The Effects of Agrimonia pilosa Ledeb, Anemone chinensis Bunge, and Smilax glabra Roxb on Broiler Performance, Nutrient Digestibility, and Gastrointestinal Tract Microorganisms.

Poultry farming is growing globally, particularly in developing countries, to meet the demands of growing populations for poultry meat and eggs. This is likely to lead to an increase in the use of antibiotics in poultry feed, thus contributing to the development and spread of antibiotic resistance which, poses a serious threat to human and animal health worldwide. One way of reducing this threat is to reduce the use of antibiotics in poultry production by finding effective and sustainable antibiotic alternatives that can be used to support poultry health and productivity. Therefore, this study evaluates the incorporation of three medicinal plants, Anemone chinensis Bunge, Smilax glabra Roxb, and Agrimonia pilosa Ledeb, in poultry feed on production performance, nutrient digestibility, and bacteria in the chicken caecum in a 35-day performance trial with 420-day-old male Ross 308 broilers. Groups of randomly selected chicks received one of six dietary treatments. These included five experimental diets of reduced nutrient specifications as a negative control (NC); with amoxicillin as a positive antibiotic control (PC1); with A. pilosa Ledeb (NC1); with A. chinensis Bunge (NC2); and with S. glabra Roxb (NC3). One other positive control diet contained the recommended nutrient specification (PC2). Weight gain and feed intake were measured weekly and used to calculate the feed conversion ratio as performance parameters. Bacteria were enumerated from chicken caecum using a traditional plating method and selective agar. S. glabra Roxb and A. chinensis Bunge showed comparable effects to amoxicillin with significantly increased weight gain in birds offered these diets, compared to those offered the negative control from days 0 to 35 (p < 0.001). S. glabra Roxb exhibited effects similar to the amoxicillin control group with an improved feed conversion ratio (p < 0.001). In addition, S. glabra Roxb decreased numbers of E. coli and Campylobacter spp. on days 21 (p < 0.05) and 35 (p < 0.01) and increased numbers of lactic acid bacteria comparable to the antibiotic group on days 14 (p < 0.001) and 35 (p < 0.01). The findings of this in vivo trial highlight the potential of S. glabra Roxb and A. chinensis Bunge as beneficial feed material to promote poultry health and productivity in the absence of antibiotics.

A Comparison of Wearable Tonometry, Photoplethysmography, and Electrocardiography for Cuffless Measurement of Blood Pressure in an Ambulatory Setting.

OBJECTIVE: While non-invasive, cuffless blood pressure (BP) measurement has demonstrated relevancy in controlled environments, ambulatory measurement is important for hypertension diagnosis and control. We present both in-lab and ambulatory BP estimation results from a diverse cohort of participants. METHODS: Participants (N=1125, aged 21-85, 49.2% female, multiple hypertensive categories) had BP measured in-lab over a 24-hour period with a subset also receiving ambulatory measurements. Radial tonometry, photoplethysmography (PPG), electrocardiography (ECG), and accelerometry signals were collected simultaneously with auscultatory or oscillometric references for systolic (SBP) and diastolic blood pressure (DBP). Predictive models to estimate BP using a variety of sensor-based feature groups were evaluated against challenging baselines. RESULTS: Despite limited availability, tonometry-derived features showed superior performance compared to other feature groups and baselines, yieldingprediction errors of 0.32 ±9.8 mmHg SBP and 0.54 ±7.7 mmHg DBP in-lab, and 0.86 ±8.7 mmHg SBP and 0.75 ±5.9 mmHg DBP for 24-hour averages. SBP error standard deviation (SD) was reduced in normotensive (in-lab: 8.1 mmHg, 24-hr: 7.2 mmHg) and younger (in-lab: 7.8 mmHg, 24-hr: 6.7 mmHg) subpopulations. SBP SD was further reduced 15-20% when constrained to the calibration posture alone. CONCLUSION: Performance for normotensive and younger participants was superior to the general population across all feature groups. Reference type, posture relative to calibration, and controlled vs. ambulatory setting all impacted BP errors. SIGNIFICANCE: Results highlight the need for demographically diverse populations and challenging evaluation settings for BP estimation studies. We present the first public dataset of ambulatory tonometry and cuffless BP over a 24-hour period to aid in future cardiovascular research.

Passively sensing SARS-CoV-2 RNA in public transit buses.

Affordably tracking the transmission of respiratory infectious diseases in urban transport infrastructures can inform individuals about potential exposure to diseases and guide public policymakers to prepare timely responses based on geographical transmission in different areas in the city. Towards that end, we designed and tested a method to detect SARS-CoV-2 RNA in the air filters of public buses, revealing that air filters could be used as passive fabric sensors for the detection of viral presence. We placed and retrieved filters in the existing HVAC systems of public buses to test for the presence of trapped SARS-CoV-2 RNA using phenol-chloroform extraction and RT-qPCR. SARS-CoV-2 RNA was detected in 14% (5/37) of public bus filters tested in Seattle, Washington, from August 2020 to March 2021. These results indicate that this sensing system is feasible and that, if scaled, this method could provide a unique lens into the geographically relevant transmission of SARS-CoV-2 through public transit rider vectors, pooling samples of riders over time in a passive manner without installing any additional systems on transit vehicles.

Are we putting ourselves in danger? Occupational hazards and job safety for orthopaedic surgeons.

As physicians, we strive to meet the needs of our patients. In doing so, we are often exposed to hazards that have the potential to not only compromise our health, but also our ability to deliver the best possible healthcare. Occupational hazards specific to the field of orthopaedics include infectious organisms, radiation, surgical smoke, chemicals, hazardous noise, musculoskeletal injury, and psychosocial stressors. Even though orthopaedic surgeons acknowledge the risk, most lack in-depth knowledge of the associated long-term harm associated with these hazards and ways of reducing risk of exposure. Orthopaedic surgeons should increase awareness, follow established guidelines, and integrate preventative measures to create the safest possible work environment. It is our hope that by improving our own health, we will be better equipped to address the health concerns of those we serve-our patients.

Effects of marine biofertilisation on Celtic bean carbon, nitrogen and sulphur isotopes: Implications for reconstructing past diet and farming practices.

RATIONALE: The application of fertilisers to crops can be monitored and assessed using stable isotope ratios. However, the application of marine biofertilisers (e.g., fish, macroalgae/seaweed) on crop stable isotope ratios has been rarely studied, despite widespread archaeological and historical evidence for the use of marine resources as a soil amendment. METHODS: A heritage variety of Celtic bean, similar in size and shape to archaeobotanical macrofossils of Vicia faba L., was grown in three 1 × 0.5 m outdoor plots under three soil conditions: natural soil (control); natural soil mixed with macroalgae (seaweed); and 15 cm of natural soil placed on a layer of fish carcasses (Atlantic cod). These experiments were performed over two growing seasons in the same plots. At the end of each growing season, the plants were sampled, measured and analysed for carbon, nitrogen and sulphur stable isotope ratios (δ13 C, δ15 N, δ34 S). RESULTS: The bean plants freely uptake the newly bioavailable nutrients (nitrogen and sulphur) and incorporate a marine isotopic ratio into all tissues. The bean δ15 N values ranged between 0.8‰ and 1.0‰ in the control experiment compared with 2‰ to 3‰ in the macroalgae crop and 8‰ to 17‰ in the cod fish experiment. Their δ34 S values ranged between 5‰ and 7‰ in the control compared with 15‰ to 16‰ in the macroalgae crop and 9‰ to 12‰ in the cod fish crop. The beans became more 13 C-depleted (δ13 C values: 1-1.5‰ lower) due to crop management practices. CONCLUSIONS: Humans and animals consuming plants grown with marine biofertilisers will incorporate a marine signature. Isotopic enrichment in nitrogen and sulphur using marine resources has significant implications when reconstructing diets and farming practices in archaeological populations.

The Cost-Effectiveness of Meniscal Repair Versus Partial Meniscectomy in the Setting of Anterior Cruciate Ligament Reconstruction.

PURPOSE: To compare the cost-effectiveness of anterior cruciate ligament (ACL) reconstruction with meniscal repair to ACL reconstruction with partial meniscectomy. METHODS: A decision-analytic Markov disease progression model with a 40-year horizon was created simulating outcomes after both meniscal repair and partial meniscectomy at the time of ACL reconstruction. Event probabilities, costs, and utilities were used for the index procedures. The development of osteoarthritis and subsequent knee replacement were either calculated or selected from published literature. Difference in cost, difference in quality-adjusted life-years (QALYs), and incremental cost-effective ratio were calculated to determine which index procedure is most cost-effective. RESULTS: There is total direct cost from ACL reconstruction with meniscus repair of $17,898 compared with that with partial meniscectomy of $24,768 (cost savings of $6,870). There was an estimated gain of 18.00 QALYs after ACL reconstruction with meniscus repair compared with 17.16 QALYs with partial meniscectomy (increase of 0.84 QALYs). In this scenario, meniscus repair is the dominant index procedure at the time of ACL reconstruction. CONCLUSIONS: Meniscal repair at the time of ACL reconstruction is more cost-effective than partial meniscectomy. LEVEL OF EVIDENCE: Level IV, economic and decision analysis.

Reliability of 3-Dimensional Glenoid Component Templating and Correlation to Intraoperative Component Selection.

Although implant-specific intraoperative targeting devices for glenoid sizing exist, a validated method for preoperatively templating glenoid component size in primary total shoulder arthroplasty (TSA) based on digital imaging does not. We conducted a study to determine if 3-dimensional (3-D) digital imaging could be used for preoperative templating of glenoid component size and to compare templated glenoid sizes with implanted glenoid sizes. We created 3-D digital models from 3 glenoid component implant sizes and preoperative scapular computed tomography scans of 24 patients who underwent primary TSA. In study arm 1, surgeons templated the 3-D components using only 2 df (superior-inferior and anterior-posterior planes). In study arm 2, surgeons templated the 3-D components using 6 df (superior-inferior, anterior-posterior, and rotational planes). Overall intraobserver agreement was substantial (0.67) in study arm 1 (P < .001) and moderate (0.58) in study arm 2 (P < .001). In arm 1, overall interobserver agreement was fair (0.36) for trial 1 (P < .001) and fair (0.32) for trial 2 (P < .001). In arm 2, overall interobserver agreement was moderate (0.54) for trial 1 (P < .001) and moderate (0.43) for trial 2 (P < .001). In both arms, surgeons tended to template glenoid components smaller than those implanted intraoperatively, particularly for female patients. Our findings show that 3-D digital models can be consistently and reliably used for preoperative templating of glenoid com-ponent size.

Effect of lower extremity fasciotomy length on intracompartmental pressure in an animal model of compartment syndrome: the importance of achieving a minimum of 90% fascial release.

BACKGROUND: There has been an increase in minimally invasive surgery for chronic exertional compartment syndrome (CECS), despite the potential for incomplete compartment release and iatrogenic injuries. To our knowledge, no study has examined the effect of the length of fascial release on compartment pressures. PURPOSE/HYPOTHESIS: The purpose was to explain the high failure rate seen in fascial release for CECS by evaluating the effect of fasciotomy length on intracompartmental pressures. We hypothesized that complete fascial release would need to be performed to return pressures to baseline levels. STUDY DESIGN: Controlled laboratory study. METHODS: Five male swine (10 lower extremities) were anesthetized. A slit catheter, connected to a pressure monitor, was inserted into the anterior compartment and a solution containing 5% swine albumin was injected into the compartment until the compartment pressure was >25 mm Hg for 10 minutes. Pressures were measured at rest, after the injection, and after each 10% incremental fasciotomy release. RESULTS: The mean resting intracompartmental pressure was 3.2 mm Hg (range, 0-6 mm Hg), which increased after the injection to a mean of 37 mm Hg (range, 26-67 mm Hg). After complete fasciotomy, the mean pressure was 1.1 mm Hg (range, 0-4 mm Hg). There was a strong negative correlation (r=-0.693) between fasciotomy length and intracompartmental pressure. In 90% of the specimens, the pressures were <15 mm Hg after 80% fascial release, and after 90% release, all pressures were ≤8 mm Hg. CONCLUSION: This study demonstrates a strong correlation between fasciotomy length and a reduction in intracompartmental pressures in a swine model. Our study suggests that 90% fascial release may represent a possible watershed zone, returning the intracompartmental pressure to a value at or near baseline values. CLINICAL RELEVANCE: The results suggest that even in cases with near complete fascial release, intracompartmental pressures may decrease enough to provide symptomatic relief and avoid possible iatrogenic injuries associated with percutaneous release. It is unknown whether the swine model may adequately translate to the clinical setting; thus, recommendations should be taken with caution, and future studies should be performed to examine the correlation in a human model.

Physical examination of the patellofemoral joint.

Examination of the patellofemoral joint can prove to be challenging. Although certain acute injuries such as patella fracture or tendon rupture can be diagnosed quickly, more chronic injuries such as patellar subluxation and patellofemoral pain syndrome are more difficult to diagnose because of the subtlety of the examination findings. The source of the problem can also vary, and must be identified to direct treatment. Adding to the complexity is that other structures around the knee may present with anterior knee pain and can be mistaken for patellofemoral disorder, which is why the patellofemoral examination should be performed in the context of a complete knee examination. For all of these reasons, performing a thorough and systematic examination of the patellofemoral joint can lead to optimal outcomes for patients.

Measuring slope to improve energy expenditure estimates during field-based activities.

This technical note describes methods to improve activity energy expenditure estimates by using a multi-sensor board (MSB) to measure slope. Ten adults walked over a 4-km (2.5-mile) course wearing an MSB and mobile calorimeter. Energy expenditure was estimated using accelerometry alone (base) and 4 methods to measure slope. The barometer and global positioning system methods improved accuracy by 11% from the base (p < 0.05) to 86% overall. Measuring slope using the MSB improves energy expenditure estimates during field-based activities.

Glenoid morphology after reaming in computer-simulated total shoulder arthroplasty.

BACKGROUND: The relationships between reaming parameters for glenoid-implant surface area and bone loss in total shoulder arthroplasty have not been well established. The hypotheses of this study are: (1) for large version corrections, a large reaming depth of 5 mm is not sufficient to obtain complete glenoid implant contact; (2) glenoid bone is removed in a linear proportion with reaming depth; and (3) initial reamer placement has no effect on glenoid bone removal. METHODS: Ten computer models from computed tomography scans of patients with advanced osteoarthritis were created for computer-simulated reaming as performed during total shoulder arthroplasty. Reaming variables studied included reaming depth, reamer placement, and version correction. The resulting reamed glenoid surface area available for implantation and bone volume removed were calculated for each permutation. RESULTS: Reamed surface area significantly increased with larger depths of reaming (P < .0001) and smaller version corrections (P < .0001). Bone volume removed and reaming depth had a strong quadratic relationship (r(2) = 0.999). With off-center reamer placement, volume removed when deviating in the posterior direction was significantly greater than when deviating in the anterior, superior, or inferior direction (P < .05). CONCLUSION: Performing smaller version corrections allows for greater attainable implant-bone surface contact because increasing reaming depth results in small increases in conforming surface area but large losses in glenoid bone stock. Bone volume removed was most sensitive to off-center position errors in the posterior direction.

The N terminus and C terminus of herpes simplex virus 1 ICP4 cooperate to activate viral gene expression.

Infected cell polypeptide 4 (ICP4) activates transcription from most viral promoters. Two transactivation domains, one N-terminal and one C terminal, are largely responsible for the activation functions of ICP4. A mutant ICP4 molecule lacking the C-terminal activation domain (n208) efficiently activates many early genes, whereas late genes are poorly activated, and virus growth is severely impaired. The regions within the N terminus of ICP4 (amino acids 1 to 210) that contribute to activation were investigated by analysis of deletion mutants in the presence or absence of the C-terminal activation domain. The mutants were assessed for their abilities to support viral replication and to regulate gene expression. Several deletions in regions conserved in other alphaherpesviruses resulted in impaired activation and viral growth, without affecting DNA binding. The single small deletion that had the greatest effect on activation in the absence of the C terminus corresponded to a highly conserved stretch of amino acids between 81 and 96, rendering the molecule nonfunctional. However, when the C terminus was present, the same deletion had a minimal effect on activity. The amino terminus of ICP4 was predicted to be relatively disordered compared to the DNA-binding domain and the C-terminal 500 amino acids. Moreover, the amino terminus appears to be in a relatively extended conformation as determined by the hydrodynamic properties of several mutants. The data support a model where the amino terminus is an extended and possibly flexible region of the protein, allowing it to efficiently interact with multiple transcription factors at a distance from where it is bound to DNA, thereby enabling ICP4 to function as a general activator of polymerase II transcription. The C terminus of ICP4 can compensate for some of the mutations in the N terminus, suggesting that it either specifies redundant interactions or enables the amino terminus to function more efficiently.

New horizons in sensor development.

BACKGROUND: Accelerometry and other sensing technologies are important tools for physical activity measurement. Engineering advances have allowed developers to transform clunky, uncomfortable, and conspicuous monitors into relatively small, ergonomic, and convenient research tools. New devices can be used to collect data on overall physical activity and, in some cases, posture, physiological state, and location, for many days or weeks from subjects during their everyday lives. In this review article, we identify emerging trends in several types of monitoring technologies and gaps in the current state of knowledge. BEST PRACTICES: The only certainty about the future of activity-sensing technologies is that researchers must anticipate and plan for change. We propose a set of best practices that may accelerate adoption of new devices and increase the likelihood that data being collected and used today will be compatible with new data sets and methods likely to appear on the horizon. FUTURE DIRECTIONS: We describe several technology-driven trends, ranging from continued miniaturization of devices that provide gross summary information about activity levels and energy expenditure to new devices that provide highly detailed information about the specific type, amount, and location of physical activity. Some devices will take advantage of consumer technologies, such as mobile phones, to detect and respond to physical activity in real time, creating new opportunities in measurement, remote compliance monitoring, data-driven discovery, and intervention.

Herpes simplex virus 1 ICP4 forms complexes with TFIID and mediator in virus-infected cells.

The infected cell polypeptide 4 (ICP4) of herpes simplex virus 1 (HSV-1) is a regulator of viral transcription that is required for productive infection. Since viral genes are transcribed by cellular RNA polymerase II (RNA pol II), ICP4 must interact with components of the pol II machinery to regulate viral gene expression. It has been shown previously that ICP4 interacts with TATA box-binding protein (TBP), TFIIB, and the TBP-associated factor 1 (TAF1) in vitro. In this study, ICP4-containing complexes were isolated from infected cells by tandem affinity purification (TAP). Forty-six proteins that copurified with ICP4 were identified by mass spectrometry. Additional copurifying proteins were identified by Western blot analysis. These included 11 components of TFIID and 4 components of the Mediator complex. The significance of the ICP4-Mediator interaction was further investigated using immunofluorescence and chromatin immunoprecipitation. Mediator was found to colocalize with ICP4 starting at early and continuing into late times of infection. In addition, Mediator was recruited to viral promoters in an ICP4-dependent manner. Taken together, the data suggest that ICP4 interacts with components of TFIID and Mediator in the context of viral infection, and this may explain the broad transactivation properties of ICP4.

Accuracy of a novel multi-sensor board for measuring physical activity and energy expenditure.

The ability to relate physical activity to health depends on accurate measurement. Yet, none of the available methods are fully satisfactory due to several factors. This study examined the accuracy of a multi-sensor board (MSB) that infers activity types (sitting, standing, walking, stair climbing, and running) and estimates energy expenditure in 57 adults (32 females) 39.2 ± 13.5 years. In the laboratory, subjects walked and ran on a treadmill over a select range of speeds and grades for 3 min each (six stages in random order) while connected to a stationary calorimeter, preceded and followed by brief sitting and standing. On a different day, subjects completed scripted activities in the field connected to a portable calorimeter. The MSB was attached to a strap at the right hip. Subjects repeated one condition (randomly selected) on the third day. Accuracy of inferred activities compared with recorded activities (correctly identified activities/total activities × 100) was 97 and 84% in the laboratory and field, respectively. Absolute accuracy of energy expenditure [100 - absolute value (kilocalories MSB - kilocalories calorimeter/kilocalories calorimeter) × 100] was 89 and 76% in the laboratory and field, the later being different (P < 0.05) from the calorimeter. Test-retest reliability for energy expenditure was significant in both settings (P < 0.0001; r = 0.97). In general, the MSB provides accurate measures of activity type in laboratory and field settings and energy expenditure during treadmill walking and running although the device underestimates energy expenditure in the field.

Isolated rupture of the teres major tendon.

Acute isolated rupture of the teres major is an uncommon injury. This article presents the first report of midterm subjective and objective functional results following nonoperative management of an isolated teres major rupture. A 30-year-old right hand dominant man presented after a waterskiing traction injury to his left upper extremity. On physical examination, the patient had swelling and retraction of the teres major at the lower scapular border, which was accentuated with resisted adduction of the extremity. His teres major attachment at the humerus was not palpable. Magnetic resonance imaging revealed an isolated teres major tendon rupture. The patient was treated non-operatively with a rehabilitation protocol emphasizing rotator cuff, periscapular, and latissimus muscle strengthening. By 3 months postinjury, the patient had returned to all of his usual sporting activities, despite a persistent muscle retraction deformity over the teres major. At 3-year follow-up, the patient had no subjective complaints in the injured extremity and excellent functional outcome scores. A mean 37 kg loss of internal rotation strength (as measured by dynamometer) in the affected extremity with the arm abducted to 90° existed, although this difference was not subjectively appreciable. Although previously published reports have presented various options for the management of teres major injuries, the present case demonstrates that nonoperative treatment can produce excellent midterm subjective results in spite of objective internal rotation weakness.

BALANCE (Bioengineering Approaches for Lifestyle Activity and Nutrition Continuous Engagement): developing new technology for monitoring energy balance in real time.

Methods that measure energy balance accurately in real time represent promising avenues to address the obesity epidemic. We developed an electronic food diary on a mobile phone that includes an energy balance visualization and computes and displays the difference between energy intake from food entries and energy expenditure from a multiple-sensor device that provides objective estimates of energy expenditure in real time. A geographic information system dataset containing locations associated with activity and eating episodes is integrated with an ArcPad mapping application on the phone to provide users with a visual display of food sources and locations associated with physical activity within their proximal environment. This innovative tool captures peoples' movement through space and time under free-living conditions and could potentially have many health-related applications in the future.

BALANCE: Towards a Usable Pervasive Wellness Application with Accurate Activity Inference.

Technology offers the potential to objectively monitor people's eating and activity behaviors and encourage healthier lifestyles. BALANCE is a mobile phone-based system for long term wellness management. The BALANCE system automatically detects the user's caloric expenditure via sensor data from a Mobile Sensing Platform unit worn on the hip. Users manually enter information on foods eaten via an interface on an N95 mobile phone. Initial validation experiments measuring oxygen consumption during treadmill walking and jogging show that the system's estimate of caloric output is within 87% of the actual value. Future work will refine and continue to evaluate the system's efficacy and develop more robust data input and activity inference methods.

Electrical Stimulation in Clinical Practice.

In brief Four forms of electrical stimulation are clinically useful in the rehabilitation of injured athletes. These forms differ mainly in the way they combine the parameters of wave form, frequency, pulse width, and amplitude. Transcutaneous electrical nerve stimulation provides effective relief of both acute and chronic pain. High-voltage pulsed galvanic stimulation has several treatment indications, including pain, swelling, tissue injury, and infection. Interferential electrical stimulation is used for muscle relaxation, analgesia, and to promote soft-tissue healing. Minimal electrical noninvasive stimulation is purported to facilitate tissue healing. Electrical stimulation should be used In concert with other modalities for a complete rehabilitation program.