Evolution in design of integral leg prosthesis leads to improved outcomes

Developments of surgical attachments for bone-anchored prostheses are slowly but surely winning over the initial disbelief in the orthopedic community. Clearly, this option is becoming accessible to a wide range of individuals with limb loss. Seminal studies have demonstrated that the pioneering procedure relying on screw-type fixation engenders major clinical benefits and acceptable safety. The surgical procedure for press-fit implants, such as the Integral-Leg-Prosthesis (ILP) has been described Dr Aschoff and his team. Some clinical benefits of press-fit implants have been also established. Here, his team is once again taking a leading role by sharing the progression over 15 years of the rate of deep infections for 69 individuals with transfemoral amputation fitted with three successive refined versions of the ILP. By definition, a double-blind randomized clinical trial to test the effect of different fixation’s design is difficult. Alternatively, Juhnke and colleagues are reporting the outcomes of action-research study for a cohort of participants. The first and foremost important outcome of this study is the confirmation that the current design of the IPL and rehabilitation program are altogether leading to an acceptable rate of deep infection and other adverse events (e.g., structural failure of implant, periprosthetic factures). This study is also providing a strong insight onto the effect of major phases in redesign of an implant on the risk of infection. This is an important reminder that the development of a successful osseointegrated implant is unlikely to be immediate but the results of a learning curve made of empirical and sequential changes led by a reflective clinical practice. Clearly, this study provided better understanding of the safety of the ILP surgical and rehabilitation procedure while establishing standards and benchmark data for future studies focusing on design and infection of press-fit implants. Complementary observations of relationship between infection and cofounders such as loading of the prosthesis and prosthetic components used would be beneficial.Further definitive evidences of the clinical benefits with the latest design would be valuable, although an increase in health related quality of life and functional outcomes are likely to be confirmed. Altogether, the authors are providing compelling evidence that bone-anchored attachments particularly those relying on press-fit implants are an established alternative to socket prostheses.

Quantifying Transmission of Campylobacter jejuni in Commercial Broiler Flocks

Since meat from poultry colonized with Campylobacter spp. is a major cause of bacterial gastroenteritis, human exposure should be reduced by, among other things, prevention of colonization of broiler flocks. To obtain more insight into possible sources of introduction of Campylobacter into broiler flocks, it is essential to estimate the moment that the first bird in a flock is colonized. If the rate of transmission within a flock were known, such an estimate could be determined from the change in the prevalence of colonized birds in a flock over time. The aim of this study was to determine the rate of transmission of Campylobacter using field data gathered for 5 years for Australian broiler flocks. We used unique sampling data for 42 Campylobacter jejuni-colonized flocks and estimated the transmission rate, which is defined as the number of secondary infections caused by one colonized bird per day. The estimate was 2.37 +/- 0.295 infections per infectious bird per day, which implies that in our study population colonized flocks consisting of 20,000 broilers would have an increase in within-flock prevalence to 95% within 4.4 to 7.2 days after colonization of the first broiler. Using Bayesian analysis, the moment of colonization of the first bird in a flock was estimated to be from 21 days of age onward in all flocks in the study. This study provides an important quantitative estimate of the rate of transmission of Campylobacter in broiler flocks, which could be helpful in future studies on the epidemiology of Campylobacter in the field.

Factors affecting localized abundance and distribution of lesser mealworm in earth-floor broiler houses in subtropical Australia.

Factors that influence the localized abundance and distribution of lesser mealworm, Alphitobius diaperinus (Panzer), in litter of two compacted earth-floor broiler houses in subtropical Australia were studied using various experimental manipulations. Numbers of lesser mealworms substantially increased inside caged areas and under uncaged empty feed pans placed in open areas of the houses. These populations were found to be localized and independent of chicken-feed, manure, and high beetle populations that normally occur under existing feed pans. Substantial horizontal movement of larvae to under feed pans was recorded. Placing metal barriers around these pans significantly restricted this movement. In almost all treatments, lesser mealworms typically peaked in numbers during the middle of the flock time. This temporal pattern of abundance also was observed under pans within barriers, where relatively low insect numbers occurred, but it was not observed in uncaged open areas (where chickens had complete access). It is likely that larvae do not establish in open areas, but fluctuate in numbers as they either move to refuges away from chickens or suffer high rates of mortality. In these refuges, larvae peak in numbers and then leave the litter environment to pupate in the earth floor before the end of the flock time. This behavior might be exploited for management of lesser mealworm by targeting applications of control agents.

Mechanically Ventilated Broiler Sheds: a Possible Source of Aerosolized Salmonella, Campylobacter, and Escherichia coli.

This study assessed the levels of two key pathogens, Salmonella and Campylobacter, along with the indicator organism Escherichia coli in aerosols within and outside poultry sheds. The study ranged over a 3-year period on four poultry farms and consisted of six trials across the boiler production cycle of around 55 days. Weekly testing of litter and aerosols was carried out through the cycle. A key point that emerged is that the levels of airborne bacteria are linked to the levels of these bacteria in litter. This hypothesis was demonstrated by E. coli. The typical levels of E. coli in litter were similar to 10(8) CFU g(-1) and, as a consequence, were in the range of 10(2) to 10(4) CFU m(-3) in aerosols, both inside and outside the shed. The external levels were always lower than the internal levels. Salmonella was only present intermittently in litter and at lower levels (10(3) to 10(5) most probable number [MPN] g(-1)) and consequently present only intermittently and at low levels in air inside (range of 0.65 to 4.4 MPN m(-3)) and once outside (2.3 MPN m(-3)). The Salmonella serovars isolated in litter were generally also isolated from aerosols and dust, with the Salmonella serovars Chester and Sofia being the dominant serovars across these interfaces. Campylobacter was detected late in the production cycle, in litter at levels of around 107 MPN g(-1). Campylobacter was detected only once inside the shed and then at low levels of 2.2 MPN m(-3). Thus, the public health risk from these organisms in poultry environments via the aerosol pathway is minimal.

Odour emissions from tunnel-ventilated broiler sheds: case study of nine Queensland farms.

Odour emission rates were measured from nine tunnel-ventilated broiler farms in south-eastern Queensland, Australia. At one farm, odour emission rates were measured over two sequential batches approximately weekly, while at the remaining farms, odour emission rates were measured just before the first pickup (around Day 35 of the batch) when bird liveweight was greatest and peak odour emission rates were expected. Odour samples were analysed using dynamic olfactometry (to AS/NZS 4323.3:2001), and an artificial olfaction system was used to continuously monitor odour emission rates at one farm. Odour emission rates ranged from 330 to 2960 ou/s per 1000 birds and from 0.19 to 2.12 ou/s.kg, with a significant amount of variability observed throughout the batch and throughout each sampling day. While the wide range in odour emission rates was primarily due to changes in bird liveweight and ventilation requirements, other factors were also involved. The artificial olfaction system proved useful for quantifying the range and variability of odour emission rates, especially when olfactometry analysis was impractical.

Optimise efficacy of broiler house treatments for the management of lesser mealworm

The Australian chicken meat industry requires effective agents for the management of lesser mealworm in broiler houses. The only two appropriate insecticides currently registered are cyfluthrin and spinosad, with gamma cyhalothrin being developed for registration. The industry requires the efficacy of cyfluthrin to be investigated, with progress and adoption of the latter two chemicals. Optimising the efficacy of each chemical and studying them singly and in rotation will, in addition to improving their efficacy, reduce overall insecticide use and improve their cost effectiveness.

Trialling Biological Agents for the Management of Lesser Mealworm in Australian Broiler Houses

For approximately three decades the Australian broiler industry has relied heavily on the use of insecticides as its key tool for management of darkling beetle or lesser mealworm, Alphitobius diaperinus [Panzer] in broiler houses. The use of these chemicals over this period has been largely unchecked which has resulted in the development of strong insecticide resistance in many beetle populations from broiler farms. Although we are in a period now with an improved knowledge of managing resistance and the availability of new more effective insecticides that are currently marketed, the industry still requires more pest management options in order to inhibit development of resistance and reduce overall chemical use. In response to this need, ‘natural’ agents such as entomopathogenic nematodes and fungi were proposed as potential agents for managing darkling beetle populations in Australian broiler houses. Since 2007 laboratory and field studies have been undertaken to assess these agents. This report outlines these studies and discusses potential benefits to the Chicken Meat industry resulting from this research.

Risk factors for delayed healing in venous leg ulcers: A review of the literature [Letter]

We thank Andrea Cariati for his comments in response to our article on ‘Risk factors for delayed healing in venous leg ulcers: a review of the literature’. The relationship between lymphoedema and venous disease has not yet been well explored and we acknowledge that impairment of lymph flow may be a risk factor for delayed healing of venous leg ulcers...

Impact of the Australian litter re-use practice on Salmonella in the broiler farming environment

This study has examined the dynamics (in terms of levels and serovar diversity) of Salmonella in the "dual litter environment" that occurs within a single shed as a result of a management practice common in Australia. The study also looked at the physical parameters of the litter (pH, moisture content, water activity and litter temperature) as a means of understanding the Salmonella dynamics in these litter environments. The Australian practice results in the brooder end of the shed having new litter each cycle while the grow-out end has re-used litter (a "dual litter environment"). Two farms that adopted this partial litter re-use practice were studied over one full broiler cycle each. Litter was sampled weekly for the levels (and serovars) of Salmonella during a farming cycle. There was a trend for lower levels of Salmonella (and a lower Salmonella serovar) diversity in the re-used litter environment as compared with the new litter environment. Of the physical parameters examined, it would appear that the lower water activity associated with the re-used litter may contribute to the Salmonella dynamics in the dual environment.

Crystal growth and characterization of two-leg spin ladder compounds: Sr14Cu24O41 and Sr2Ca12Cu24O41

Single crystals of Sr14−xCaxCu24O41 (x=0 and 12) are grown by the travelling solvent floating zone technique using an image furnace. The grown crystals are characterized for their single crystallinity by the X-ray and Neutron Laue method. The magnetic susceptibility measurements in Sr14Cu24O41 show considerable anisotropy along the main crystallographic axes. Low-temperature specific heat measurement and DC susceptibility measurement in Ca-doped crystal showed antiferromagnetic ordering at 2.8 K at ambient pressure. High-pressure AC susceptibility measurement on Ca-doped crystal showed a sharp superconducting transition at 2 K under 40 kbars. Tc onset reached a maximum value of 9.9 K at 54 kbars. The bulk superconductivity of the sample is confirmed by the high-pressure AC calorimetry with Tc max=9.4 K and TN=5 K at 56 kbars.

Quantitative effects of in-line operations on Campylobacter and Escherichia coli through two Australian broiler processing plants

Campylobacter is an important food borne pathogen, mainly associated with poultry. A lack of through-chain quantitative Campylobacter data has been highlighted within quantitative risk assessments. The aim of this study was to quantitatively and qualitatively measure Campylobacter and Escherichia coli concentration on chicken carcasses through poultry slaughter. Chickens (n = 240) were sampled from each of four flocks along the processing chain, before scald, after scald, before chill, after chill, after packaging and from individual caeca. The overall prevalence of Campylobacter after packaging was 83% with a median concentration of 0.8 log10 CFU/mL. The processing points of scalding and chilling had significant mean reductions of both Campylobacter (1.8 and 2.9 log10 CFU/carcase) and E. coli (1.3 and 2.5 log10 CFU/carcase). The concentration of E. coli and Campylobacter was significantly correlated throughout processing indicating that E. coli may be a useful indicator organism for reductions in Campylobacter concentration. The carriage of species varied between flocks, with two flocks dominated by Campylobacter coli and two flocks dominated by Campylobacter jejuni. Current processing practices can lead to significant reductions in the concentration of Campylobacter on carcasses. Further understanding of the variable effect of processing on Campylobacter and the survival of specific genotypes may enable more targeted interventions to reduce the concentration of this poultry associated pathogen.

Re-use of chicken litter across broiler cycles – managing the food-borne pathogen risk

Thus the objectives of this study can be broadly categorised as follows:-  Evaluate current practices adopted (e.g. litter pile-up) prior to re-use of litter for subsequent chicken cycles  To establish pathogen die-off that occurs during currently adopted methods of in-shed treatment of litter  To establish simple physical parameters to monitor this pathogen reduction and create an understanding of such reduction strategies to aid in-shed management of re-use litter  To carry out studies to assess the potential of the re-used litter (once spread) to support pathogens during a typical chicken production cycle.  To provide background data for the development of a simple code of practice for an in-shed litter pile-up process

On-farm Campylobacter and Escherichia coli in commercial broiler chickens: Re-used bedding does not influence Campylobacter emergence and levels across sequential farming cycles

Limitations in quality bedding material have resulted in the growing need to re-use litter during broiler farming in some countries, which can be of concern from a food-safety perspective. The aim of this study was to compare the Campylobacter levels in ceca and litter across three litter treatments under commercial farming conditions. The litter treatments were (a) the use of new litter after each farming cycle; (b) an Australian partial litter re-use practice; and (c) a full litter re-use practice. The study was carried out on two farms over two years (Farm 1, from 2009–2010 and Farm 2, from 2010–2011), across three sheds (35,000 to 40,000 chickens/shed) on each farm, adopting three different litter treatments across six commercial cycles. A random sampling design was adopted to test litter and ceca for Campylobacter and Escherichia coli, prior to commercial first thin-out and final pick-up. Campylobacter levels varied little across litter practices and farming cycles on each farm and were in the range of log 8.0–9.0 CFU/g in ceca and log 4.0–6.0 MPN/g for litter. Similarly the E. coli in ceca were ∼log 7.0 CFU/g. At first thin-out and final pick-up, the statistical analysis for both litter and ceca showed that the three-way interaction (treatments by farms by times) was highly significant (P < 0.01), indicating that the patterns of Campylobacter emergence/presence across time vary between the farms, cycles and pickups. The emergence and levels of both organisms were not influenced by litter treatments across the six farming cycles on both farms. Either C. jejuni or C. coli could be the dominant species across litter and ceca, and this phenomenon could not be attributed to specific litter treatments. Irrespective of the litter treatments in place, cycle 2 on Farm 2 remained campylobacter-free. These outcomes suggest that litter treatments did not directly influence the time of emergence and levels of Campylobacter and E. coli during commercial farming.

The reproducibility of acquiring three dimensional gait and plantar pressure data using established protocols in participants with and without type 2 diabetes and foot ulcers

Background Several prospective studies have suggested that gait and plantar pressure abnormalities secondary to diabetic peripheral neuropathy contributes to foot ulceration. There are many different methods by which gait and plantar pressures are assessed and currently there is no agreed standardised approach. This study aimed to describe the methods and reproducibility of three-dimensional gait and plantar pressure assessments in a small subset of participants using pre-existing protocols. Methods Fourteen participants were conveniently sampled prior to a planned longitudinal study; four patients with diabetes and plantar foot ulcers, five patients with diabetes but no foot ulcers and five healthy controls. The repeatability of measuring key biomechanical data was assessed including the identification of 16 key anatomical landmarks, the measurement of seven leg dimensions, the processing of 22 three-dimensional gait parameters and the analysis of four different plantar pressures measures at 20 foot regions. Results The mean inter-observer differences were within the pre-defined acceptable level (<7 mm) for 100 % (16 of 16) of key anatomical landmarks measured for gait analysis. The intra-observer assessment concordance correlation coefficients were > 0.9 for 100 % (7 of 7) of leg dimensions. The coefficients of variations (CVs) were within the pre-defined acceptable level (<10 %) for 100 % (22 of 22) of gait parameters. The CVs were within the pre-defined acceptable level (<30 %) for 95 % (19 of 20) of the contact area measures, 85 % (17 of 20) of mean plantar pressures, 70 % (14 of 20) of pressure time integrals and 55 % (11 of 20) of maximum sensor plantar pressure measures. Conclusion Overall, the findings of this study suggest that important gait and plantar pressure measurements can be reliably acquired. Nearly all measures contributing to three-dimensional gait parameter assessments were within predefined acceptable limits. Most plantar pressure measurements were also within predefined acceptable limits; however, reproducibility was not as good for assessment of the maximum sensor pressure. To our knowledge, this is the first study to investigate the reproducibility of several biomechanical methods in a heterogeneous cohort.