Excess pressure as an analogue of blood flow velocity

INTRODUCTION: Derivation of blood flow velocity from a blood pressure waveform is a novel technique, which could have potential clinical importance. Excess pressure, calculated from the blood pressure waveform via the reservoir-excess pressure model, is purported to be an analogue of blood flow velocity but this has never been examined in detail, which was the aim of this study. METHODS: Intra-arterial blood pressure was measured sequentially at the brachial and radial arteries via fluid-filled catheter simultaneously with blood flow velocity waveforms recorded via Doppler ultrasound on the contralateral arm (n = 98, aged 61 ± 10 years, 72% men). Excess pressure was derived from intra-arterial blood pressure waveforms using pressure-only reservoir-excess pressure analysis. RESULTS: Brachial and radial blood flow velocity waveform morphology were closely approximated by excess pressure derived from their respective sites of measurement (median cross-correlation coefficient r = 0.96 and r = 0.95 for brachial and radial comparisons, respectively). In frequency analyses, coherence between blood flow velocity and excess pressure was similar for brachial and radial artery comparisons (brachial and radial median coherence = 0.93 and 0.92, respectively). Brachial and radial blood flow velocity pulse heights were correlated with their respective excess pressure pulse heights (r = 0.53, P < 0.001 and r = 0.43, P < 0.001, respectively). CONCLUSION: Excess pressure is an analogue of blood flow velocity, thus affording the opportunity to derive potentially important information related to arterial blood flow using only the blood pressure waveform

The impact of gastrointestinal parasitism on the behaviour and welfare of weaned housed lambs

Gastrointestinal (GI) parasitism is a health and production concern in sheep, yet its impact on animal welfare remains unclear. The impact of subclinical infections is especially ambiguous as GI parasitism often remains undiagnosed until clinical signs such as diarrhoea are evident. This study applied quantitative and qualitative methods to examine the effects of subclinical Teladorsagia circumcincta infection on the behaviour and welfare of 96 Suffolk-cross lambs (24 pens of 4 lambs) weaned at 10 weeks old. The hypothesis that parasitism causes negative affective states was tested. Lambs were divided into three groups at the pen level: ad-lib fed control (AC), restricted-fed control (RC), and ad-lib fed parasitised (AP). Parasitised lambs (AP) were dosed three times weekly with 7000 third stage T. circumcincta larvae (L 3) from 16 weeks of age. Lambs in the RC group were pair fed to match AP feed intake to separate the effects of infection-induced anorexia from the potential direct impacts of infection. From 7 days pre-infection to 23 days post-infection, scan and behaviour samples were taken from video recordings to quantitatively monitor behaviour, and animal-based measures such as faecal soiling score (FSS) were recorded as welfare indicators. Lying, standing, eating, play and social behaviour were monitored. Qualitative behaviour assessment (QBA) was conducted weekly using the AWIN (2015) protocol to gain insight into the lambs’ affective states over the onset of infection. Parasitised lambs were more likely to stand inactive than AC lambs as the infection progressed (P=0.006). They were also less likely to display eating behaviour in the third daily scan sample than RC lambs (P&lt;0.001). Principal Component Analysis of the QBA data revealed that the first dimension (PC1) described arousal levels, the second (PC2) described the valence of the animals’ affective states, and the third (PC3) described fearfulness and aggression levels. Parasitised lambs (est=10.64,SE=0.33) scored higher than RC lambs (est=9.42, SE=0.33) on PC3, the fearfulness dimension (P=0.030). There were no differences between fearfulness scores of AC and AP lambs or RC lambs and treatment group had no significant impact on the distribution of scores on PC1 or PC2. These findings demonstrate that subclinical GI parasitism negatively impacts lamb welfare not only in the health domain but in the behaviour and mental domains as well. This has implications for welfare assessments and early disease detection in lambs. Future research could explore remote monitoring of the indicators of parasitism identified in this study.</p

The impact of gastrointestinal parasitism on the behaviour and welfare of weaned housed lambs

Gastrointestinal (GI) parasitism is a health and production concern in sheep, yet its impact on animal welfare remains unclear. The impact of subclinical infections is especially ambiguous as GI parasitism often remains undiagnosed until clinical signs such as diarrhoea are evident. This study applied quantitative and qualitative methods to examine the effects of subclinical Teladorsagia circumcincta infection on the behaviour and welfare of 96 Suffolk-cross lambs (24 pens of 4 lambs) weaned at 10 weeks old. The hypothesis that parasitism causes negative affective states was tested. Lambs were divided into three groups at the pen level: ad-lib fed control (AC), restricted-fed control (RC), and ad-lib fed parasitised (AP). Parasitised lambs (AP) were dosed three times weekly with 7000 third stage T. circumcincta larvae (L 3) from 16 weeks of age. Lambs in the RC group were pair fed to match AP feed intake to separate the effects of infection-induced anorexia from the potential direct impacts of infection. From 7 days pre-infection to 23 days post-infection, scan and behaviour samples were taken from video recordings to quantitatively monitor behaviour, and animal-based measures such as faecal soiling score (FSS) were recorded as welfare indicators. Lying, standing, eating, play and social behaviour were monitored. Qualitative behaviour assessment (QBA) was conducted weekly using the AWIN (2015) protocol to gain insight into the lambs’ affective states over the onset of infection. Parasitised lambs were more likely to stand inactive than AC lambs as the infection progressed (P=0.006). They were also less likely to display eating behaviour in the third daily scan sample than RC lambs (P&lt;0.001). Principal Component Analysis of the QBA data revealed that the first dimension (PC1) described arousal levels, the second (PC2) described the valence of the animals’ affective states, and the third (PC3) described fearfulness and aggression levels. Parasitised lambs (est=10.64,SE=0.33) scored higher than RC lambs (est=9.42, SE=0.33) on PC3, the fearfulness dimension (P=0.030). There were no differences between fearfulness scores of AC and AP lambs or RC lambs and treatment group had no significant impact on the distribution of scores on PC1 or PC2. These findings demonstrate that subclinical GI parasitism negatively impacts lamb welfare not only in the health domain but in the behaviour and mental domains as well. This has implications for welfare assessments and early disease detection in lambs. Future research could explore remote monitoring of the indicators of parasitism identified in this study.</p

Social gradient of birthweight in England assessed using the INTERGROWTH-21st gestational age-specific standard.

OBJECTIVE: To determine the socioeconomic gradient of birthweights in England with reference to the prescriptive INTERGROWTH-21st Birthweight Standard. DESIGN: National cross-sectional study using data from Hospital Episode Statistics. SETTING: National Health Service in England. PARTICIPANTS: All singleton babies, live born between 34 weeks' gestation and 42 weeks' gestation, between 1 April 2011 and 31 March 2012. MAIN OUTCOME MEASURES: Birthweight distribution of babies with a birthweight of 90th centile, that is, small for gestational age (SGA) or large for gestational age (LGA) using Index of Multiple Deprivation quintiles as a proxy for socioeconomic status. RESULTS: Of 508 230 babies born alive between 1 April 2011 and 31 March 2012, 38 838 (7.6%) were SGA and 81 026 (15.9%) were LGA. Median birthweight was 3405 g, median z-score was 0.25 (SD 1.06). Birthweight z-score demonstrated a social gradient, from 0.26 (SD 1.1) in the most deprived areas to 0.53 (1.0) in the least deprived. Women in the most deprived areas were twice as likely to have SGA babies using the INTERGROWTH-21st chart (OR 1.94; 95% CI 1.87 to 2.01) compared with those in the least deprived areas. If all women had the same rate of SGA equivalent to those living in the least deprived areas, approximately 12 410 (30%) fewer babies would be born SGA in England each year. CONCLUSIONS: This study gives a measure of the social gradient in singleton SGA and LGA babies across England using an international standard of newborn size at birth

Cardiopulmonary Exercise Testing Provides Additional Prognostic Information in Cystic Fibrosis

RATIONALE: The prognostic value of cardiopulmonary exercise testing (CPET) for survival in cystic fibrosis (CF) in the context of current clinical management, when controlling for other known prognostic factors, is unclear. OBJECTIVES: To determine the prognostic value of CPET-derived measures beyond peak oxygen uptake (V.o2peak) following rigorous adjustment for other predictors. METHODS: Data from 10 CF centers in Australia, Europe, and North America were collected retrospectively. A total of 510 patients completed a cycle CPET between January 2000 and December 2007, of which 433 fulfilled the criteria for a maximal effort. Time to death/lung transplantation was analyzed using Cox proportional hazards regression. In addition, phenotyping using hierarchical Ward clustering was performed to characterize high-risk subgroups. MEASUREMENTS AND MAIN RESULTS: Cox regression showed, even after adjustment for sex, FEV1% predicted, body mass index (z-score), age at CPET, Pseudomonas aeruginosa status, and CF-related diabetes as covariates in the model, that V.o2peak in % predicted (hazard ratio [HR], 0.964; 95% confidence interval [CI], 0.944–0.986), peak work rate (% predicted; HR, 0.969; 95% CI, 0.951–0.988), ventilatory equivalent for oxygen (HR, 1.085; 95% CI, 1.041–1.132), and carbon dioxide (HR, 1.060; 95% CI, 1.007–1.115) (all P < 0.05) were significant predictors of death or lung transplantation at 10-year follow-up. Phenotyping revealed that CPET-derived measures were important for clustering. We identified a high-risk cluster characterized by poor lung function, nutritional status, and exercise capacity. CONCLUSIONS: CPET provides additional prognostic information to established predictors of death/lung transplantation in CF. High-risk patients may especially benefit from regular monitoring of exercise capacity and exercise counseling