Evolution of maternal feed restriction practices over 60 years of selection for broiler productivity.

The effect of commercial selection by poultry breeders on the growth, efficiency, and sexual maturity of broiler breeders was studied using 2 University of Alberta Meat Control strains unselected since 1957 and 1978 (AMC-1957 and AMC-1978, respectively) and 2 strains originating from the University of Arkansas; 1995 Random-bred (1995RB) and 2015 Random-bred (2015RB). A study with a 4 × 2 factorial arrangement was conducted with the 4 strains fed at either ad libitum, or restricted levels to achieve a current commercial breeder target BW profile. Growth rate, feed intake, feed efficiency, age at sexual maturity, carcass components, and body conformation were measured. To assess reproductive development, birds were assigned to 2 fates: dissected at photostimulation or dissected after the second oviposition. At 22.4 wk of age, the restricted-fed AMC-1957, AMC-1978, 1995RB, and 2015RB reached 100, 61, 46, and 38% of their ad libitum-fed counterparts' BW, respectively. During the rearing phase, the amount of feed needed to maintain restricted-fed birds on the target BW was 99.4, 57, 29.5, and 24.9% of their ad libitum-fed counterparts for AMC-1957, AMC-1978, 1995RB, and 2015RB, respectively. Feed restricted birds in the 2015RB had lower heat production relative to the AMC-1957 and AMC-1978, which shows that modern strains utilized feed more efficiently compared to the antique strains. This might be related to the increasing severity of feed restriction of broiler breeders over the past 60 years. Relative to AMC-1957 and AMC-1978 strains, the 1995RB and 2015RB strains had heavier breast muscle and lower fat pad weight. Although the pubertal threshold for age and BW have increased over the last 6 decades, changes in selection programs for feed efficiency have resulted in broiler breeders that prioritize nutrient allocation to growth and breast development rather than adipose storage. As a result, feed restricted modern broiler breeders may have marginally sufficient fat resources to support reproduction.

A phase 2 multimodality trial of docetaxel/prednisone with sunitinib followed by salvage radiation therapy in men with PSA recurrent prostate cancer after radical prostatectomy.

BACKGROUND: In men with high Gleason PC and rapid PSA progression after surgery, failure rates remain unacceptably high despite salvage radiation. We explored a novel multimodality approach of docetaxel with anti-angiogenic therapy before salvage radiotherapy (RT). METHODS: This was a phase 2 single-arm prospective open-label trial with historic controls. Eligible men had a rising PSA of 0.1-3.0 ng ml(-1) within 4 years of radical prostatectomy, no metastases except resected nodal disease, no prior androgen-deprivation therapy (ADT) and Gleason 7-10. Men received four cycles of docetaxel 70 mg m(-2) every 3 weeks with low dose prednisone and sunitinib 37.5 mg daily for 14/21 days each cycle, with no ADT. Salvage prostate bed RT (66 Gy) started at day 100. The primary end point was progression-free survival (PFS) rate at 24 months. Safety data, quality of life (QOL) and dose-limiting toxicities (DLTs) were measured over time. RESULTS: Thirty-four men accrued in this multi-institutional clinical trial: 24% of men were node positive, 47% were Gleason 8-10, median PSA at entry was 0.54. The trial was terminated prematurely owing to excess DLTs (nine) including grade 3 hand-foot syndrome (n=4), neutropenic fever (n=2), AST increase (n=1), fatigue (n=1) and vomiting with diarrhea (n=1). PFS rate at 24 months was 51% (95% CI: 33, 67%) with a median PFS of 26.2 months (95% CI: 12.5, -). Six men (17.6%) had an undetectable PSA at 2 years. CONCLUSIONS: Sunitinib and docetaxel/prednisone followed by salvage RT resulted in excess pre-specified DLTs. Although nearly half of the men experienced durable disease control, efficacy was not greater than expected with radiation alone. The use of the intermediate end point of PFS in this salvage setting permitted an early decision on further development of this combination.

Digit ratio (2D:4D) predicts sporting success among female fencers independent from physical, experience, and personality factors.

Research particularly focusing on male athletes and popular sports (running and soccer) suggests associations of lower (masculinized) second-to-fourth digit ratio (2D:4D), a putative marker of prenatal androgen action, with better sports performance. Studies focusing on women, non-mainstream sports, or controlling for covariates relevant for sporting success are still sparse. This study examined associations between 2D:4D and performance of both male and female athletes active in fencing (a non-mainstream sport dominated by male participants), while controlling for covariates. National fencing rankings and 2D:4D of 58 male and 41 female Austrian tournament fencers (mean age 24 years) were correlated. Among female, but not male, fencers, lower 2D:4D was related to better national fencing rankings. 2D:4D still accounted for incremental variance (12%) in fencing success, when the effects of salient performance factors (age, body mass index, years of fencing, training intensity, and the personality variables achievement, control, harm avoidance, and social potency) were controlled for (totaling 35% attributable variance). Athletes active in the most aggressive form (the sabre) had lower 2D:4D than those active in the other forms (épée and foil fencing). Sporting success in adult life might be partly prenatally programmed via long-lasting extragenital effects of testosterone.

Older adult perceptions of smart home technologies: implications for research, policy & market innovations in healthcare.

Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of older adults. While these technologies offer significant benefits to older people and their families, they are also transforming older adults into lead adopters of a new 24/7 lifestyle of being monitored, managed, and, at times, motivated, to maintain their health and wellness. To better understand older adult perceptions of smart home technologies and to inform future research a workshop and focus group was conducted with 30 leaders in aging advocacy and aging services from 10 northeastern states. Participants expressed support of technological advance along with a variety of concerns that included usability, reliability, trust, privacy, stigma, accessibility and affordability. Participants also observed that there is a virtual absence of a comprehensive market and policy environment to support either the consumer or the diffusion of these technologies. Implications for research, policy and market innovation are discussed.

Morbidity and mortality in elderly trauma patients.

BACKGROUND: Despite an increasing incidence, relatively few studies have examined the factors that predict morbidity and mortality in older patients and several reports have found standard predictors such as the Injury Severity Score to be less useful in this patient population. Similarly, the effect of skeletal injury has not been examined with regard to complications and mortality. The purpose of this study was to review a large multicenter experience with elderly trauma patients to isolate factors that might predict morbidity and mortality. The potential effect of skeletal long-bone injury was of particular interest. METHODS: The charts of all patients older than 60 years who were admitted to one of four Level I trauma centers after sustaining blunt trauma were reviewed. Mechanisms of injury included in the study were motor vehicle crash, pedestrian struck, fall from a height, and crush injury. Slip-and-fall injuries were excluded. A total of 326 patients met inclusion criteria. Variables studied included age, sex, mechanism of injury, Injury Severity Score (ISS), Revised Trauma Score, Glasgow Coma Scale (GCS) score, blood transfusion, fluid resuscitation, surgery performed (laparotomy, long-bone fracture stabilization, both), and timing of surgery. Outcome variables measured included incidence of adult respiratory distress syndrome, pneumonia, sepsis, myocardial infarction, deep venous thromboembolism, gastrointestinal complications, and death. chi2, logistic regression, t test, and nonparametric analyses were done as appropriate for the type of variable. RESULTS: The average age of the patients was 72.2+/-8 years. Overall, 59 patients (18.1%) died, of whom 52 of 59 survived at least 24 hours. Statistical significance for continuous variables (p < 0.05) using univariate analysis was reached for the following factors for the patients who died: higher ISS (33.1 vs. 16.4), lower GCS score (11.5 vs. 13.9), greater transfusion requirement (10.9 vs. 2.9 U), and more fluid infused (12.4 vs. 4.9 L). Logistic regression analysis was performed to determine the factors that predicted mortality. They included (odds ratios and p values in parentheses) transfusion (1.11, p = 0.01), ISS (1.04, p = 0.008), GCS score (0.87, p = 0.007), and fluid requirement (1.06, p = 0.06). Regarding surgery, orthopedic surgery alone had an odds ratio of 0.53, indicating that orthopedic patients was less likely to die than patients who did not undergo any surgery. Patients who underwent only a general surgical procedure were 2.5 times more likely to die (p = 0.03) and patients who underwent both general and orthopedic procedures were 1.5 times more likely to die (p = 0.32) than patients who did not require surgery. Early (< or =24 hours) versus late (>24 hours) surgery for bony stabilization did not have a statistical effect on mortality (11% early vs. 18% late). Two patients in need of bony stabilization, however, died before these procedures were performed. With regard to complications, regression analysis revealed that ISS predicted adult respiratory distress syndrome, pneumonia, sepsis, and gastrointestinal complications; fluid transfusion predicted myocardial infusion; and need for surgery and transfusion requirements predicted sepsis. These complications, in turn, were significant risk factors for mortality. This large series of elderly patients demonstrates that mortality correlates closely with ISS and is influenced by blood and fluid requirements and by GCS score. The institution-specific mortality was the same when adjusted for ISS. The need for orthopedic surgery and the timing of the surgery was not a risk factor for systemic complications or mortality in this series. CONCLUSION: Mortality is predicted by ISS and by complications in older patients. Seventy-seven percent of the orthopedic injuries were stabilized early, but the timing of surgery did not have any statistical effect on the incidence of complications or mortality. (ABSTRACT TRUNCA

Results of cochlear implantation in patients with severe to profound hearing loss--implications for patient selection.

In patients with some residual hearing and minor benefit from conventional hearing aids, the benefits of cochlear implantation have to be weighed carefully against eventual adverse effects. In this study, pre- and post-operative thresholds as well as functional results after cochlear implantation are reported; 17 of 44 implanted adults had residual hearing pre-operatively (mean threshold(250 to 4000 Hz): 106 dB HL) in the implanted ear. Residual hearing in the implanted ear could not, in general, be preserved post-operatively. Seventeen of 44 implanted children had some amount of residual hearing in the implanted ear pre-operatively (implanted ear: 114 dB HL; contralateral ear: 109.9 dB HL; mean thresholds(250 to 4000 Hz))). Contrary to the results in adults, residual hearing in the implanted ear remained statistically unchanged. Hearing in the contralateral ear increased significantly from 109.9 to 101.9 dB HL post-operatively. This increase was mainly attributed to maturation of the central auditory pathway. In adults with residual hearing, the monosyllable word recognition scores increased significantly from 9 per cent pre-operatively to 42 per cent post-operatively. Children with residual hearing tended to perform better on speech-related test material compared to children without prior auditory experience. Cochlear implantation is indicated in adults and children with residual hearing and minor benefit from conventional amplification. The contralateral ear in children should be considered for additional acoustical stimulation.

"Crack" cocaine-induced bilateral amblyopia.

Illicit use of cocaine has been associated with adverse vascular events involving most organ systems. A case report of a 30-year-old female with acute, bilateral loss of vision after smoking "crack" cocaine is presented. Other adverse ocular manifestations of cocaine use, and the differential diagnosis of toxin-induced blindness are presented.

Tibial autogenous cancellous bone as an alternative donor site in maxillofacial surgery: a preliminary report.

This preliminary report reviews the use of the proximal tibial metaphysis as an alternative to other bone graft donor sites. A series of 21 cancellous grafts were procured from 20 patients using a predictable orthopedic approach. A singular finding was the overall lack of morbidity at the donor site and the apparent favorable quality and quantity of the procured bone. Data describing the use of tibial cancellous bone grafting in a wide range of maxillofacial reconstructive procedures are presented.

Traumatic iliofemoral arterial injury: an association with high anterior acetabular fractures.

Two patients with documented anteroposterior compression injuries to the pelvis sustained concomitant injury to the iliofemoral artery and fracture of the acetabulum involving the high anterior column (the portion of the ilium forming the anterior component of the acetabulum). In a series of 800 major pelvic fractures similar arterial injuries have not occurred in association with other documented mechanisms. A high index of suspicion for iliofemoral artery injuries should be held by the clinician treating patients with acetabular fractures of the high anterior column sustained from anteroposterior compressive forces.