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Background: The effects of immobilization of the right lower limb on driving performance are unknown. Therefore, clinicians and legislators cannot put forth recommendations for road safety for patients requiring such immobilization. The objective of the present study was to evaluate the effect of two orthopaedic immobilization devices on the braking performances of healthy volunteers under simulated driving conditions.Methods: The braking performances of forty-eight healthy volunteers were evaluated under three conditions: wearing a running shoe, wearing a walking cast, and wearing an Aircast Walker on the right lower limb. A computerized driving simulator was used to measure the maximum force applied on the brake pedal during braking as well as the braking reaction time and the total braking time during emergency braking with and without a distractor.Results: The mean braking forces applied with the shoe, the walking cast, and the Aircast Walker were 293.8, 275.4, and 287.2 lb (133.3, 124.9, and 130.3 kg), respectively. The value with the walking cast was significantly lower than that with the shoe or Aircast Walker (p < 0.0001); there was no difference between the shoe and the Aircast Walker. The adjusted mean braking reaction times during emergency braking without a distractor were 0.580 second (shoe), 0.609 second (cast), and 0.619 second (Aircast Walker). The value with the running shoe was significantly lower than that with either type of immobilization (p < or = 0.0001). With a distractor, the mean braking reaction time was shorter with the running shoe than it was with either form of immobilization (p < or = 0.0001); the mean time was also shorter with the walking cast than it was with the Aircast Walker (p = 0.003). During both emergency braking tasks (with and without a distractor), the mean total braking time was shorter with the shoe than it was with either type of immobilization (p < 0.0001). With a distractor, the adjusted mean total braking time was shorter with the walking cast than it was with the Aircast Walker (p = 0.035).Conclusions: Immobilization of the right lower limb affects the braking force as well as the braking reaction time and total braking time during emergency braking by healthy volunteers. While these changes are significant, their impact on the ability to drive safely during emergency braking situations is questionable. Future research into the impact of such immobilization on the emergency braking performances of patients is warranted to confirm these observations. [ABSTRACT FROM AUTHOR]

Abstract Background Fractures associated with bone fragility in older adults signal the potential for secondary fracture. Fragility fractures often precipitate further decline in health and loss of mobility, with high associated costs for patients, families, society and the healthcare system. Promptly initiating a coordinated, comprehensive pharmacological bone health and falls prevention program post-fracture may improve osteoporosis treatment compliance; and reduce rates of falls and secondary fractures, and associated morbidity, mortality and costs. Methods/design This pragmatic, controlled trial at 11 hospital sites in eight regions in Quebec, Canada, will recruit community-dwelling patients over age 50 who have sustained a fragility fracture to an intervention coordinated program or to standard care, according to the site. Site study coordinators will identify and recruit 1,596 participants for each study arm. Coordinators at intervention sites will facilitate continuity of care for bone health, and arrange fall prevention programs including physical exercise. The intervention teams include medical bone specialists, primary care physicians, pharmacists, nurses, rehabilitation clinicians, and community program organizers. The primary outcome of this study is the incidence of secondary fragility fractures within an 18-month follow-up period. Secondary outcomes include initiation and compliance with bone health medication; time to first fall and number of clinically significant falls; fall-related hospitalization and mortality; physical activity; quality of life; fragility fracture-related costs; admission to a long term care facility; participants’ perceptions of care integration, expectations and satisfaction with the program; and participants’ compliance with the fall prevention program. Finally, professionals at intervention sites will participate in focus groups to identify barriers and facilitating factors for the integrated fragility fracture prevention program. This integrated program will facilitate knowledge translation and dissemination via the following: involvement of various collaborators during the development and set-up of the integrated program; distribution of pamphlets about osteoporosis and fall prevention strategies to primary care physicians in the intervention group and patients in the control group; participation in evaluation activities; and eventual dissemination of study results. Study/trial registration Clinical Trial.Gov NCT01745068 Study ID number CIHR grant # 267395

Asian small-clawed otters (ASCO; Aonyx cinereus ) are a popular species of otter housed in zoological institutions. A common health challenge in this species is the development of uroliths, which may have a dietary origin. Feeding recommendations for ASCO are largely based on the nutrient requirements of domestic carnivore models. Using otter-specific feeding ecology may allow for further refinement of these nutrient recommendations. This study aimed to assess if a naturalistic diet of crustaceans, mollusks, and fish could control the development of uroliths in ASCO. Baseline data were collected on 10 ASCO (five males and five females) of different ages and repeated 2 years after the treatment diet was introduced. Blood and urine parameters, as well as the size of nephroliths based on radiographic images, were recorded. The treatment diet was higher in protein and lower in calcium than the nontreatment diet and did not contain any kibble. During the 2-year treatment trial, blood globulin, glucose, and sodium increased and albumin decreased. Glucosuria and leukocyturia significantly decreased. There were no significant changes in urolith size over the 2 years, and animals without nephroliths at the beginning of the study remained urolith free. The development of nephroliths was significantly reduced during the treatment compared with the year prior. Although interpretation is limited by the methods used, a naturalist diet may have a beneficial impact in the development of uroliths in ASCO.

Pangolins (Manis spp.) are myrmecophagous mammals with a wild diet of termites and ants. Diets are not yet readily acceptable by all pangolins and lack soil and chitin compared to their wild diet. This study aimed to assess the usefulness of including soil and chitin in pangolin diets by measuring changes in digestibility, food mean retention time, faecal scoring and body weight changes. Two male and two female Sunda pangolins (Manis javanica) from Night Safari (Singapore) were fed their typical gruel-type diets, with soil and chitin added in various amounts throughout 10 different treatments. Diet intake was calculated daily and faecal boluses were collected for digestibility analysis. Chromium oxide was added to the diet to measure mean retention time four times per animal per treatment. Faecal consistency scores were recorded daily where 1 is firm and 5 is liquid. Every animal was weighed weekly. Adding soil or chitin to the diet had various effects on the apparent digestibility of organic matter, crude protein and fiber with little effects on crude fat or calcium. Soil had a general positive influence on organic matter and fiber digestion. The addition of chitin and soil together had the stronger effects. Only at 25% inclusion of soil did the faecal score begin to improve. The overall maintenance energy requirements for adult M. javanica was 79.28 Kcal/kg BW 0.75 /day, similar to other myrmecophagous mammals. The usage of soil and chitin in pangolin diets may be helpful in controlling weights while preventing behaviours associated with hunger., (© 2019 Wiley Periodicals, Inc.)

Background: Advanced practice physiotherapists (APP) have helped improve accessibility to orthopaedic outpatient care. Several studies have validated the APP practice model in orthopaedic care, demonstrating high agreement between APPs and orthopaedic surgeons (OS) regarding diagnosis and management. However, as APPs tend to be experienced senior physiotherapists, such a study involving physiotherapy students (PS) has not yet been explored. The objective of this study was to evaluate the agreement for orthopaedic diagnoses and surgical triage between a PS and OSs., Methods: A prospective study involving a final year PS and seven OSs was conducted in a university hospital, after the PS had undergone a three-week intensive training. Eighty-six adult patients referred to OSs for knee osteoarthritis, hip osteoarthritis or shoulder problem were independently evaluated by the PS, and then re-evaluated by an OS. The diagnoses and surgical triage recommendations of both clinicians were analyzed for agreement using raw percent agreement and Cohen's kappa. Patient satisfaction with the outpatient clinic experience was noted using a modified version of the Visit-Specific Satisfaction Instrument., Results: Our sample consisted of 86 patients (mean age = 63.4 years). Reasons for consultation included shoulder problems (36%), knee osteoarthritis (52%) and hip osteoarthritis (12%). The raw percent agreement for diagnosis was 95.3%. The agreement for surgical triage was high (κ = 0.86, 95% CI: 0.74-0.98) with a raw agreement of 94.2%. Patient satisfaction was high., Conclusions: The PS and OSs made similar diagnoses and triage recommendations suggesting that clinical experience alone is not a prerequisite for physiotherapists to help increase accessibility to orthopaedic care.

Lories and lorikeets are popular birds in the pet bird trade, captured from the wild and exported worldwide. Their captive propagation has not been so successful for many species due to health issues, low breeding success and reduced longevity. As a result, uptake from the wild is currently the only way to meet the market's demand. Field studies on Asian species of loris and lorikeets are limited; therefore, dietary recommendations are based on the well-studied Australian species such as the rainbow lorikeet (Trichoglossus moluccanus). We aimed to provide an ad libitum diet to diverse Loriinae species at Jurong Bird Park (Singapore) which allowed for them to select between a low and moderate protein diet to compare their nutrient and energy intake with other Loriinae species. We measured the following variables: daily dry matter (DM) intake, nectar-to-fruit energy intake ratio (NF ratio), metabolisable energy (ME), protein and non-protein energy (NPE)-to-protein energy (PE) ratio intake (all by kg metabolic body weight MBW, kg 0.75 ) for 36 pairs over a 1-month period. A Kruskal-Wallis test revealed every genus had significantly different intakes of DM, NF ratio, NPE-to-PE ratio, ME and protein than each other. Post hoc Mann-Whitney U tests confirmed that the majority of variables were ingested in different amounts for each genus except for NF ratio, NPE/PE ratio which Lorius spp. are not different to Charmosyna sp. or Trichoglossus spp. and protein intake of Eos spp. does not differ from Trichoglossus spp. Our conclusion is that no species should be used as a model for a species from another genus of Loriinae; future studies should be species-specific for each genus to increase captive propagation success., (© 2018 Blackwell Verlag GmbH.)

Uroliths (urinary stones) are routinely found in both domestic and exotic animals kept under human care. In zoos, Asian small-clawed otters (ASCOs, Aonyx cinereus) have been identified as being particularly prone to this disease. Risk factors are thought to be nutritional; however, recommendations contradict each other, depending on which physiological model was used. Our study aimed to determine the prevalence of uroliths in ASCOs under human care and to evaluate which feeding patterns and nutrients may be linked to their occurrence. Questionnaires were sent to zoos holding ASCOs in North America (AZA), Europe (EAZA), and Japan and Southeast Asia (Asia) asking about diets and medical histories of all ASCOs alive or dead within the last 10 yr. A risk-factor style binary logistic regression was conducted on these data. A total of 94 questionnaires were received; however, only 56 were usable (15.6% return rate), representing 161 otter cases. AZA had the significantly highest incidence of kidney stones (62.8%), followed by EAZA (12.9%) and Asia (9.4%). Age and calcium were risk factors, whereas crude protein and sodium were protective. Therefore, calcium may need to be controlled within their diet. A diet high in fish and crustaceans may be beneficial and is consistent with wild ASCO diets. The feline model may be the best choice out of other models; however, many factors cannot be compared with ASCO, such as urinary pH.

Red-shanked doucs (Pygathrix nemaeus) are endangered, foregut-fermenting colobine primates which are difficult to maintain in captivity. There are critical gaps in our understanding of their natural lifestyle, including dietary habits such as consumption of leaves, unripe fruit, flowers, seeds, and other plant parts. There is also a lack of understanding of enteric adaptations, including their unique microflora. To address these knowledge gaps, we used the douc as a model to study relationships between gastrointestinal microbial community structure and lifestyle. We analyzed published fecal samples as well as detailed dietary history from doucs with four distinct lifestyles (wild, semi-wild, semi-captive, and captive) and determined gastrointestinal bacterial microbiome composition using 16S rRNA sequencing. A clear gradient of microbiome composition was revealed along an axis of natural lifestyle disruption, including significant associations with diet, biodiversity, and microbial function. We also identified potential microbial biomarkers of douc dysbiosis, including Bacteroides and Prevotella, which may be related to health. Our results suggest a gradient-like shift in captivity causes an attendant shift to severe gut dysbiosis, thereby resulting in gastrointestinal issues.

The mammalian gastrointestinal (GI) tract is home to trillions of bacteria that play a substantial role in host metabolism and immunity. While progress has been made in understanding the role that microbial communities play in human health and disease, much less attention has been given to host-associated microbiomes in nonhuman primates (NHPs). Here we review past and current research exploring the gut microbiome of NHPs. First, we summarize methods for characterization of the NHP gut microbiome. Then we discuss variation in gut microbiome composition and function across different NHP taxa. Finally, we highlight how studying the gut microbiome offers new insights into primate nutrition, physiology, and immune system function, as well as enhances our understanding of primate ecology and evolution. Microbiome approaches are useful tools for studying relevant issues in primate ecology. Further study of the gut microbiome of NHPs will offer new insight into primate ecology and evolution as well as human health., (© 2018 Wiley Periodicals, Inc.)

Marmoset wasting syndrome (MWS) describes a series of symptoms in callitrichids that lead to general weakness and a failure to thrive in captive conditions such as zoological institutions. Though the cause of MWS has not been identified, the majority of hypotheses are linked to deficiencies of specific nutrients and increased stress levels. Questionnaires were sent to zoos requesting information on diets and housing of currently living and dead callitrichids before their deaths, as well as their postmortem reports. Risk factors for development and occurrence of MWS include close proximity of predator enclosures and high levels of dietary magnesium and zinc. Variables with effects which may protect against the development of MWS included provision of a nest box, natural trees within enclosure, reduced visibility to visitors, as well as dietary factors such as higher concentrations of potassium and fiber fractions. The protective effects of limited concentrate feeds and increased total dietary fiber may help reduce the risks of developing MWS. The minerals may not have biological implications in MWS per se, however, they may be reflective of diets too high in concentrates and too low in plant matter. Habitat designs that are less naturalistic and those which provide insufficient privacy or hide areas may increase chronic stress for callitrichid species, possibly because of visitor-related stress. Other causes of chronic stress in captive zoo populations should be the topic of further research to reduce occurrence of MWS., (© 2018 Wiley Periodicals, Inc.)

Gum is a widely available carbohydrate, composed mainly of non-digestible structural carbohydrates. No mammalian enzymes can digest gum; therefore, a mammal ingesting gum must rely on microbial fermentation to access the energy it possesses. Gums are relatively nutrient poor. Despite this, some mammals have evolved to exploit this food resource. We aim to review the literature for all mammal species which have been recorded to ingest gum, whether quantified or not, and discuss this in the context of their evolutionary adaptations. We also investigated the recommended captive diets for these species to look at whether gum is recommended. We conducted a literature search on ISI Web of Knowledge to tabulate all mammal species observed ingesting gum and classified them as obligate, facultative or opportunistic feeders. We encountered 94 mammal species that eat gum in the wild (27 obligate feeders, 34 facultative feeders and 33 opportunistic feeders). Obligate feeders have entirely evolved to exploit this resource but were found to not be given gum in captivity, which may explain why they are failing to thrive, as opposed to facultative feeders, which have fewer issues. Gum may be necessary for the health of obligate feeders in captivity. Future research should focus on the physiological effects that gum ingestion poses on different digestive systems., (© 2017 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Pangolins are ant specialists which are under intense threat from the illegal wildlife trade. Nutrition has notoriously been their downfall in captivity and is still an issue in regards to rescue and rehabilitation. We analyzed the nutrient content of diets used by institutions that are successfully keeping Asian pangolins and to assess the variety of the ingredients and nutrients, compared these with the nutritional requirements of potential nutritional model species. We performed intake studies at five institutions and also had data from three other institutions. We also analyzed five different wild food items to use as a proxy of wild diet. We observed two categories of captive diets: those mostly or completely composed of insects and those high in commercial feeds or animal meat. Nutrient values were broad and there was no clear rule. The non-protein energy to protein energy ratio of the diets were much higher than the wild food items, more so for those which receive less insects. The average contribution of carbohydrate, fat and protein energy were also further away from the wild samples the less insects they contained. The previously suggested nutritional model for pangolins is the domestic dog which is supported by our relatively large nutrient ranges of apparently successful diets, however due to their highly carnivorous nature; the upper most nutrient intake data are not consistent with this and favor the feline nutrient recommendations. We are unable to render a conclusion of what model is more appropriate based on our data collected., (© 2017 Wiley Periodicals, Inc.)

Objectives: To describe the strategy employed by exudativorous primates during seasonal shifts in food abundance using the Javan slow loris as a model. Males and females may cope differently as well as exploit fallback foods in different proportions., Materials and Methods: Observing 15 free ranging Javan slow lorises over a year, we quantified their seasonal diet and nutrient intake using intake rates. For gum intake rates, we conducted a trial with 10 captive Javan slow lorises measuring the length of time it took for them to ingest 10 g of gum. We monitored phenology in our field site over five plots that were assessed monthly. We weighed our free-ranging animals every six months. We analyzed all food items slow lorises ingested for macronutrients using the nutritional geometry framework., Results: The slow loris diet consisted of eight food categories, with gum and insects being the major food sources in terms of wet weight intake. The captive gum trials resulted in an intake rate of 0.021 g/s. All food items eaten by wild Javan slow lorises were available in the wet season and were restricted in the dry season. Males and females reacted differently to seasonal abundances with females ingesting more protein, gum, fruits and flowers and males ingesting more fiber., Conclusions: The strategy used by the Javan slow lorises during periods of lower food availability were similar to folivorous primates and included increased dependence on lower quality foods. The reproductive costs of gestation and lactation may place a burden on females that requires them to alter their foraging strategy during the dry season to ensure enough protein and overall energy is ingested. The overall strategy used by these exudativorous primates is one of nutrient maximization as no nutrient was clearly preferred over another., (© 2017 Wiley Periodicals, Inc.)

Background and Introduction: Telerehabilitation after total knee arthroplasty (TKA) is supported by strong evidence on the effectiveness of such intervention and from a cost-benefit point of view. Satisfaction of patients toward in-home telerehabilitation after TKA has not yet been examined thoroughly in large-scale clinical trials. This study aims to compare satisfaction level of patients following in-home telerehabilitation (TELE) after TKA to one of the patients following a usual face-to-face home visit (STD) rehabilitation. Secondarily, to determine if any clinical or personal variables were associated to the level of satisfaction., Materials and Methods: This study was embedded in a multicenter randomized controlled trial with 205 patients randomized into two groups. Rehabilitation intervention was the same for both groups; only approach for service delivery differed (telerehabilitation or home visits). Participants were assessed at baseline (before TKA), at hospital discharge, and at 2 and 4 months postdischarge (E4) using functional outcomes. Patient satisfaction was measured using the validated Health Care Satisfaction Questionnaire (HCSQ) at E4., Results: Characteristics of all participants were similar at baseline. Satisfaction level of both groups did not differ and was very high (over 85%). It was neither correlated to personal characteristics nor to improvements of functional level from preoperative to E4. Satisfaction was rather found associated to walking and stair-climbing performances., Conclusions: These results, in conjunction with evidences of clinical effectiveness and cost benefits demonstrated in the same sample of patients, strongly support the use of telerehabilitation to improve access to rehabilitation services and efficiency of service delivery after TKA.

The primate gastrointestinal tract is home to trillions of bacteria, whose composition is associated with numerous metabolic, autoimmune, and infectious human diseases. Although there is increasing evidence that modern and Westernized societies are associated with dramatic loss of natural human gut microbiome diversity, the causes and consequences of such loss are challenging to study. Here we use nonhuman primates (NHPs) as a model system for studying the effects of emigration and lifestyle disruption on the human gut microbiome. Using 16S rRNA gene sequencing in two model NHP species, we show that although different primate species have distinctive signature microbiota in the wild, in captivity they lose their native microbes and become colonized with Prevotella and Bacteroides, the dominant genera in the modern human gut microbiome. We confirm that captive individuals from eight other NHP species in a different zoo show the same pattern of convergence, and that semicaptive primates housed in a sanctuary represent an intermediate microbiome state between wild and captive. Using deep shotgun sequencing, chemical dietary analysis, and chloroplast relative abundance, we show that decreasing dietary fiber and plant content are associated with the captive primate microbiome. Finally, in a meta-analysis including published human data, we show that captivity has a parallel effect on the NHP gut microbiome to that of Westernization in humans. These results demonstrate that captivity and lifestyle disruption cause primates to lose native microbiota and converge along an axis toward the modern human microbiome., Competing Interests: The authors declare no conflict of interest.

Background: Proximal humerus fractures can be treated surgically (eg: pinning, plate and screws) or conservatively by wearing a splint or a cast. Following both of these approaches, rehabilitation has proven effective to prevent functional limitations and to re-establish normal shoulder function. However, access to these rehabilitation services and compliance tends to be limited in elderly patients due to travelling difficulties caused by their precarious health status and, in some cases, social and marital status. Since the majority of patients with a proximal humerus fracture are elderly, it becomes relevant to find a new way to offer quick, simple and suitable rehabilitation service. Thus, the use of promising alternative approaches, as in-home telerehabilitation, can enhance access to rehabilitation services for such population. The main objective of the study is to compare the clinical effects of the innovative telerehabilitation approach (TELE group) compared to face-to-face visits to a clinic (CLINIC group) for patients treated for a proximal humerus fracture., Methods/design: In this randomized controlled trial, individuals who have had a proximal humerus fracture treated conservatively at the Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre hospitalier universitaire de Sherbrooke (CIUSSS de l'Estrie CHUS), and who are returning home will be included. Participants will be recruited during their visit to the emergency ward or outpatient clinic by the medical or research team and will then sign the informed consent form if they are interested to participate in the study. We expect to recruit 52 participants (26 per group). Randomization will be done by a random number generator with sealed envelopes. Each patient will be evaluated before the beginning of the rehabilitation (T1), and immediately after the 2-month intervention (T2). The following outcomes will be measured: 1) upper extremity function (Constant Shoulder Score and Disability of the Arm, Shoulder and Hand questionnaire [DASH]); 2) range of motion (conventional goniometer); 3) user satisfaction (Health Care Satisfaction questionnaire); and 4) cost of services to the public healthcare system. The difference between the two groups will be compared using a t-test or a chi-squared test, and through a cost-effectiveness economic analysis., Discussion: We hypothesize that in-home telerehabilitation will provide a good alternative to conventional rehabilitation, in terms of its efficacy, simplicity, patient satisfaction, and low associated costs., Trial Registration: ClinicalTrials.gov: NCT02425267. April 22(nd), 2015.

Background: Audio/video-mediated communication between patients and clinicians using videoconferencing over telecommunication networks is a key component of providing teletreatments in rehabilitation., Objective: The objectives of this study were to (1) document the conditions of use, performance, and reliability of videoconferencing-based communication in the context of in-home teletreatment (TELE) following total knee arthroplasty (TKA) and (2) assess from the perspective of the providers, the quality attributes of the technology used and its impact on clinical objectives., Materials and Methods: Descriptive embedded study in a randomized controlled trial using a sample of 97 post-TKA patients, who received a total of 1,431 TELE sessions. Technical support use, service delivery reliability, performance, and use of network connection were assessed using self-report data from a costing grid and automated logs captured from videoconferencing systems. Physical therapists assessed the quality and impact of video-mediated communications after each TELE session on seven attributes., Results: Installation of a new Internet connection was required in 75% of the participants and average technician's time to install test and uninstall technology (including travel time) was 308.4 min. The reliability of service delivery was 96.5% of planned sessions with 21% of TELE session requiring a reconnection during the session. Remote technical support was solicited in 43% of the sessions (interventions were less than 3-min duration). Perceived technological impacts on video-mediated communications were minimal with quality of the overall technical environment evaluated as good or acceptable in 96% of the sessions and clinical objectives reached almost completely or completely in 99% of the sessions., Conclusions: In-home rehabilitation teletreatments can be delivered reliably but requires access to technical support for the initial setup and maintenance. Optimization of the processes of reliably connecting patients to the Internet, getting the telerehabilitation platform in the patient's home, installing, configuring, and testing will be needed to generalize this approach of service delivery.

Background: Previous studies have revealed a weak to moderate relationship between pain and disability in individuals suffering from low back pain (LBP). However, to our knowledge, no studies have evaluated if this relationship is different between young and older adults., Purpose: The objective of this descriptive, cross-sectional study was to determine whether the relationship between LBP intensity and physical disability is different between young and older adults., Methods: Pain intensity (measured with a visual analog scale) and physical disability scores (measured with the Oswestry Disability Index) were collected from the medical files of 164 patients with LBP. Separate Pearson correlation coefficients were calculated between these 2 variables for young (mean age 40 ± 6 years, n = 82) and older (62 ± 9 years, n = 82) individuals and a Fisher r-to-z transformation was used to test for group differences in the strength of the relationship. Linear regression analyses were also performed to determine whether the slope of the association was different between the 2 groups., Results: A significant and positive association was found between pain intensity and disability for both young and older individuals. However, the correlation was stronger in the young group (r = 0.66; P < .01) than in the older group (r = 0.44; P < .01) (Fisher Z = 2.03; P < .05). The linear regression model also revealed that the slope of the relationship was steeper in the young group (P < .05)., Conclusion: Although both young and older individuals showed a significant association between pain intensity and disability, the relationship between these 2 variables was more tenuous in older individuals than in young patients. Future research is essential to identify the factors underlying this age-related difference.

Background: Healthy elderly individuals are particularly prone to catastrophic events at any moment of their lives. One stressful event for individuals aged 65 and older is a fall that results in a fracture of the hip (HF). HF causes a state of inflammation that may affect immune responses. In this connection, we have reported that HF induced alterations in neutrophil functions., Objective: To assess the impact of HF on classical (cM), intermediate (iM) and non-classical (ncM) monocyte subsets., Methods: Distribution, functions (chemotaxis, phagocytosis, superoxide production and cytokine production), phenotype and activation (NF-x03BA;B and PI3K) were evaluated in monocyte subsets before surgery and 6 weeks and 6 months after the event., Results: The distribution of cM and ncM was unchanged, but iM transiently increased before surgery. Sustained increases (iM response to CCL2 and CX3CL1) and decreases (cM and ncM response to CCL2) in chemotaxis were observed. Phagocytosis and superoxide production were impaired in cM but not in iM or ncM. Sustained expression of HLA-DR occurred in cM but not in iM and ncM. Sustained decreased expression of CD11b occurred only in ncM. Sustained decreases (cM and ncM) and increases (iM) in CCR2 expression were observed. An elevated expression of CX3CR1 was found only in iM. cM produced elevated quantities of TNFα. There was a transient oxidative burst of production before surgery in iM and a sustained decrease in ncM. IL-10 production was severely impaired in cM and decreased in iM prior to surgery. Sustained activation (cM), inhibition (ncM) and transient activation (iM) of NF-x03BA;B were observed. Activation of PI3K was severely impaired in cM and ncM but was sustained in iM., Conclusion: HF had more impact on cM and ncM functions than on iM. HF triggered a switch in cM functions from phagocytic to inflammatory elevated TNFα-producing cells. These changes may impact clinical outcomes of HF with respect to inflammation, opportunistic infections and physical recovery., (© 2016 S. Karger AG, Basel.)

Asian slow lorises are found in zoos and rescue centres worldwide with Nycticebus pygmaeus, the pygmy slow loris, boasting the largest population in captivity. Diet are reportedly high in fruit and concentrates and low in insects and exudates. Wild feeding studies place insects, nectar, and gums as the most important diet components. Captive populations also show high incidences of health afflictions, many of which may be caused by nutrition. Our study, aims at identifying a causative agent within the diets of N. pygmaeus in regards to diseases prominent within captive populations. We sent out 55 diet and health questionnaires to institutions worldwide. Returned diets were nutritionally analyzed. Nutrient values and proportions of each ingredient were used in a principle components analysis. Resulting factors were used as variables in a binary logistic regression (BLR), with dental disease as the dependent variable. 39 questionnaires were returned with a total of 47 diets. 20 (51.7%) institutions reported the presence of diseases with dental issues being prominent. Factors that were significant in the principle components analysis included gum, nectar, protein, acid detergent fibre, calcium, ash, phosphorus, potassium, Ca:P, magnesium, vitamin D, and energy. Gum was the only significant predictor in the BLR. Lastly, a chi square test for association was performed with the presence of dental disease as the dependent variable and the amount of fruit in the diet. The combination of high fruits and little to no gum promotes the occurrence of dental diseases. Current captive diets do not reflect the evolutionary adaptations of Nycticebus primates., (© 2015 Wiley Periodicals, Inc.)

Data on in-situ diet and nutritional requirements should inform the provision of food to captive insectivorous primates. Despite the growing availability of such information an over-reliance on commercially available primate foods and fruit continues in many captive establishments. Wild slender lorises are almost exclusively insectivorous, yet captive conspecifics are fed a primarily frugivorous diet that is likely to contribute to behavioral and health problems. We investigated the effect of naturalizing diet in the Northern Ceylon grey slender loris (Loris lydekkerianus nordicus) by providing live insect prey to a captive group of five individuals. We calculated activity budgets in accordance with six established categories and recorded positional behaviors. We collected data over 30 hours for each of three conditions: pre-enrichment, enrichment, post-enrichment. We hypothesized that increased opportunity for the display of natural behaviors would be stimulated by the dietary enrichment of live insects and made the following predictions; 1) Percentage time spent foraging would increase and time spent inactive would decrease; 2) behavioral repertoires would increase; 3) foraging patterns would be more constant over time with reduced feeding-time peaks. We analyzed time budget and behavioral changes using Friedman tests. We found significant changes in activity budgets with inactivity reduced and foraging levels increased to levels seen in wild slender lorises. We found a significant increase in postures used in foraging and a wider behavioral repertoire. We discuss the benefits of providing free-ranging live food in relation to enhancing the temporal-spatial distribution of food acquisition, satisfying nutritional requirements, balancing energy intake, and expenditure, expanding sensory stimulation, and promoting behavioral competence. We discuss our findings in relation to other insectivorous primates., (© 2015 Wiley Periodicals, Inc.)