months of age at time of PRP-T immunization received one, two or three doses. Serum was obtained for total PRP antibody, complement mediated bactericidal activity and specific IgG1 and IgG2 PRP antibodies before (n = 25), 1 to 2 months (n = 24) and > 5 months (n = 13) after completed vaccination. One to 2 months after immunization, all but one patient developed > 1 microg/ml of antibody (geometric mean level 50.7 microg/ ml). The non-responder developed protective antibody levels when tested at 6 months after vaccination. Twenty out of 22 sera had detectable complement mediated bactericidal activity (median dilution titer 1:24), 1-2 months after vaccination. Three patients failed to demonstrate PRP antibodies in the IgG1 or IgG2 subclasses, although two of them had protective (> 1 microg/ml) total antibody levels. The second post immunization sera showed persistence of the total PRP antibody levels (geometric mean level 38.2 microg/ml) as well as of the bactericidal activity (median dilution titer 1:32). CONCLUSION: PRP-T conjugate vaccine is able to elicit a protective immune response in children who have low or unmeasurable PRP antibody levels after a systemic Hib infection.

EMS Agenda for the Future: where we are...where we want to be.

During the past 30 years, emergency medical services (EMS) in the United States have experienced explosive growth. The American health care system is now transforming, providing an opportune time to examine what we have learned over the past three decades in order to create a vision for the future of EMS. Over the course of several months, a multidisciplinary steering committee collaborated with hundreds of EMS-interested individuals, organizations, and agencies to develop the EMS Agenda for the Future. Fourteen EMS attributes were identified as requiring continued development in order to realize the vision established within the Agenda. They are integration of health services, EMS research, legislation and regulation, system finance, human resources, medical direction, education systems, public education, prevention, public access, communication systems, clinical care, information systems, and evaluation. Discussion of these attributes provides important guidance for achieving a vision for the future of EMS that emphasizes its critical role in American health care.

Resident perspectives of EMS as a subspecialty.

OBJECTIVE: Emergency medical services (EMS) is frequently considered to be a subspecialty of emergency medicine (EM) despite the unavailability of subspecialty certification. An assessment of future interest in EMS subspecialization and the perceived educational needs of potential EMS physicians was performed in order to provide data to leaders responsible for development of this subspecialty area. METHODS: A survey concerning EMS subspecialization issues was distributed to 2,464 members of the Emergency Medicine Residents Association (EMRA). Questions addressed demographic information, interest in EMS, educational issues, and desired credentials. The response rate was 30% (n = 737). All surveys were analyzed by the Pearson chi-square probability and Mantel-Haenszel tests for linear association. RESULTS: A moderate to very high interest in EMS medical direction was expressed by 84% of the respondents, with 14% interested in full-time EMS positions. This interest increased with years of training (p < 0.0001). Almost 89% believed that EMS physicians should have special preparations prior to practice beyond EM residency training. Fewer than half (44%) thought that an EM residency provided sufficient preparation for a significant role in EMS, and this perception increased in intensity with years of training (p < 0.0052). Interest in EMS fellowships (24%) would increase to 36% if subspecialty certification were available (p < 0.0001). Thirty-nine percent believed subcertification should be required of all EMS medical directors if available. CONCLUSIONS: Many EM residents have an interest in active participation in EMS on either a part-time or a full-time basis. Most respondents think EMS is a unique area requiring focused education beyond an EM residency. Interest in EMS fellowships would greatly increase if subspecialty certification were available.

Effect of substrate roughness on D spacing supports theoretical resolution of vapor pressure paradox.

The lamellar D spacing has been measured for oriented stacks of lecithin bilayers prepared on a variety of solid substrates and hydrated from the vapor. We find that, when the bilayers are in the L(alpha) phase near 100% relative humidity, the D spacing is consistently larger when the substrate is rougher than when it is smooth. The differences become smaller as the relative humidity is decreased to 80% and negligible differences are seen in the L(beta') phase. Our interpretation is that rough substrates frustrate the bilayer stack energetically, thereby increasing the fluctuations, the fluctuational repulsive forces, and the water spacing compared with stacks on smooth surfaces. This interpretation is consistent with and provides experimental support for a recently proposed theoretical resolution of the vapor pressure paradox.

EMS agenda for the future: where we are ... where we want to be. EMS Agenda for the Future Steering Committee.

During the past 30 years, emergency medical services (EMS) in the United States have experienced explosive growth. The American health care system is now transforming, providing an opportune time to examine what we have learned over the past three decades in order to create a vision for the future of EMS. Over the course of several months, a multidisciplinary steering committee collaborated with hundreds of EMS-interested individuals, organizations, and agencies to develop the "EMS Agenda for the Future." Fourteen EMS attributes were identified as requiring continued development in order to realize the vision established within the Agenda. They are Integration of Health Services, EMS Research, Legislation and Regulation, System Finance, Human Resources, Medical Direction, Education Systems, Public Education, Prevention, Public Access, Communication Systems, Clinical Care, Information Systems, and Evaluation. Discussion of these attributes provides important guidance for achieving a vision for the future of EMS that emphasizes its critical role in American health care.

Locomotion on the water surface: propulsive mechanisms of the fisher spider

Using kinematic and mechanical experiments, we have shown how fisher spiders, Dolomedes triton (Araneae, Pisauridae), can generate horizontal propulsive forces using their legs. This horizontal thrust is provided primarily by the drag of the leg and its associated dimple as both move across the water surface. Less important sources of resistance are surface tension and bow waves. The relative contributions of drag, surface tension and bow waves were examined in several different ways. In one experiment, we measured the forces acting on a leg segment as water flowed past it in non-turbulent flow; the bow wave was not present at leg relative velocities below 0.2ms-1 and thus cannot play a role in thrust production at low leg speeds. In a second experiment, we varied the surface tension by altering the concentration of ethanol from 0% to 9% in the experimental water tank. At a constant dimple depth, force varied little with changes in surface tension, a result consistent with the hypothesis that drag is the primary source of resistance. In addition, however, as surface tension decreased from 0.072 to 0.064Nm-1, the power exponent of the relationship between force and velocity (as measured by the exponent of the power function relating the two variables) increased; at lower surface tensions, down to 0.054Nm-1, the power exponent of the relationship between force and velocity decreased. These results suggest an influence of surface tension (albeit still secondary to drag) in generating horizontal resistance to leg movement. We also measured flow disturbance in the water downstream from a leg segment and confirmed that, even at velocities well below 0.2ms-1, the leg-cum-dimple transferred momentum to the water, which is a clear indication that drag is a contributor to the resistance encountered by a spider's leg. Finally, modeling the leg-cum-dimple as a circular cylinder generates values of drag that account for 75­98% of the measured leg force when the dimple is 0 or 1mm deep. These results not only elucidate the primary mechanism of propulsion for D. triton and other similar-sized arthropods, such as adult water striders (Gerridae), but also suggest that the formerly enigmatic locomotion of very small water-walking organisms (e.g. first-instar water striders) can be understood in the same way.

Structure of gel phase saturated lecithin bilayers: temperature and chain length dependence.

Systematic low-angle and wide-angle x-ray scattering studies have been performed on fully hydrated unoriented multilamamellar vesicles of saturated lecithins with even chain lengths N = 16, 18, 20, 22, and 24 as a function of temperature T in the normal gel (L beta') phase. For all N, the area per chain Ac increases linearly with T with an average slope dAc/dT = 0.027 A2/degree C, and the lamellar D-spacings also increase linearly with an average slope dD/dT = 0.040 A/degree C. At the same T, longer chain length lecithins have more densely packed chains, i.e., smaller Ac's, than shorter chain lengths. The chain packing of longer chain lengths is found to be more distorted from hexagonal packing than that of smaller N, and the distortion epsilon of all N approaches the same value at the respective transition temperatures. The thermal volume expansion of these lipids is accounted for by the expansion in the hydrocarbon chain region. Electron density profiles are constructed using four orders of low-angle lamellar peaks. These show that most of the increase in D with increasing T is due to thickening of the bilayers that is consistent with a decrease in tilt angle theta and with little change in water spacing with either T or N. Because of the opposing effects of temperature on area per chain Ac and tilt angle 0, the area expansivity alpha A is quite small. A qualitative theoretical model based on competing head and chain interactions accounts for our results.

Structure of the ripple phase in lecithin bilayers.

The phases of the x-ray form factors are derived for the ripple (Pbeta') thermodynamic phase in the lecithin bilayer system. By combining these phases with experimental intensity data, the electron density map of the ripple phase of dimyristoyl-phosphatidylcholine is constructed. The phases are derived by fitting the intensity data to two-dimensional electron density models, which are created by convolving an asymmetric triangular ripple profile with a transbilayer electron density profile. The robustness of the model method is indicated by the result that many different models of the transbilayer profile yield essentially the same phases, except for the weaker, purely ripple (0,k) peaks. Even with this residual ambiguity, the ripple profile is well determined, resulting in 19 angstroms for the ripple amplitude and 10 degrees and 26 degrees for the slopes of the major and the minor sides, respectively. Estimates for the bilayer head-head spacings show that the major side of the ripple is consistent with gel-like structure, and the minor side appears to be thinner with lower electron density.

X-ray structure determination of fully hydrated L alpha phase dipalmitoylphosphatidylcholine bilayers.

Bilayer form factors obtained from x-ray scattering data taken with high instrumental resolution are reported for multilamellar vesicles of L alpha phase lipid bilayers of dipalmitoylphosphatidylcholine at 50 degrees C under varying osmotic pressure. Artifacts in the magnitudes of the form factors due to liquid crystalline fluctuations have been eliminated by using modified Caillé theory. The Caillé fluctuation parameter eta 1 increases systematically with increasing lamellar D spacing and this explains why some higher order peaks are unobservable for the larger D spacings. The corrected form factors fall on one smooth continuous transform F(q); this shows that the bilayer does not change shape as D decreases from 67.2 A (fully hydrated) to 60.9 A. The distance between headgroup peaks is obtained from Fourier reconstruction of samples with four orders of diffraction and from electron density models that use 38 independent form factors. By combining these results with previous gel phase results, area AF per lipid molecule and other structural quantities are obtained for the fluid L alpha phase. Comparison with results that we derived from previous neutron diffraction data is excellent, and we conclude from diffraction studies that AF = 62.9 +/- 1.3 A2, which is in excellent agreement with a previous estimate from NMR data.

Anomalous phase behavior of long chain saturated lecithin bilayers.

X-ray scattering has been performed on fully hydrated unoriented multilamellar vesicles of lecithins with even chain lengths n from 16 to 24 as a function of temperature in chain ordered phases. The longer chain lengths, n > or = 20, show anomalous behavior compared to the shorter chain lengths, n < 20. This report concentrates on n = 24. Although the history and time dependence shows that equilibrium was not always achieved, it appears that there is a second gel-like phase G2 below 40 degrees C. The G2 phase has a small tilt angle and opposite hexagonal symmetry breaking from the usual G1 gel phase. Also, as T is raised above 45 degrees C, the wide-angle data suggest the appearance of a phase with hexagonal chain packing and small chain tilt angle.

Small-angle x-ray scattering from lipid bilayers is well described by modified Caillé theory but not by paracrystalline theory.

X-ray scattering data at high instrumental resolution are reported for multilamellar vesicles of L alpha phase lipid bilayers of 1,2-dipalmitoyl-sn-glycero-3-phosphatidylcholine at 50 degrees C under varying osmotic pressure. The data are fitted to two theories that account for noncrystalline disorder, paracrystalline theory (PT) and modified Caillé theory (MCT). The MCT provides good fits to the data, much better than the PT fits. The particularly important characteristic of MCT is the long power law tails in the scattering. PT fits (as well as ordinary integration with no attempt to account for the noncrystalline disorder) increasingly underestimate this scattering intensity as the order h increases, thereby underestimating the form factors used to obtain electron density profiles.

Kinetics of subgel formation in DPPC: X-ray diffraction proves nucleation-growth hypothesis.

Wide-angle and low-angle X-ray diffraction data were obtained during the time course of the gel to subgel phase transformation in fully hydrated DPPC. When the system was kept close to equilibrium by following a T-jump protocol, the X-ray data unequivocally demonstrate the coexistence of growing subgel and shrinking gel domains. When the system was supercooled and held further from equilibrium as in previous studies, the kinetic behavior was more complicated. These data prove that the basic mechanism for the gel to subgel phase transformation is one of nucleation of subgel domains followed by growth of the domains.