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Major health conditions in sheep contribute to substantial economic losses throughout the sheepmeat supply chain in Australia. A systematic review was undertaken to explore the measurable impact of six conditions: arthritis, sheep measles, pleurisy, pneumonia, grass seeds and rib fractures, on the production of lamb and mutton across the meat value chain. Peer‐reviewed scientific literature from three databases and non‐peer‐reviewed articles and reports from Australian government and non‐government websites were searched between 11 and 17 November 2019. Original articles, including studies conducted in Australia and New Zealand, that had measurable impacts on conditions of interest were included. The search yielded 16 articles and reports and were classified as producer impact and/or processor impact studies. Mortalities were quantified for pneumonia and arthritis, with pneumonia having the highest impact for producers. Grass seed infestation resulted in the highest impact on carcase and liveweight losses compared to arthritis and pneumonia. Arthritis had the highest trim weight losses for both lamb and mutton and the highest rate of carcase condemnation. Grass seed was the only condition where other impacts on the processor (chain speed and staff relocation to the boning room) were quantified. Although quantifiable production and processing losses were available for some conditions, this review has highlighted that limited quantifiable data based on scientifically sound research were not available for other conditions. The evidence for some conditions found in this review can be used to target future research activities and to further assist producers in making informed management decisions on prevention and control. [ABSTRACT FROM AUTHOR]

Background and Objectives: Continuous sciatic nerve blockade at the popliteal level effectively alleviates postoperative pain after major foot and ankle surgery. No randomized controlled trials have previously compared the success rate of continuous sciatic nerve sensory blockade between ultrasound and nerve stimulation guidance. In the current study, we tested the hypothesis that ultrasound-guided catheter placement improves the success rate of continuous sciatic nerve sensory blockade compared with catheter placement with nerve stimulation guidance.Methods: After research ethics committee approval and informed consent, 100 patients scheduled for elective major foot and ankle surgery were randomly allocated to popliteal catheter placement either with ultrasound or nerve stimulation guidance. The primary outcome was the success rate of sensory block the first 48 postoperative hours. Successful sensory blockade was defined as sensory loss in both the tibial and common peroneal nerve territories at 1, 6, 24, and 48 hrs postoperatively.Results: The ultrasound group had significantly higher success rate of sensory block compared with the nerve stimulation group (94% versus 79%, P=0.03). Ultrasound compared with nerve stimulation guidance also entails reduced morphine consumption (median of 18 mg [range, 0-159 mg] versus 34 mg [range, 0-152 mg], respectively, P=0.02), fewer needle passes (median of 1 [range, 1-6] versus 2 [range, 1-10], respectively, P=0.0005), and greater patient satisfaction (median numeric rating scale 9 [range, 5-10] versus 8 [range, 3-10)] respectively, P=0.0006) during catheter placement.Conclusion: Ultrasound guidance used for sciatic catheter placement improves the success rate of sensory block, number of needle passes, patient satisfaction during catheter placement, and morphine consumption compared with nerve stimulation guidance. [ABSTRACT FROM AUTHOR]

Study Design: Nationwide epidemiological open cohort study., Objectives: To evaluate whether individuals with traumatic spinal cord injury (TSCI) are more prone to develop autoimmune diseases compared to a general non-TSCI population., Setting: Danish public national registries., Methods: An open nationwide cohort, including individuals born in Denmark from or alive during 1945-2018 was collected and the study period was 1980-2018. Poissons Log-linear regression estimated the incidence rate ratio (IRR) for developing eight groups of autoimmune diseases. A dose-response relationship based on the cervical/thoracic level of injury was assessed by stratification., Results: The cohort included 3,272 individuals with TSCI and 4.8 million background individuals, accounting for 50,865 and 140 million person-years respectively. The TSCI population had an overall IRR of 1.81 (95% CI, 1.59 to 2.05) of getting any autoimmune disease. Subgroup analysis found positive associations for; a) Other neurologic IRR 5.19 (95% CI, 2.79 to 9.65), b) multiple sclerosis IRR 3.70 (95% CI, 2.54 to 5.40), c) Dermatologic IRR 2.57 (95% CI, 1.86 to 3.55), d) Type 1 diabetes mellitus IRR 2.01 (95% CI, 1.54 to 2.61), e) Systemic 1.92 (95% CI, 1.44 to 2.55), and f) Gastroenterologic IRR 1.42 (95% CI, 1.05 to 1.92). Cervical levels of TSCI showed an IRR of 1.70 (95% CI, 1.43 to 2.02), while thoracic levels had an IRR 1.98 (95% CI, 1.63 to 2.39)., Conclusions: TSCI may be an individual risk factor of developing an autoimmune disease. There does not appear to exist a dose-response relationship from the level of injury., Sponsorship: None., (© 2024. The Author(s).)

Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Background: Hip arthroscopy causes severe pain during the first few hours in the postoperative care unit. This is probably due to the intraoperative stretching of the hip joint capsule. Pain relief requires high doses of opioids which may prolong recovery and may cause opioid-related adverse events.The majority of hip joint capsule nociceptors are located anteriorly. The obturator nerve innervates the anteromedial part of the hip joint capsule. We hypothesized that a subpectineal obturator nerve block using 15 ml bupivacaine 5 mg/mL with added epinephrine 5 μg/mL would reduce the opioid consumption after hip arthroscopy., Methods: 40 ambulatory hip arthroscopy patients were enrolled in this randomized, triple-blind controlled trial. All patients were allocated to a preoperative active or placebo subpectineal obturator nerve block. The primary outcome was opioid consumption for the first 3 hours in the postanesthesia care unit. Secondary outcomes were pain, nausea, and hip adductor strength., Results: 34 patients were analyzed for the primary outcome. The mean intravenous morphine equivalent consumption in the subpectineal obturator nerve block group was 11.9 mg vs 19.7 mg in the placebo group (p<0.001). The hip adductor strength was significantly reduced in the active group. No other intergroup differences were observed regarding the secondary outcomes., Conclusion: We found a significant reduction in the opioid consumption for patients receiving an active subpectineal obturator nerve block. The postoperative intravenous morphine equivalent reduction the first painful 3 hours was reduced by 40% for patients receiving a subpectineal obturator nerve block in this randomized, triple-blind trial., Trial Registration Number: EudraCT database 2021-006575-42., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background/Objectives: The intermediate femoral cutaneous nerve (IFCN), the saphenous nerve, and the medial femoral cutaneous nerve (MFCN) innervate the skin of the anteromedial knee region. However, it is unknown whether the MFCN has a deeper innervation. This would be relevant for total knee arthroplasty (TKA) that intersects deeper anteromedial genicular tissue layers. Primary aim: to investigate deeper innervation of the anterior and posterior MFCN branches (MFCN-A and MFCN-P). Secondary aim: to investigate MFCN innervation of the skin covering the anteromedial knee area and medial parapatellar arthrotomy used for TKA. Methods: This study consists of (1) a dissection study and (2) unpublished data and post hoc analysis from a randomized controlled double-blinded volunteer trial (EudraCT number: 2020-004942-12). All volunteers received bilateral active IFCN blocks (nerve block round 1) and saphenous nerve blocks (nerve block round 2). In nerve block round 3, all volunteers were allocated to a selective MFCN-A block. Results: (1) The MFCN-A consistently innervated deeper structures in the anteromedial knee region in all dissected specimens. No deep innervation from the MFCN-P was observed. (2) Sixteen out of nineteen volunteers had an unanesthetized skin gap in the anteromedial knee area and eleven out of the nineteen volunteers had an unanesthetized gap on the skin covering the medial parapatellar arthrotomy before the active MFCN-A block. The anteromedial knee area and medial parapatellar arthrotomy was completely anesthetized after the MFCN-A block in 75% and 82% of cases, respectively. Conclusions: The MFCN-A shows consistent deep innervation in the anteromedial knee region and the area of MFCN-A innervation overlaps the skin area covering the medial parapatellar arthrotomy. Further trials are mandated to investigate whether an MFCN-A block translates into a clinical effect on postoperative pain after total knee arthroplasty or can be used for diagnosis and interventional pain management for chronic neuropathic pain due to damage to the MFCN-A during surgery.

Introduction: There is an increasing focus on the prevention of secondary injuries following traumatic spinal cord injury (TSCI), especially through improvement of spinal cord perfusion and immunological modulation. Such therapeutic strategies require translational and controlled animal models of disease progression of the acute phases of human TSCI., Research Question: Is it possible to establish a 72-h sedated porcine model of incomplete thoracic TSCI, enabling controlled use of continuous, invasive, and non-invasive modalities during the entire sub-acute phase of TSCI?, Material and Methods: A sham-controlled trial was conducted to establish the model, and 10 animals were assigned to either sham or TSCI. All animals underwent a laminectomy, and animals in the TSCI group were subjected to a weight-drop injury. Animals were then kept sedated for 72 h. The amount of injury was assessed by ex-vivo measures MRI-based fiber tractography, histology and immunohistochemistry., Results: In all animals, we were successful in maintaining sedation for 72 h without comprising vital physiological parameters. The MRI-based fiber tractography showed that all TSCI animals revealed a break in the integrity of spinal neurons, whereas histology demonstrated no transversal sections of the spine with complete injury. Notably, some animals displayed signs of secondary ischemic tissue in the cranial and caudal sections., Discussion and Conclusions: This study succeeded in producing a porcine model of incomplete TSCI, which was physiologically stable up to 72 h. We believe that this TSCI model will constitute a potential translational model to study the pathophysiology secondary to TSCI in humans., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Mathias Thygesen reports financial support was provided by Offerfonden (Victims Foundation, Ministry of Justice Denmark). Mathias Thygesen reports financial support was provided by The Riisfort Foundataion. Mathias Thygesen reports financial support was provided by AP Møller Mærsk Foundation. Mathias Thygesen reports financial support was provided by The Dagmar Marshalls Foundation., (© 2024 The Authors.)

Study Objective: A saphenous nerve block is an important tool for analgesia after foot and ankle surgery. The conventional midthigh approach to saphenous nerve block in the femoral triangle may impede ambulation by impairing quadriceps motor function., Primary Objective: Developing a selective saphenous nerve block targeting the nerve distal to its emergence from the adductor canal in the subsartorial compartment., Design: This study consists of A) a dissection study and B) Data from a clinical case series., Setting: A) Medical University of Innsbruck, Austria (dissection of 15 cadaver sides) and. B) Aarhus University Hospital, Denmark (5 patients)., Interventions: A) Five mL of methylene blue was injected into the subsartorial compartment distal to the intersection of the saphenous nerve and the tendon of the adductor magnus guided by ultrasound. B) Five patients undergoing major hindfoot and ankle surgery had a subsartorial compartment block with 10 mL of local anesthetic in addition to a popliteal sciatic nerve block., Measurement: A) The frequencies of staining the saphenous and medial vastus nerves. B) Assessment of postoperative pain by NRS score (0-10) and success rate of saphenous nerve block by presence of cutaneous anesthesia in the anteromedial lower leg, and motor impairment by ability to ambulate., Main Results: A) The saphenous nerve was stained in 15/15 cadaver sides. A terminal branch of the medial vastus nerve was stained in 2/15 cadaver sides. B) All patients were fully able to ambulate without support. No patients had any post-surgical pain from the anteromedial aspect of the ankle and foot (NRS score 0). The success rate of saphenous nerve block was 100%., Conclusion: The saphenous nerve can be targeted in the subsartorial compartment distal to the intersection of the nerve and the tendon of the adductor magnus. The subsartorial compartment block provided efficient analgesia without quadriceps motor impairment., Competing Interests: Declaration of Competing Interest None. M.V. is post-doc employed by Aarhus University and GE HealthCare. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the manuscript., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Early identification of patients at risk of hospital-acquired urinary tract infections (HA-UTI) enables the initiation of timely targeted preventive and therapeutic strategies. Machine learning (ML) models have shown great potential for this purpose. However, existing ML models in infection control have demonstrated poor ability to support explainability, which challenges the interpretation of the result in clinical practice, limiting the adaption of the ML models into a daily clinical routine. In this study, we developed Bayesian Network (BN) models to enable explainable assessment within 24 h of admission for risk of HA-UTI. Our dataset contained 138,250 unique hospital admissions. We included data on admission details, demographics, lifestyle factors, comorbidities, vital parameters, laboratory results, and urinary catheter. Models developed from a reduced set of five features were characterized by transparency compared to models developed from a full set of 50 features. The expert-based clinical BN model over the reduced feature space showed the highest performance (area under the curve = 0.746) compared to the naïve- and tree-augmented-naïve BN models. Moreover, models developed from expert-based knowledge were characterized by enhanced explainability., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Intraoperative stretching of the hip joint capsule often generates severe pain during the first 3 hours after hip arthroscopy. The short-lived severe pain mandates high opioid consumption, which may result in adverse events and delay recovery. The femoral nerve nociceptors are located anteriorly in the hip joint capsule. A femoral nerve block reduces pain and opioid demand after hip arthroscopy. It impedes, however, ambulation and home discharge after outpatient surgery. The iliopsoas plane block selectively anesthetizes the femoral sensory nerve branches innervating the hip joint capsule without compromising ambulation. We aimed to assess reduction of opioid consumption after iliopsoas plane block during the short-lived painful postsurgical period of time after hip arthroscopy., Methods: In a randomized, triple-blind trial, 50 patients scheduled for hip arthroscopy in general anesthesia were allocated to active or placebo iliopsoas plane block. The primary outcome was opioid consumption during the first three postoperative hours in the postanesthesia care unit. Secondary outcomes included pain, nausea, and ability to ambulate., Results: Forty-nine patients were analyzed for the primary outcome. The mean 3-hour intravenous morphine equivalent consumption in the iliopsoas plane block group was 10.4 mg vs 23.8 mg in the placebo group (p<0.001). No intergroup differences were observed for the secondary outcomes during the postoperative follow-up., Conclusion: An iliopsoas plane block reduces opioid consumption after hip arthroscopy. The reduction of opioid consumption during the clinically relevant 3-hour postsurgical period of time was larger than 50% for active versus placebo iliopsoas plane block in this randomized, triple-blind trial., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The midline skin incision for total knee arthroplasty may be an important generator of chronic neuropathic pain. The incision is innervated by the medial femoral cutaneous nerve (MFCN), the intermediate femoral cutaneous nerves (IFCN) and the infrapatellar branch from the saphenous nerve. The MFCN divides into an anterior (MFCN-A) and a posterior branch (MFCN-P). The primary aim was to compare the areas anesthesized by MFCN-A versus MFCN-P block for coverage of the incision., Methods: Nineteen healthy volunteers had IFCN and saphenous nerve blocks. The subgroup of volunteers with a non-anesthetized gap between the areas anesthetized by the saphenous and the IFCN blocks was defined as the study group for the primary outcome. Subsequently selective MFCN-A block and MFCN block (MFCN-A + MFCN-P) were performed to investigate the contributions from MFCN-A and MFCN-P to the innervation of the midline incision. All assessments were performed blinded., Results: Ten out of 19 volunteers had a non-anesthetized gap. Nine out of these 10 volunteers had coverage of the non-anesthetized gap after selective anesthesia of the MFCN-A, whereas anesthesia of the MFCN-P did not contribute to coverage of the gap in any of the 10 volunteers., Conclusions: In half of the cases, a gap of non-anesthetized skin was present on the surgical midline incision after anesthesia of the saphenous nerve and the IFCN. This gap was covered by selective anesthesia of the MFCN-A without contribution from MFCN-P. The selective MFCN-A block may be relevant for diagnosis and interventional management of neuropathic pain due to injury of MFCN-A.

Background: Machine learning (ML) models for early identification of patients at risk of hospital-acquired urinary tract infection (HA-UTI) may enable timely and targeted preventive and therapeutic strategies. However, clinicians are often challenged in the interpretation of the predictive outcomes provided by the ML models, which often reach different performances., Aim: To train ML models for predicting patients at risk of HA-UTI using available data from electronic health records at the time of hospital admission. This study focused on the performance of different ML models and clinical explainability., Methods: This retrospective study investigated patient data representing 138,560 hospital admissions in the North Denmark Region from 1 st January 2017 to 31 st December 2018. Fifty-one health sociodemographic and clinical features were extracted as the full dataset, and χ 2 test and expert knowledge were used for feature selection, resulting in two reduced datasets. Seven different ML models were trained and compared between the three datasets. The SHapley Additive exPlanation (SHAP) method was used to support population- and patient-level explainability., Findings: The best-performing ML model was the neural network model based on the full dataset, with an area under the curve (AUC) of 0.758. The neural network model was also the best-performing ML model based on the reduced datasets, with an AUC of 0.746. Clinical explainability was demonstrated with a SHAP summary and forceplot., Conclusion: Within 24 h of hospital admission, the ML models were able to identify patients at risk of developing HA-UTI, providing new opportunities to develop efficient strategies for the prevention of HA-UTI. SHAP was used to demonstrate how risk predictions can be explained at individual patient level and for the patient population in general., (Copyright © 2023. Published by Elsevier Ltd.)

Classifying sleep stages in real-time represents considerable potential, for instance in enabling interactive noise masking in noisy environments when persons are in a state of light sleep or to support clinical staff in analyzing sleep patterns etc. However, the current gold standard for classifying sleep stages, Polysomnography (PSG), is too cumbersome to apply outside controlled hospital settings and requires manual as well as highly specialized knowledge to classify sleep stages. Using data from Consumer Sleep Technologies (CSTs) to inform machine learning algorithms represent a promising opportunity for automating the process of classifying sleep stages, also in settings outside the confinements of clinical expert settings. This study reviews 27 papers that use CSTs in combination with Artificial Intelligence (AI) models to classify sleep stages. AI models and their performance are described and compared to synthesize current state of the art in sleep stage classification with CSTs. Furthermore, gaps in the current approaches are shown and how these AI models could be improved in the near-future. Lastly, the challenges of designing interactions for users that are asleep are highlighted pointing towards avenues of more interactive sleep interventions based on AI-infused CSTs solutions., Competing Interests: Declaration of competing interest The authors declare no competing financial or non-financial interests., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Motivation: Despite recent advancements in sequencing technologies and assembly methods, obtaining high-quality microbial genomes from metagenomic samples is still not a trivial task. Current metagenomic binners do not take full advantage of assembly graphs and are not optimized for long-read assemblies. Deep graph learning algorithms have been proposed in other fields to deal with complex graph data structures. The graph structure generated during the assembly process could be integrated with contig features to obtain better bins with deep learning., Results: We propose GraphMB, which uses graph neural networks to incorporate the assembly graph into the binning process. We test GraphMB on long-read datasets of different complexities, and compare the performance with other binners in terms of the number of High Quality (HQ) genome bins obtained. With our approach, we were able to obtain unique bins on all real datasets, and obtain more bins on most datasets. In particular, we obtained on average 17.5% more HQ bins when compared with state-of-the-art binners and 13.7% when aggregating the results of our binner with the others. These results indicate that a deep learning model can integrate contig-specific and graph-structure information to improve metagenomic binning., Availability and Implementation: GraphMB is available from https://github.com/MicrobialDarkMatter/GraphMB., Supplementary Information: Supplementary data are available at Bioinformatics online., (© The Author(s) 2022. Published by Oxford University Press.)

Purpose: To evaluate the causality between interventions on spinal cord perfusion pressure and neurological outcome in traumatic spinal cord injury., Methods: A systematic review was conducted in concordance with PRISMA guidelines. The literature was found in the EMBASE, PUBMED, SCOPUS, and WEB OF SCIENCE. Eligible studies included those that reported measurements and interventions on the spinal cord perfusion pressure in either animals or patients suffering from spinal cord injury. Only studies that reported a clinical or relevant clinical outcome measure (i.e., neurophysiology) were included., Results: The search yielded 795 unique records, and six studies were included after careful review. These studies suggested a positive correlation between spinal cord perfusion pressure and neurological outcome, but conclusions on causality could not be made., Conclusion: In spite of growing indications that neurological outcomes are related to the spinal cord perfusion pressure in traumatic spinal cord injuries, a solid conclusion cannot be made due to the limited literature available. Additional well-designed studies are needed to address this issue., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This report reviews the topographical and functional anatomy relevant for assessing whether or not the obturator nerve (ON) can be anesthetized using a fascia iliaca compartment (FIC) block. The ON does not cross the FIC. This means that the ON would only be blocked by an FIC block if the injectate spreads to the ON outside of the FIC. Such a phenomena would require the creation of one or more artificial passageways to the ON in the retro-psoas compartment or the retroperitoneal compartment by disrupting the normal anatomical integrity of the FI. Due to this requirement for an artificial pathway, an FIC block probably does not block the ON., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Little is known about the global bat souvenir trade despite previous research efforts into bat harvest for bushmeat. We screened eBay listings of bats in Australia, Canada, Italy, Switzerland, United Kingdom and USA to assess the nature and extent of the online offers. A total of 237 listings were retrieved in between the 11th and 25th of May 2020 with a median price per item of US$38.50 (range: US$8.50-2,500.00). Items on offer were mostly taxidermy (61.2%) or skull (21.1%) specimens. Overall, 32 different species of bat were advertised, most of which ( n = 28) are listed as "Least Concern" on the International Union for Conservation of Nature (IUCN) Red List. One species ( Nycteris javanica ) is classified as "Vulnerable" and one ( Eidolon helvum ) as "Near Threatened." Pteropus spp. specimens were the most expensive specimens on offer and the conservations status of these species may range from "Critically Endangered" to "Data Deficient" by IUCN and the entire genus is listed in the Appendix II by the Convention on the International Trade in Endangered Species of Wild Fauna and Flora (CITES). However, the exact species concerned, and their respective conservation status, could not be confirmed based on the listings' photos. The sourcing of bat was restricted to mostly South-East Asian countries (a third of items sourced from Indonesia) and to two African countries. Our survey revealed that the online offer of bat products is diverse, abundant, and facilitated by worldwide sellers although most offered bats species are from South-East Asia. With a few exceptions, the species on offer were of little present conservation concern, however, many unknowns remain on the potential animal welfare, biosecurity, legal implications, and most importantly public health risks associated with this dark trade., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Chaber, Amstrong, Wiantoro, Xerri, Caraguel, Boardman and Nielsen.)

Recent advances in statistical inference have significantly expanded the toolbox of probabilistic modeling. Historically, probabilistic modeling has been constrained to very restricted model classes, where exact or approximate probabilistic inference is feasible. However, developments in variational inference, a general form of approximate probabilistic inference that originated in statistical physics, have enabled probabilistic modeling to overcome these limitations: (i) Approximate probabilistic inference is now possible over a broad class of probabilistic models containing a large number of parameters, and (ii) scalable inference methods based on stochastic gradient descent and distributed computing engines allow probabilistic modeling to be applied to massive data sets. One important practical consequence of these advances is the possibility to include deep neural networks within probabilistic models, thereby capturing complex non-linear stochastic relationships between the random variables. These advances, in conjunction with the release of novel probabilistic modeling toolboxes, have greatly expanded the scope of applications of probabilistic models, and allowed the models to take advantage of the recent strides made by the deep learning community. In this paper, we provide an overview of the main concepts, methods, and tools needed to use deep neural networks within a probabilistic modeling framework.

Background: A femoral nerve block relieves pain after total hip arthroplasty, but its use is controversial due to motor paralysis accompanied by an increased risk of fall. Assumedly, the iliopsoas plane block (IPB) targets the hip articular branches of the femoral nerve without motor blockade. However, this has only been indicated in a cadaver study. Therefore, we designed this volunteer study., Methods: Twenty healthy volunteers were randomly allocated to blinded paired active vs. sham IPB (5 mL lidocaine 18 mg/mL with epinephrine vs saline). The primary outcome was reduction of maximal force of knee extension after IPB compared to baseline. Secondary outcomes included reduction of maximal force of hip adduction, and the pattern of injectate spread assessed with magnetic resonance imaging., Results: Mean (confidence interval) change of maximal force of knee extension from baseline to after IPB was -9.7 N (-22, 3.0) (P = .12) (n = 14). The injectate was consistently observed in an anatomically well-defined closed fascial compartment between the intra- and extra-pelvic components of the iliopsoas muscle anterior to the hip joint., Conclusion: We observed no significant reduction of maximal force of knee extension after an IPB. The injectate was contained in a fascial compartment previously shown to contain all sensory branches from the femoral nerve to the hip joint. The clinical consequence of selective anesthesia of all sensory femoral nerve branches from the hip could be a reduced risk of fall compared to a traditional femoral nerve block. Registration of Trial: The trial was prospectively registered in EudraCT (Reference: 2018-000089-12, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-000089-12)., (© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background and Objectives: For pain relief after total knee arthroplasty (TKA), an injection at the midthigh level may produce analgesia inferior to that of a femoral nerve block as the anterior femoral cutaneous nerves (intermediate femoral cutaneous nerve (IFCN) and medial femoral cutaneous nerve (MFCN)) are not anesthetized. The IFCN can be selectively anesthetized in the subcutaneous tissue above the sartorius muscle and the MFCN by an injection in the proximal part of the femoral triangle (FT). The primary aim was to investigate the area of cutaneous anesthesia in relation to the surgical incision for TKA and anteromedial knee area after intermediate femoral cutaneous nerve blockade (IFCNB) in combination with an injection in the proximal or distal part of the FT (proximal vs distal femoral triangle block (FTB))., Methods: The study was carried out as two separate investigations: first, dissection of nine cadaver sides to verify a technique for IFCNB; second, a volunteer study with 40 healthy volunteers. The surgical midline incision for TKA was drawn bilaterally. All volunteers received an active distal FTB combined with a placebo proximal FTB on one side and vice versa on the other side. All volunteers were randomized to an active IFCNB on one side and placebo IFCNB on the contralateral side., Results: Identification of IFCN was successful in all cadaver sides. Fifteen out of 20 volunteers had complete anesthesia of the incision line after IFCNB combined with proximal FTB, which was significantly higher compared with proximal FTB alone and with distal FTB+IFCNB. A gap at the anteromedial knee area was present in 2/20 volunteers with proximal FTB compared with 17/20 with distal FTB when all volunteers had active IFCNB., Conclusion: Ultrasound-guided blockade of the IFCN and MFCN anesthetize the surgical midline incision and the anteromedial area of the knee relevant for TKA. In contrast, an injection at the midthigh level produces insufficient cutaneous anesthesia not covering the areas of interest., Trial Registration Number: EudraCT: 2018-004986-15., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Thoracic paravertebral block (TPVB) is considered the gold standard for hemithoracic regional anaesthesia. Erector spinae plane block (ESPB) is a new posterior thoracic wall block. Multiple-injection costotransverse block (MICB) mimics TPVB but with injection points within the thoracic intertransverse tissue complex and posterior to the superior costotransverse ligament. We aimed to compare the spread of injectate into the thoracic paravertebral space (TPVS) resulting from single-injection ESPB and MICB, respectively, with TPVB., Methods: Ten soft-embalmed cadavers were utilised. In five cadavers, the right hemithorax was randomly allocated either to ultrasound-guided single-injection ESPB or single-injection TPVB; vice versa on the other side. In another five cadavers, the right hemithorax was randomly allocated either to ultrasound-guided MICB or multiple-injection TPVB. About 20 mL of dye was injected in each hemithorax with all techniques., Results: With TPVB, the dye was consistently present in the TPVS with concomitant epidural spread in the majority of cases. The injectate spread into the TPVS with ESPB (60%) and MICB (100%). MICB consistently stained the ventral rami (T1-7), communicating rami and thoracic sympathetic trunk without epidural spread. Dissection after MICB revealed dye spread into the TPVS via the costotransverse foramina and along the dorsal branches of the posterior intercostal veins., Conclusions: Consistent spread of dye into the TPVS colouring the ventral rami, the communicating rami, and the sympathetic trunk was observed with MICB; in this respect equivalent to TPVB. ESPB exhibited only partial success and was not equivalent to TPVB. No epidural spread was found with neither MICB nor ESPB., (© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Competing Interests: Competing interests: None declared.

Background and Objectives: The superior cluneal nerves originate from the dorsal rami of primarily the upper lumbar spinal nerves. The nerves cross the iliac spine to innervate the skin and subcutaneous tissue over the gluteal region. The nerves extend as far as the greater trochanter and the area of innervation may overlap anterolaterally with the iliohypogastric and the lateral femoral cutaneous (LFC) nerves. A selective ultrasound-guided nerve block technique of the superior cluneal nerves does not exist. A reliable nerve block technique may have application in the management of postoperative pain after hip surgery as well as other clinical conditions, for example, chronic lower back pain. In the present study, the primary aim was to describe a novel ultrasound-guided superior cluneal nerve block technique and to map the area of cutaneous anesthesia and its coverage of the hip surgery incisions., Methods: The study was carried out as two separate investigations. First, dissection of 12 cadaver sides was conducted in order to test a novel superior cluneal nerve block technique. Second, this nerve block technique was applied in a randomized trial of 20 healthy volunteers. Initially, the LFC, the subcostal and the iliohypogastric nerves were blocked bilaterally. A transversalis fascia plane (TFP) block technique was used to block the iliohypogastric nerve. Subsequently, randomized, blinded superior cluneal nerve blocks were conducted with active block on one side and placebo block contralaterally., Results: Successful anesthesia after the superior cluneal nerve block was achieved in 18 of 20 active sides (90%). The area of anesthesia after all successful superior cluneal nerve blocks was adjacent and posterior to the area anesthetized by the combined TFP and subcostal nerve blocks. The addition of the superior cluneal nerve block significantly increased the anesthetic coverage of the various types of hip surgery incisions., Conclusion: The novel ultrasound-guided nerve block technique reliably anesthetizes the superior cluneal nerves. It anesthetizes the skin posterior to the area innervated by the iliohypogastric and subcostal nerves. It improves the anesthetic coverage of incisions used for hip surgery. Among potential indications, this new nerve block may improve postoperative analgesia after hip surgery and may be useful as a diagnostic block for various chronic pain conditions. Clinical trials are mandated., Trial Registration Number: EudraCT, 2016-004541-82., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

The plastic carrier bag epitomises many of the features that have transformed plastics into a material that defines our contemporary modern culture. The versatility, durability, strength and low cost have made it into an indispensable companion for consumers. In parallel with plastic becoming an increasingly contested material, the plastic carrier bag has emerged as a controversial object in many jurisdictions. This paper explores where, how and to what extent public authorities in different cases across the globe regulate plastic carrier bags. The number of public policies on plastic carrier bags has more than tripled since 2010, and they are now found on all continents, ranging from the municipal to the intergovernmental level. They mainly come in the form of either bans or levies, with the former being predominant. There have been many examples of policies leading to reduced consumption of plastic carrier bags, however this paper also identifies key challenges, including resistance towards plastic carrier bag regulations, uncertainty in measuring the effects, and the undesired side-effects. Far from being a simple issue, public policies on plastic carrier bags highlight the complexity of governing plastics., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background and Objectives: A substantial group of patients suffer from moderate to severe pain following elective total hip arthroplasty (THA). Due to the complex innervation of the hip, peripheral nerve block techniques can be challenging and are not widely used. Since the obturator nerve innervates both the anteromedial part of the joint capsule as well as intra-articular nociceptors, we hypothesized that an obturator nerve block (ONB) would decrease the opioid consumption after THA., Methods: Sixty-two patients were randomized to receive ONB or placebo (PCB) after primary THA in spinal anesthesia. Primary outcome measure was opioid consumption during the first 12 postoperative hours. Secondary outcome measures included postoperative pain score, nausea score and ability to ambulate., Results: Sixty patients were included in the analysis. Mean (SD) opioid consumption during the first 12 postoperative hours was 39.9 (22.3) mg peroral morphine equivalents (PME) in the ONB group and 40.5 (30.5) mg PME in the PCB group (p=0.93). No difference in level of pain or nausea was found between the groups. Paralysis of the hip adductor muscles in the ONB group reduced the control of the operated lower extremity compared with the PCB group (p=0.026). This did, however, not affect the subjects' ability to ambulate., Conclusions: A significant reduction in postoperative opioid consumption was not found for active versus PCB ONB after THA., Trial Registration Number: NCT03064165 and 2017-000068-14., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Cutaneous nerve blockade may improve analgesia after hip surgery. Anaesthesia after the lateral femoral cutaneous (LFC) nerve block is too distal for complete coverage of most hip surgery incisions, which requires additional anaesthesia of the adjacent, proximal area. The transversalis fascia plane (TFP) block potentially anaesthetises the iliohypogastric and subcostal nerves. The primary aim of the present study was to investigate, if the TFP block provides cutaneous anaesthesia adjacent to the LFC nerve block., Methods: Active vs placebo TFP blocks were compared in a paired randomised controlled trial (RCT) in 20 volunteers, who all had bilateral LFC nerve blocks. The day preceding the RCT, the area anaesthetised by a novel selective ultrasound guided subcostal nerve block was identified bilaterally in order to assess the contribution of the subcostal nerve to the area anaesthesia by the TFP block., Results: Anaesthesia of the lateral hip region after TFP block was 80%. The cutaneous anaesthesia after active TFP block was in continuity with the LFC nerve block in 65%. Combined TFP and LFC nerve blockade significantly increased the coverage of hip surgery incisions compared to LFC nerve block alone. The success rate of blocking the subcostal nerve was 50% with the TFP block., Conclusion: The TFP block anaesthetises the skin proximal to the LFC nerve block by anaesthetising the iliohypogastric and subcostal nerves. TFP block as a supplement to LFC nerve block improves the coverage of the proximal surgical incisions used for hip surgery., (© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background: Anatomical knowledge dictates that regional anaesthesia after total hip arthroplasty requires blockade of the hip articular branches of the femoral and obturator nerves. A direct femoral nerve block increases the risk of fall and impedes mobilisation. We propose a selective nerve block of the hip articular branches of the femoral nerve by an ultrasound-guided injection in the plane between the iliopsoas muscle and the iliofemoral ligament (the iliopsoas plane). The aim of this study was to assess whether dye injected in the iliopsoas plane spreads to all hip articular branches of the femoral nerve., Methods: Fifteen cadaver sides were injected with 5 mL dye in the iliopsoas plane guided by ultrasound. Dissection was performed to verify the spread of injectate around the hip articular branches of the femoral nerve., Results: In 10 dissections (67% [95% confidence interval: 38-88%]), the injectate was contained in the iliopsoas plane staining all hip articular branches of the femoral nerve without spread to motor branches. In four dissections (27% [8-55%]), the injection was unintentionally made within the iliopectineal bursa resulting in secondary spread. In one dissection (7% [0.2-32%]) adhesions partially obstructed the spread of dye., Conclusion: An injection of 5 mL in the iliopsoas plane spreads around all hip articular branches of the femoral nerve in 10 of 15 cadaver sides. If these findings translate to living humans, injection of local anaesthetic into the iliopsoas plane could generate a selective sensory nerve block of the articular branches of the femoral nerve without motor blockade., (© 2018 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Background and Objectives: Nerve blockade of the lateral femoral cutaneous (LFC) nerve provides some analgesia after hip surgery. However, knowledge is lacking about the extent of the cutaneous area anesthetized by established LFC nerve block techniques, as well as the success rate of anesthetic coverage of various surgical incisions. Nerve block techniques that rely on ultrasonographic identification of the LFC nerve distal to the inguinal ligament can be technically challenging. Furthermore, the branching of the LFC nerve is variable, and it is unknown if proximal LFC nerve branches are anesthetized using the current techniques. The primary aim of this study was to investigate a novel ultrasound-guided LFC nerve block technique based on injection into the fat-filled flat tunnel (FFFT), which is a duplicature of the fascia lata between the sartorius and the tensor fasciae latae muscle, in order to assess the success rate of anesthetizing the proximal LFC nerve branches and covering of the different surgical incisions used for hip surgery., Methods: First, a cadaveric study was conducted in order to identify an FFFT injection technique that would provide adequate injectate spread to the proximal LFC nerve branches. Second, a clinical study was conducted in a group of 20 healthy volunteers over 2 consecutive days. On trial day 1, successful complete anesthesia of the LFC nerve was defined by performing a suprainguinal fascia iliaca block bilaterally in each subject. On trial day 2, a triple-blind randomized controlled trial compared the effect of the novel ultrasound-guided LFC nerve block technique for bupivacaine versus placebo. The primary end point was the success rate of anesthesia of the proximal cutaneous area innervated by the LFC nerve for the FFFT injection with bupivacaine versus placebo., Results: Adequate spread of injectate to the proximal LFC nerve branches in cadavers was obtained by injecting 10 mL with dynamic needle-tip tracking in the FFFT. Application of this technique in the randomized controlled trial provided anesthesia of the lateral thigh with a success rate of 95% (95% confidence interval, 73.9%-99.8%) for the active side and 0% for placebo (P < 0.001). The proximal branches were anesthetized with a success rate of 68% (95% confidence interval, 43.4%-87.4%) on the active side. The proximal extent of the anesthetized cutaneous area was on average 7.9 cm distal to the greater trochanter., Conclusions: This novel LFC nerve block technique is easy and quick and reliably produces anesthesia of the lateral thigh. The greater trochanter is rarely included in the area of anesthesia, which reduces the coverage of each specific surgical incision. The success rate of 68% in anesthetizing the proximal nerve branches must be further evaluated by future research.

Background and Objectives: The femoral and obturator nerves are assumed to account for the primary nociceptive innervation of the hip joint capsule. The fascia iliaca compartment block and the so-called 3-in-1-block have been used in patients with hip fracture based on a presumption that local anesthetic spreads to anesthetize both the femoral and the obturator nerves. Evidence demonstrates that this presumption is unfounded, and knowledge about the analgesic effect of obturator nerve blockade in hip fracture patients presurgically is thus nonexistent. The objectives of this cadaveric study were to investigate the proximal spread of the injectate resulting from the administration of an ultrasound-guided obturator nerve block and to evaluate the spread around the obturator nerve branches to the hip joint capsule., Methods: Fifteen milliliters of methylene blue was injected into the interfascial plane between the pectineus and external obturator muscles in 7 adult cadavers. The spread of the injectate into the obturator canal and around the obturator and accessory obturator nerve branches to the hip joint was evaluated by subsequent dissection., Results: The injected dye spread into the obturator canal and colored all obturator branches to the hip joint capsule in all 14 sides. Furthermore, the accessory obturator nerve was present in 3 sides (21%), and the nerve and its branches to the hip joint capsule were colored in all cases., Conclusions: In cadavers, injection of 15 mL of methylene blue into the interfascial plane between the pectineus and the external obturator muscle effectively spreads proximally to reach the obturator canal, as well as the obturator nerve branches to the hip joint capsule and the accessory obturator nerve.

Access to the most up-to-date evidence is an important cornerstone for veterinarians attempting to practice in an evidence-based manner; therefore, an understanding of what and how information is accessed is vital. The aim of this study was to identify what resources the UK veterinary profession access and regard as most useful. Based on questionnaires received from veterinarians, the Veterinary Times was nominated as most often read journal or magazine by respondents (n=3572, 79 per cent). In Practice (n=3224, 82 per cent) and the Veterinary Record (n=165, 34 per cent) were seen as most useful by clinicians, and non-clinicians, respectively. Google was the most often nominated electronic resource by all respondents (n=3076, 71 per cent), with Google (n=459, 23 per cent) and PubMed (n=60, 17 per cent) seen as most useful by clinicians and non-clinicians, respectively. The abstract and conclusion sections were the most read parts of scientific manuscripts nominated by all respondents. When looking for assistance with difficult cases, colleagues were the common information choice for clinicians. Different sections of the veterinary profession access information, and deem resources useful, in different ways. Access to good quality evidence is important for the practice of evidence-based veterinary medicine, and therefore, researchers should think about disseminating their findings in a targeted way for optimal use by the profession., (British Veterinary Association.)

The practice of evidence-based veterinary medicine involves the utilisation of scientific evidence for clinical decision making. To enable this, research topics pertinent to clinical practice need to be identified, and veterinary clinicians are best placed to do this. The main aim of this study was to describe the veterinary population, the common species and conditions veterinary clinicians nominated they saw in practice and how much information clinicians perceived was available in the literature for these. A questionnaire was distributed to all Royal College of Veterinary Surgeons registered veterinarians agreeing to be contacted for research purposes (n=14,532). A useable response rate of 33 per cent (4842/14,532) was achieved. The most commonly seen species reported by vets were dogs, cats and rabbits followed by equines and cattle. Overall, skin conditions were most commonly mentioned for small animals, musculoskeletal conditions for equines and reproduction conditions for production animals. Veterinary clinicians perceived there was a higher level of information available in the literature for conditions in dogs, cattle and equines and lower levels for rabbits and guinea pigs. The results from this study can be used to help define the research needs of the profession to aid the incorporation of evidence in veterinary practice.

Salmonella Dublin affects production and animal health in cattle herds. The objective of this study was to quantify the gross margin (GM) losses following introduction and spread of S. Dublin within dairy herds. The GM losses were estimated using an age-structured stochastic, mechanistic and dynamic simulation model. The model incorporated six age groups (neonatal, pre-weaned calves, weaned calves, growing heifers, breeding heifers and cows) and five infection stages (susceptible, acutely infected, carrier, super shedder and resistant). The effects of introducing one S. Dublin infectious heifer were estimated through 1000 simulation iterations for 12 scenarios. These 12 scenarios were combinations of three herd sizes (85, 200 and 400 cows) and four management levels (very good, good, poor and very poor). Input parameters for effects of S. Dublin on production and animal health were based on literature and calibrations to mimic real life observations. Mean annual GMs per cow stall were compared between herds experiencing within-herd spread of S. Dublin and non-infected reference herds over a 10-year period. The estimated GM losses were largest in the first year after infection, and increased with poorer management and herd size, e.g. average annual GM losses were estimated to 49 euros per stall for the first year after infection, and to 8 euros per stall annually averaged over the 10 years after herd infection for a 200 cow stall herd with very good management. In contrast, a 200 cow stall herd with very poor management lost on average 326 euros per stall during the first year, and 188 euros per stall annually averaged over the 10-year period following introduction of infection. The GM losses arose from both direct losses such as reduced milk yield, dead animals, treatment costs and abortions as well as indirect losses such as reduced income from sold heifers and calves, and lower milk yield of replacement animals. Through sensitivity analyses it was found that the assumptions about milk yield losses for cows in the resistant or carrier stages had the greatest influence on the estimated GM losses. This was more influential in the poorer management scenarios due to increased number of infected cows. The results can be used to inform dairy farmers of the benefits of preventing introduction and controlling spread of S. Dublin. Furthermore, they can be used in cost-benefit analyses of control actions for S. Dublin both at herd and sector level., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The effect of Salmonella on milk production is not well established in cattle. The objective of this study was to investigate whether introduction of Salmonella into dairy cattle herds was associated with reduced milk yield and determine the duration of any such effect. Longitudinal data from 2005 through 2009 were used, with data from 12 mo before until 18 mo after the estimated date of infection. Twenty-eight case herds were selected based on an increase in the level of Salmonella-specific antibodies in bulk-tank milk from <10 corrected optical density percentage (ODC%) to ≥70 ODC% between 2 consecutive three-monthly measurements in the Danish Salmonella surveillance program. All selected case herds were conventional Danish Holstein herds. Control herds (n=40) were selected randomly from Danish Holstein herds with Salmonella antibody levels consistently <10 ODC%. A date of herd infection was randomly allocated to the control herds. Hierarchical mixed effect models with the outcome test-day yield of energy-corrected milk (ECM)/cow were used to investigate daily milk yield before and after the estimated herd infection date for cows in parities 1, 2, and 3+. Control herds were used to evaluate whether the effects in the case herds could be reproduced in herds without Salmonella infection. Herd size, days in milk, somatic cell count, season, and year were included in the models. Yield in first-parity cows was reduced by a mean of 1.4 kg (95% confidence interval: 0.5 to 2.3) of ECM/cow per day from 7 to 15 mo after the estimated herd infection date, compared with that of first-parity cows in the same herds in the 12 mo before the estimated herd infection date. Yield for parity 3+ cows was reduced by a mean of 3.0 kg (95% confidence interval: 1.3 to 4.8) of ECM/cow per day from 7 to 15 mo after herd infection compared with that of parity 3+ cows in the 12 mo before the estimated herd infection. We observed minor differences in yield in second-parity cows before and after herd infection and observed no difference between cows in control herds before and after the simulated infection date. Milk yield decreased significantly in affected herds and the reduction was detectable several months after the increase in bulk tank milk Salmonella antibodies. It took more than 1 yr for milk yield to return to preinfection levels., (Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Studies reporting on how to control Salmonella in cattle herds have mainly been theoretical simulation models or case reports describing control of clinical salmonellosis outbreaks. The objective of this observational study was to investigate which management routines were associated with successful control of Salmonella Dublin in calves in dairy herds with previous signs of endemic infection. A total of 86 bulk-tank milk Salmonella Dublin antibody-positive bovine dairy herds were enrolled in the study in September 2008 and were all encouraged to control spread of the infection. One year later it was assessed if they were successful. The criterion for successful control was defined as the 10 youngest calves above three months of age testing Salmonella Dublin antibody-negative, indicating that exposure to Salmonella of these calves from birth until close to the day of testing had been successfully prevented. Management routines were registered through telephone interviews based on a questionnaire resulting in 45 variables for analysis. By the end of the study, a total of 84 herds had completed the interviews and had serum samples collected from calves. Data were analysed using two statistical methods: logistic regression analysis and discriminant analysis. Both analyses identified that increased probability of successful control was strongly associated with avoiding purchase of cattle from test-positive herds. Additionally, ensuring good calving area management, separating calf pens by solid walls rather than bars and not introducing biosecurity routines between the barn sections (e.g. boot wash, change of clothing) were associated with increased probability of successful control in the logistic analysis. The latter may seem illogical, but may be explained by successful herds already having good hygienic routines in place and therefore not having introduced new routines between barn sections in the study period. The discriminant analysis furthermore identified successful control to be associated with preventing cows from calving before being moved to the designated calving pen, by only letting one person be responsible for colostrum management and by not feeding poorer quality colostrum to bull calves than to heifer calves. The results are useful for dairy cattle producers and veterinary authorities to substantiate advice on management practices that are likely to lead to successful control of Salmonella Dublin., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Specialised veal producers that purchase and raise calves from several dairy herds are potentially at high risk of delivering Salmonella-infected animals to slaughter. However, the true prevalence of Salmonella infected veal producing herds and the prevalence of infected calves delivered to slaughter from infected herds are unknown in Denmark. Due to uncertainties about test sensitivity and specificity, these prevalences are not straightforward to assess. The objective of this study was to estimate the within-herd- and between-herd prevalence of Salmonella in veal calves delivered for slaughter to abattoirs in Denmark. Furthermore, it was investigated to which extent the estimates differed between a setup using both serological tests and faecal culture, compared to just serological tests, and whether the applied sampling scheme in the national surveillance programme in Denmark was sufficient to establish high posterior estimates of freedom from infection in individual herds. We used Bayesian analysis to avoid bias as a result of fixed test validity estimates. Serological test results from 753 animals and faecal culture from 1233 animals from 68 randomly selected Danish veal producing herds that delivered more than 100 calves to slaughter per year were used to estimate the prevalences and estimates of freedom from Salmonella. Serological test results of 7726 animals from 185 herds were used to compare the difference in prevalence estimates between serology alone vs. faecal culture combined with serology. We estimated that 34-57% of specialised veal producing herds were infected with Salmonella. Within the infected herds, 21-49% of the animals were infected. Few herds obtained high posterior estimates for the probability of freedom from infection given the collected data, with only six of 68 herds obtaining posterior probability of being infected less than 10%. Furthermore, this study indicated that serology is sufficiently sensitive and specific to be used for estimating the prevalence of Salmonella-infected specialised veal producing herds., (© 2011 Elsevier B.V. All rights reserved.)

Aim: We hypothesized that the serine protease prostasin is necessary for differentiation of a high-resistance renal collecting duct epithelium governed by glucocorticoid., Methods: Postnatal rat kidney and adult human kidney was used to study the expression and localization of prostasin. The murine collecting duct cell line (M-1) was cultured in Snapwell inserts to investigate the significance of prostasin for the development of transepithelial electrical resistance (TER)., Results: In the cortex and medulla of rat kidney, prostasin mRNA and protein increased significantly between birth and weaning (day 21) and was detected in collecting ducts. Immunoreactive prostasin was associated with collecting ducts and loops of Henle in human kidney. In rat, adrenalectomy at day 10 had no effect on prostasin mRNA level in kidney at day 20. Cultured M-1 cells exhibited parallel increases in prostasin mRNA, protein and TER 5 days after seeding. Apical addition of the serine protease inhibitor aprotinin to M-1 cell cultures inhibited development of TER and led to aberrant localization of E-cadherin. This effect was mimicked by the protease inhibitor nafamostat. Apical addition of phospholipase C to cleave glycosylphosphatidylinositol (GPI) anchors released prostasin to the medium and attenuated development of TER with time of culture. Disruption of lipid rafts by methyl-β-cyclodextrin attenuated development of TER in M-1 cells. Omission of dexamethasone impaired development of TER in M-1 cells, while prostasin protein abundance and E-cadherin distribution did not change., Conclusion: Apical, GPI-anchored, lipid raft-associated serine protease activity, compatible with prostasin, is necessary for the development of a high-resistance collecting duct epithelium., (© 2010 The Authors. Acta Physiologica © 2010 Scandinavian Physiological Society.)