Reducing Shoulder Complaints in Employees with High Occupational Shoulder Exposures: A Cluster-Randomised Controlled Study (The Shoulder-Café Study).

PURPOSE: To evaluate if a group-based Shoulder-Café intervention could reduce shoulder complaints more effectively than an individual-based control intervention in employees with shoulder complaints and high occupational shoulder exposures. METHODS: A cluster-randomised controlled study of 109 participants from 60 companies in Central Denmark Region. Companies were randomised and allocated to either Shoulder-Café or control intervention. Participants in both interventions received a pamphlet on home-based shoulder exercises and a pamphlet with general information on reducing occupational shoulder exposures. They also had their occupational shoulder exposures assessed. Shoulder-Café participants additionally received three café-meetings with casual discussion, clinical shoulder evaluation, education about shoulder anatomy and occupational shoulder exposures, supervised exercises, workplace-oriented counselling, and an optional workplace visit. The primary outcome measure was the Oxford Shoulder Score (OSS) at 6-month follow-up. Secondary outcome measures were the OSS at 12 months, Fear-Avoidance Beliefs Questionnaire - Physical Activity at 6 and 12 months, and Patients' Global Impression of Change at 6 months. The study also included seven supplementary outcome measures. RESULTS: Both groups improved from baseline to 6 months with respect to the primary outcome (P < 0.01). No group differences were found for the primary outcome (mean difference (MD) [95% confidence interval]: 0.3 [- 1.6; 2.2]) or secondary outcomes. The supplementary outcomes "felt informed about handling shoulder complaints" and "felt informed about reducing occupational exposures" at 6 months, and "Patients' Global Impression of Change" and "overall satisfaction" at 12 months favoured the Shoulder-Café intervention. CONCLUSION: The Shoulder-Café intervention did not reduce shoulder complaints more effectively than the control intervention. TRIAL REGISTRATION: The trial was registered at Clinicaltrials.gov on 19 May 2017 (ID: NCT03159910).

Improving cause of death certification in the Philippines: implementation of an electronic verbal autopsy decision support tool (SmartVA auto-analyse) to aid physician diagnoses of out-of-facility deaths.

BACKGROUND: The majority of deaths in the Philippines occur out-of-facility and require a medical certificate of cause of death by Municipal Health Officers (MHOs) for burial. MHOs lack a standardised certification process for out-of-facility deaths and when no medical records are available, certify a high proportion of ill-defined causes of death. We aimed to develop and introduce SmartVA Auto-Analyse, a verbal autopsy (VA) based electronic decision support tool in order to assist the MHOs in certifying out-of-facility deaths. METHOD: We conducted a stakeholder consultation, process mapping and a pre-test to assess feasibility and acceptability of SmartVA Auto-Analyse. MHOs were first asked to conduct an open-ended interview from the family members of the deceased, and if they were not able to arrive at a diagnosis, continue the interview using the standardised SmartVA questionnaire. Auto-Analyse then presented the MHO with the three most likely causes of death. For the pilot, the intervention was scaled-up to 91 municipalities. We performed a mixed-methods evaluation using the cause of death data and group discussions with the MHOs. RESULTS: Of the 5649 deaths registered, Auto-Analyse was used to certify 4586 (81%). For the remaining 19%, doctors believed they could assign a cause of death based on the availability of medical records and the VA open narrative. When used, physicians used the Auto-Analyse diagnosis in 85% of cases to certify the cause of death. Only 13% of the deaths under the intervention had an undetermined cause of death. Group discussions identified two themes: Auto-Analyse standardized the certification of home deaths and assisted the MHOs to improve the quality of death certification. CONCLUSION: Standardized VA combined with physician diagnosis using the SmartVA Auto-Analyse support tool was readily used by MHOs in the Philippines and can improve the quality of death certification of home deaths.

Drivers and constraints on offshore foraging in harbour seals.

Central place foragers are expected to offset travel costs between a central place and foraging areas by targeting productive feeding zones. Harbour seals (Phoca vitulina) make multi-day foraging trips away from coastal haul-out sites presumably to target rich food resources, but periodic track points from telemetry tags may be insufficient to infer reliably where, and how often, foraging takes place. To study foraging behaviour during offshore trips, and assess what factors limit trip duration, we equipped harbour seals in the German Wadden Sea with high-resolution multi-sensor bio-logging tags, recording 12 offshore trips from 8 seals. Using acceleration transients as a proxy for prey capture attempts, we found that foraging rates during travel to and from offshore sites were comparable to offshore rates. Offshore foraging trips may, therefore, reflect avoidance of intra-specific competition rather than presence of offshore foraging hotspots. Time spent resting increased by approx. 37 min/day during trips suggesting that a resting deficit rather than patch depletion may influence trip length. Foraging rates were only weakly correlated with surface movement patterns highlighting the value of integrating multi-sensor data from on-animal bio-logging tags (GPS, depth, accelerometers and magnetometers) to infer behaviour and habitat use.

Pre-clinical evaluation of the effect of co-medication with antibiotics and oral steroids in Göttingen Minipigs on the biological activity of the probiotic medicinal product TSO (Trichuris suis ova).

The probiotic medicinal product TSO (Trichuris suis ova) is administered to patients with active ulcerative colitis in an ongoing clinical phase IIb trial where the typical co-medications are steroids (prednisolone or budesonide) and antibiotics (e.g., phenoxymethylpenicillin). The present pre-clinical study evaluates the effects of these co-medications on the biological activity of TSO in Göttingen Minipigs. This translationally relevant pre-clinical model allows administration of TSO with and without oral steroids or antibiotics in a manner similar to the administration to patients, followed by quantification of the biological activity of TSO. The biological activity of TSO was not affected by oral steroids but was reduced by oral antibiotics. Fecal calprotectin, the common marker of intestinal inflammation in patients with UC, did not differ between groups.

Effect of extended scope physiotherapists assessments in orthopaedic diagnostic setting: a systematic review.

BACKGROUND: Patients with musculoskeletal diseases can potentially be assessed by an extended scope physiotherapist (ESP) instead of by an orthopaedic surgeon (OS). OBJECTIVES: To evaluate the effectiveness of the diagnostic musculoskeletal assessment performed by ESP compared to OS. DATA SOURCES: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PEDro and reference lists of included studies and previous reviews were searched in November 2015. ELIGIBILITY CRITERIA: Studies were included if they evaluated adults with a musculoskeletal disease referred to an outpatient orthopaedic clinic where a diagnostic assessment had been conducted by an ESP. DATA EXTRACTION: Data were extracted using a customised data extraction sheet. Two reviewers using checklists evaluated methodological independently. RESULTS: We included one randomised controlled trial and 31 observational studies. Diagnostic agreement between ESPs and OSs was 65 to 100% across studies. Health care cost savings for diagnostic assessments performed by ESPs were 27 to 49% compared to OSs. Overall, 77 to 100% of the patients were satisfied with the ESP assessment. Results were comparable on diagnostic agreement, cost and satisfaction in studies with high, moderate and low risk of bias. LIMITATIONS: Risk of bias in the included studies. CONCLUSION AND IMPLICATION OF KEY FINDINGS: Diagnostic assessments performed by ESP may be as beneficial as or even better than assessment performed by OSs in terms diagnostic agreement, costs and satisfaction. However, the methodological quality was generally too low to determine the clear effectiveness of ESP assessment, and more high quality studies are needed. Systematic review registration number: PROSPERO CRD42014014229.

X-ray tomography data of compression tested unidirectional fibre composites with different off-axis angles.

This data article contains lab-based micro-computed tomography (µCT) data of unidirectional (UD) non-crimp fabric (NCF) carbon fibre reinforced composite specimens that have been deformed by compression. The specimens contain UD fibres with off-axis angles of 0°, 5°, 10°, 15° and 20° and the compression testing induces kink-band formation. This data formed the basis for the analysis of the influence of in-plane shear on kink-plane orientation as reported in Wilhelmsson et al. (Wilhelmsson et al., 2019).

Persistent infection by Salmonella enterica servovar Typhimurium: are synbiotics a therapeutic option? - a case report.

Little is known about the prevalence of persistent human infections by nontyphoidal Salmonella (NTS). Recently published study results indicate that a small fraction (at least 2.2%) of NTS-infected patients continue to shed Salmonella for an extended period of time (up to years). Despite the recommendation not to use antibiotics for the treatment of uncomplicated NTS-Salmonella infection, little treatment guidance is available. Clinical findings from a NTS-patient indicate that administration of synbiotics (probiotic bacteria plus prebiotic) might be considered as a treatment option. We report data of a patient who was treated with a synbiotic preparation containing nine different probiotic bacteria and the prebiotic fructooligosaccharides (FOS). Starting from day one of the treatment, the patient experienced an improvement of symptoms and was symptom-free at the end of a 10 days treatment course. After finishing the treatment, the stool proved to be Salmonella enterica serovar Typhimurium negative. In vitro pathogenic inhibition studies showed the inhibitory effects of the multistrain synbiotic mixture against S. Typhimurium. Growth of S. Typhimurium was also inhibited by individual bacterial strains making part of the composition of the mixture. However, he inhibitory effects of individual strains varied significantly, with those of Streptococcus thermophilus St-21 and Lactobacillus helveticus SP-27 exhibiting the strongest inhibitory effect. Persistent infections by S. Typhimurium are a severe concern for the affected patients. Besides the symptomatic burden, infected persons are banned from work in certain areas (e.g. food related service). In addition, patients with persistent S. Typhimurium infections are a threat for the public health in general, as they serve as a reservoir for NTS transmission. The findings indicate that treatment with a synbiotic preparation might provide a treatment option for persistent S. Typhimurium infections. More clinical data have to be gathered to confirm the relevance of this potential treatment approach.

Our gut microbiota: a long walk to homeostasis.

The microbiome of the human gastrointestinal tract (GIT) consists of billions of bacteria, fungi and viruses, of which bacteria play the most important role in nutrition, immune development, production of vitamins and maintaining a well-balanced (homeostatic) microbial population. Many papers have been published on the microbiota in the human GIT, but little is known about the first group of bacteria that colonises an infant. The intestinal tract of an unborn is, despite general belief, not sterile, but contains bacteria that have been transferred from the mother. This opens a new research field and may change our understanding about the role bacteria play in early life, the selection of strains with probiotic properties and the treatment of diseases related to bacterial infections. Differences in bacterial populations isolated from meconia may provide answers to the prevention of certain forms of diabetes. More research is now focusing on the effect that a genetically diverse group, versus a much simpler microbial population, may have on the development of a homeostatic gut microbiome. The effect different bacterial species have on the gut-associated lymphoid tissue and cascade of immune responses has been well researched, but we still fail in identifying the ideal group of intestinal bacteria and if we do, it will certainly not be possible to maintain homeostasis with so many challenges the gut faces. Changes in diet, antibiotics, food preservatives and stress are some of the factors we would like to control, but more than often fail to do so. The physiology and genetics of the GIT changes with age and so the microbiome. This review summarises factors involved in the regulation of a gut microbiome.

Crack Detection in Fibre Reinforced Plastic Structures Using Embedded Fibre Bragg Grating Sensors: Theory, Model Development and Experimental Validation.

In a fibre-reinforced polymer (FRP) structure designed using the emerging damage tolerance and structural health monitoring philosophy, sensors and models that describe crack propagation will enable a structure to operate despite the presence of damage by fully exploiting the material's mechanical properties. When applying this concept to different structures, sensor systems and damage types, a combination of damage mechanics, monitoring technology, and modelling is required. The primary objective of this article is to demonstrate such a combination. This article is divided in three main topics: the damage mechanism (delamination of FRP), the structural health monitoring technology (fibre Bragg gratings to detect delamination), and the finite element method model of the structure that incorporates these concepts into a final and integrated damage-monitoring concept. A novel method for assessing a crack growth/damage event in fibre-reinforced polymer or structural adhesive-bonded structures using embedded fibre Bragg grating (FBG) sensors is presented by combining conventional measured parameters, such as wavelength shift, with parameters associated with measurement errors, typically ignored by the end-user. Conjointly, a novel model for sensor output prediction (virtual sensor) was developed using this FBG sensor crack monitoring concept and implemented in a finite element method code. The monitoring method was demonstrated and validated using glass fibre double cantilever beam specimens instrumented with an array of FBG sensors embedded in the material and tested using an experimental fracture procedure. The digital image correlation technique was used to validate the model prediction by correlating the specific sensor response caused by the crack with the developed model.

Effect of early supervised progressive resistance training compared to unsupervised home-based exercise after fast-track total hip replacement applied to patients with preoperative functional limitations. A single-blinded randomised controlled trial.

OBJECTIVE: To examine if 2 weekly sessions of supervised progressive resistance training (PRT) in combination with 5 weekly sessions of unsupervised home-based exercise is more effective than 7 weekly sessions of unsupervised home-based exercise in improving leg-extension power of the operated leg 10 weeks after total hip replacement (THR) in patients with lower pre-operative function. METHOD: A total of 73 patients scheduled for THR were randomised (1:1) to intervention group (IG, home based exercise 5 days/week and PRT 2 days/week) or control group (CG, home based exercise 7 days/week). The primary endpoint was change in leg extension power at 10 week follow up. Secondary outcomes were isometric hip muscle strength, sit-to-stand test, stair climb test, 20 m walking speed and patient-reported outcome (HOOS). RESULTS: Sixty-two completed the trial (85%). Leg extension power increased from baseline to the 10 week follow up in both groups; mean [95% CI] IG: 0.29 [0.13; 0.45] and CG: 0.26 [0.10; 0.42] W/kg, with no between-group difference (primary outcome) (P = 0.79). Maximal walking speed (P = 0.008) and stair climb performance (P = 0.04) improved more in the IG compared to CG, no other between-group differences existed. CONCLUSIONS: In this trial, supervised PRT twice a week in addition to 5 weekly sessions of unsupervised exercise for 10 weeks was not superior to 7 weekly sessions of unsupervised home-based exercise for 10 weeks in improving the primary outcome, leg-extension power of the operated leg, at the primary endpoint 10 weeks after surgery in THR patients with lower pre-operative function. TRIAL REGISTRATION: NCT01214954.

Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement? A non-randomized, controlled study.

BACKGROUND: Improvements in surgical techniques and increase of femoral head size might have changed the rationale for movement restrictions after total hip replacement (THR). AIM: To evaluate the influence of movement restrictions and assistive devices on rehabilitation after fast track THR. DESIGN: Non-randomized, controlled study. SETTING: Inpatient. POPULATION: 365 consecutively included THR patients. METHODS: Patients included the 3 initial month of the study underwent rehabilitation with restrictions in hip movement and a standard package of assistive devices (restricted group). This group was compared to patients included the following 3 months with less restricted hip movement and use of assistive devices according to individual needs (unrestricted group). Questionnaires on function, pain, quality of life (HOOS), anxiety (HADS), working status and patient satisfaction were completed before THR, 3 and 6 weeks after. RESULTS: The HOOS function score at the 3 measurement times was (mean ± SD); unrestricted group: 46 ± 17 - 76 ± 9 - 83 ± 14 compared to restricted group: 43 ± 16 - 81 ± 14 - 83 ± 13. Changes over time was significantly higher in the restricted group (P=0.004). Return to work 6 weeks after THR for the unrestricted group compared to restricted group was: 53% versus 32% (P=0.045). No significant differences between groups in pain, symptoms, quality of life, anxiety/depression, hip dislocations and patient satisfaction. CONCLUSION: This study showed slightly slower recovery in patient-reported function after reduction in movement restrictions and use of assistive devices, but the difference was eliminated after 6 weeks. Reduced movement restrictions did not affect the other patient-reported outcomes and led to earlier return to work. CLINICAL REHABILITATION IMPACT: It is possible to reduce movement restrictions and use of assistive devices considerably. More research on safety issues is needed to elucidate the effect of unrestricted rehabilitation on hip dislocation.

Fasting of mice: a review.

Fasting of mice is a common procedure performed in association with many different types of experiments mainly in order to reduce variability in investigatory parameters or to facilitate surgical procedures. However, the effects of fasting not directly related to the investigatory parameters are often ignored. The aim of this review is to present and summarize knowledge about the effects of fasting of mice to facilitate optimization of the fasting procedure for any given study and thereby maximize the scientific outcome and minimize the discomfort for the mice and hence ensure high animal welfare. The results are presented from a number of experimental studies, providing evidence for fasting-induced changes in hormone balance, body weight, metabolism, hepatic enzymes, cardiovascular parameters, body temperature and toxicological responses. A description of relevant normal behaviour and standard physiological parameters is given, concluding that mice are primarily nocturnal and consume two-thirds of their total food intake during the night. It is argued that overnight fasting of mice is not comparable with overnight fasting of humans because the mouse has a nocturnal circadian rhythm and a higher metabolic rate. It is suggested that because many physiological parameters are regulated by circadian rhythms, fasting initiated at different points in the circadian rhythm has different impacts and produces different results.

Functional interactions of manno-oligosaccharides with dietary threonine in chicken gastrointestinal tract. I. Growth performance and mucin dynamics.

1. An experiment was conducted to evaluate the interactive effects of manno-oligosaccharides (MOS; Bio-MOS®) and dietary threonine on the growth performance in relation to intestinal mucin dynamics in broiler chickens from 1 to 21 and from 22 to 35 d of age. Two concentrations of MOS (0 or 2 g/kg for d 1 to 21; and 0 or 1 g/kg for d 22 to 35) and three concentrations of threonine (0.0, 1.0 and 1.2 of National Research Council (NRC), 1994, recommendations) were included in the experimental diets for each age group. 2. Body weight gain was significantly lower in threonine-deficient birds compared with those fed on adequate or excess threonine diets. Positive interaction between MOS and threonine supplementation on body weight gain was apparent in all phases of growth due mainly to the significantly poorer performance of birds given excess threonine in the absence of MOS. 3. The duodenal and ileal adherent mucous thickness were reduced at 14 and 28 d in threonine-deficient birds. Nevertheless, MOS significantly increase duodenal adherent mucous thickness at 14 d and ileal mucous thickness at 14 and 28 d. At 14 d, a significant MOS and threonine interaction on the jejunal adherent mucous thickness was also noted in that there was no difference between adequate and excess threonine groups in the absence of MOS, but a significant increase with excess threonine and MOS supplementation. 4. Dietary threonine greatly influenced mucin synthesis at the translational stage with no effect on jejunal MUC2 gene expression. Conversely, MOS modulated the transcriptional stage of intestinal mucin synthesis by consistently up-regulating jejunal MUC2 gene expression which was independent of dietary threonine concentration. There were no significant interactions between threonine and MOS on all the goblet cell densities. However, there was a MOS and threonine interaction on the staining intensities of jejunal sulphomucins due mainly to the significantly lower staining intensities in birds fed excess threonine in the absence of MOS. 5. The ameliorative effect of MOS on the growth-suppressive effects of excess threonine is likely to be linked to its modulating effects on the intestinal mucin dynamics.

Functional interactions of manno-oligosaccharides with dietary threonine in chicken gastrointestinal tract. III. Feed passage rate.

1. A 3 × 2 factorial experimental design was used to investigate the interaction between threonine concentration (0.70, 1.0 and 1.3 of National Research Council (NRC), 1994, recommendations) and manno-oligosaccharides (0 and 2 g/kg) on feed passage rate in relation to intestinal microbial activities and crude mucin turnover. 2. There was no interaction between the effects of manno-oligosaccharides (MOS) and dietary threonine on total tract transit time. However, an interaction between MOS and threonine was apparent where increasing threonine in the absence of MOS led to a reduction in the mean retention time, but a trend in the opposite direction in the presence of MOS. The ileal mean retention time at deficient and adequate concentrations of threonine was also significantly shorter in the presence of MOS. 3. In the jejunum, dietary MOS interacted with threonine to increase the villus-to-crypt ratio with deficient and adequate concentrations of threonine but not with an excess. In the ileum, MOS had no effect on the villus-to-crypt ratio at the deficient and adequate concentrations of threonine but significantly increased the ileal villus-to-crypt ratio with an excess. 4. There were significant interactions between MOS and dietary threonine in their effects on ileal flow of crude mucin, with MOS supplementation increasing mucin concentration and output when threonine was adequate but not when deficient or in excess. 5. Neither MOS nor threonine affected volatile fatty acids and intestinal musculature. No effects of gut microflora or voluntary feed intake on feed passage rate was attributable to dietary threonine or MOS supplementation.

Functional interactions of manno-oligosaccharides with dietary threonine in chicken gastrointestinal tract. II. Mucosal development, mucin dynamics and nutrient utilisation.

1. A 3 × 2 factorial experimental design was used to investigate the interaction between threonine concentration (0.7, 1.0 and 1.3 of National Research Council (NRC), 1994, recommendations) and manno-oligosaccharides (MOS) supplemented at 0 and 2 g/kg on growth performance in relation to intestinal flow of crude mucins, mucosal development and nutrient utilisation. 2. There was no interaction between MOS and dietary threonine in any performance variable analysed, except for body weight gain during the period to 14 d of age, where body weight gain was significantly lower in birds fed excess threonine in the absence of MOS. Dietary MOS was also observed to significantly increase the body weight gain at deficient and adequate concentrations of threonine. 3. Dietary treatments had no significant effect on either the ileal external muscularis thickness or crypt depth. However, there was a MOS and threonine interaction in the ileal villus to crypt ratio and ileal crude mucin output with both being increased only at the adequate threonine concentration. 4. Dietary MOS tended to interact with threonine to increase the ileal uptake of D-glucose and L-threonine, but the effect was only apparent in birds fed on the deficient or excess threonine diet. There was no significant interaction between MOS and threonine on ileal digestibility of amino acids. Supplementation of MOS or increased dietary threonine significantly increased the apparent and standardised ileal digestibility of threonine. 5. Results from the current study indicate the possible link between the modulating effects of these supplements on intestinal mucosal development and mucin dynamics. This, in turn, may suggest a relatively higher proportion of mature enterocytes and absorptive area, which would be expected to improve the capacity for digestion and mucosal nutrient absorption.

The effect of environmental enrichment on the behavior of captive tufted capuchin monkeys (Cebus apella).

The authors provided different forms of environmental enrichment to six old laboratory male tufted capuchin monkeys (Cebus apella) and studied the behavior of the monkeys during a baseline period and during three enrichment periods. Each observation period lasted 5 d, with an interval of 6 d between periods. During the first enrichment period, the authors provided Buster cubes and wood cylinders with drilled holes filled with gum arabic. During the second enrichment period, monkeys were provided with a deep litter of bark shavings, and during the third enrichment period, they were given Buster cubes, wood cylinders and bark shavings. When provided with enrichment, the monkeys engaged in natural, species-specific activities and began to exhibit behavioral profiles that more closely resembled those of their natural counterparts. This suggests that their psychological well-being had improved and that group housing combined with environmental enrichment can improve the welfare of old laboratory tufted capuchin monkeys that were previously housed individually.

Characterisation and response of intestinal microflora and mucins to manno-oligosaccharide and antibiotic supplementation in broiler chickens.

1. An experiment was conducted to characterise and evaluate, in comparison to zinc bacitracin (ZnB), the response of intestinal microflora and mucins to manno-oligosacchares (MOS, Bio-MOS(R), Alltech Biotechnology, Nicholasville, Kentucky, USA). 2. Supplementation of MOS and ZnB selectively increased the intensity of sulphomucins. As revealed by the plate culture method, MOS accelerated the maturation of gut microflora by promoting the growth of lactobacilli in the ileal mucosa and vice versa on ileal and caecal clostridia. Unlike MOS, ZnB suppressed the growth of intestinal bacteria, especially those of lactobacilli and clostridia. Use of T-RFLP further revealed that MOS increased the diversity of lactobacilli in the ileum and ileal mucosa but the opposite was observed for ZnB. It also appears that MOS and ZnB possessed a common property in differentially favouring the growth of certain Lactobacillus species. There was also evidence to show that both MOS and ZnB also increased the homogeneity of the gut microflora, possibly through the regulation of the overall gut bacterial communities. 3. Improvement in intestinal microbial homogeneity and mucin synthesis, coupled with the differential selections for certain specific beneficial bacterial species, may ultimately be proven to be the target mechanisms in the search for more effective alternatives to antibiotics.

Comparison of alternatives to in-feed antimicrobials for the prevention of clinical necrotic enteritis.

AIMS: The capacity for Lactobacillus johnsonii and an organic acid (OA) blend to prevent Clostridium perfringens-induced clinical necrotic enteritis (NE) in chickens was studied. METHODS AND RESULTS: Cobb 500 birds were allocated into six groups (n = 25 birds/pen, eight pens/treatment); Unchallenged, Challenged, Antimicrobial (zinc bacitracin (ZnB)/monensin), OA, probiotic Lact. johnsonii and probiotic sham (Phosphate-buffered saline). All birds were challenged with Eimeria spp. and Cl. perfringens except for unchallenged controls. Birds fed antimicrobials were protected from NE development as indicated by maintenance of body weight, low mortality and clostridium levels, and decreased intestinal macroscopic lesion scores compared to challenged controls (P < 0.05). Lactobacillus johnsonii-fed birds had reduced lesion scores, whilst OA-fed birds had decreased Cl. perfringens levels. Both Lact. johnsonii and OA-fed birds had improved feed efficiency between days 0 and 28 compared to challenged controls; however, mortality and body weights were not improved by either treatment. Microbial profiling indicated that the challenge procedure significantly altered the jejunal microbiota. The microbiota of antimicrobial-fed birds was significantly different from all other groups. CONCLUSIONS: Whilst Lact. johnsonii and OA altered specific intestinal parameters, significant protection against NE was not observed. SIGNIFICANCE AND IMPACT OF THE STUDY: Lactobacillus johnsonii and OA did not prevent NE; however, some improvements were evident. Other related treatments, or combinations of these two treatments, may provide greater protection.

Effect of potassium diformate on growth performance and gut microbiota in broiler chickens challenged with necrotic enteritis.

1. The effect of potassium diformate (KDF) on mortality, growth performance, microbial populations, pH and short chain fatty acid concentrations in the intestinal tract of broiler chickens challenged with necrotic enteritis was investigated. 2. An experiment with 1050 Cobb male broiler chickens was conducted from 1 to 35 d of age. There were 7 treatment groups: (1) unchallenged negative control, (2) unchallenged KDF (4.50 g/kg feed), (3) challenged negative control, (4) challenged positive control (100 ppm monensin and 45 ppm Zn-bacitracin), and (5) to (7) challenged KDF (inclusion rate 2.25, 4.50 and 6.75 g/kg feed, respectively). 3. The necrotic enteritis challenge caused significant growth depression except in the challenged positive control group. Inclusion of KDF in feed had no significant effect on weight gain or feed conversion ratio, neither under challenged nor unchallenged conditions. Necrotic-enteritis-related mortalities were reduced in response to the positive control feed and KDF at 2.25 and 4.50 g/kg rates, but with no effect at the 6.75 g/kg rate. 4. There was no effect of KDF on Clostridium perfringens numbers in jejunum during the necrotic enteritis challenge (d 15). Post challenge (d 35), 4.5 g/kg KDF reduced the number of C. perfringens and Enterobacteria in jejunum compared with the negative control group. 5. Intestinal pH was not affected by adding KDF to the feed. The challenge reduced jejunum pH compared with the unchallenged treatment groups and challenged positive control group. 6. Chickens fed the KDF diets had detectable concentrations of formic acid in the jejunum. There was a tendency towards higher concentrations of acetic acid and lactic acid in the small intestine of unchallenged birds, whereas challenged birds had higher concentrations of butyric acid in the caeca. 7. It is concluded that KDF holds promise as an agent to control necrotic enteritis in broiler chickens and it may be possible to enhance the efficacy of KDF by manipulating dietary properties that may influence the dissociation kinetics of KDF in the gut.

Intestinal function and gut microflora of broiler chickens as influenced by cereal grains and microbial enzyme supplementation.

A study was conducted to investigate the effect of the key cereal grains and a microbial enzyme supplement on broiler chicken performance, gut microflora and intestinal function. Ingestion of the barley-based diet was associated with low 28-day body weight, decreased feed intake and high FCR. The supplemental enzyme increased feed intake and weight gain of the chickens on a wheat-based diet. The pH of the gizzard and caecal contents varied with the grain type. Enzyme supplementation reduced ileal viscosity, particularly in birds that received the diet based on wheat. The birds on the barley-based diet had lower ileal digestibility of dry matter, protein and energy than those given maize and sorghum-based diets. The ileal digestibility of starch was increased by enzyme supplementation. Enzyme supplementation increased the number of total anaerobic bacteria in the gizzard of birds fed on sorghum and increased lactobacilli in the gizzard of those fed both sorghum and wheat. The birds fed the sorghum-based diet had the lowest counts of caecal total anaerobic bacteria and lactobacilli. Jejunal villus height and villus:crypt ratio of birds fed the barley-based diet were the lowest when compared with those fed the other diets. Enzyme application induced an increase in villus height and villus:crypt ratio of birds on wheat, crypt depth on barley and a reduction in crypt depth of chickens on the sorghum-based diets. The highest activity of maltase and the lowest activity of sucrase were observed in tissue from birds fed on maize and sorghum-based diets respectively. The differences in the performance of broilers on cereal grains could be explained by changes in intestinal morphology, enzyme activities and gut microflora as well as nutrient digestibility. The improved performance by supplemental enzyme in wheat-fed chickens was associated with beneficial changes in intestinal morphology and digesta viscosity.