Determinants of hospital length of stay after thoracoabdominal aortic aneurysm repair

AbstractPurpose: Extended hospital length of stay (LOS) and consequent high costs are associated with thoracic and thoracoabdominal aortic aneurysm (TAAA) surgery. In this study, we examined factors that may influence LOS after TAAA repair. Methods: Five hundred forty thoracic and TAAA repairs were performed by one surgeon between 1990 and 1999. The data were analyzed with multiple linear regression with appropriate logarithmic transformation. The predictor variables included patient demographics, disease extent, severity indicators, intraoperative factors, and postoperative complications. Results: The median LOS was 15 days. Postoperative creatinine level of greater than 2.9 was the most important predictor of LOS, followed by spinal cord deficit, age, and pulmonary complication (all statistically significant with P <.05). A second model constrained to preoperative risk factors showed both age and complete diaphragmatic division to be associated with increased LOS. Preservation of the diaphragm led to reduced LOS by an average of 4 days. The adjunct cerebrospinal fluid drainage and distal aortic perfusion was associated with a decrease in LOS, although it did not reach statistical significance. Conclusion: Renal failure, spinal cord deficit, and pulmonary complication were the major determinants of LOS in patients for TAAA repair. This study shows that the preservation of diaphragmatic function and the use of the adjunct distal aortic perfusion and cerebrospinal fluid drainage may reduce hospital LOS. (J Vasc Surg 2002;35:648-53.

Effects of increasing air temperature on skin and respiration heat loss from dairy cows at different relative humidity and air velocity levels

The focus of this study was to identify the effects of increasing ambient temperature (T) at different relative humidity (RH) and air velocity (AV) levels on heat loss from the skin surface and through respiration of dairy cows. Twenty Holstein dairy cows with an average parity of 2.0 ± 0.7 and body weight of 687 ± 46 kg participated in the study. Two climate-controlled respiration chambers were used. The experimental indoor climate was programmed to follow a diurnal pattern with ambient T at night being 9°C lower than during the day. Night ambient T was gradually increased from 7 to 21°C and day ambient T was increased from 16 to 30°C within an 8-d period, both with an incremental change of 2°C per day. A diurnal pattern for RH was created as well, with low values during the day and high values during the night (low: RH_l = 30-50%; medium: RH_m = 45-70%; and high: RH_h = 60-90%). The effects of AV were studied during daytime at 3 levels (no fan: AV_l = 0.1 m/s; fan at medium speed: AV_m = 1.0 m/s; and fan at high speed: AV_h = 1.5 m/s). The AV_m and AV_h were combined only with RH_m. In total, there were 5 treatments with 4 replicates (cows) for each. Effects of short and long exposure time to warm condition were evaluated by collecting data 2 times a day, in the morning (short: 1-h exposure time) and afternoon (long: 8-h exposure time). The cows were allowed to adapt to the experimental conditions during 3 d before the main 8-d experimental period. The cows had free access to feed and water. Sensible heat loss (SHL) and latent heat loss (LHL) from the skin surface were measured using a ventilated skin box placed on the belly of the cow. These heat losses from respiration were measured with a face mask covering the cow's nose and mouth. The results showed that skin SHL decreased with increasing ambient T and the decreasing rate was not affected by RH or AV. The average skin SHL, however, was higher under medium and high AV levels, whereas it was similar under different RH levels. The skin LHL increased with increasing ambient T. There was no effect of RH on the increasing rate of LHL with ambient T. A larger increasing rate of skin LHL with ambient T was observed at high AV level compared with the other levels. Both RH and AV had no significant effects on respiration SHL or LHL. The cows lost more skin sensible heat and total respiration heat under long exposure than short exposure. When ambient T was below 20°C the total LHL (skin + respiration) represented approx. 50% of total heat loss, whereas above 28°C the LHL accounted for more than 70% of the total heat loss. Respiration heat loss increased by 34 and 24% under short and long exposures when ambient T rose from 16 to 32°C

Size Distribution of Airborne Particles in Animal Houses

[EN] The concentration and size distribution of airborne particles were measured inside and outside typical animal houses such as broilers, broiler breeders (both floor housing with litter); layers (floor housing system and aviary housing system); turkeys (floor housing with litter), pigs: fattening pigs (traditional houses, low emission houses with dry feed, and low emission houses with wet feed), piglets, sows (individual and group housing); cattle (cubicle house), and mink (cages). Using an aerosol spectrometer, particles were counted and classified into 30 size classes (total range: 0.25 ¿ 32 µm). Particles were measured on for two days, one in spring and the other in summer, in two of each species/housing combination during 30 min inside and outside the animal house. Outside temperature and relative humidity were also measured. Particle counts in the different size classes were generally higher in poultry houses than in pig houses, and counts in pig houses were generally higher than those in cattle and mink houses. The particle counts in animal houses were highest (on average 87%) in the size classes 2.5 ¿m (on average 97%). Most particles outside were in the size class <1.0 ¿m (99% in counts). Mean count median diameter (CMD) of particles inside the animal houses ranged from 0.32 to 0.59 ¿m, while mean mass median diameter (MMD) ranged from 3.54 to 12.4 ¿m. Particle counts in different size fractions were highly correlated, with correlation coefficients varying from 0.69 to 0.98; higher coefficients were found for the closer size ranges. Although particle counts in different size ranges varied greatly, for all particle classes, except the particles in the 0.25 ¿ 1.0 µm range, the most variation could be accounted for by species/housing combination and outside temperature and relative humidity. It should be recognized that the measurements were done during short periods of the day and only during the spring and summer period.Lai, H.; Aarnink, A.; Cambra López, M.; Huynh, T.; Parmentier, H.; Groot Koerkamp, P. (2014). Size Distribution of Airborne Particles in Animal Houses. Agricultural Engineering International: CIGR Journal. 16(3):28-42. http://hdl.handle.net/10251/102747S284216

Pig Production in Cambodia, Laos, Philippines, and Vietnam: A Review

In the last two decades, Asia has become the world’s fastest economically growing area. Countries in Southeast Asia are growing at an increasing rate. For instance, the average annual income is increasing from 4% to 8%, population from 2% to 3%, urbanization from 4% to 6%, and meat consumption from 4% to 8%. In this region, pork is the most important source of meat, accounting for approximately 58% of total meat output. However, pig production in the region is small in scale with more than 70% being smallholders. Regional and national goals to reach the international market threaten traditional pig production due to its perceived low standard of output. Alongside, natural resources are under high pressure from heavy pollution emanating from pig production. Industrialization has caused the migration of the pig population from rural areas to the outskirts of big cities like Manila, Ho Chi Minh, and Siemriep, or Phnom Penh. Industrialization has also resulted in air, soil, and water pollution in these cities. In addition, the region shares a huge area of the South China Sea and by intensive pig keeping, surplus nutrients and minerals flow into that sea. This paper aims to: 1) provide an overview of the current pig production situation in certain selected ASEAN countries, namely Cambodia, Laos, Philippines, and Vietnam; 2) analyze how these changes may occur over the coming years and how it will affect the livelihoods of different types of pig farmers (large, medium, small); 3) identify some of the constraints that will need to be overcome (e.g., environmental impact, disease challenge, breed loss, effect of globalization, marginalization of small farmers, climate change issues); and 4) to pinpoint certain guidelines for drawing up a regional strategy on pig production

Evaporative water loss from dairy cows in climate-controlled respiration chambers

The effects of ambient temperature (AT) on total evaporative water loss from dairy cows at different relative humidity (RH) and air velocity (AV) levels were studied. Twenty Holstein dairy cows with an average parity of 2.0 ± 0.7 and body weight of 687 ± 46 kg participated in the study. Two climate-controlled respiration chambers were used. The experimental indoor climate was programmed to follow a diurnal pattern with AT at night being 9°C lower than during the day. Night AT was gradually increased from 7 to 21°C and day AT was increased from 16°C to 30°C within an 8-d period, both with an incremental change of 2°C/d. The effect of 3 RH levels with a diurnal pattern were studied as well, with low values during the day and high values during the night: low (day, 30%; night, 50%), medium (day, 45%; night, 70%), and high (day, 60%; night, 90%). The effects of AV were studied during the daytime at 3 levels: no fan (0.1 m/s), fan at medium speed (1.0 m/s), and fan at high speed (1.5 m/s). The medium and high AV levels were only combined with medium RH. In total, there were 5 treatments with 4 replicates each. The animals had free access to feed and water. Based on the water balance principle inside the respiration chambers, the total evaporative water loss from dairy cows at a daily level was quantified by measuring the mass of water in the incoming and outgoing air, condensed water, added water from a humidifier, and evaporative water from a wet floor, drinking bowl, manure reservoir, and water bucket. Water evaporation from a sample skin area was measured with a ventilated skin box, and water evaporation, through respiration with a face mask. The results show that RH/AV levels had no significant effect on total evaporative water loss, whereas the interaction effect between RH/AV with AT was significant. Cows at a high RH had a tendency for a lower increasing rate of evaporative water loss compared with cows at a low RH (0.61 vs. 0.79 kg/d per 1°C increase of AT). Cows at medium and high AV levels had a greater increasing rate than cows at low AV (0.91 and 0.95 vs. 0.71 kg/d per 1°C increase of AT, respectively). The increase of evaporative heat loss from dairy cows was mainly a result of the increase in evaporation (of sweat) from the skin. The skin water evaporation determined with the water balance method (less evaporation from respiration) and the ventilated skin box method showed no significant difference. The implication of this study is that cows at a high AT depend mainly on evaporative cooling from the skin. The ventilated skin box method, measuring only a small part of the skin during a short period during the day, can be a convenient and accurate way to determine the total cutaneous evaporative water loss from cows