Prolonged temporary cardiac pacing using subcutaneous tunnelled active-fixation permanent pacing leads.
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Biomedical subjects
Publications and source records attributed to J D Ferguson.
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A survey of 715 Holstein dairy farms in Pennsylvania was used to construct demographics for the average Holstein dairy farm. The average Holstein dairy farm was composed of 69 lactating cows; 11 nonlactating, pregnant cows; 44 heifers; and 18 calves. Milk production averaged 27.3 kg (60.0 lb). Crop area averaged 73.6 ha. Milk production, crop area and type, average county yields, and herd animal groups were used to construct a typical feeding program for these farms. Typical rations were constructed for six feeding groups (three milk production groups, one nonlactating group, two heifer groups) to meet milk production, pregnancy, and growth requirements. Rations were constructed based on three forage qualities (excellent, average, and poor) typically observed on Pennsylvania dairy farms. Data for animal description (milk production, body weight, growth, and pregnancy status) and ration components and amounts consumed for each animal group were input into the excretion model of the Dairy Nutrient Planner computer program (DNP). Excretion of fecal N and dry matter (DM), urinary N, and total P and K were produced for each animal group and used to assess potential volatile losses of N. Work at the Marshak Dairy, New Bolton Center, indicates the majority of urinary N is rapidly lost as ammonia from dairy facilities. Based on this observation, the losses of N as ammonia were estimated to be 4.63, 4.62, and 4.28 tonne/year for the farm with excellent, average, and poor quality forages, respectively. Volatile losses of N may be reduced most by controlling levels of urea in urine. Urinary N may be reduced through dietary manipulation of protein and carbohydrate sources. Conversion of urea to ammonia may be reduced by altering the pH of barn floors and gutters. Entrapment of ammonia may be accomplished by acidification of manure slurry. Atmospheric ammonia contributes to acid rain, eutrophication of estuaries and lakes, and particulate air pollution. Reduction of ammonia emissions from dairy barns can significantly reduce atmospheric pollution and improve air and water quality.
Temporary DDD pacing offers significant hemodynamic benefits in emergency management of bradyarrhythmias but is underused because of its complexity (two leads) and unreliability. Single lead VDD pacing with atrial sensing via a floating dipole is feasible, but atrial pacing is limited by high thresholds and phrenic nerve stimulation (PNS). Overlapping biphasic impulse (OLBI) stimulation may avoid these problems. The authors designed a single lead balloon-tipped catheter for temporary transvenous DDD pacing, incorporating noncontact atrial dipoles for OLBI stimulation. This catheter was deployed using fluoroscopic guidance in 74 patients (43 men, 31 women) with mean age 56.9 +/- 17.0 years. Pacing parameters were assessed at implantation and follow-up. The median procedural time was 6.6 (range 1.2-25.0) minutes and fluoroscopy time 1.9 (range 0.2-7.8) minutes. Stable VDD pacing was achieved in all cases. Atrial capture was achieved in 73 of 74 cases with both modes at maximum output but was restricted by PNS at outputs below atrial capture threshold in 3 of 74 cases with OLBI and 10 of 74 cases with standard bipolar mode (P = 0.04). At outputs > or = 1.0 V above atrial threshold, reliable DDD pacing without PNS was achieved and maintained in 67 (91%) of 74 patients in OLBI compared to 53 (72%) of 74 patients in bipolar mode (P = 0.003). Pacing parameters were stable during follow-up (median 53 hours, range 6-168 hours). In conclusion, the single lead catheter with OLBI stimulation allows temporary VDD and DDD pacing without PNS to be achieved in > 90% of patients. This rapid and convenient approach should facilitate DDD pacing in emergency settings.
Ultrasound guided percutaneous thrombin injection has recently been described for the treatment of iatrogenic femoral pseudoaneurysms. Patient selection and technical aspects of this technique are still evolving and safety data, particularly after coronary intervention, remains limited. The percutaneous thrombin injection of femoral artery pseudoaneurysms in 13 consecutive patients, most of whom were receiving antiplatelet/anticoagulant treatment (aspirin 11, heparin 4, clopidogrel 6), is reported. Thrombin (1000 U/ml) was injected over several seconds until Doppler colour flow within the cavity ceased. The median dose of thrombin injected was 800 U (range 200-1000 U) and the treatment was successful in all cases without complication. In one case, thrombus was visualised within the arterial lumen immediately after thrombin injection, but this dissolved spontaneously within five minutes without evidence of embolisation. In contrast to ultrasound guided compression, percutaneous thrombin injection of femoral pseudoaneurysms is a rapid, well tolerated, and successful technique even in patients receiving antiplatelet/anticoagulant treatment.
A survey was conducted to collect information on nutrient management practices on dairy farms in south-central Pennsylvania. Of the 994 responding farms, the average farm consisted of 64 lactating cows, 10 dry cows, 41 heifers, and 17 calves with 69.7 ha of tillable land. Manure from lactating cows was mainly collected on a daily basis (84% of the farms) and stored as slurry or liquid (73%), while dry cow and heifer manure was collected weekly or less frequently (69 and 85% of the farms) and stored as solid stack or bedded pack (67 and 82%). Manure utilization featured consistent use of on-farm spreading, with limited incorporation, to corn or small grain fields before planting. Spreading on perennial forages or pasture was also common. Irrigation or injection of manure occurred on less than 5% of the farms. Only 20% of the farms reported manure nutrient testing, contrasting to over 90% for soil testing. Farm advisors and their services can be of vital importance in helping producers make conscientious management decisions for enhanced nutrient utilization. For example, ration balancing involved the services of feed and mineral sales representatives (85% of the farms), independent consultants (12%), and veterinarians (5%). Manure nutrient crediting to determine manure application rates was made by fertilizer dealers (40%), crop advisors and independent consultants (31%), and others. Nutrient management strategies and efforts must address the specific needs of farms with different animal densities and nutrient balances in order to be effective and applicable on the majority of farms.
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Milk production was simulated in a 50-cow herd averaging 8182 kg of 305-d milk with a standard deviation of 1364 kg. Herd demographics were 35% first lactation, 20% second lactation, and 45% third or greater lactation cows. A lactation model was developed with the Wood's equation (Milk/d = A*DIM*e(-c*dim)) to which random variation was added to be consistent with a coefficient of variation of 10% for daily milk production. Five sequential sampling periods, 30 d apart, were randomly selected for the experiment. For each of these sampling periods data were simulated for cow, lactation number, milk, and days in milk (DIM). To the third sampling period, a known input was pulsed into each cow record to simulate a change in milk production. Inputs and number of herds simulated were -1.140 kg and 15 herds, 0.909 kg and 30 herds, -0.455 kg and 20 herds, 0 kg and 65 herds, 0.455 kg and 21 herds, -0.909 kg and 47 herds, 1.140 kg and 20 herds, and 2.270 kg and 15 herds. Regression by cow was used to estimate milk production change for the known inputs: Milk(ijk) = Intercept + beta(i)*DIM(ij) + TRT(ik) + epsilon(ijk). Parameter estimates for each cow were submitted to analysis of variance with herd as a class variable. The least square mean of TRT (dummy variable for known input of milk volume change) for herd was tested for difference from zero based on a "t" statistic. Herd responses were classed as negative, not different from zero, and greater than zero based on P < 0.10. Herd responses were categorized based on the known input to assess the ability of the method to detect a change in production. The mean estimate of TRT from the regression analysis was used to assess the ability of the method to estimate the magnitude of the known input. The regression method was able to detect changes in production greater than 0.455 kg, but is more useful when changes of 0.9 kg or greater are shown. Adjustment for days postcalving on first test day is necessary to correct for the bias in linear regression to estimate response across the curvilinear milk production function.
We assessed the change in milk production in 35 dairy herds located in eight states when a blended animal-marine protein product was included in diets at 2 (22 herds) to 4% (13 herds) of dry matter. Average 305-d production across herds was 8844.1 kg (SEM = 153.7 kg) of milk, with a range of 6876.9 to 11,293.2 kg. The mean days in milk for all herds at initiation of the trial was 118.8 d (SEM = 3.7, herd mean range of 68.8 to 160.0 d), and the average daily milk production was 32.6 kg (SEM = 0.6 kg, range 24.2 to 39.6 kg). The animal-marine protein blend was included in herd rations for 30 d, beginning immediately after a DHI herd test month and ending immediately after the next DHI sample test. Cow milk records were collected for 1 to 2 mo before the protein blend was included and for 2 to 3 mo after the protein was removed. Sample days were assigned a dummy variable to indicate months off or on the animal-marine protein blend. A total of 33,190 milk records from 7135 cows were analyzed. The numbers within herd ranged from 35 to 2012 cows. Of the 35 herds, 19 were classed as having increased milk yield, 12 herds as having no change, and 4 herds as having decreased milk yield when the animal-marine protein blend was included in the diet. The population mean for change in milk yield with the inclusion of the animal-marine protein blend was 1.24 kg/d of milk (SEM = 0.05 kg). There was no significant effect of parity on mean response. Milk protein content was not influenced by animal-marine protein blend inclusion. Fat content was lower for the month on which the animal-marine protein blend was fed (3.51%) compared with the month prior (3.63%) and the month after (3.70%), respectively (SEM = 0.032). Stage of lactation influenced the method for calculating the production response and the actual response to the animal-marine protein blend.
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OBJECTIVE: To assess the effect of vaccination against bovine respiratory syncytial virus on milk production, reproductive performance, and health in lactating dairy cows. DESIGN: Prospective randomized block design. ANIMALS: 385 Holstein dairy cows and heifers. PROCEDURE: Cows were grouped by lactation number, season of calving, and previous mature equivalent 305-day milk production (where appropriate). Prior to parturition, cows and heifers were randomly assigned to be vaccinated i.m. against infectious bovine rhinotracheitis, bovine viral diarrhea, and parainfluenza 3 viruses by use of a three-way vaccine, or to be vaccinated against those viruses as well as bovine respiratory syncytial virus, using a four-way vaccine. Milk production was measured daily through 305 days of lactation. Reproductive and medical records were reviewed to obtain insemination dates and record medical problems of cows in each vaccine treatment group. RESULTS: Compared with the three-way vaccine, administration of the four-way vaccine was associated with higher milk production (1.39 kg [3.06 lb] more milk/d) in first-parity cows during the first 21 weeks of lactation. Vaccination did not have any effect on milk production after the first 21 weeks of lactation in cows of any parity. Conception rates at first insemination were higher for four-way vaccinated first-parity cows than for three-way vaccinated first-parity cows (54.6 vs 32.7%). Compared with second-parity cows that received the three-way vaccine, first insemination conception rate was improved for second-parity cows vaccinated with the four-way vaccine (28.9 vs 47.8%, respectively). In cows of third or greater parity, first insemination conception rate was not different between the 2 vaccine treatment groups. CLINICAL IMPLICATIONS: Vaccination of heifers against bovine respiratory syncytial virus prior to partrition may increase milk production and first insemination conception rates.
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Beginning at wk 5 of lactation, 136 cows (34 per treatment) were supplemented daily for 38 wk with 0, 10.3, 20.6, or 41.2 mg of recombinantly derived bST monomer. Cows were obtained from University of Kentucky, University of Minnesota, University of Pennsylvania, and The Ohio State University. Nine cows (4 at 0 mg/d, 1 at 10.3 mg/d, 1 at 20.6 mg/d, and 3 at 41.2 mg/d) did not complete the experiment because of health problems. Data from these cows were included in the reproduction and health databases but not in the production database. Cows supplemented with bST produced more milk, consumed more feed, had lower rates of BW gain, and had improved efficiencies of milk production (conversion of feed and NEL to milk). Additional increases in productivity were modest at 20.6 and 41.2 mg/d versus productivity at 10.3 mg/d of bST. Concentrations of fat, protein, and TS in milk were unaffected. At 10.3 mg/d, bST did not adversely affect reproduction or health.
Approximately 70% of dairy cows are inseminated with semen from bulls provided by commercial artificial insemination centers. To help producers in the selection process, artificial insemination centers publish information regarding production and type traits associated with each bull. Producers must decide from these lists which bulls to use, how often they are to be used, and to which cows they should be allocated. The bulls selected have a direct effect on cost of semen for the herd and genetic improvement in production of future generations. In general, producers' goals are to replace poor genes through strategic culling (not breeding certain cows) with better genes through semen purchases in an economically efficient manner. The cost of semen, however, is realized immediately, whereas economic returns from the traits selected are dependent on the realization of future cash flows. Higher production returns are needed to justify using more expensive bulls. The purposes of the study reported here were to examine the bull selection portfolio of a 450-cow commercial dairy herd in southeastern Pennsylvania and to use linear optimizing programming to select a genetically similar group of bulls at a much lower cost than that the producer had been using. This approach of dominant decision-making can be generalized and implemented for various dairy from conditions.
Four multiparous Holstein cows were used in a 4 x 4 Latin square to investigate the effects of protein concentration, degradability, and quality on plasma urea concentration and milk N constituents. Diets varied in the amount and proportion of RDP and RUP relative to NRC requirements: diet 1, excessive RDP, deficient RUP; diets 2 and 3, balanced for RDP and RUP; and diet 4, excessive RDP, balanced for RUP. Diet 3 was formulated for optimal AA balance as predicted by the Cornell Net Carbohydrate and Protein System. Diets contained 34% corn silage, 19% alfalfa haylage, and 49% concentrate (DM basis). Concentrates varied in amounts of urea and soybean, corn gluten, and fish and blood meals. Concentrations of urea N and NPN in milk varied among diets: diet 1, 19 and 34 mg/dl; diet 2, 16 and 31 mg/dl; diet 3, 15 and 30 mg/dl; and diet 4, 23 and 39 mg/dl, respectively. Increases in NPN concentration were attributed to increases in the urea fraction of NPN. Intake of RUP and AA balance influenced milk true protein content; diet 1, 2.89%; diet 2, 2.90%; diet 3, 3.01%; and diet 4, 2.95%. the proportions of true protein and urea in milk are influenced by CP concentration, protein type, and protein quality.
The objective of this study was to assess objectively the ability of observers to assess body condition of dairy cows. Four observers independently assigned a body condition score (five-point scale, .25 increments) and described the appearance of seven body regions of 225 Holstein cows. Areas described were the thurl region, ischial and ileal tuberosities, ilio-sacral and ischio-coccygeal ligaments, transverse processes of the lumbar vertebrae, and spinous processes of the lumbar vertebrae. An absolute body condition score was designated for each cow based on the modal body condition score for all observers. If there was no modal body condition score, the mean score was used for the absolute body condition score. Statistical analysis of principal components was used to examine the relationship between body region description and absolute body condition score. Descriptions of body regions were highly correlated across all absolute body condition scores. Four principal component vectors explained 83.6% of the variation of the body region correlation matrix. The first principal latent vector accounted for 55% of the variation and was uniformly correlated with all body regions. Analysis of variance of first principal latent vector as the dependent variable and absolute body condition score as the class variable indicated that body condition could be separated into .25 units between 2.5 and 4.0, inclusively. Below 2.5 and > 4.0, body condition could only be separated by .5 units. Distinct changes in specific body regions were associated with change in absolute body condition score. Observers agreed with the absolute score 58.1% of the time, deviating by .25 units 32.6% of the time. A body condition score can be given to a cow based on principal descriptors of specific body regions between 2.5 and 4.0 by .25 units.