Growth performance, meat quality, strength of jejunum and leg bones of both sexes Cherry Valley ducks fed with zeolite.

Zeolite, as a natural mineral, could be a good additive for ducks, in line with pro-environmental trends. The study aimed to evaluate zeolite additives in feed for broiler ducks of both sexes on production results, meat quality, and the strength of the jejunum, tibia, and femur. The experiment used 200 Cherry Valley ducks, divided into a control group of males (CM) and females (CF) and an experimental group of males (ZM) and females (ZF). In the control groups, a commercial diet was used. In the experimental groups, 1% zeolite was added. The ZM group demonstrated higher body weight and weight gain than the CM group. Zeolite reduced the feed conversion ratio. A higher liver weight was found in the experimental group (ZM). Notably, zeolite influenced the weight of male pectoral muscles. Higher water loss in the pectoral muscles and higher protein content in the leg muscles were found in the same group. Females had a higher weight of neck and wings with skin. Female pectoral muscles had lower protein and water content. Zeolite in feed at a 1% level for broiler ducks could be recommended as a natural additive that positively affects the ducks' production results concerning good quality meat.

Growth of broiler chickens, and physical features of the digestive system, and leg bones after aluminosilicates used.

The assessment of aluminosilicates' impact on the production of chickens, the physical features of the intestines, and leg bones was done. 500 Ross 308 chickens were used and divided into 5 groups. The control group was I. Groups II, III, IV, and V were fed with halloysite and zeolite (1:3 ratio) at 0,5% (1-35 days; starter, grower 1 and 2) and 1% (36-42 days; finisher) levels. Aluminosilicates were also used for the peat litter: II-500 g of halloysite/m2; III-250 g of halloysite/m2 and 250 g of zeolite/m2; IV-500 g of zeolite/m2; V-130 g halloysite/m2, 370 g zeolite/m2. During 42 days, growth and feed indicators were recorded. 10 birds from each group were selected for slaughter. The digestive tract, femur, and tibia bones were sampled, and physical features were analyzed (weight, length, and strength). A lower feed conversion ratio on days 23-35 was found in the groups with the aluminosilicates addition. In group V a lower weight of the gizzard was found than in group I. A liver weight was higher in group V than in group III. A higher strength of the femurs was demonstrated in group IV. The tibia bones were characterized by higher strength than the femurs of broiler chickens. The aluminosilicates to feed and litter had no adverse effect.

Study on ultrasonic wave propagation in equine leg bone for screening bucked shin.

For simple, safe, portable, and inexpensive evaluation suitable for leg bone diseases of racehorses in the field, an ultrasonic measurement technique was applied to evaluate wave velocities. A digital model of the third metacarpal bone with the bucked shin was fabricated using high-resolution peripheral quantitative computerized tomography data of a racehorse. This model was anisotropic and heterogeneous, and was constructed using the measured ultrasonic wave velocities in the bone. With this model, ultrasonic wave propagation along the bone axis was simulated using the elastic finite-difference time-domain method. We found two main waves with different propagation velocities. The fast-waves showed a wave velocity close to the longitudinal wave in the axial direction. However, the apparent velocities changed dramatically owing to bone surface irregularities (changes of the shape) in the area of bucked shin. The slow-waves showed a wave velocity close to the shear wave, which was unaffected by the bone surface irregularities. The simple comparison of different wave behaviors may be a suitable parameter for the initial in vivo screening of bucked shin in the legs of racehorses, which can be performed in the field.

LONG-TERM RESULTS OF TREATING PATIENTS WITH OPEN FRACTURES OF LOW-LEG BONES.

OBJECTIVE: The aim: To analyse long-term results of treating patients with open fractures of low-leg bones within a specific time period and to describe concomitant problems. PATIENTS AND METHODS: Materials and methods: A retrospective study was carried out to evaluate the results of the final treatment of patients after one year and after five years. Patients were divided into two groups. Group I included 47 (61.84%) patients for whom the treatment method was changed from external fixation to internal fixation. Group II included 29 (38.16%) patients for whom the final treatment of an open fracture was performed with an external fixation device without changing the method. The study exclusion criteria were patients under 18 years old and patients with gunshot fractures of the lower leg bones. RESULTS: Results: Patient treatment included initial surgical debridement and fracture stabilization with external fixation devices. In all patients, wound healing occurred within 30 days (on average, 24 ± 4.5 days). When evaluating the treatment of patients in group I, 32 (68.09%) of them underwent a one-stage removal of an external fixation device and osteosynthesis of fragments during the first 7-10 days. In 3 (20.0%) patients, osteosynthesis was performed with an intramedullary locking nail, in 12 (80.0%) patients - with a plate. The decision to change the fixation method was made taking into account clinical and laboratory parameters. It is noted that the treatment of patients with type III open fractures of the lower leg bones according to the Gustilo-Andersen classification, provided that the method of external fixation is replaced with an internal one, gives better results compared to osteosynthesis with external fixation devices. CONCLUSION: Conclusions: Treatment of patients with high-energy injuries of the lower leg bones is a long-term process. It is possible to improve the therapy efficiency by changing the fixation method from external to internal one. In this regard, the main evaluative characteristics are such indicators as uncomplicated wound healing combined with the absence of laboratory and clinical signs of inflammation.

Management of Chronic Osteomyelitis by an Orthoplastic Team: 7-Year Experience of a University Hospital.

BACKGROUND: Treating chronic osteomyelitis of the lower extremities is challenging. The treatment of acute lower limb trauma by orthoplastic teams has shown good results over the past few decades. This study aimed to characterize surgical outcomes of leg and heel chronic osteomyelitis by an orthoplastic team. METHODS: The cases of 113 consecutive leg and heel chronic osteomyelitis patients undergoing soft-tissue reconstruction with an orthopedic procedure were reviewed in this retrospective single-center observational study. The main objective was to assess surgical outcomes of skin healing and gait recovery at the 1-year follow-up. The secondary objective was to evaluate the global success rate at the last follow-up. RESULTS: The median follow-up was 19.7 months. A free flap was performed for 33 patients (29.2 percent) and a locoregional flap was used in 79 patients (69.9 percent). Seventy-two patients (63.7 percent) had chronic osteomyelitis on continuous bone. The others had a septic pseudarthrosis with a mean bone defect length of 42.9 mm. Forty-four patients (38.9 percent) underwent curettage only, eight (7.1 percent) underwent curettage and cement, 20 (17.7 percent) underwent curettage and bone fixation, and 39 (34.5 percent) underwent the Masquelet technique. At the 1-year follow-up, 72 patients (63.7 percent) had achieved skin healing and had recovered their gait. The success rate at all follow-up time points was 82.3 percent. The median time to achieve skin healing was 6.5 months and that to bone union in cases of septic pseudarthrosis was 7.9 months. CONCLUSION: Orthoplastic management of leg and heel chronic osteomyelitis patients with combined soft-tissue reconstruction using an orthopedic procedure was a viable strategy that offered good results even though the time to complete healing was long. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

National trends in extremity fracture hospitalizations among older adults between 2003 and 2017.

BACKGROUND: Fractures in late life are highly consequential for health, services use, and spending. Little is known about trends in extremity fracture hospitalizations among older adults in the United States. DESIGN: Retrospective longitudinal cohort study. SETTING: The 2003-2017 National Inpatient Sample (NIS), a representative sample of U.S. community hospitals. PARTICIPANTS: Hospitalized adults aged 65 and older with a diagnosis of upper or lower extremity fracture. MEASUREMENTS: Incidence of extremity fracture hospitalization and mortality, using NIS discharge and trend weights, and population denominators derived from the U.S. Census Bureau. Incidence was reported separately for men and women by age, fracture diagnosis, and injury mechanism. Weighted linear regression was used to test for significant trends over time. RESULTS: Incidence of extremity fracture hospitalizations declined in both women (15.7%, p trend < 0.001) and men (3.2%, p trend < 0.001) between 2003 and 2017. This trend was primarily attributed to a decline in low energy femur fractures which accounted for 65% of all fracture hospitalizations. Among older adults with an extremity fracture hospitalization, mortality declined from 5.1% in 2003 to 3.3% in 2017 in men, and from 2.6% to 1.9% in women (p trend < 0.001). High energy fractures were due to falls (53%), motor vehicle accidents (34%), and other high impact injuries (13%). Overall, 12% of extremity fracture hospitalizations were attributed to high-energy injuries: increases were observed among men ages 65-74 (20%; p trend < 0.001) and 75-84 (10%; p trend = 0.013), but not among women of any age. CONCLUSION: Observed declines in the incidence of extremity fracture hospitalizations and related mortality are encouraging. However, increasing incidence of fracture hospitalization from high energy injuries among men suggests that older adults with complex injuries will be seen with more prevalence in the future.

De novo c.2455C>T mutation of NPR2 gene in a fetus with shortened long bones and a ventricular septal defect conceived by a mother with a fragile site at 16q22.1 and a father with a rare heterochromatic variant of chromosome 4 from Vietnam.

BACKGROUND: A heterozygous natriuretic peptide receptor 2 (NPR2) gene c.2455C>T mutation was identified as a cause of familial idiopathic short stature (ISS). Only two cases with this mutation were reported previously, and the probands with ISS had no organ system defects. METHODS: Next-generation sequencing (NGS) was performed on an amniotic fluid DNA sample of a fetus with shortened long bones and a small ventricular septal defect detected by an obstetric ultrasound examination. The pathogenic variant of the fetus was confirmed by Sanger sequencing. Sanger sequencing, G-banded, and C-banded karyotyping of the fetus's parents were subsequently performed. RESULTS: A de novo NPR2 gene c.2455C>T, p.(Arg819Cys) mutation was identified in the fetus. No microdeletion or microduplication was identified in the fetus by copy number variation sequencing with a maximum resolution of 400 kb. The two previous miscarriages experienced by the fetus's parents were interpreted as a result of chromosomal aberrations, including a maternal fragile site at 16q22.1 and a rare paternal variant involving in a large G-band-positive and C-band-positive block of paracentric heterochromatin of chromosome 4p. CONCLUSION: This report provides clinical signs of a de novo heterozygous NPR2 gene c.2455C>T mutation in the fetus and shows paternal chromosomal aberrations causing repeated pregnancy loss.

Effects of lower limb and pelvic pin positions on leg length and offset measurement errors in experimental total hip arthroplasty.

BACKGROUND: Leg length (LL) and offset (OS) are important factors in total hip arthroplasty (THA). Because most LL and OS callipers used in THA depend on fixed points on the pelvis and the femur, limb position could affect measurement error. This study was conducted on a THA simulator to clarify the effects of lower limb position and iliac pin position on LL and OS errors and to determine the permissible range of limb position for accurate LL and OS measurement. METHODS: An LL and OS measurement instrument was used. Two pin positions were tested: the iliac tubercle and the top of the iliac crest intersecting with the extension of the femoral axis. First, the limb was moved in one direction (flexion-extension, abduction-adduction, or internal-external rotation), and LL and OS were measured for each pin position. Next, the limb was moved in combinations of the three directions. Then, the permissible range of combined limb position, which resulted in LL and OS measurement error within ±2 mm, was determined for each pin position. RESULTS: Only 4° of abduction/adduction caused 5-7 mm error in LL and 2-4 mm error in OS, irrespective of pin position. The effects of flexion-extension and internal-external rotation on LL error were smaller for the top of the iliac crest than for the iliac tubercle, though OS error was similar for both pin positions. For LL, the permissible range of the combined limb position was wider for the top of the iliac crest than for the iliac tubercle. CONCLUSION: To minimize LL and OS measurement errors in THA, adduction-abduction must be maintained. The iliac pin position in the top of the iliac crest is preferred because it provides less LL measurement error and a wider permissible range of combined limb position for accurate LL measurement.

Neither altered incubation temperature during fetal development nor preferred rearing temperature improves leg bone characteristics of broilers.

The present study evaluated whether broiler femoral and tibiotarsal characteristics (as assessed at slaughter age) could be improved if birds were reared under their preferred temperature and whether continuous high or low incubation temperature during the fetal period improves bone characteristics of broilers reared under heat stress or thermal preference. Broiler breeder eggs were incubated from day 13 until hatching under cold (36 °C), control (37.5 °C), or hot (39 °C) temperatures. Under these conditions, the eggshell temperatures were 37.4 ± 0.1°C, 37.8 ± 0.15°C, and 38.8 ± 0.3°C, respectively. Then, broiler chicks were reared under control, preferred (determined previously in thermal preference test), or high temperatures. At day 42 of age, the broilers were weighed and euthanized, and femora and tibiotarsi collected to measure weight, length, diaphysis perimeter, breaking strength, maximum flexion, rigidity, ash, phosphorus, and calcium. Rearing under the preferred temperature did not affect broiler body weight or femoral and tibiotarsal characteristics (P > 0.05). In contrast, high rearing temperature, decreased the body weight, mineral contents of both bones, femoral breaking strength, and tibiotarsal rigidity (P < 0.05). Regarding incubation temperature effects, egg exposure to cold and hot temperatures during the fetal period minimized or avoided a few effects of high rearing temperature, such as those on femoral and tibiotarsal morphological characteristics, mineral composition, and mechanical properties at slaughter age (P < 0.05), but not all. In conclusion, rearing under the preferred broiler temperature did not improve the bone characteristics, and the negative effects of high rearing temperature on bone development were minimized but not completely prevented by high or low temperature incubation during the fetal period.

Multidisciplinary management of the bone and joint infection complicating treatment of an open fracture of the lower limb.

Bone and joint infections (BJI) of the lower limb can cause functional sequelae and in some cases have an impact on patient's life prognostic. One of the main objectives of multidisciplinary consultation team meetings (MTM) in the treatment of bone and joint infections is to provide an appropriate medical-surgical care, pooling skills of different organ specialists: infectious disease physicians, microbiologists, orthopedic surgeons and plastic surgeons. Treatment is based on aggressive debridement, bone stabilization, adequate antibiotic therapy, long-term coverage of the loss of skin substance and close clinical monitoring. The authors present their multidisciplinary diagnostic and therapeutic approaches to BJI complicating an open fracture at a referent center in the management of complex bone and joint infections.

The methylation status of the embryonic limb skeletal progenitors determines their cell fate in chicken.

Digits shape is sculpted by interdigital programmed cell death during limb development. Here, we show that DNA breakage in the periphery of 5-methylcytosine nuclei foci of interdigital precursors precedes cell death. These cells showed higher genome instability than the digit-forming precursors when exposed to X-ray irradiation or local bone morphogenetic protein (BMP) treatments. Regional but not global DNA methylation differences were found between both progenitors. DNA-Methyl-Transferases (DNMTs) including DNMT1, DNMT3B and, to a lesser extent, DNMT3A, exhibited well-defined expression patterns in regions destined to degenerate, as the interdigital tissue and the prospective joint regions. Dnmt3b functional experiments revealed an inverse regulation of cell death and cartilage differentiation, by transcriptional regulation of key genes including Sox9, Scleraxis, p21 and Bak1, via differential methylation of CpG islands across their promoters. Our findings point to a regulation of cell death versus chondrogenesis of limb skeletal precursors based on epigenetic mechanisms.

Characterisation of peripheral bone mineral density in youth at risk of secondary osteoporosis - a preliminary insight.

OBJECTIVES: To describe peripheral long bone material and structural differences in youth at risk of secondary osteoporosis across disease-specific profiles. METHODS: Upper- and lower limbs of children and adolescents were scanned at 4% distal and 66% mid-shaft sites using peripheral Quantitative Computed Tomography sub-categorised as (1) increased risk of secondary osteoporosis (neuromuscular disorders; chronic diseases; endocrine diseases; inborn errors of metabolism; iatrogenic conditions), (2) low motor competence and (3) non-affected controls. RESULTS: Children with disease-specific profiles showed a range of bone deficits compared to the control group with these predominantly indicated for neuromuscular disorders, chronic diseases and low motor competence. Deficits between upper arm and lower leg long bone parameters were different for disease-specific profiles compared to the control group. Endocortical radius, muscle area, and mid-cortical ring density were not significantly different for any disease-specific profile compared to the control group for any bone sites. CONCLUSIONS: Neuromuscular disorders, chronic diseases and low motor competence have a strong correlation to bone health for appendicular bone parameters in youth, suggesting a critical mechanical loading influence which may differ specific to disease profile. As mechanical loading effects are observed in regional bone analyses, targeted exercise interventions to improve bone strength should be implemented to examine if this is effective in reducing the risk of secondary osteoporosis in youth.

Using ultrasound to diagnose long bone fractures.

Point-of-care ultrasound may be an alternative to radiographs for diagnosing long bone fractures when medical resources are limited. Safe and timesaving, ultrasound also can be used in the ED as a screening tool for suspected long bone fractures and can detect associated musculoskeletal injuries. Ultrasound can be used in radiation-sensitive patients such as children and pregnant patients.Studies have found that clinicians using ultrasound can detect long bone fractures with an average 90% sensitivity and specificity after an average of 1 to 4 hours total of didactic and practical training. More research is needed to determine standards for ultrasound training, patient morbidity outcomes, cost effectiveness, and insurance benefits.

Skeletal Effects of Nine Months of Physical Activity in Obese and Healthy Weight Children.

PURPOSE: Obesity during adolescence has multisystem health consequences. The objective of this work was to determine whether preadolescent overweight/obese children's bones respond to a 9-month physical activity intervention by increasing bone density similar to healthy weight children. METHODS: Participants included overweight/obese (BMI > 85%) and healthy weight (15% < BMI < 85%) preadolescents (8-9 yr old). Participants in the physical activity group participated in a 9-month physical activity curriculum every day after school. The wait list control group received no intervention. Both groups had overweight/obese children and healthy weight controls. Whole-body bone mineral content, area, and bone mineral apparent density (BMAD) were assessed using dual x-ray absorptiometry) at the beginning and end of the 9-month trial in the physical activity and control group. RESULTS: Overweight/obese preadolescent children had higher BMAD than healthy weight children (P < 0.001 for spine, leg, and whole body). However, the density/weight (BMAD/lean mass) was lower in overweight/obese children than that in healthy weight children, indicating that the density of bones in overweight/obese children may not compensate sufficiently for the excessive load due to weight. The change in BMAD over 9 months was greater in healthy weight children than overweight/obese children in the whole body and leg, but not the lumbar spine. Physical activity caused a site-specific increase in bone density, affecting the legs more than the lumbar spine, but there was no significant difference in the effect of exercise between the healthy weight and the overweight/obese group. CONCLUSIONS: The smaller change in BMAD over the 9 months and lower BMAD per unit lean mass in overweight/obese compared with healthy weight children may indicate a slower rate of bone mass accrual, which may have implications for bone health during skeletal growth in obese/overweight children.

Risk Factors for Compartment Syndrome in Pediatric Trauma Patients.

OBJECTIVE: This study aimed to identify risk factors for compartment syndrome (CS) in pediatric trauma populations. METHODS: We included patients younger than 19 years treated at trauma centers contributing to the National Trauma Data Bank between 2009 and 2012. Multivariable logistic regression was used to examine the association between risk factors and the development of CS. The final model adjusted for age, sex, race, number of comorbidities, Glascow Coma Scale, Injury Severity Score, mechanism of injury, and fracture of the lower limb. RESULTS: A total of 341,238 patients were eligible for analysis, and 896 patients developed CS (0.3%). In adjusted regression models, older patients had significantly higher odds of CS compared with patients 1 years or younger (odds ratio [OR], 3.29 [95% confidence interval [CI], 1.29-8.37; 2-6 years]; OR, 7.55 [95% CI, 3.08-18.55 [7-12 years]; OR, 10.34 [95% CI, 4.26-25.09 [13-18 years]). Male patients had significantly increased odds of CS compared with female patients, as did patients with lower limb fractures compared with patients without lower limb fractures (OR, 1.93 [95% CI, 1.56-2.40]; OR, 7.61 [95% CI, 6.48-8.94]; respectively). Finally, patients with a firearm injury had higher odds of CS compared with other mechanisms of injury (OR, 3.51 [95% CI, 2.70-4.56]). CONCLUSIONS: Older pediatric trauma patients, male patients, and those with lower limb fractures and firearm injuries have increased odds of CS. Information on risk factors can be used to help identify patients most likely to develop CS, facilitating timely diagnosis and treatment.

Last appearance of Homo erectus at Ngandong, Java, 117,000-108,000 years ago.

Homo erectus is the founding early hominin species of Island Southeast Asia, and reached Java (Indonesia) more than 1.5 million years ago1,2. Twelve H. erectus calvaria (skull caps) and two tibiae (lower leg bones) were discovered from a bone bed located about 20 m above the Solo River at Ngandong (Central Java) between 1931 and 19333,4, and are of the youngest, most-advanced form of H. erectus5-8. Despite the importance of the Ngandong fossils, the relationship between the fossils, terrace fill and ages have been heavily debated9-14. Here, to resolve the age of the Ngandong evidence, we use Bayesian modelling of 52 radiometric age estimates to establish-to our knowledge-the first robust chronology at regional, valley and local scales. We used uranium-series dating of speleothems to constrain regional landscape evolution; luminescence, 40argon/39argon (40Ar/39Ar) and uranium-series dating to constrain the sequence of terrace evolution; and applied uranium-series and uranium series-electron-spin resonance (US-ESR) dating to non-human fossils to directly date our re-excavation of Ngandong5,15. We show that at least by 500 thousand years ago (ka) the Solo River was diverted into the Kendeng Hills, and that it formed the Solo terrace sequence between 316 and 31 ka and the Ngandong terrace between about 140 and 92 ka. Non-human fossils recovered during the re-excavation of Ngandong date to between 109 and 106 ka (uranium-series minimum)16 and 134 and 118 ka (US-ESR), with modelled ages of 117 to 108 thousand years (kyr) for the H. erectus bone bed, which accumulated during flood conditions3,17. These results negate the extreme ages that have been proposed for the site and solidify Ngandong as the last known occurrence of this long-lived species.

An ideal solution? Optimising pretreatment methods for artificially mummified ancient Egyptian tissues.

RATIONALE: Although the analysis of skeletal remains dominates the study of ancient dietary stable isotopes, mummified bodies also allow short-term diet to be studied through the analysis of soft tissues. The application of resins, waxes and oils during mummification can affect the results obtained. This study assesses a range of methods for removing such substances from mummified tissue. METHODS: An experimental mummification model following ancient Egyptian methods was created using a modern pig leg. Sub-samples of skin, muscle and bone were removed and coated with a range of substances used in Egyptian mummification. Four methods were used to clean these samples before the measurement of the carbon and nitrogen stable isotope ratios of their gelatinised collagen content using a ThermoFinnigan Flash Elemental analyser coupled to a DeltaPlus XL isotope ratio mass spectrometer via a ConFlo III interface. RESULTS: The results showed that embalming materials can significantly affect dietary stable isotope ratios, and that these substances are most effectively removed using a mixture of polar and non-polar solvents. Results indicate that bone samples demineralised with HCl and skin samples produce more accurate results than bone samples demineralised with EDTA or muscle samples. CONCLUSIONS: The choice of tissue and the preparation methods used can have a significant effect on the accuracy of stable isotope data obtained from mummified tissue, particularly when embalming materials are also present. A mixture of solvents appears to be a more effective cleaning agent than a single solvent. Demineralisation with HCl is preferable for well-preserved bone, as used in this study, but whether this is the case for more fragile, less well-preserved bone requires further study. Skin samples produce more consistent data than muscle, but visually distinguishing between these tissues is not simple on ancient mummies.