Short communication: Repeat breeder cows with fluid in the uterine lumen had poorer fertility.

The objective of the present study was to test the association between the presence of fluid in uterine lumen and the fertility of repeat breeder cows (RBC). Grazing Holstein cows that were clinically normal and were not pregnant after at least 3 consecutive inseminations were defined as RBC and included in the study (n = 358). A cut-point ≥2 mm of uterine lumen visible by ultrasonography was used as indicative of the presence of fluid in the uterus. The effect of this fluid on the fertility of RBC was assessed by mixed logistic regression. Twenty percent of the RBC had ≥2 mm of fluid in their uterus, and this finding was associated with a marked reduction in the odds of conception (odds ratio = 0.46). Additional intrauterine sampling revealed that 24.0% of RBC showed signs of subclinical endometritis [≥5% neutrophils in endometrial cytology (SCE)]. However, we found no agreement between the finding of uterine fluid and the diagnosis of SCE (kappa coefficient = 0.03, 95% confidence interval = -0.07 to 0.14). In conclusion, the presence of fluid (≥2 mm) in uterine lumen, detected by ultrasonography, was associated with lower fertility in RBC, but was not related to the diagnosis of SCE. Thus, ultrasonographic evaluation is an important tool to assist in assessment of RBC.

Technical note: Evaluation of a system for monitoring individual feeding behavior and activity in beef cattle.

Behavioral observations are important to detect illness in beef cattle. However, traditional observation techniques are time and labor intensive and may be subjective. The objective was to validate a system for monitoring individual feeding behavior and activity in beef cattle (Fedometer [FEDO]; ENGS, Rosh Pina, Israel). Sixteen steers (initial BW ± SD = 326 ± 46 kg) were fitted with data loggers (FEDO) on their left front leg and housed in a pen with a feedbunk equipped with an antenna emitting an electromagnetic field that reached 30 ± 2 cm in front of the feedbunk. Feedbunk attendance (duration of visit and frequency of meals) measured by FEDO was compared with live observations (27 observational periods lasting between 72 and 240 min; mean 126 min). Lying time and frequency of lying bouts were compared with previously validated accelerometers fitted to the hind leg (10 steers equipped for 10 to 12 d; HOBO Pendant G Acceleration Data Logger [HOBO]; Onset Computer Corporation, Pocasset, MA). Step counts were compared with video recordings (15 observations for 6-min intervals in 6 steers). Concordance correlation coefficients (CCC), accounting for repeated measures, and limits of agreement were computed. Comparison between FEDO and observed time at the feedbunk yielded a CCC of 0.98 (95% confidence interval [CI] 0.97-0.99). All 68 meal events observed were recorded by FEDO. However, FEDO recorded 4 meal events during the 27 observational periods that were not observed. Lying time measured by HOBO and FEDO were highly correlated (CCC = 0.98; 95% CI 0.97-0.99). However, frequency of lying bouts measured by FEDO was only moderately correlated to HOBO (CCC = 0.71; 95% CI 0.63-0.77); FEDO underestimating the number of lying bouts (on average, 0.4 fewer bouts per 6 h). Step count by FEDO was moderately correlated to video observations (CCC = 0.75; 95% CI 0.49-0.89); FEDO overestimating the number of steps (on average, 5 more steps per 6 min). In conclusion, the FEDO system accurately measured duration of feedbunk attendance, frequency of meals, and lying time. However, it overestimated the number of steps and underestimated the frequency of lying bouts.

Evaluation of a Computer-aided Lung Auscultation System for Diagnosis of Bovine Respiratory Disease in Feedlot Cattle.

BACKGROUND: A computer-aided lung auscultation (CALA) system was recently developed to diagnose bovine respiratory disease (BRD) in feedlot cattle. OBJECTIVES: To determine, in a case-control study, the level of agreement between CALA and veterinary lung auscultation and to evaluate the sensitivity (Se) and specificity (Sp) of CALA to diagnose BRD in feedlot cattle. ANIMALS: A total of 561 Angus cross-steers (initial body weight = 246 ± 45 kg) were observed during the first 50 day after entry to a feedlot. METHODS: Case-control study. Steers with visual signs of BRD identified by pen checkers were examined by a veterinarian, including lung auscultation using a conventional stethoscope and CALA that produced a lung score from 1 (normal) to 5 (chronic). For each steer examined for BRD, 1 apparently healthy steer was selected as control and similarly examined. Agreement between CALA and veterinary auscultation was assessed by kappa statistic. CALA's Se and Sp were estimated using Bayesian latent class analysis. RESULTS: Of the 561 steers, 35 were identified with visual signs of BRD and 35 were selected as controls. Comparison of veterinary auscultation and CALA (using a CALA score ≥2 as a cut off) revealed a substantial agreement (kappa = 0.77). Using latent class analysis, CALA had a relatively high Se (92.9%; 95% credible interval [CI] = 0.71-0.99) and Sp (89.6%; 95% CI = 0.64-0.99) for diagnosing BRD compared with pen checking. CONCLUSIONS: CALA had good diagnostic accuracy (albeit with a relatively wide CI). Its use in feedlots could increase the proportion of cattle accurately diagnosed with BRD.

A generic framework for modeling brain deformation as a constrained parametric optimization problem to aid non-diffeomorphic image registration in brain tumor imaging.

OBJECTIVES: In the present paper a novel computational framework for modeling tumor induced brain deformation as a biophysical prior for non-rigid image registration is described. More precisely, we aim at providing a generic building block for non-rigid image registration that can be used to resolve inherent irregularities in non-diffeomorphic registration problems that naturally arise in serial and cross-population brain tumor imaging studies due to the presence (or progression) of pathology. METHODS: The model for the description of brain cancer dynamics on a tissue level is based on an initial boundary value problem (IBVP). The IBVP follows the accepted assumption that the progression of primary brain tumors on a tissue level is governed by proliferation and migration of cancerous cells into surrounding healthy tissue. The model of tumor induced brain deformation is phrased as a parametric, constrained optimization problem. As a basis of comparison and to demonstrate generalizability additional soft constraints (penalties) are considered. A back-tracking line search is implemented in conjunction with a limited memory Broyden-Fletcher-Goldfarb-Shanno (LBFGS) method in order to handle the numerically delicate log-barrier strategy for confining volume change. RESULTS: Numerical experiments are performed to test the flexible control of the computed deformation patterns in terms of varying model parameters. The results are qualitatively and quantitatively related to patterns in patient individual magnetic resonance imaging data. CONCLUSIONS: Numerical experiments demonstrate the flexible control of the computed deformation patterns. This in turn strongly suggests that the model can be adapted to patient individual imaging patterns of brain tumors. Qualitative and quantitative comparison of the computed cancer profiles to patterns in medical imaging data of an exemplary patient demonstrates plausibility. The designed optimization problem is based on computational tools widely used in non-rigid image registration, which in turn makes the model generally applicable for integration into non-rigid image registration algorithms.

[Individual and function-dependent therapeutic concept for the ruptured anterior cruciate ligament]. / Individuelles und funktionsabhängiges Therapiekonzept nach vorderer Kreuzbandruptur.

The knee joint is a ligament guided and muscular stabilized joint. Therefore the rupture of the anterior cruciate ligament (ACL) causes a functional deficit with change of the knee kinematics and the dynamic muscle stabilization. The muscular dysfunction can be the result of inadequate muscle strength, a neuro-muscular control defizit, a propriozeptive dysfunction or often the combination of these causes. Due to the complex anatomy of the ACL an exact, patient specific operative anatomical reconstruction is not possible. Therefore we suggest primarily a conservative therapeutic approach. If this approach fails the reconstruction will be performed after the first rehabilitation phase. Independently from the conservative or surgical approach, the rehabilitation program consists of four function-based phases and the overall therapy goal is to achieve the same or even higher activity level than before the lesion.

[Prospective study on injuries of the German national ice hockey teams in more than 1000 games]. / Prospektive Studie über Verletzungsmuster der Deutschen Eishockeynationalmannschaften bei über 1000 Länderspielen.

Due to the fast and physical nature of the game, prevention of injuries is an important issue in ice hockey. The injuries of the German male senior and junior (U16, U17, U18, U19, U20) national ice hockey teams were documented and analyzed in 1006 games between 1986 and 2006. This unique long observation period over 20 years, as well as the standardized protocol of documentation provides reliable data concerning injury pattern in German international ice hockey. Overall 277 injuries were recorded. Comparing the first and the last ten years of observation, the number did not decline over the time, despite various national and international efforts of injury prevention. The majority of the injuries, almost 60%, were caused by body contact with increasing tendency. Remarkably, the injuries with no body or puck/stick contact more than doubled in the last ten years compared to the first ten years of observation. Most injuries happened to the extremities with decreasing tendency to lower body and increasing tendency to upper body injuries. The number of head injuries did not change significantly. More injuries occurred in the second and third period compared to the first period of the game. The data of this study indicate that many injuries might be due to insufficient physical condition with consecutive lack of concentration and coordination. Players do not seem to meet the increasing technical and athletic requirements of international ice-hockey. The increasing speed and physical energy in international ice-hockey make the game unique and fascinating. Therefore, the aim must be to decrease the number and above all the severity of injuries by further development and adjustment of the player's equipment. Also, a better cooperation of players, coaches, sports medicine and referees seems to be necessary for injury prevention in the future.

Biocompatibility of an electrochemical sensor for continuous glucose monitoring in subcutaneous tissue.

BACKGROUND: The continuous monitoring of glucose allows for tighter control of the glucose concentration and thus may prevent hyper- and hypoglycemia as well as long-term complications of diabetes. While most current systems depend on the transport of fluid to a glucose sensor outside the body, we investigate the possibility of implanting a reagent-based sensor directly into the skin. In this manuscript, the biocompatibility of an electrochemical sensor for continuous glucose monitoring was assessed in vitro and in vivo. METHODS: Cytotoxicity was investigated in vitro using agar diffusion testing. In vivo biocompatibility was assessed by means of histomorphological examination of the surrounding tissue 10 days after sensor implantation in rats. RESULTS: The grade of cytotoxicity of the individual sensor components in vitro was between none and mild based on agar diffusion testing. The complete sensor also showed no cytotoxic effects when coated with the co-polymer MPC (2-methacryloyloxyethyl phosphorylcholine, Lipidure CM 5206, NOF Corp., Tokyo, Japan) and when assessed under working conditions, i.e., when a bias voltage was applied to the sensor. Additionally, the hydrogen peroxide-which is inherently generated by the enzymatic glucose detection process using glucose oxidase (GOD)-is likely to have been sufficiently decomposed under these working conditions. Finally, no toxic leachable substances were found during the cytotoxicity testing of sensors and its extracts in vitro. In the in vivo experiments, the strongest foreign body reaction (FBR) was found near the GOD-electrode using a sensor without MPC coating and without a porous membrane. Covering the sensor with MPC, a porous membrane, or both led to a gradual decrease of the FBR down to the level of the negative control. CONCLUSIONS: The electrochemical, reagent-based sensor with MPC coating and/or a porous membrane is suitable for continuous monitoring of glucose from a biocompatibility standpoint.

The lateral osteotomy in rhinoplasty: clinical and radiographic rationale for osteotome selection.

A preferred osteotome for endonasal osteotomy would facilitate reliable, complete osteotomies with minimal soft-tissue trauma. In this report, a radiographic evaluation of the bony lateral nasal wall thickness along the track of a high-low-high osteotomy was undertaken to guide the determination of appropriate osteotome size. Bone window axial computed tomographic scans were evaluated in 56 patients with a mean age of 48 years (range, 19 to 86 years). The average thickness along the site of lateral osteotomy was determined to be 2.47 mm (standard deviation, 0.47) in male patients and 2.29 mm (standard deviation, 0.40) in female patients. On the basis of these data, clinical evaluation of prototype 3- and 2.5-mm low-profile guarded osteotomes was undertaken in comparison with a "standard" 4-mm low-profile guarded osteotome to assess both their reliability and the degree of intranasal trauma, as reflected by intranasal mucosal tears. Although 2- and 3-mm unguarded osteotomes are time-tested, they may be reliable only in the hands of the most experienced surgeons. Therefore, a low-profile guard was included in the osteotome design to allow the surgeon to engage the bone securely and minimize the risk of slippage. Forty patients underwent rhinoplasty, for a total of 80 lateral osteotomies; the mean age of the patients was 38 (range, 16 to 75). In all cases, lateral osteotomies were accomplished with one pass. The 4-mm osteotome causes intranasal mucosal tears in 95 percent of osteotomies, the 3-mm osteotome in 34 percent, and the 2.5-mm in 4 percent. Early postoperative edema and ecchymosis were comparable among the groups. One patient, who underwent osteotomies with a 4-mm osteotome, had excessive postoperative narrowing, possibly due to his wearing of eyeglasses earlier than directed. This report suggests that proper selection of osteotome and attention to proper surgical technique results in a reliable, minimally traumatic lateral osteotomy through the endonasal approach. The 2.5-mm osteotome was reliable and the least traumatic to soft tissue of the osteotomes evaluated.

The flight from Rwanda in 1994: what were (are) the priorities?

EXTENT OF THE CATASTROPHE: More than 2 million refugees, 2-3 million displaced persons internally, thousands of unaccompanied children, and a total number of reported fatalities of 48,347 in Goma, Zaire. PRIORITIES FOR INTERNATIONAL RELIEF: International relief support started with coordination provided by the United Nations High Commissioner for Refugees (UNHCR). In the first phase, availability of potable water was the highest priority. Current priorities are to intensify repatriation of Rwandan refugees under conditions that will guarantee human rights and allow for dignified daily living. CONCLUSIONS: Education beginning at childhood, to overcome conflicts, social inequality, and overpopulation should be promoted by assisting governments, instead of pursuing policies aimed largely at forwarding their own national interests.