The Next Food Revolution Is Here: Recombinant Microbial Production of Milk and Egg Proteins by Precision Fermentation.

Animal-based agriculture and the production of protein-rich foods from animals, particularly from ruminants, are not sustainable and have serious climate effects. A new type of alternative proteins is now on the menu, namely animal proteins produced recombinantly by microbial fermentation. This new technology, precision fermentation, is projected to completely disrupt traditional animal-based agriculture. Certain milk and egg proteins along with specific meat substitute analog components produced by precision fermentation are already entering the market. This first wave of precision fermentation products targets the use of these proteins as protein additives, and several commercial players are already active in the field. The cost-efficiency requirements involve production titers above 50 g/L which are several orders of magnitude higher than those for pharmaceutical protein manufacture, making strain engineering, process optimization, and scale-up critical success factors. This new development within alternative proteins defines a new research direction integrating biotechnology, process engineering, and sustainable food protein production.

Reported accuracy of cranial closing wedge ostectomy variants for management of canine cranial cruciate ligament insufficiency: A systematic review and meta-analysis.

Concerns have been raised about the predictability of achieving appropriate tibial plateau angles (TPA), the occurrence of axis shift and tibial length reduction following cranial closing wedge ostectomy (CCWO). The primary objective of this review was to quantify typical errors in achieving target TPA with CCWO, with secondary objectives of assessing axis shift and length reduction. Retrospective or prospective studies of CCWO used as the primary treatment, from any date and in English, were eligible for inclusion. Searches were performed in EMBASE, Ovid MEDLINE, Agricola, Scopus, Web of Science, and CAB abstracts. Risk of bias was assessed, and data were screened for outliers and influential cases. Extracted data from 11 included studies were tabulated and underwent meta-analysis using R. Mean errors in TPA after CCWO ranged from - 0.6-2.9°, indicating the possibility of both under- and over-correction depending on the selected technique. Errors were relatively consistent for technique subgroups. Mean axis shifts ranged from 3.4° to 5.2°, and length reduction ranged from 0.4% to 3.2% of initial length, based on 6/11 and 3/11 studies, respectively. Data had high heterogeneity, many studies had small populations, and reporting standards were inconsistent. Concerns about the predictability of postoperative TPA may be overstated. With the limited data available, limb shortening does not appear to be a clinically important consideration. Axis shift will occur to varying degrees and must be considered during CCWO planning, as it influences the postoperative TPA. Careful choice of CCWO technique may allow clinicians to reliably achieve predictable TPA values.

Geometric modelling of error sources for tibial plateau levelling osteotomy in the dog.

Tibial plateau levelling osteotomy is widely performed for stabilization of cranial cruciate ligament deficient stifles in dogs. A wide range of postoperative tibial plateau angles around the target angle has been reported. The main aim of this study was to investigate if osteotomy placement could explain this range. Landmarks were derived from 50 tibial radiographs by five observers and used to define osteotomy placement and correction angles for simulation. Observer-specific osteotomy locations with mean landmark data were used to simulate planning errors, and simulated malpositioning of the osteotomy at 5 mm and 10 mm from the ideal location was used to simulate surgical errors. The tibial plateau midpoint was used as the ideal centre of the osteotomy in this model. Planning errors mostly arose from tibial plateau misidentification, with osteotomy centre locations dispersed up to 2.4% of tibial length from ideal. Malpositioning of the osteotomy resulted in variable changes in tibial plateau angle. Synthesis with historical data suggested such changes are likely limited in magnitude in tibiae with a mechanical axis length over 140 mm, but will be greater in smaller dogs and with steeper tibial plateaus. In medium to large breed dogs, our findings indicate osteotomy inaccuracy alone cannot explain the reported postoperative ranges in tibial plateau angles. Other error sources such as rotational inaccuracies or shifts during implant placement may be more significant. Surgeons should exercise additional caution when operating small and miniature breeds due to the much larger potential for clinically significant errors in these smaller dogs.

Clinically decisive (dis)agreement in multidisciplinary team assessment of esophageal squamous cell carcinoma; a prospective, national, multicenter study.

BACKGROUND: Decisions regarding tumor staging, operability, resectability, and treatment strategy in patients with esophageal cancer are made at multidisciplinary team (MDT) conferences. We aimed to assess interobserver agreement from four national MDT conferences and whether this would have a clinical impact. METHODS: A total of 20 patients with esophageal cancer were included across all four upper gastrointestinal (GI) cancer centers. Fully anonymized patient data were distributed among the MDT conferences which decided on TNM category, resectability, operability, curability, and treatment strategy blinded to each other's decisions. The interobserver agreement was expressed as both the raw observer agreement and with Krippendorff's α values. Finally, a case-by-case evaluation was performed to determine if disagreement would have had a clinical impact. RESULTS: A total of 80 MDT evaluations were available for analysis. A moderate to near-perfect observer agreement of 79.2%, 55.8%, and 82.5% for TNM category was observed, respectively. Substantial agreement for resectability and moderate agreement for curability were found. However, an only fair agreement was observed for the operability category. The treatment strategies had a slight agreement which corresponded to disagreement having a clinical impact in 12 patients. CONCLUSIONS: Esophageal cancer MDT conferences had an acceptable interobserver agreement on resectability and TM categories; however, the operability assessment had a high level of disagreement. Consequently, the agreement on treatment strategy was reduced with a potential clinical impact. In future MDT conferences, emphasis should be on prioritizing the relevant information being readily available (operability, T & M categories) to minimize the risk of disagreement in the assessments and treatment strategies, and thus, delayed or suboptimal treatment.

Geometric modelling of CORA-based levelling osteotomy in the dog.

Centre of rotation of angulation (CORA)-based levelling osteotomy (CBLO) is a recent addition to surgical procedures for stabilization of the cranial cruciate ligament-deficient canine stifle joint. Careful identification of the CORA location preoperatively and use of this location intraoperatively are required to ensure accurate correction of the tibial plateau angle. Limited data are available regarding the magnitude and source of potential errors during planning and execution of CBLO. A geometric model enabling isolation of various error sources is described. Landmarks were derived from tibial radiographs (n = 50) by 5 observers and used to define proximal and distal anatomical axes for simulation of CBLO. Observer-specific CORA locations with mean landmark data were used to assess planning errors, and simulated malpositioning of the CORA at 10 mm from the ideal location was used to assess surgical errors. Planning errors result mainly from tibial plateau misidentification, with CORA locations dispersed up to ±10 mm proximodistally from ideal (95% confidence). Malpositioning of the CORA during surgery causes equal and opposite changes in tibial plateau angle (TPA) and anatomical-mechanical axis angles, and varying degrees of translation and limb length changes. The magnitude of these changes is dependent on initial TPA and limb length, with smaller dogs and steeper tibial plateaus resulting in larger errors. Optimal planning and execution are required to achieve the planned outcome of CBLO. The main source of error in our simulation is identification of the tibial plateau. While both pre- and intraoperative errors influenced TPA, based on our geometric model the effect in larger dogs may not be clinically significant. If distalisation of the CORA is required during surgery, compensation of the CORA angle to maintain the target TPA is possible.

Effect of pen design on tail biting and tail-directed behaviour of finishing pigs with intact tails.

Tail biting is a welfare and economical concern in modern pig production. One common preventive measure used throughout the world is tail docking, which is generally considered one of the most effective methods for limiting tail biting. However, tail docking is a painful mutilation and systematic tail docking is not allowed in the EU. Therefore, the aim was to compare pig behaviour and the prevalence of tail biting in finishing pigs with intact tails housed in two different pen designs under Danish commercial conditions. PEN1 was a traditional Danish pen and PEN2 was inspired by Swedish finisher pen design and had a larger proportion of solid floor area (PEN1: 1/3 and PEN2: 2/3), reduced group size (PEN1: 15 and PEN2: 12), increased space allowance per head (PEN1: 0.7 m2 and PEN2: 0.89 m2) and straw allocated on the floor (PEN2) whereas straw was provided in a straw rack in PEN1. Tail damage observations were carried out daily by the stockperson and every 2 weeks one trained research technician assessed tail damages according to a tail scoring system. Tail lesions were observed in 51% of PEN1 and in 11% of PEN2 (P < 0.001). PEN1 had higher prevalence of tail damages than PEN2 (23% v. 5%, P < 0.001). Behavioural observations were carried out by the use of video recordings. Pigs in PEN2 tended to spend more time on tail-directed behaviour than pigs in PEN1 (P = 0.07), whereas pigs in PEN1 tended to spend more time on ear-directed behaviour (P = 0.08). Pigs in PEN2 spent more time on straw-directed behaviour compared to pigs in PEN1 (P < 0.001). Pen design did not affect time spent on other penmate-directed behaviour. In addition, the level of welfare between the two pen designs was compared using the Welfare Quality® protocol. PEN2 received an overall score of 'excellent' while PEN1 scored 'enhanced'. PEN2 scored higher on all principles besides 'good health', where PEN1 scored better on lameness and wounds. The main measurements accounting for the differences were water supply, huddling, tail biting, social behaviour and fear of humans. In conclusion, the combination of increased space allowance, increased area of solid flooring, straw allocated onto the floor and reduced group size (PEN2) resulted in fewer tail damaged pigs and a better overall welfare assessment, despite a tendency for more tail-directed behaviour.

Asteroseismic detection of latitudinal differential rotation in 13 Sun-like stars.

The differentially rotating outer layers of stars are thought to play a role in driving their magnetic activity, but the underlying mechanisms that generate and sustain differential rotation are poorly understood. We report the measurement using asteroseismology of latitudinal differential rotation in the convection zones of 40 Sun-like stars. For the most significant detections, the stars' equators rotate approximately twice as fast as their midlatitudes. The latitudinal shear inferred from asteroseismology is much larger than predictions from numerical simulations.

Standardised assessment of competence in Focused Assessment with Sonography for Trauma.

PURPOSE: The aim of this study was to develop and gather validity evidence for a standardised test of competence in Focused Assessment with Sonography for Trauma (FAST) and to define the appropriate cut-off point in simulation-based learning of the FAST protocol. METHODS: A 20-item simulation-based test for assessing competence in FAST was created. The test was administered to thirteen novices and twelve radiologists experienced in abdominal ultrasound diagnostics. The Contrasting Groups' method was used to establish a credible passing score. RESULTS: The internal consistency was high (Cronbach's α = 0.90) and the test had good discriminatory ability (P < .001). The mean score was 16.9 (95% CI: 15.5-18.3) in the experienced group and 8.0 (95% CI: 5.8-10.2) in the novice group, corresponding to 85% and 40% of the total score, respectively. A pass/fail standard of 14 points was established using the Contrasting Groups' method. CONCLUSIONS: The FAST simulation-based test provided valid assessment of competence in FAST. The FAST test could be used to guide training and ensure basic competence of physicians using FAST.

Alcohol use among Norwegian workers: associations with health and well-being.

Background: There is a lack of published data on the association between alcohol consumption and health and well-being in working populations. Aims: To determine how levels of alcohol consumption are associated with psychological distress, somatic complaints, sleep and job satisfaction in the Norwegian workforce. Methods: Survey questionnaire data from a probability sample comprising Norwegian employees. The association between alcohol consumption and health and well-being was assessed using analysis of covariance. Results: There were 1608 respondents (response rate 32%); 20% of the sample were abstainers, 72% were low- to moderate-alcohol users, 6% were moderate to high users and 2% were risky users. Adjusting for age, gender and tobacco use, employees with risky alcohol use reported significantly higher levels of psychological distress and lower job satisfaction when compared to employees who drank less. There were no differences between risky users and other employees with regard to sleep problems and somatic complaints, nor were there any gender differences. Conclusions: Our findings indicate that risky alcohol use in the Norwegian workforce is associated with impaired health and well-being, with no evidence of a gender differential. The findings support the thresholds for risky alcohol use as proposed by internationally recognized guidelines for alcohol consumption.

Sprint and jump performance in elite male soccer players following a 10-week Nordic Hamstring exercise Protocol: a randomised pilot study.

OBJECTIVE: The preseason Nordic Hamstring Protocol (NHP) reduces hamstring strain injuries in football players. Despite persisting injury rates, elite clubs are reluctant to apply the NHP often over concerns of negative impacts on performance. This pilot study investigated if sprint or jump-performance outcomes tended to increase or decrease following implementation of the NHP in elite male soccer-players. RESULTS: Nineteen male soccer players from the Danish 1st division were randomised to perform NHP (27 sessions) during pre-season, or to control group (CG). Sprint performance (30 m with 5 and 10 m split times) and countermovement jump (CMJ height) was measured before the mid-seasonal break and again after 10 weeks of performing the NHP at the end of pre-season. Dropouts were due to transfers and injuries unrelated to performing NHP (NHP = 0, CG = 5). Sprint performance on the short split distances improved for most players in the NHP (6 out of 9 improved, median changes for 5 m split: - 0.068 s; 10 m split: - 0.078 s), but not CG (2 out of 5 improved, median changes for 5 m split: + 0.1 s; 10 m split: CG: + 0.11 s), but both groups had small declines at 30 m sprint (NHP: 7 out of 9 declined, median changes: + 0.116 s; CG: 4 out of 5 declined, median changes: + 0.159 s). CMJ height mostly improved in both groups (NHP: 6 out of 9 improved, median changes: + 2.1 cm; CG: 4 out of 8 improved, median changes: + 0.55 cm). Performing the NHP in elite soccer players did therefore not seem to negatively affect sprint and vertical jump performance outcomes in the present study, while in fact showing some promise for the more explosive characteristics such as the short 5 and 10 m split-times and maximal CMJ height, which all are highly relevant performance parameters in elite football.

Nutrient re-routing and altered gut-islet cell crosstalk may explain early relief of severe postprandial hypoglycaemia after reversal of Roux-en-Y gastric bypass.

BACKGROUND: Roux-en-Y gastric bypass is associated with an increased risk of postprandial hyperinsulinaemic hypoglycaemia, but the underlying pathophysiology remains poorly understood. We therefore examined the effect of re-routing of nutrient delivery on gut-islet cell crosstalk in a person with severe postprandial hypoglycaemia after Roux-en-Y gastric bypass. CASE REPORT: A person with severe postprandial hypoglycaemia, who underwent surgical reversal of Roux-en-Y gastric bypass, was studied before reversal and at 2 weeks and 3 months after reversal surgery using liquid mixed meal tests and hyperinsulinaemic-euglycaemic clamps. The nadir of postprandial plasma glucose rose from 2.8 mmol/l to 4.1 mmol/l at 2 weeks and to 4.4 mmol/l at 3 months after reversal. Concomitant insulin- and glucagon-like peptide-1 secretion (peak concentrations and area under the curve) clearly decreased after reversal, while concentrations of glucose-dependent insulinotropic polypeptide and ghrelin increased. Insulin clearance declined after reversal, whereas clamp-estimated peripheral insulin sensitivity was unchanged. The person remained without symptoms of hypoglycaemia, but had experienced significant weight gain at 15-month follow-up. DISCUSSION: Accelerated nutrient absorption may be a driving force behind postprandial hyperinsulinaemic hypoglycaemia after Roux-en-Y gastric bypass. Re-routing of nutrients by reversal of the Roux-en-Y gastric bypass diminished postprandial plasma glucose excursions, alleviated postprandial insulin and glucagon-like peptide-1 hypersecretion and eliminated postprandial hypoglycaemia, which emphasizes the importance of altered gut-islet cell crosstalk for glucose metabolism after Roux-en-Y gastric bypass.

Screening instruments for predicting return to work in long-term sickness absence.

BACKGROUND: Multiple somatic symptoms are common and may cause prolonged sickness absence (SA) and unsuccessful return to work (RTW). AIMS: To compare three instruments and their predictive and discriminative abilities regarding RTW. METHODS: A longitudinal cohort study of participants recruited from two municipal job centres, with at least 8 weeks of SA. The instruments used were the Symptom Check List of somatic distress (SCL-SOM) (score 0-48 points), the Bodily Distress Syndrome Questionnaire (BDSQ) (0-120 points) and the one-item self-rated health (SRH) (1-5 points). The instruments' predictive value was explored in a time-to-event analysis. Different cut-points were analysed to find the highest number of correctly classified RTW cases, identified in a register on public transfer payments. RESULTS: The study involved 305 subjects. The adjusted relative risk regarding prediction of RTW was 0.89 [95% confidence interval (CI) 0.83-0.95], 0.89 (95% CI 0.83-0.95) and 0.78 (95% CI 0.70-0.86) per 5-, 10- and 1-point increase in the SCL-SOM, BDSQ and SRH, respectively. After mutual adjustment for the three instruments, only the prediction of RTW from SRH remained statistically significant 0.81 (95% CI 0.72-0.92). The highest sensitivity (86%) was found by SRH at the cut-point ≤5, at which 62% were correctly classified. CONCLUSIONS: All three instruments predicted RTW, but only SRH remained a significant predictor after adjustment for the SCL-SOM and BDSQ. The SRH provides an efficient alternative to more time-consuming instruments such as SCL-SOM or BDSQ for estimating the chances of RTW among sickness absentees.

Shift work, mental distress and job satisfaction among Palestinian nurses.

BACKGROUND: Associations between shift work (SW) schedules, mental distress and job satisfaction have never been completely described. AIMS: To examine gender-specific associations of SW with mental distress and job satisfaction in nurses in Hebron District, Palestine, in 2012. METHODS: Detailed information on work schedules (day versus shift), socio-demographic status, mental distress (General Health Questionnaire, GHQ-30) and job satisfaction (Generic Job Satisfaction Scale) in nurses employed in Hebron District, Palestine, was obtained through a questionnaire survey. Associations of SW and outcomes were examined by linear regression analysis. RESULTS: Of 372 nurses eligible for the study, 309 and 338 completed surveys regarding mental distress and job satisfaction, respectively. The sample comprised 62% women and 38% men. After adjusting for covariates, women working shifts reported significantly higher levels of mean mental distress [ß coefficient 3.6; 95% confidence interval (CI) 0.3-7.0] compared with women working regular day shifts. Men working shifts reported significantly lower levels of job satisfaction (-3.3; 95% CI -6.2 to -0.5) than men working regular day shifts. Women reported higher levels of mental distress than men, but this was unrelated to work schedule. CONCLUSIONS: In this study, nurses working shifts reported higher levels of mental distress and lower levels of job satisfaction, although these associations were weaker when adjusted for potential covariates. There was no evidence of a gender differential in the association between SW and mental distress and job satisfaction.

Ultrasound Vascular Elastography as a Tool for Assessing Atherosclerotic Plaques - A Systematic Literature Review.

Atherosclerosis is a widespread disease that accounts for nearly 3-quarters of deaths due to cardiovascular disease. Ultrasound elastography might be able to reliably identify characteristics associated with vulnerable plaques. There is a need for the evaluation of elastography and its ability to distinguish between vulnerable and stable plaques. The aim of this paper is to provide an overview of the literature on vascular elastography. A systematic search of the available literature for studies using elastography for assessing atherosclerotic plaques was conducted using the MEDLINE, Embase, Cochrane Library and Web of Science databases. A standardized template was used to extract relevant data following the PRISMA 2009 checklist. 20 articles were included in this paper. The studies were heterogeneous. All studies reported that elastography was a feasible technique and provided additional information compared to B-mode ultrasound alone. Most studies reported higher strain values for vulnerable plaques. Ultrasound elastography has potential as a clinical tool in the assessment of atherosclerotic plaques. Elastography is able to distinguish between different plaque types, but there is considerable methodological variation between studies. There is a need for larger studies in a clinical setting to determine the full potential of elastography.

Impact Factors and Prediction of Popular Topics in a Journal.

The impact factor (IF) for 2015 was recently released and this could be the time to once again reflect on its use as a metric of a journal. Problems and concerns regarding the IF have been addressed extensively elsewhere 1 2. The principle of the IF for a given year is that it represents the average number of citations of articles published in the journal in the two previous years.While authors frequently cite the IF as a determining factor for submission, the IF does not predict how many times individual articles will be cited. In a study from a peer-reviewed cardiovascular journal, nearly half of all published articles were poorly cited, i. e., less than five citations in five years 3. A similar percentage seems to apply to our journal. In nearly all journals we estimate that the majority of citations relate to a minority of the articles. Some articles are never cited. 13 % of the articles published in our journal from 2010 to 2013 have never been cited. Even authors of poorly cited articles benefit from the IF since many institutions use the combined impact factors of their published papers to measure research activity and this may be reflected in their research budgets.The competition for the printed pages in the six annual issues of Ultraschall in der Medizin/European Journal of Ultrasound (UiM/EJU) has resulted in high rejection rates (between 80 % and 90 %). One negative review with recommendation of major revision may therefore result in rejection. Peer-review fraud where the submitting author listed recommended reviewers with fake email addresses supplying fabricated peer reviews has recently been described in the New England Journal of Medicine 4. Some of the editors of our journal believe they have experienced this as well. Fabricating reviews in order to get a high IF for an article is to be considered fraud and is inexcusable.One aspect of using impact factors as a measure of the quality of a journal is that the IF only goes back two years. There may be differences between journals for different medical specialties since the citations in some areas seem to "burn out" within a few years while some articles continue to be cited even after several years. Therefore, a citation window that is longer than 2 years has been proposed 5.For this editorial we took a look at the 60 articles published in UiM/EJU in 2010. Half of them were no longer being cited in 2015. However, 10 articles were cited more than 5 times in 2015, and 5 of these were cited more than 10 times 6 7 8 9 10. It therefore seems that many of our articles have a long scientific life and generate more citations than indicated by the IF. Moreover, some articles have the highest number of citations after three years when they are no longer contributing to the impact factor. The most frequently cited articles from 2010 were multicenter studies, recommendations, and papers on hot topics like contrast-enhanced ultrasound (CEUS) and elastography, but it should be noted that there were also articles on the same topics that were poorly cited.The same trending topics continued into 2013 now topped by European guidelines and recommendations 11 12 13. 9 of the 10 most cited articles we published in 2014 were on CEUS or elastography 14 15 16 17 18 19 20 21 22, but the most cited article from that year so far has been on peripheral nerves 23. Surprisingly many good scientific papers on obstetrics/fetal US and musculoskeletal US have low citation rates 24 25 26. Our predictions for 2016 based on the topics of submitted articles in the last 12 months are that CEUS and elastography will continue to be popular topics.It is also worth mentioning that there can be a discrepancy between which titles are cited and which are accessed online. In addition to international guidelines, our CME articles are usually popular according to online access. CME articles are well established educational papers but they are rarely cited for the IF. Looking at the most read full-text recent articles on our journal's website shows that multicenter studies as well as recommendations backed by a national society or by the EFSUMB (European Federation of Societies for Ultrasound in Medicine and Biology) are still important 27 28 29 30 31 32 33. Upcoming important topics appear to be pediatric use of CEUS, simulation training and the introduction of ultrasound to medical students 34 35 36 37. Some of these are also backed by EFSUMB.A recent paper on the IF of radiology journals found that subspecialty radiology journals had a higher IF than general radiology journals 38. This could prove a challenge to interdisciplinary journals like ours but we take pride in continuing to cover all aspects of ultrasound in more than 15 fields.The distribution between reviews, original articles and case reports in a journal is worth addressing. An important aspect of a journal is the publication of original scientific research articles. CME articles, pictorials and letters are important for other reasons but are cited at a lower rate. The value of case reports with regard to the IF is low since they are rarely cited 39 and we have observed that some journals have abandoned the publication of case reports, thus leaving them to spin-off journals. The rationale is that keeping case reports in a journal will only increase the denominator, thereby decreasing the IF 39. At our journal we have seen a decline in case report submissions but still want to publish them and even put one case on the front cover of every issue. Case reports still hold an educational value 40 and are important to our readers.In conclusion, a healthy mix of original articles, CME articles, reviews and case reports combined with a few international guidelines and recommendations is important to UIM/EJU. Although we see popular topics like CEUS and elastography, it is not possible to predict which articles will be read or even cited based on the topic, with multicenter studies being the exception.

Work participation and health-related characteristics of sickness absence beneficiaries with multiple somatic symptoms.

OBJECTIVES: The primary aim was to study whether high levels of multiple symptoms influenced sick-listed individuals' employment status or desire to return to work (RTW) and whether this was associated with social relations at work. STUDY DESIGN: A cross-sectional study nested in a clinical trial. METHODS: In 2011-2012, 736 (34%) of 2172 sick-listed individuals completed a posted questionnaire and were included. Main outcome was self-reported employment status. The Symptom Check List (SCL-SOM)'s sum score (0-48) was categorized in high (>18) and low (≤18) levels. Previous employment, sick-listing, and use of health care were register-data. Multivariate logistic regression analyses with adjustments were performed. RESULTS: Beneficiaries with high SCL-SOM score (n = 218, 33%) reported poorer health, job satisfaction, a lower desire to RTW and more problems with supervisors. The risk of being unemployed was higher for this group than for those with a low score. Adjusting for general health reduced the association between symptoms and unemployment, whereas problems with social relations only affected it marginally. CONCLUSIONS: Sick-listed individuals reporting high levels of symptoms were more often unemployed and less frequently desired to RTW than those with few symptoms. The association could not be explained by problems with social relations at work. TRIAL REGISTRATIONS: ISRCTN43004323, and ISRCTN51445682.

Temporary confinement of loose-housed hyperprolific sows reduces piglet mortality.

The objective of this study was to investigate piglet mortality in a commercial setting where sows were accommodated in a loose-housed system with an option to confine the sow for a few days around farrowing and during early lactation. The study was conducted in a Danish piggery where records were obtained from 2,139 farrowings. Sows were randomly allocated to 1 of 3 treatments: loose-loose (LL), loose-confined (LC), and confined-confined (CC). In LL, sows were loose housed from the time they entered the farrowing pens to weaning. In LC, sows were loose housed until farrowing was finished and then confined to d 4 after farrowing. In CC, sows were confined at d 114 of gestation to d 4 after farrowing. All sows were loose housed from d 5 to weaning. Total piglet mortality was analyzed at batch level to include piglets fostered by nurse sows and at sow level to analyze the effects of confinement during different time periods. Total piglet mortality was greater in LL (26.0%) and LC (25.4%) compared with CC (22.1%; < 0.001). The proportion of stillborn piglets was not different between treatments ( = 0.21) but a larger proportion was crushed in LL (10.7%) compared with LC (9.7%; = 0.03), which again was greater than CC (7.8%; < 0.001). Piglet mortality before equalization was lower in CC (3.7%) than in LL (7.5%) and LC (7.0%; < 0.001). Confinement reduced mortality from litter equalization to d 4 (7.6% for LL vs. 6.7% for LC; = 0.01) but more so in CC (5.6%) than in LC ( < 0.001). From d 4 to weaning, LL had lower mortality (5.6%) than LC (6.9%) and CC (6.6%; = 0.01). A larger proportion of sows in CC were classified as "low mortality" compared with LL and LC both before ( < 0.001) and after ( = 0.002) litter equalization. The results in this study emphasize that the period of time from the birth of the first piglet to litter equalization is important in relation to piglet mortality. The results also suggest that confinement for 4 d after farrowing can reduce mortality in this specific period, but only confinement from d 114 of gestation to d 4 after farrowing reduced total piglet mortality.

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (Short Version).

This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (short version; the long version is published online).

EFSUMB Guidelines on Interventional Ultrasound (INVUS), Part I. General Aspects (long Version).

This is the first part of the Guidelines on Interventional Ultrasound of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) and covers all general aspects of ultrasound-guided procedures (long version).

High-pressure phase transitions in ordered and disordered Bi2Te2Se.

We report studies of pressure-induced phase transitions of ordered and disordered ternary tetradymite-like Bi2Te2Se by synchrotron powder X-ray diffraction (PXRD) in diamond anvil cells (DACs) for pressures up to 59 and 49 GPa, respectively. The first sample (SB) was prepared from a single crystal with ordered Se/Te sites while the second sample (Q) was prepared from a quenched melt resulting in disordered Se/Te. This allows for an investigation of the effect of disorder on the phase transitions and the equation of states (EoS) of the tetradymite-like α phase. Fitting of a third order Birch-Murnaghan EoS to the α phases yielded bulk moduli K0 of 34.5(10) and 38.3(17) GPa and K' of 6.2(3) and 5.0(5) for the SB and Q samples, respectively. An electronic topological transition (ETT) was identified in both samples at pressures of 4.4 and 3.1 GPa, respectively. This was followed by a transition near 11 GPa to a phase that is isostructural with the ß phase of Bi2Te3. The Se/Te ordering only affects the transition pressure to a small extent. A cubic phase that resembles the δ phase observed in high-pressure studies of Bi2Te3 appears at 17-20 GPa, but the ternary composition leads to a more complex structure. The presence of a low angle diffraction peak in the δ phase demonstrates that the true structure is not simply body-centred cubic. In this way the samples resemble Bi2Se3 where Bi and Se show a high degree of ordering, but the proposed structure of δ-Bi2Se3 also does not fully describe the data for δ-Bi2Te2Se.