Initial blood urea nitrogen concentration predicts subsequent blood urea nitrogen concentration in beef cows

This study was performed to determine whether beef cows have an inherent ability to maintain their relative blood urea nitrogen (BUN) concentration when cattle are exposed to varying levels of dietary nitrogen supplementation. Ten Hereford and 11 Nguni cows, aged between 2 and 16 years, were utilised in two crossover designs. In the first design, cows were exposed to diets containing normal and high crude protein (CP) levels. At the end of the first crossover design, cows received a normal diet for one week before commencement of the second design. In the second crossover design, cows were fed diets containing normal and low CP levels. Blood urea nitrogen concentration was measured 17-21 times (mean = 20) during the study. A linear mixed-effects model was used to assess whether baseline BUN concentration (measured one week before onset of the study) was predictive of subsequent BUN concentration in individual cows. The model was also used to assess whether any of the measured variables were predictive of subsequent BUN concentrations. Baseline BUN concentration was a significant predictor of subsequent BUN concentration in individual cows (P = 0.004). Other variables that were significantly associated with subsequent BUN concentration were breed (P = 0.033), the diet that the cows received before the current treatment (P < 0.001), treatment (P < 0.001) and the week during which sampling was performed (P < 0.001). Beef cattle appear to have an inherent ability to maintain their relative BUN concentration within herds despite changes in levels of dietary nitrogen supplementation.Poster presented at the University of Pretoria, Faculty of Veterinary Science Faculty Day, August 25, 2016, Pretoria, South Africa.ab201

Long-term evidence for ecological intensification as a pathway to sustainable agriculture

Ecological intensification (EI) could help return agriculture into a ‘safe operating space’ for humanity. Using a novel application of meta-analysis to data from 30 long-term experiments from Europe and Africa (comprising 25,565 yield records), we investigated how field-scale EI practices interact with each other, and with N fertilizer and tillage, in their effects on long-term crop yields. Here we confirmed that EI practices (specifically, increasing crop diversity and adding fertility crops and organic matter) have generally positive effects on the yield of staple crops. However, we show that EI practices have a largely substitutive interaction with N fertilizer, so that EI practices substantially increase yield at low N fertilizer doses but have minimal or no effect on yield at high N fertilizer doses. EI practices had comparable effects across different tillage intensities, and reducing tillage did not strongly affect yields

Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial

Background High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset. Methods We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment, whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053. Findings Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups. Interpretation Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting. Funding British Heart Foundation

Independent and combined effects of improved water, sanitation, and hygiene, and improved complementary feeding, on child stunting and anaemia in rural Zimbabwe: a cluster-randomised trial.

BACKGROUND: Child stunting reduces survival and impairs neurodevelopment. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH), and improved infant and young child feeding (IYCF) on stunting and anaemia in in Zimbabwe. METHODS: We did a cluster-randomised, community-based, 2 × 2 factorial trial in two rural districts in Zimbabwe. Clusters were defined as the catchment area of between one and four village health workers employed by the Zimbabwe Ministry of Health and Child Care. Women were eligible for inclusion if they permanently lived in clusters and were confirmed pregnant. Clusters were randomly assigned (1:1:1:1) to standard of care (52 clusters), IYCF (20 g of a small-quantity lipid-based nutrient supplement per day from age 6 to 18 months plus complementary feeding counselling; 53 clusters), WASH (construction of a ventilated improved pit latrine, provision of two handwashing stations, liquid soap, chlorine, and play space plus hygiene counselling; 53 clusters), or IYCF plus WASH (53 clusters). A constrained randomisation technique was used to achieve balance across the groups for 14 variables related to geography, demography, water access, and community-level sanitation coverage. Masking of participants and fieldworkers was not possible. The primary outcomes were infant length-for-age Z score and haemoglobin concentrations at 18 months of age among children born to mothers who were HIV negative during pregnancy. These outcomes were analysed in the intention-to-treat population. We estimated the effects of the interventions by comparing the two IYCF groups with the two non-IYCF groups and the two WASH groups with the two non-WASH groups, except for outcomes that had an important statistical interaction between the interventions. This trial is registered with ClinicalTrials.gov, number NCT01824940. FINDINGS: Between Nov 22, 2012, and March 27, 2015, 5280 pregnant women were enrolled from 211 clusters. 3686 children born to HIV-negative mothers were assessed at age 18 months (884 in the standard of care group from 52 clusters, 893 in the IYCF group from 53 clusters, 918 in the WASH group from 53 clusters, and 991 in the IYCF plus WASH group from 51 clusters). In the IYCF intervention groups, the mean length-for-age Z score was 0·16 (95% CI 0·08-0·23) higher and the mean haemoglobin concentration was 2·03 g/L (1·28-2·79) higher than those in the non-IYCF intervention groups. The IYCF intervention reduced the number of stunted children from 620 (35%) of 1792 to 514 (27%) of 1879, and the number of children with anaemia from 245 (13·9%) of 1759 to 193 (10·5%) of 1845. The WASH intervention had no effect on either primary outcome. Neither intervention reduced the prevalence of diarrhoea at 12 or 18 months. No trial-related serious adverse events, and only three trial-related adverse events, were reported. INTERPRETATION: Household-level elementary WASH interventions implemented in rural areas in low-income countries are unlikely to reduce stunting or anaemia and might not reduce diarrhoea. Implementation of these WASH interventions in combination with IYCF interventions is unlikely to reduce stunting or anaemia more than implementation of IYCF alone. FUNDING: Bill & Melinda Gates Foundation, UK Department for International Development, Wellcome Trust, Swiss Development Cooperation, UNICEF, and US National Institutes of Health.The SHINE trial is funded by the Bill & Melinda Gates Foundation (OPP1021542 and OPP113707); UK Department for International Development; Wellcome Trust, UK (093768/Z/10/Z, 108065/Z/15/Z and 203905/Z/16/Z); Swiss Agency for Development and Cooperation; US National Institutes of Health (2R01HD060338-06); and UNICEF (PCA-2017-0002)

Extraction of Magnesium From Chrome Slag by Sulphiric Acid Leaching at Low Temperatures

In this this article ,a solvent extraction method by using sulphuric acid leaching was developed .The process conditions and parameters of sulphuric acid concentration ,leaching temperature ,leaching time and solid to liquid ratio were studied. These studied conditions and parameters were varied from 0.5M to 5M at 0.5 M interval, 30oC to 60oC at 5oC interval and 30 minutes to 240 minutes at 30 minute interval respectively. The solid to liquid ratios used were 1:2, 1:3, 1:4, 1:5, 1:6, 1:7, 1:8, 1:9, 1:10.The optimum percentage extraction efficiency of magnesium as found to be 66.87% at optimum operating conditions of 4M sulphuric acid concentration 60oC leaching temperature, 120 minutes leaching time and 1:2 solid to liquid ratio

Stress and training satisfaction among resident doctors in Nigeria: Any justification for a change in training policy?

Background: There are pointers in existing literature to the stressful nature of residency program, thereby placing training physicians at increased risk of psychological distress. Objectives: The study identified perceived stress, its sources, training satisfaction, and the associated sociodemographic characteristics among resident doctors. Materials and Methods: A total of 405 self-administered questionnaires were given to all attendees of the National Postgraduate Medical College Revision Course. The questionnaires sought information on sociodemographic variables, sources of stress, and training satisfaction. Only 20 questionnaires were not returned. Data were collated and analyzed. Results: A majority of the respondents were male (69.1%), mostly between 31 and 35 years of age. Most (80%) of the respondents were married while 51.4% had over 4 dependents. All the respondents reported a significant level of stress, and different sources of stress were identified. Only 12 (3.1%) of the respondents were satisfied with the quality of training being received in their institutions. Conclusion: Our study found residency training to be stressful for doctors and often compounded by identifiable variables as shown in this study. Such stressful experience can, in turn, have negative impacts on their physical along with mental well-being and the patient care. Thus, there is a need for relevant stakeholders to review the structure of residency program with the view of addressing “modifiable risks” of stress among would-be specialists

Occurrence and characterization of seven major Shiga toxin‐producing Escherichia coli serotypes from healthy cattle on cow–calf operations in South Africa

Cattle are a major reservoir of Shiga toxin‐producing Escherichia coli. This study investigated the occurrence of seven major STEC serogroups including O157, O145, O103, O121, O111, O45 and O26 among 578 STEC isolates previously recovered from 559 cattle. The isolates were characterized for serotype and major virulence genes. Polymerase chain reaction revealed that 41.7% (241/578) of isolates belonged to STEC O157, O145, O103, O121, O45 and O26, and 33 distinct serotypes. The 241 isolates corresponded to 16.5% (92/559) of cattle that were STEC positive. The prevalence of cattle that tested positive for at least one of the six serogroups across the five farms was variable ranging from 2.9% to 43.4%. Occurrence rates for individual serogroups were as follows: STEC O26 was found in 10.2% (57/559); O45 in 2.9% (16/559); O145 in 2.5% (14/559); O157 in 1.4% (8/559); O121 in 1.1% (6/559); and O103 in 0.4% (2/559). The following proportions of virulence genes were observed: stx1, 69.3% (167/241); stx2, 96.3% (232/241); eaeA, 7.1% (17/241); ehxA, 92.5% (223/241); and both stx1 and stx2, 62.2% (150/241) of isolates. These findings are evidence that cattle in South Africa carry STEC that belong to six major STEC serogroups commonly incriminated in human disease. However, only a subset of serotypes associated with these serogroups were clinically relevant in human disease. Most STEC isolates carried stx1, stx2 and ehxA but lacked eaeA, a major STEC virulence factor in human disease.The Gauteng Department of Agriculture Rural Development (GDARD) (Grant No. FY 2013/14-A0W907), the National Research Foundation (NRF)-Thuthuka Fund, the University of Pretoria, Institutional Research Theme (IRT)-Animal and Zoonotic Diseases (AZD) (Grant No. UP-AZD IRT A0W596), and the Global Disease Detection (GDD) Program of the Centers for Disease Control and Prevention (CDC) (Grant No. 1U2GGH001874-01).http://wileyonlinelibrary.com/journal/zph2019-11-01hj2019Paraclinical SciencesProduction Animal Studie