Effects of flow-controlled vacuum on milking performance and teat condition in a rotary milking parlor.

The objective of this study was to compare a vacuum control system that increases milking system vacuum during the peak flow period of milking to conventional constant vacuum control technology regarding its effect on milk flowrate and milking duration. Further objectives were to study the effects of flow-controlled vacuum on milking parlor performance. An observational study was conducted on a commercial dairy farm milking from 848 to 896 cows per day over the study period using a 60-stall rotary milking parlor. The flow-controlled vacuum control system was applied for 3 wk. Milking performance and teat condition were compared with 3-wk periods prior and subsequent to the test period using conventional vacuum control. Statistical analysis was performed assuming a cross-sectional study design during each period. Flow-controlled vacuum increased peak milk flowrate by 12% and increased average milk flowrate by 4%. The decrease in individual cow milking duration was proportional to milk yield per milking. Postmilking teat condition was good during the entire study period. The occurrence of rough teat ends was slightly reduced during the flow-controlled vacuum period with no meaningful difference in the occurrence of teats with blue color, palpable rings, or petechia. The combination of reduced vacuum during the low flow period of milking and the decrease in milking duration are likely factors that are protective of teat tissues. Bioeconomic modeling of the use of flow-controlled vacuum on the performance of rotary milking parlors, using the data that were collected during the study, showed that the reduction in milking duration of individual cows allows a higher rotary parlor speed. Modeled parlor throughput increased by 5.0% to 419 cows/h, 6.8% to 407 cows/h, and 4.2% to 326 cows/h when 80%, 95%, and 99% of the cows were finished milking at the end of the rotation for a 60-stall parlor. Model results showed that increased parlor throughput resulted in increased labor efficiency, reduced labor costs for milking, and a positive benefit-cost ratio on the investment for all but the smallest herd and parlor sizes considered.

Towards blood flow in the virtual human: efficient self-coupling of HemeLB.

Many scientific and medical researchers are working towards the creation of a virtual human-a personalized digital copy of an individual-that will assist in a patient's diagnosis, treatment and recovery. The complex nature of living systems means that the development of this remains a major challenge. We describe progress in enabling the HemeLB lattice Boltzmann code to simulate 3D macroscopic blood flow on a full human scale. Significant developments in memory management and load balancing allow near linear scaling performance of the code on hundreds of thousands of computer cores. Integral to the construction of a virtual human, we also outline the implementation of a self-coupling strategy for HemeLB. This allows simultaneous simulation of arterial and venous vascular trees based on human-specific geometries.

[Child sexual abuse: Description of a French population having consulted in a forensic medical service between 2011 and 2015]. / Agressions sexuelles sur mineurs : étude d'une population d'enfants ayant consulté dans une unité médico-judiciaire hospitalière entre 2011 et 2015.

BACKGROUND: When child sexual abuse (CSA) is suspected, the detection of anogenital anomalies is rare. In France, since 2011, most clinical examinations of children for whom CSA is suspected take place in the forensic medical service (FMS). OBJECTIVES: To describe a population of children examined for suspected CSA in the FMS of the Nancy Regional University Hospital Center. PATIENTS AND METHODS: Children under the age of 18 who consulted for suspected CSA in the Nancy FMS between 2011 and 2015 were included. Demographic data as well as data from questioning, the physical examination, any further examination, and the medical conclusions were collected. RESULTS: Three hundred and twenty-five girls and 79 boys were enrolled. The average age at the time the abuse was committed was 118.9 months. Two hundred sixty-nine (66.6%) children alleged fondling and 59 (14.6%) fellatio. Two hundred twelve victims (52.5%) described a penetration, 163 (76.9%) in the vagina and 73 (34.4%) in the anus. Significant bruises were found at the examination of 13 children, accounting for 2.5% of all victims. Thirty-four (11.7%) girls had lesions in the external genitalia and 28 (9.8%) lesions of the virginal membrane. One boy (1.3%) had a nonspecific lesion of the external genitalia. Six (8.2%) children alleging anal penetrations showed injury. The examiner concluded that clinical examinations were compatible with alleged facts for 253 (62.6%) victims. It was impossible to conclude for 116 (28.7%) children. CONCLUSION: In the case of suspected CSA, the clinical examination is frequently normal. This examination must be performed by physicians trained in child abuse, under appropriate conditions. It is important not to jump to conclusions about the reality of the alleged facts. A multidisciplinary approach, with the cooperation of the medical, social, and forensics sector is necessary.

The pharmacological control of neuronal excitability in the retinal spreading depression model of migraine.

Spreading Depression is the underlying patho physiological mechanism for the neurological symptoms of migraine aura and is thought to play a major role in triggering migraine. Therefore it seems reasonable to use the Spreading Depression as a pharmacological tool for anti migraine drugs. Drugs that are able to alter parameters of Spreading Depression should also influence appearance and course of migraine attacks. Concerning the classification on the different mechanisms of drug action, especially the retinal Spreading Depression is useful, due to the separation of vascular and neuronal effects. In this study we investigated substances from different classes of common anti migraine drugs on different parameters of the retinal spreading depression. The results are discussed according to the classification of the drug.

Demonstration of the metaphylactic use of gamithromycin against bacterial pathogens associated with bovine respiratory disease in a multicentre farm trial.

On five commercial cattle rearing sites across Europe, a total of 802 young cattle at high risk of developing bovine respiratory disease (BRD) associated with the bacterial pathogens Mannheimia haemolytica or Pasteurella multocida and/or Mycoplasma bovis were enrolled into a multicentre, controlled field trial. Half were treated with a single dose of gamithromycin at 6 mg/kg bodyweight by subcutaneous injection and half received an injection of a saline placebo as the control. All animals were observed daily for 14 days for signs of BRD as defined by set criteria. The proportion of metaphylactic preventive treatment successes, defined as animals surviving to day 14 without signs of BRD, in the gamithromycin-treated group (86 per cent) was significantly (P=0.0012) higher than in the saline-treated controls (61 per cent). Morbidity among the treated animals was reduced by 64 per cent compared with the controls.

Anaerobic Work Capacity derived from isokinetic and isoinertial cycling.

The purpose of this study was to compare Anaerobic Work Capacity (AWC) measured on an isoinertial or an isokinetic bicycle ergometer. Twelve male participants completed two randomly ordered exercise testing sessions including a torque-velocity test followed by a 30-s all-out test on an isokinetic ergometer, or a force-velocity test followed by a Wingate Anaerobic Test on an isoinertial ergometer. Optimal load measured during the force-velocity test on the isoinertial ergometer was 1.13+/-0.11 N.kg(-1). Optimal cadence measured during the torque-velocity test on the isokinetic ergometer was 107+/-13 rpm. Although P(peak) measures were significantly correlated (r=0.77), we found a large difference between them (effect size=2.85) together with wide limits of agreement (bias+/-95%LOA=24+/-12%). The same observation was made with P(mean), but with a smaller magnitude of difference (bias+/-95%LOA=4.2+/-12%; effect size=0.51; r=0.73). This lack of agreement led us to the conclusion that AWC measures obtained during 30-s all-out tests performed on an isoinertial or an isokinetic bicycle ergometer are not necessarily similar and cannot be used interchangeably.

Microgravity dependence of excitable biological and physicochemical media.

Neuronal tissue and especially the central nervous system (CNS) is an excitable medium. Self-organisation, pattern formation, and propagating excitation waves as typical characteristics in excitable media consequently have been found in neuronal tissue. The properties of such phenomena in excitable media do critically depend on the parameters (i.e., electromagnetic fields, temperature, chemical drugs) of the system and on small external forces to which gravity belongs. The spreading depression, a propagating excitation depression wave of neuronal activity, is one of the best described of the those wave phenomena in the CNS. Especially in the retina as a true part of the CNS it can be easily observed with optical techniques due to the high intrinsic optical signal of this tissue. Another of such waves in neuronal tissue is the propagating action potential in nerve fibres. In this paper, data from our laboratories concerning the influence of gravity on the velocity of propagating waves in excitable media are summarized mainly in terms of the retinal spreading depression and propagating action potentials. Additionally, we have used waves in gels of the Belousov-Zhabotinsky reaction as the physicochemical model system of biological activity as the properties of these waves follow the same theories as the spreading depression and action potentials and they have some striking similarities in wave behavior. Thus propagating Belousov-Zhabotinsky waves are described by their gravity dependence.

The mouse Fgfrl1 gene coding for a novel FGF receptor-like protein.

The mouse Fgfrl1 gene codes for a novel cell surface protein that is closely related to the family of the FGF receptors. It contains three extracellular Ig C2 loops and an acidic box, which share 29-33% sequence identity (48-50% similarity) with FGF receptors 1-4. The intracellular portion of the novel protein, however, lacks a tyrosine kinase domain required for signal transduction by transphosphorylation. The gene for Fgfrl1 comprises six exons and is located on mouse chromosome 5 in close proximity to the Idua gene for L-iduronidase.

[A new combined surgical interventional method for univentricular palliation of congenital heart defects]. / Eine neue kombinierte chirurgisch-interventionelle Methode zur univentrikulären Palliation angeborener Herzfehler.

UNLABELLED: Total cavo-pulmonary anastomosis is frequently performed to palliate patients with a broad variety of congenital heart defects with functionally univentricular hearts precluding biventricular circulation. In patients with risk factors for primary repair a stepwise approach is frequently chosen with initial creation of an aorto-pulmonary shunt followed by a Glenn anastomosis or hemifontan procedure. Finally a total cavo-pulmonary connection is completed surgically. The aim of this feasibility study was to develop a combined surgical-interventional approach for creation of a total cavo-pulmonary anastomosis which reduces the number of surgical interventions, precludes extracorporeal circulation and intracardiac sutures, putting the patients at risk for subsequent rhythm disturbances. METHODS: A Glenn anastomosis was created in 10 sheep without cardio-pulmonary bypass. The superior vena cava was banded superior to the cavo-atrial junction leaving a minimal lumen for subsequent interventional balloon dilatation and implantation of a stent graft. A 15 mm Gore-Tex tube was sutured around the inferior vena cava intrapericardially to provide resistance for subsequent interventional stent implantation. Total cavo-pulmonary anastomosis was completed interventionally by dilating the banded vena cava superior and connection of the inferior vena cava to the superior vena cava by implanting an Aneurx covered stent graft. RESULTS: All animals survived the combined surgical-interventional procedure. Stent deployment was possible without causing obstruction to the hepatic veins. Neither stent dislocation nor rhythm disturbances were encountered. CONCLUSIONS: Total cavo-pulmonary anastomosis can be achieved without intracardiac sutures and cardio-pulmonary bypass by use of a combined surgical-interventional approach using the Aneurx covered stent graft.

Control of the excitability of neuronal tissue by weak external forces.

The spreading depression (SD) is a pronounced example of excitation-depression waves in excitable media, to which neuronal tissue according to its structure and functions belongs. SD waves can especially easily be observed in the vertebrate retina which is neuronal tissue and a true part of the central nervous system (CNS). According to the high intrinsic optical signal (IOS) concomitant with the retinal spreading depression (rSD), it can be monitored with standard video imaging techniques, thus the retina has been used in our studies as a suitable model system for neuronal tissue in general. In particular, the control of wave set-up and propagation in excitable media by weak external forces is of high interest. Accordingly, the interaction of rSD waves with DC and AC electromagnetic fields of low amplitude and frequency and with gravity has been investigated in this study. The dependence of rSD-wave propagation velocity on the given parameters as one important indication of excitability control has been investigated in detail. Our results with rSD waves are partially compared to another well known excitable medium, the Belousov-Zhabotinsky reaction, where some data about the effects of electrical fields and gravity have already been published.

Characterization of a novel protein (FGFRL1) from human cartilage related to FGF receptors.

Utilizing a subtractive cDNA cloning approach we have identified a novel protein from human cartilage. This protein represents an integral membrane protein with 504 amino acids and a molecular mass of 55 kDa. It is composed of a signal peptide, three extracellular Ig-like modules, a transmembrane segment, and a short intracellular domain. The extracellular domain is closely related to the extracellular domain of FGF receptors. The intracellular domain, however, does not show any similarity to the protein tyrosine kinase domain of FGF receptors. The novel gene (FGFRL1) is located on human chromosome 4 band p16 in close proximity to the gene for FGFR3. Its mRNA is preferentially expressed in cartilaginous tissues. Owing to the structural similarity, it is conceivable that the novel protein plays a role in the modulation of FGF receptor activity.

Lubeluzole shows neuroprotective effects in an "in-vitro"-model for neuronal lesions in the chicken retina.

In this study, the isolated chicken retina was used as an "in-vitro"-model for investigation of neuronal lesions to show the neuroprotective effects of lubeluzole. Lubeluzole is a neuroprotective compound that has been shown to stereoselectively rescue sensorimotor function and reduce infarct size in photochemical stroke models in rats. In the retina, the typical cell swelling of a developing lesion is accompanied by a very strong intrinsic optical signal (IOS), occurring simultaneous with the electrical signal which is based on changes in light scattering. In the presented model, lesions were elicited electrically with a tungsten microelectrode (0.1 MOmega). The degree of damage was evaluated with optical methods by measuring area and brightness of the affected tissue. Lubeluzole was much more effective in reducing the growth of the lesions than its R-isomer. However, both compounds enhanced the possibility of the neuronal tissue to recover after excitotoxic stimuli.

Healthcare systems--an international review: an overview.

Based on the source of their funding, three main models of healthcare can be distinguished. The first is the Beveridge model, which is based on taxation and has many public providers. The second is the Bismarck 'mixed' model, funded by a premium-financed social insurance system and with a mixture of public and private providers. Finally, the 'Private Insurance model' is only in existence in the US. The present report explores the impact of these healthcare models on the access to, quality and cost of healthcare in selected European countries. Access is nearly 100% in countries with a public provider system, while in most of the 'mixed' countries, the difference from 100% is made up by supplementary private insurance. No differences are seen between public and mixed provider systems in terms of quality of care, despite the fact that the countries with the former model spend, in general, less of their Gross National Product on healthcare. The Private Insurance/private provider model of the US produces the highest costs, but is lowest in access and is close to lowest ranking in quality parameters.

Healthcare systems and end-stage renal disease (ESRD) therapies--an international review: costs and reimbursement/funding of ESRD therapies.

BACKGROUND: In healthcare economics, the cost factor plays a leading role, particularly for chronic diseases such as end-stage renal disease because of the growing number of patients. OBJECTIVES: An international comparison was made of the costs and reimbursement/funding of a selection of key dialysis modalities--centre haemodialysis (CHD), limited care haemodialysis (LCHD), home haemodialysis (home HD), continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD)--in various industrial countries. The focus was on treatment costs plus erythropoietin medication and reimbursement of transportation costs. RESULTS: Reimbursement/funding of dialysis is different from country to country, with some healthcare system-specific commonalities: in 'public' systems, the funding is based more on global budgets, whereas in mixed public and private countries it is based mainly on reimbursement rates per treatment. Only in the 'private system' of the US is there one DRG (diagnostic-related group)-type rate for dialysis. By comparing the costs (in public countries) or reimbursements (in mixed countries) of treatment modalities within each country, we could see similar curves: the costs were the highest for public CHD, followed by private CHD. They were lower on LCHD and the lowest for home HD and CAPD, which were at nearly the same level. The cost level for APD was almost the same as that of LCHD. The reimbursements followed the cost pattern. Some countries introduced increases for CAPD and APD with the intention of increasing the share of home care. The costs and reimbursement patterns in the majority of countries (except the US and Japan) were very similar and therefore did not explain the different distribution of modalities in these countries. One explanation could be, however, the difference in microeconomics, CHD being a treatment with high fixed costs (personnel and structure) and CAPD being a treatment with low fixed costs, but high variable costs (supplies) and a low need for investments. DISCUSSION: The choice of treatment modality seems to be influenced strongly by the provider's perspective, being either public with limited HD capacity or private having invested in HD capacity. For public providers (and healthcare payers), CAPD is less expensive than CHD and offers a number of potential savings. In many countries, two CAPD patients could be treated for the same costs as one CHD patient. The microeconomics of private centres, however, are meant to use the investments maximally for CHD. Only if capacity limits are reached, is PD, with mainly supply costs, interesting. The future with constantly increasing numbers of patients and growing cost constraints will force all providers to make the best use of their resources by also offering home therapies such as PD to patients. The latter are cost efficient and offer comparable survival and quality of life.

Biphasic effects of melatonin on the propagation of excitation waves in the chicken retina.

The retinal spreading depression (SD) is a propagating wave in an excitable medium, the neuronal tissue of the retina. Its velocity is about 3 mm/min and it is accompanied by a variety of changes in the tissue, including electrical and optical events. The pronounced intrinsic optical signal (IOS) of the retinal SD makes it an extremely versatile tool for the investigation of the action of drugs on neuronal tissue and more specific on propagating excitation waves in neuronal tissue. Furthermore, in the last decade increasing evidence has been collected, which shows that SD waves are the basic mechanism of the aura in classical migraine. We have investigated the influence of melatonin on the propagation of retinal SD waves as it has been postulated to have protective effects on neuronal tissue. The results demonstrate that melatonin indeed slows down the retinal SD, however, only in a defined concentration range. Additionally, it changes the IOS of the wave.

Beta blockers: evidence versus wishful thinking.

Catecholamines and ischemia play an important role in the induction of ventricular tachyarrhythmias. Beta blockers antagonize the effect of catecholamines and have anti-ischemic properties. Several controlled studies performed in the early 1980s in patients after myocardial infarction have shown that beta-blocker therapy clearly decreases sudden and nonsudden cardiac death. Despite the lack of recent randomized trials, data from uncontrolled studies suggest that the beneficial effect of beta blockers is still present in the thrombolytic era. Thus, it is incomprehensible that today in the United States and in most parts of Europe, < 40% of post-myocardial infarction patients are treated with beta blockers. Even in patients with documented sustained ventricular tachycardias (VTs) or ventricular fibrillation (VF), clinical studies indicate that beta blockers improve survival. Thus, even in the thrombolytic era, beta blockers should be used as a basic therapy in patients who are at risk of sudden cardiac death.

Molecular cloning of avian matrix Gla protein.

Matrix Gla protein plays an essential role in preventing the calcification of blood vessel walls, cartilage and other tissues. We report here the primary structure of chicken matrix Gla protein as deduced from the cDNA sequence. The avian protein exhibited the characteristic motifs previously identified in the mammalian proteins, but its amino acid sequence shared only 51-56% identity with the latter proteins. Moreover, a region proposed to function as binding site for gamma-carboxylase in the mammalian proteins was poorly conserved in the chicken protein. Our sequence data should be helpful in the design of mutational analyses which are intended to characterize functional interactions of matrix Gla proteins with other proteins.

End-stage renal disease treatment: a European perspective.

There is presently much debate about the optimal flow chart of pre-end-stage renal disease (ESRD) and ESRD patients. This article summarizes two important nonmedical factors that affect the outcome of ESRD patients in Europe: late referral and the structure of the health care system. In a European survey, 30% of patients were referred to a nephrologist less than 1 mo before the start of renal replacement therapy (RRT). This had an impact on the modality choice, as 77.5% of late versus 51.1% of early referrals were started on hemodialysis. Hospitalization at start of RRT was longer in late versus early referrals (15.1 +/- 16.0 versus 27.8 +/- 23.7 d respectively, P < 0.001). There were more patients without antihypertensive medication in the late referral group (28.6% versus 15.5%, P = 0.004), and diastolic BP in this group was higher (83.5 +/- 15.8 versus 74.4 +/- 15.0 mmHg, P = 0.03). One year after the start of dialysis, the number of deaths in the late referrals was higher (26.7 versus 16.4%, P = 0.07) and the number of transplanted patients was lower (4.7 versus 17.5%, P = 0.02). Creatinine clearance at start of RRT was 7.0 +/- 3.5 ml/min in the patients who died during the first year after start of RRT versus 9.5 +/- 3.6 ml/min in those surviving. Only 18% of patients were started with a creatinine clearance > 10 ml/min, as recommended by the Dialysis Outcomes Quality Initiative guidelines. It is concluded that late referral to a nephrologist is still a major problem that has a negative influence on modality choice for peritoneal dialysis, and on morbidity and mortality of ESRD patients.

The chicken retina as an experimental model for investigation of central nervous lesions.

The aim of this study was to establish an experimental model to investigate neuronal lesions. The retina is an easy accessible model system to study central nervous system (CNS) disorders or neuronal effective drugs. It consists of only a few characteristic layers and is easy to prepare as an intact piece of tissue. In the retina the typical cell swelling of a developing lesion is accompanied by a very strong intrinsic optical signal (IOS) which is simultaneous with the electrical signal and is based on changes in light scattering. The IOS can be easily observed during the whole experiment and can be recorded with non-invasive optical methods for further quantification of damage. In the developed model, the lesions are elicited electrically with a tungsten microelectrode (0.1 M[omega]). The degree of damage depends on the magnitude of the stimulus. The parameters for the quantification of damage are the area and the brightness of the affected tissue. The growth of the lesions can be influenced with drugs added to the perfusion system. In the present study we tested, glycerol, mannitol and ketamine which are known to be neuroprotective in other animal models.