Neonatal piglets lack immunoglobulins at birth. Sufficient colostrum intake (CI) and immunoglobulin absorption are essential for an appropriate passive transfer of immunity via the colostrum. Most methods to measure immunoglobulins in serum of piglets are labour-intensive, expensive or imprecise and not designed for on-farm use. The present diagnostic test study evaluated digital Brix refractometry to measure immunoglobulins in serum of neonatal piglets and to suggest thresholds for different serum immunoglobulin concentration. Additionally, agreements between Brix refractometry and optical refractometer (serum total protein, STP) and between Brix refractometry and ELISA (immunoglobulin G, IgG) were also investigated. Forty-five sows and 269 piglets from three different farms were enrolled in the study. Piglets were weighed at birth and 24 h later to calculate the CI. Serum was collected at 24 h after birth and analysed for STP, γ-globulins (electrophoresis), % Brix and IgG. In piglets, median (interquartile range, IQR) CI was 412 (196) g per piglet. Median (IQR) STP, γ-globulin and % Brix concentrations in piglet serum were 60 (11) g/L, 35 (10) g/L and 8 (2) %, respectively. Average (±SD) IgG concentration was 49 ± 23 g/L. Passing-Bablok regression revealed a strong concordance between % Brix and STP (Kendall's tau (Τ): 0.620, P < 0.0001, n = 267) and % Brix and γ-globulin concentration (Kendall's Τ: 0.575, P < 0.0001, n = 267). The agreement between the Brix refractometer and IgG concentration was poor (Kendall's Τ: 0.267, P < 0.0001, n = 269). Receiver operating characteristic curves were performed to evaluate test characteristics of Brix refractometry for three γ-globulin cut-off values, i.e. 10, 20 and 30 g/L. The % Brix cut-off values resulting in the optimal combination of sensitivity and specificity were 5.4 (100 and 98.5%), 7.0 (100 and 89.3%) and 7.9 (90.1 and 80.6%), respectively. In conclusion, digital Brix refractometry is a sufficiently fast and practical method to assess serum γ-globulin concentrations in neonatal piglets on-farm and to evaluate them by considering the thresholds found in this study. Further studies are needed to validate those thresholds regarding piglet's survival in the pre-weaning period.

Introduction: In 2002, an expert panel representing prominent American orthopaedic, sports and family medicine societies placed the team physician prominently as the gate-keeper of the return to sport decision. The field of sport and exercise medicine has progressed considerably since then. Now, decision making models and ways of practicing place the athlete in the position of an active decision maker along with other relevant stakeholders. The purpose was to provide consensus on the current state of play in return to sport.

The antibacterial effects of odd-numbered medium-chain fatty acids (MCFA), such as C7 and C9 carboxylic acids, are poorly described and, hence, their potential as a feed additive for weaned piglets has not been explored. First, the antimicrobial activity was tested in in vitro incubations simulating the digestion in the stomach (pH 3), duodenum (pH 5), and ileum (pH 7) at 0, 17.5, 35.0, and 70.0 mmol/L carboxylate and compared with even-numbered MCFA. All compounds showed a significant reduction of analyzed bacterial counts compared with the control, in many cases >2 log reduction up to complete disappearance, depending on pH and dose. At pH 3 and 5, C6 through C9 carboxylic acids were equally effective against coliforms, whereas C10 was less effective. The activity against lactobacilli and streptococci was higher at the lower pH and increased with chain length. The antimicrobial effects of C7 and C9 carboxylic acids were, in most cases, in between or, in one case, better than that of their respective neighboring even-numbered MCFA. Next, an equal mixture of C7 and C9 carboxylic acid was fed to weaned piglets at 0, 0.1, 0.2, and 0.4% carboxylic acids in the diet for 42 d (8 pen replicates with 6 pigs each). At d 13/14, 1 piglet per pen was sampled to determine major gastric and proximal and distal small intestinal bacterial groups and histomorphological characteristics. Numerical improvements of animal performance for all supplemented diets were observed (P > 0.05) and this corroborated with a trend for longer villi in the proximal small intestine (P = 0.082). The highest dose tended to reduce streptococci in the stomach contents (P = 0.079). In vitro, C7 and C9 carboxylic acids demonstrated clear and significant antibacterial effects against the major bacterial groups in the stomach and small intestine. In the postweaning performance trial, they showed potential to ameliorate performance.

Background: Shoulder pain is a common musculoskeletal disorder and is considered a challenge for many physiotherapists. Within patients with shoulder dysfunction, subacromial pain syndrome is the most common diagnosis. In the literature different treatment strategies to restore shoulder function have been evaluated. However, current evidence is difficult to interpret in relation to its use in clinical practice and provides little guidance to help physiotherapists choose the most appropriate treatment strategy.

Sport Specific Adaptation in Resting Length of Pectoralis Minor in Professional Male Golfers Objective: In professional male golfers the shoulder is the third most commonly injured area with the lead/non-dominant shoulder three times more likely to be injured than the trail/dominant shoulder. Resting length of pectoralis minor musculature influences scapular and glenohumeral orientation which when suboptimal is associated with shoulder injuries. This study investigates the resting pectoralis minor muscle length in professional male golfers. Method: Forty five male golfers on European Challenge Tour and thirty six control volunteers met the inclusion criteria for the study. Resting pectoralis minor length was measured in the supine position with the Palmmeter device. Results: Within groups: controls exhibited a significantly longer pectoralis minor muscle on the non-dominant side (p=0.01), and golfers had a significantly longer pectoralis minor muscle on the trail/dominant side (p=0.01). Between groups: controls exhibited a significantly longer pectoralis minor length on the non-dominant/ lead side when compared to golfers (p=0.01). Conclusion: When compared to age-matched controls professional male golfers have a unique pattern of resting pectorals minor muscle length, with longer pectoralis minor length noted in the trail/ dominant shoulder. Comparison of the lead/non-dominant shoulder with controls highlights that golfers have a shorter pectoralis minor length which in turn affects scapular and glenohumeral orientation. This may place the golfer at greater risk of shoulder injury in the lead side.

Learning objectives: 1. To explain and provide evidence for alternative hypotheses regarding the aetiology of shoulder impingement syndrome. 2. To describe and evaluate the efficacy of alternative treatment approaches for shoulder impingement syndrome. 3. To evaluate whether differences in opinion regarding the aetiology of shoulder impingement syndrome have a significant impact on how physiotherapists treat this common musculoskeletal problem.

The aim of this study was to identify sow and piglet parameters that were associated to piglets׳ daily weight gain (DWG) and survival. We were especially interested in associations with colostrum intake (CI) and how CI affects amino acid use in neonatal piglets. Survival and DWG was recorded of piglets born to 37 PIC sows (parity 1–7) until weaning. Parameters regarding reproduction, sow body condition, colostrum quantity, and colostrum nutritional and immunological composition were noted. Four piglets per litter were randomly selected for serum collection 24–30 h after birth and this was analysed for urea, creatinine, non-esterified fatty acids (NEFA), immunoglobulin G (IgG) and A (IgA), and 7 free amino acids. The DWG was positively associated with birth weight (BWB) and CI/kg BWB, and negatively with time between birth and first suckle (tFS) until day 3 of lactation (R2=0.39, p<0.001), day 7 of lactation (R2=0.26, p<0.001) and weaning (R2=0.18, p<0.001). The mortality rate was higher for piglets with a BWB <1 kg (p<0.001), a CI/kg BWB <160 g (p<0.001) and a tFS>60 min (p<0.01). The CI/kg BWB was negatively associated to urea (p=0.002), positively to some free amino acids (p<0.05) but not to creatinine, NEFA, IgG and IgA in piglets׳ serum. The DWG was negatively associated to urea and positively to leucine until day 3 of lactation (R2=0.19, p<0.001), until day 7 of lactation (R2=0.13, p<0.001) and until weaning (R2=0.08, p<0.001). A lower CI/kg BWB was accompanied by a higher catabolism of protein that did not seem to originate from the piglets׳ body reserves. It seems that piglets with a lower CI/kg BWB use a larger proportion of colostral protein as a substrate for energy production instead of other purposes such as lean growth, as there was a negative association between parameters indicating protein catabolism and DWG at least until weaning. In conclusion, the study demonstrated that piglets׳ daily weight gain and survival until weaning was positively associated with birth weight, colostrum intake per kg birth weight and negatively to time between birth and first suckle. The effect of colostrum intake per kg birth weight seems to be related to a shift in nutrient use. With a decreasing colostrum intake per kg birth weight, piglets use a relatively higher amount of colostral protein in catabolic processes.

Background Shoulder pathology in adult tennis players including rotator cuff pathology is well known. However, early adaptations have not previously been studied in the adolescent elite tennis players. Objectives To describe magnetic resonance imaging (MRI) findings in the shoulder in asymptomatic elite adolescent tennis players. Design A MRI scan using a 3 Tesla scanner of both shoulders were performed. PD (proton density) weighted images with fat-saturation in oblique coronal, oblique sagittal and axial planes together with oblique sagittal T2 images were reviewed especially for the presence of abnormalities regarding labral lesions and rotator-cuff lesions by two radiologists in consensus. The MRI scans were evaluated by to independent experienced radiologists in a blinded manner according to a pre-defined protocol. Data were collected retrospectively for the dominant arm and contralateral arm respectively. Statistical analyses were performed using SPSS software. Setting Testing environment at Medical Rontgen, Sweden. Participants 35 adolescent elite tennis players from the Swedish national team were selected (ages 13–24 years median age 17). 15 boys and 20 girls participated in the study. Intervention Findings were described according to a predefined protocol. Main outcome measurements MRI findings of the dominant and non-dominant shoulder. Results 19 players (54%) had a normal MRI examination and 16 players (46%) had abnormal findings of which 14 players showed affected tendons/tendinosis. The predominant findings were made in infraspinatus (n=10), Supraspinatus (n=5) and Subscapularis (n=1). Two players had findings in both infra- and supraspinatus. Conclusions This is the first study describing MRI findings in adolescent elite tennis players, revealing infraspinatus and supraspinatus affected tendons/tendinosis in this asymptomatic overhead athletic population. The results can serve as the baseline for a future prospective longitudinal cohort study.

Research showed a positive association between back fat (BF) change the week before farrowing and colostrum yield (CY). This study tested the causality of this association, hence to optimize CY by altering the sows' peripartal feeding strategy. Sows were randomly divided into 2 treatment groups at d 108 of gestation. The first group (L, n = 28) received 1.5 kg feed·d-1, the second group (H, n = 22) received 3 times 1.5 kg feed·d-1 until farrowing. Daily feed intake and CY were measured. Colostrum was analyzed for nutrient composition, AA and fatty acids, IgG and IgA. Sow serum was obtained at d 108 of gestation and d 1 of lactation after overnight fasting and analyzed for NEFA, (iso)butyrylcarnitine (C4), creatinine, urea, 3-OH-butyrylcarnitine (3-OH-C4), IgG, and IgA. Based on BF at d 108, sows were divided into body condition (BC) groups: skinny (<17 mm, n = 15), moderate (17 to 23 mm, n = 21), fat (>23 mm, n = 14). We performed ANOVA with treatment and BC as fixed factors and Scheffé post-hoc test. The week before farrowing, the L group had the lowest daily feed intake (DFI; 1.5 kg), and within the H group, fat sows (3.8 kg) had a lower DFI than skinny sows (4.3 kg; p = 0.006). The H group tended to have a greater total CY (P = 0.074) and had a greater CY/kg liveborn piglet (P = 0.018) than the L group. Compared with sows in moderate BC, fat sows had a lower total CY (P = 0.044) and a lower CY/kg liveborn piglet (P = 0.005). The H group had a greater concentration of lactose (p = 0.009) and n-3 PUFA (p < 0.001) but a lower concentration of protein (p = 0.040) in colostrum than the L group. The concentration of IgG and IgA did not differ between treatment and BC groups. Serum parameters at d 108 were similar between the treatment groups and BC groups. At d 1, the H group mobilized less body fat (NEFA: p = 0.002) and protein (creatinine: p < 0.001, C4: p = 0.016) reserves but had a greater ratio urea:NEFA (p < 0.001) and less ketone bodies (3-OH-C4: p < 0.001) compared with the L group. This indicates a more balanced entry of metabolites in the citric acid cycle and thus a better support of the maternal peripartal metabolism in the H group. Serum parameters did not differ between BC groups. Both CY and composition can be influenced by the peripartal feeding strategy and BC. The highest CY and most beneficial colostrum composition were obtained when sows entered the farrowing unit in a moderate BC and were provided a high peripartal feeding strategy.

A proper culling policy in sow herds is a prerequisite to maintain a stable parity profile of the breeding animals and to maintain consistent production. This study investigated reasons for culling of 502 sows from 7 commercial pig herds and examined the reproductive tract of these sows by macroscopical, bacteriological and histopathological examination. Associations between all three examinations were statistically analysed. More than 50% of the sows was culled because of reproduction failure, while old age was the second most common reason (23%). Approximately 75% of the examined uteri were visually normal. Purulent exudate was detected in 18% of the animals. No abnormalities were found in 54% of the ovaries, whereas 28% showed inactivity. Sixty-two percent of the uteri were bacteriologically positive, with Escherichia coli (18%) being the most frequently isolated. Histologically, 52% of the uteri showed mild to severe inflammation. From the uteri with endometritis based on visual inspection and histology, 26% and 30% was bacteriologically negative, respectively. The presence of bacteria showed a slight agreement with macroscopical (κ=0.14, p=0.04) and histopathological endometritis (κ=0.18, p=0.04). No agreement was found between macroscopical and histopathological lesions (κ=−0.06, p>0.05). Major differences were found between herds for all parameters. In conclusion, sows are mostly culled because of insufficient reproductive performance, and many of the culled sows show endometritis lesions. Histopathology appears to be more sensitive than visual inspection.

Background Gymnastic sports requires repetitive high load overhead movements that can lead to upper extremity injury. The scapula and the shoulder play a vital role in injury-free performance. Scapular dysfunction and glenohumeral changes in strength and range of motion (ROM) have been associated with shoulder injury in the overhead athlete. Objectives The purpose of this study was to describe scapular position and strength, and shoulder ROM and strength variables in a population of junior and adolescent recreational and elite gymnastics in the age categories 6–18 years. Design Descriptive study, cross-sectional design. Setting Training sports facilities. Participants Junior and adolescent gymnastics from different disciplines. Risk factor assessment A clinical screening protocol, using a digital inclinometer and a hand held dynamometer, to measure strength and mobility of the shoulder girdle. Main outcome measures (1) scapular upward rotation (UR) at several angles of arm elevation, (2) isometric scapular muscle strength (3) glenohumeral ROM, and (4) isometric rotator cuff strength. Results Data will be collected sept-dec 2013, and will be presented at the conference. Conclusion This study provides a descriptive profile of shoulder and scapular measurements in a population of elite and recreational gymnasts. These data may help the clinician to screen healthy gymnasts in their injury prevention program.

To overcome negative energy balance during the peripartal period of sows, an ad libitum feeding strategy (ADLIB) as alternative for commonly used restricted feeding (STANDARD, on average 3kg feed/day) was evaluated. Plasma metabolites and thyroid hormones, change of back fat thickness (BF), reproductive traits, and piglet performance were monitored. Voluntary feed intake of ADLIB sows declined at farrowing but was still more than twice the amount of what was offered to STANDARD sows. Consequently, ADLIB sows lost less BF than STANDARD sows (P=0.041). Additionally, BF change was affected by body condition. LEAN sows (BF<18mm on d 105 of gestation) lost less BF than MODERATE sows (18mm≤BF≤22mm) which lost less BF than FAT sows (BF>22mm) (P<0.001). Except for a decreased percentage of stillborn piglets for MODERATE sows (P=0.044), reproduction results were not affected. Piglet weaning weight of ADLIB-FAT and STANDARD-MODERATE sows was reduced in comparison with that of ADLIB-LEAN sows (P=0.005). Regardless of body condition, all metabolites and thyroid hormones measured showed a time dependent profile (P<0.001). On d 112 of gestation increased concentrations of creatinine (P=0.004), non-esterified fatty acids (P=0.039), and serum crosslaps (P=0.016) for STANDARD sows were observed. Triglycerides were increased for FAT sows (P<0.001), and decreased faster over time for ADLIB (P=0.013) and for FAT (P=0.012). Although ad libitum feeding during the peripartal period only resulted in less mobilization of muscle, fat, and bone reserves on d 112 of gestation, results of BF change and piglet weaning weight indicated that ad libitum feeding is beneficial for sow performance provided that BF is below 22mm.

Background Recently, a novel reliable and valid protocol has been described for the measurement of eccentric strength of the external rotators of the shoulder, using a Hand Held Dynamometer (HHD). These muscles are prone to weakness in healthy as well as in injured overhead athletes. Objective assessment of muscle strength is imperative in the prevention and rehabilitation of shoulder injuries in the overhead athlete. Objective To provide a normative database of eccentric muscle strength in overhead athletes from several disciplines (tennis, volleyball, swimming, and gymnastics). Design Descriptive laboratory study. Participants 200 healthy overhead athletes, active in different sport disciplines participated in the study. Risk factor assessment Eccentric rotator cuff strength of the external rotators was assessed from a position of 90°–90° abduction/external rotation to 90° abduction in neutral rotation at a speed of 30°/sec, and correlated to isometric rotator cuff muscle strength values in several positions. Results The study will be executed sept-jan 2013, results are to be presented from March 2014. Conclusion This study provides a normative database of eccentric muscle strength data, measured with a HHD. This device is easy to use in a field or training center environment, and therefore valuable in the prevention and rehabilitation of shoulder injuries in the overhead athlete.

Acute health care interventions for residents of skilled nursing facilities (SNFs) are often unwarranted, unwanted, and/or harmful. We describe a provider-focused care model to reduce unwarranted or unwanted acute health care utilization.Assess the capability of the Reducing Avoidable Facility Transfers (RAFT) model to reduce unwanted and unwarranted acute health care utilization among residents in 3 rural SNFs between January 1, 2016 and June 30, 2017.Prospective cohort, pre/post study.Three rural SNFs in collaboration with a geriatric practice in a tertiary academic medical center.Post-acute care (PAC) and long-term care (LTC) residents of 3 rural SNFs.RAFT includes the following components: (1) a small team of providers who manage longitudinal care and after hours call; (2) elicitation of advance care plans and preferences regarding acute care; (3) standardized communication process engaging the provider at the identification of an acute care event; (4) a biweekly case review of all emergency department (ED) transfers.ED and hospital utilization.RAFT demonstrated a 35% reduction in monthly ED transfers and a 30.5% reduction in monthly hospitalizations. These reductions were greatest for LTC residents.The RAFT approach substantially reduced unwarranted ED and hospital utilization in this study. Results support replication and evaluation in a larger, more diverse setting and population.

Elastic taping is widely used in sports medicine for correcting functional alignment and muscle recruitment. However, evidence regarding its influence on scapular dynamic positioning is scarce. This study aimed to investigate the effect of a specific kinesiotaping method on scapular kinematics in female elite handball players without shoulder complaints. 25 athletes (18.0±1.5 years) active in the highest national division were recruited. All subjects received an elastic adhesive tape (K-active tape©) with the purpose to correct scapular position. 3-dimensional scapular motion measurements were performed (Fastrak®) during humeral elevation in the sagittal, frontal and scapular plane. The results showed that taping has a moderate to large effect (Cohen's d>0.7) towards scapular posterior tilting, in all 3 planes of humeral movement and for all angles of elevation (mean posteriorizing effect of 4.23 °, 3.23 ° and 4.33 ° respectively for elevation in the sagittal, frontal and scapular plane, p<0.001). In addition, taping also moderately increased the scapular upward rotation at 30 °, 60 ° and 90 ° of humeral abduction (mean increase of 2.90 °, Cohen's d>0.7). Together these results suggest that kinesiotape application causes positive changes in scapular motion. This could support its use in sports medicine for preventing shoulder problems in overhead athletes.

Highly prolific sows often experience peripartum hypophagia, resulting in decreased production rate. Leptin, ghrelin, and resistin are known as feed intake-regulating hormones in many species, but it is yet unknown how feeding strategy and body condition will affect these hormones around parturition in sows. In the present study, a total of 63 sows, parity 2 to 7 were divided over 2 treatment groups which were fed either restricted (RESTRICT) or ad libitum (ADLIB) during the peripartum period (day 106 of gestation until day 7 of lactation). Within each treatment group, sows were assigned to 1 of 3 body condition groups based on back fat thickness at day 106 of gestation: <18 mm (LEAN), between 18 and 22 mm (MODERATE), and >22 mm (FAT). Postprandial blood samples were taken on days 107, 109, and 112 of gestation and on days 1, 3, and 5 of lactation. With RIA, leptin, ghrelin, and resistin of each sample were analyzed. For both leptin and resistin, the hormonal profile gradually increased throughout the peripartum period (P < 0.001), whereas ghrelin peaked on day 109 of gestation compared with day 107 of gestation and day 1 of lactation. Other time points were intermediate between those two (P < 0.001). The peripartum profile of leptin was significantly higher for FAT sows than for the 2 other condition groups. No effect of body condition on ghrelin and resistin concentrations was observed. None of the 3 measured hormones were affected by feeding strategy. In conclusion, during the peripartum period feed intake of sows did not affect leptin, ghrelin, or resistin profiles. Leptin was the only hormone investigated that reflected body condition. Although body condition and late gestation feed intake have been previously described as risk factors for peripartum hypophagia, they did not induce hypophagia in any of the sows or affect the profile of the observed feed intake-regulating hormones during the peripartum period.

Directing protein and energy sources towards lactation is crucial to optimise milk production in sows but how this influences colostrum yield (CY) remains unknown. The aim of this study was to identify associations between CY and the sow’s use of nutrient resources. We included 37 sows in the study that were all housed, fed and managed similarly. Parity, back fat change (ΔBF), CY and performance parameters were measured. We obtained sow serum samples 3 to 4 days before farrowing and at D1 of lactation following overnight fasting. These were analysed for non-esterified fatty acids (NEFA), urea, creatinine, (iso)butyrylcarnitine (C4) and immunoglobulins G (IgG) and A (IgA). The colostrum samples collected 3, 6 and 24 h after the birth of the first piglet were analysed for their nutrient and immunoglobulins content. The technical parameters associated with CY were parity group (a; parities 1 to 3=value 0 v. parities 4 to 7=value 1) and ΔBF D85-D109 of gestation (mm) (b): CY (g)=4290–842a–113b. (R2=0.41, P<0.001). The gestation length (P<0.001) and the ΔBF between D109 and D1 of lactation (P=0.050) were identified as possible underlying factors of the parity group. The metabolic parameters associated with CY were C4 at 3 to 4 days before farrowing (a), and 10logC4 (b) and 10logNEFA (c) at D1 of lactation: CY (g)=3582–1604a+1007b−922c (R2=0.39, P=0.001). The colostrum composition was independent of CY. The negative association between CY and ΔBF D85-D109 of gestation could not be further explained based on our data. Sows that were catabolic 1 week prior to farrowing seemed unable to produce colostrum to their full potential. This was especially the case for sows with parities 4 to 7, although they had a similar feed intake, litter birth weight and colostrum composition compared with parities 1 to 3 sows. In conclusion, this study showed that parity and the use of body fat and protein reserves during late gestation were associated with CY, indicating that proper management of the sow’s body condition during late gestation could optimise the intrinsic capacity of the sow’s CY.

The aim of this study is to investigate if there is a change in oxygen saturation and blood flow in the different parts of the trapezius muscle in office workers with and without trapezius myalgia during a standardized computer task. Twenty right-handed office workers participated; ten were recruited based on pain in the trapezius and ten as matching controls. Subjects performed a combination of typing and mousing tasks for 60 min at a standardized workstation. Muscle tissue oxygenation and blood flow data were collected from the upper trapezius (UT), the middle trapezius (MT) and the lower trapezius (LT), both on the left and right side at seven moments (at baseline and every tenth minute during the 1-h typing task) by use of the oxygen to see device. In all three parts of the trapezius muscle, the oxygen saturation and blood flow decreased significantly over time in a similar pattern ( p < 0.001). Oxygenation of the left and right UT was significantly higher compared to the other muscle parts ( p < 0.001). Oxygen saturation for the MT was significantly lower in the cases compared to the control group ( p = 0.027). Blood flow of the UT on the right side was significantly lower than the blood flow on the left side ( p = 0.026). The main finding of this study was that 1 h of combined workstation tasks resulted in decreased oxygen saturation and blood flow in all three parts of the trapezius muscle. Future research should focus on the influence of intervention strategies on these parameters.