Nonlinear analysis of heart rate variability for evaluating the growing pig stress response to an acute heat episode.

Heart rate variability (HRV) is a proxy measure of autonomic function and can be used as an indicator of swine stress. While traditional linear measures are used to distinguish between stressed and unstressed treatments, inclusion of nonlinear HRV measures that evaluate data structure and organization shows promise for improving HRV interpretation. The objective of this study was to evaluate the inclusion of nonlinear HRV measures in response to an acute heat episode. Twenty 12- to 14-week-old growing pigs were individually housed for 7 days and acclimated to thermoneutral conditions (20.35°C ± 0.01°C; 67.6% ± 0.2% RH) before undergoing one of the two treatments: (1) thermoneutral control (TN; n = 10 pigs) or (2) acute heat stress (HS; n = 10 pigs; 32.6°C ± 0.1°C; 26.2% ± 0.1% RH). In Phase 1 of the experimental procedure (P1; 60 min), pigs underwent a baseline HRV measurement period in thermoneutral conditions before treatment [Phase 2; P2; 60 min once gastrointestinal temperature (Tg) reached 40.6°C], where HS pigs were exposed to heated conditions and TN pigs remained in thermoneutral conditions. After P2, all pigs were moved back to thermoneutral conditions (Phase 3; P3; 60 min). During each phase, Tg data were collected every 5 min and behavioural data were collected to evaluate the amount of time each pig spent in an active posture. Additionally, linear (time and frequency domain) and nonlinear [sample entropy (SampEn), de-trended fluctuation analysis, percentage recurrence, percentage determinism (%DET), mean diagonal line length in a recurrence plot] HRV measures were quantified. Heat stressed pigs exhibited greater Tg (P = 0.002) and spent less time in an active posture compared to TN pigs during P2 (P = 0.0003). Additionally, low frequency to high frequency ratio was greater in HS pigs during P3 compared to TN pigs (P = 0.02). SampEn was reduced in HS pigs during P2 (P = 0.01) and P3 (P = 0.03) compared to TN pigs. Heat stressed pigs exhibited greater %DET during P3 (P = 0.03) and tended to have greater %DET (P = 0.09) during P2 than TN pigs. No differences between treatments were detected for the remaining HRV measures. In conclusion, linear HRV measures were largely unchanged during P2. However, changes to SampEn and %DET suggest increased heat stress as a result of the acute heat episode. Future work should continue to evaluate the benefits of including nonlinear HRV measures in HRV analysis of swine heat stress.

Short communication: Assessment of disbudding pain in dairy calves using nonlinear measures of heart rate variability.

The purpose of this study was to evaluate whether pain-related stress caused by disbudding could be detected using nonlinear measures of heart rate variability (HRV). Twenty-five female Holstein calves (4-7 wk of age) were randomly assigned to 1 of 3 treatments: (1) sham disbud (SHAM; n = 9), (2) disbud with lidocaine-meloxicam pain mitigation (MED; n = 8), or (3) disbud without pain mitigation (NoMED; n = 8). Heart rate variability (sample entropy, percentage determinism, percentage recurrence, or mean length of diagonal lines in a recurrence plot) was recorded on d -1, 0, 1, 3, and 5 relative to the experimental procedure, with disbudding taking place on d 0. The short-term detrended fluctuation analysis scaling exponent was greater in MED calves than in SHAM calves, indicating a greater stress response to the disbudding procedure regardless of pain mitigation. These results indicate that calves in the MED group may have experienced pain-related stress as a result of the disbudding procedure. The remaining nonlinear HRV measures did not differ by treatment. Future research on this topic should address additional potential confounding factors, such as the effect of pain-mitigating drugs on autonomic function or the influence of the autonomic nervous system on wound healing, that may prohibit HRV measurement as an indicator of disbudding pain severity.

The impact of farrowing room noise on sows' reactivity to piglets.

Despite much interest in sow welfare, the impact of the acoustic environment on sow reactivity to her piglets is rarely considered. The objective of this study was to understand the impact of noise produced by mechanical ventilation and other sows on a sow's reactivity to her piglets. Sows were farrowed in one of three environments: 1) with eight other sows exposed to constant fan noise (GROUP-FAN; n = 10), 2) alone with fan noise present (ISO-FAN; n = 10), and 3) alone without fans running (ISO-QUIET; n = 10). Sows were subjected for 5 min to a piglet removal event (REMOVAL) by an unknown handler twice, at 24 and 48 h postfarrowing. During a REMOVAL, sows were observed via video recording for changes in posture, eating and drinking behavior, and head orientation. Audio was recorded to quantify vocalizations by the sow. Once piglets were returned, sows underwent further behavior observations for 10 min (RETURN), resulting in approximately 15 min of total video observation. Sows were classified as young (second and third parity) and old (fifth parity and older). The YOUNG sows tended to be more Alert (looking toward the handler or their piglets) during REMOVE than OLD sows (P = 0.07; 2.01 and 1.33, respectively). The ISO-FAN sows vocalized the loudest during REMOVAL (P < 0.001) with ISO-QUIET sows performing the quietest vocalizations (GROUP-FAN: 72.22 ± 1.06 dB; ISO-FAN: 73.61 ± 1.07 dB; ISO-QUIET: 67.41 ± 0.99 dB). During RETURN, YOUNG sows spent more time sitting than OLD sows (P < 0.01; 7.48 ± 1.6% and 0.91 ± 1.8%, respectively). The ISO-QUIET sows tended to have more posture changes during the RETURN with ISO-FAN having the least changes (P = 0.06; GROUP-FAN: 1.23 ± 0.4; ISO-FAN: 0.44 ± 0.3; ISO-QUIET: 1.61 ± 0.4). Finally, sows decreased the amount of time Alert in the second RETURN (P = 0.03; first: 3.9 ± 0.6%; second: 2.5 ± 0.6%). Overall, sows acclimated to the removal and return events with decreased vocalizations and decreased Alert behaviors in the second REMOVAL and RETURN. Additionally, YOUNG sows performed more active behaviors than OLD sows, indicating that sows may become less interested in or cannot hear their piglets as they age. Finally, there is some indication that ventilation presence has an effect on sow-piglet communication with ISO-FAN sows having the loudest vocalizations when compared with sows without ventilation noise, indicating that ventilation noise may be a possible competitor with a sow's ability to communicate with her piglets.

Generation of a series of Bn fused oligo-naphthalenes (n = 1 to 3) from a B1-polycyclic aromatic hydrocarbon.

A series of Bn-PAHs have been prepared by functionalisation of a B1-PAH, leading to the first only boron doped B3-PAH to the best of our knowledge. These Bn-PAHs represent the first three members of a series of {B-Mes} fused oligo-naphthalenes and trends in key properties of this series have been elucidated.

Effects of dirty housing and a Typhimurium DT104 challenge on pig growth performance, diet utilization efficiency, and gas emissions from stored manure.

The objectives of this study were to elucidate the effects of a dirty environment and a challenge plus associated environmental contamination on pig growth performance, diet utilization efficiency, and gas emissions (CO, NH, CH, NO, and HS) from stored manure. Twenty-four weaned barrows, aged 31 d at initiation of the trial, were randomly allotted to 3 different treatments in a completely randomized design. Treatments were: pigs housed in cages with manure removed and cages washed daily (Clean); pigs housed in cages sprayed daily with manure slurry mixtures (Dirty); or pigs challenged with Typhimurium DT104 and housed in cages that were not washed, but manure was removed daily ( challenge). Rectal temperature, body weight, daily feed intake, manure output, manure composition, and gas emissions from stored manure were measured throughout the 24-d animal phase. The Dirty and challenge treatments were statistically compared to the Clean treatment to evaluate individual effects. Dirty housing tended to decrease ADG from d 1 to 24 ( = 0.06) but there were no other effects on pig performance compared with the Clean treatment. In contrast, a challenge was associated with a marked reduction in each of the measured indicators of pig performance. challenge increased the carbon to nitrogen ratio, ether extract, and lignin concentrations in excreted manure ( = 0.02, 0.01, 0.003, respectively), and increased manure and head space temperatures in manure tanks ( < 0.0001). Gas emissions from stored manure of pigs on the Dirty or treatments were increased for each of the measured gases as compared to the Clean treatment ( < 0.01) when expressed per unit of BW gain. When gas emissions from manure of pigs housed in the Dirty treatment were expressed per unit of manure volatile solids (VS), they were increased for NH, CH, and HS ( < 0.02). challenge was associated with increased emissions of CO, and NO and decreased emissions of HS per kilogram manure VS compared to the Clean treatment ( = 0.06, 0.03, 0.04, respectively). Collectively, these results indicated that a challenge and associated housing contamination caused depressed growth rate and increased manure gas emissions, while exposure to a Dirty environment slightly reduced growth performance and clearly increased manure gas emissions per unit of BW gain as compared to Clean control.

Effects of porcine reproductive and respiratory syndrome virus on pig growth, diet utilization efficiency, and gas release from stored manure.

The objectives of this study were to examine the effects of porcine reproductive and respiratory syndrome virus (PRRSV) infection and vaccination on pig growth, dietary nutrient efficiency of utilization, manure output, and emissions of CO, CH, HS, NO, and NH gases from stored manure. Forty-eight pigs, aged 21 d at the start of the study, were subjected to 1 of 4 treatment combinations arranged in a 2 × 2 factorial design with main factors of PRRSV vaccination and PRRSV infection. Body weight, ADFI, manure output, and nutrient efficiency of utilization were assessed and gas emissions from stored manure were determined daily from 50 to 78 d of age and for 24 d after completion of the animal phase. Infection with PRRSV markedly reduced final BW, ADG, and ADFI ( < 0.01) and reduced efficiencies of ADF and ether extract utilization ( = 0.05 and = 0.02, respectively) regardless of vaccination status. No significant treatment effects were found on manure output, manure pH, efficiencies of lignin utilization, and N retention. Infecting pigs with PRRSV increased daily manure CO emission per pig ( = 0.01). There was an interaction between immunization and infection for NO per pig with manure from uninfected, vaccinated pigs producing as much as the manure from infected, vaccinated pigs whereas there was a difference by PRRSV infection state for nonvaccinated pigs. There were also interactions between treatments for HS and NO emissions per kilogram of manure volatile solids excreted ( = 0.01 and = 0.0001, respectively) with the same pattern as for NO per pig; that is, the vaccinated pigs had similar rates of emission regardless of infection state. Pigs infected with PRRSV increased NO nitrogen per kilogram of total N excreted compared with noninfected groups ( = 0.03). Collectively, these results indicated that PRRSV infection caused decreased growth rates and nutrient utilization efficiency and increased gas emissions from stored manure.

Omega-3 Fatty Acids in Early Prevention of Inflammatory Neurodegenerative Disease: A Focus on Alzheimer's Disease.

Alzheimer's disease (AD) is the leading cause of dementia and the most common neurodegenerative disease in the elderly. Furthermore, AD has provided the most positive indication to support the fact that inflammation contributes to neurodegenerative disease. The exact etiology of AD is unknown, but environmental and genetic factors are thought to contribute, such as advancing age, family history, presence of chronic diseases such as cardiovascular disease (CVD) and diabetes, and poor diet and lifestyle. It is hypothesised that early prevention or management of inflammation could delay the onset or reduce the symptoms of AD. Normal physiological changes to the brain with ageing include depletion of long chain omega-3 fatty acids and brains of AD patients have lower docosahexaenoic acid (DHA) levels. DHA supplementation can reduce markers of inflammation. This review specifically focusses on the evidence in humans from epidemiological, dietary intervention, and supplementation studies, which supports the role of long chain omega-3 fatty acids in the prevention or delay of cognitive decline in AD in its early stages. Longer term trials with long chain omega-3 supplementation in early stage AD are warranted. We also highlight the importance of overall quality and composition of the diet to protect against AD and dementia.

The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods and analysis of data.

Accidental awareness during general anaesthesia with recall is a potentially distressing complication of general anaesthesia that can lead to psychological harm. The 5th National Audit Project was designed to investigate the reported incidence, predisposing factors, causality and impact of accidental awareness. A nationwide network of local co-ordinators across all UK and Irish public hospitals reported all new patient reports of accidental awareness to a central database, using a system of monthly anonymised reporting over a calendar year. The database collected the details of the reported event, anaesthetic and surgical technique, and any sequelae. These reports were categorised into main types by a multidisciplinary panel, using a formalised process of analysis. The main categories of accidental awareness were: certain or probable; possible; during sedation; on or from the intensive care unit; could not be determined; unlikely; drug errors; and statement only. The degree of evidence to support the categorisation was also defined for each report. Patient experience and sequelae were categorised using current tools or modifications of such. The 5th National Audit Project methodology may be used to assess new reports of accidental awareness during general anaesthesia in a standardised manner, especially for the development of an ongoing database of case reporting. This paper is a shortened version describing the protocols, methods and data analysis from 5th National Audit Project - the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home#pt.

The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380-1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out-of-hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were not risk factors for accidental awareness: ASA physical status; race; and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from 5th National Audit Project - the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home#pt.

The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues.

The 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients' experiences ranged from isolated auditory or tactile sensations to complete awareness. A striking finding was that 75% of experiences were for < 5 min, yet 51% of patients (95% CI 43-60%) experienced distress and 41% (95% CI 33-50%) suffered longer-term adverse effect. Distress and longer-term harm occurred across the full range of experiences but were particularly likely when the patient experienced paralysis (with or without pain). The patient's interpretation of what is happening at the time of the awareness seemed central to later impact; explanation and reassurance during suspected accidental awareness during general anaesthesia or at the time of report seemed beneficial. Quality of care before the event was judged good in 26%, poor in 39% and mixed in 31%. Three quarters of cases of accidental awareness during general anaesthesia (75%) were judged preventable. In 12% of cases of accidental awareness during general anaesthesia, care was judged good and the episode not preventable. The contributory and human factors in the genesis of the majority of cases of accidental awareness during general anaesthesia included medication, patient and education/training. The findings have implications for national guidance, institutional organisation and individual practice. The incidence of 'accidental awareness' during sedation (~1:15 000) was similar to that during general anaesthesia (~1:19 000). The project raises significant issues about information giving and consent for both sedation and anaesthesia. We propose a novel approach to describing sedation from the patient's perspective which could be used in communication and consent. Eight (6%) of the patients had resorted to legal action (12, 11%, to formal complaint) at the time of reporting. The 5th National Audit Project methodology provides a standardised template that might usefully inform the investigation of claims or serious incidents related to accidental awareness during general anaesthesia.

5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods, and analysis of data.

BACKGROUND: Accidental awareness during general anaesthesia (AAGA) with recall is a potentially distressing complication of general anaesthesia that can lead to psychological harm. The 5th National Audit Project (NAP5) was designed to investigate the reported incidence, predisposing factors, causality, and impact of accidental awareness. METHODS: A nationwide network of local co-ordinators across all the UK and Irish public hospitals reported all new patient reports of accidental awareness to a central database, using a system of monthly anonymized reporting over a calendar year. The database collected the details of the reported event, anaesthetic and surgical technique, and any sequelae. These reports were categorized into main types by a multidisciplinary panel, using a formalized process of analysis. RESULTS: The main categories of accidental awareness were: certain or probable; possible; during sedation; on or from the intensive care unit; could not be determined; unlikely; drug errors; and statement only. The degree of evidence to support the categorization was also defined for each report. Patient experience and sequelae were categorized using current tools or modifications of such. CONCLUSIONS: The NAP5 methodology may be used to assess new reports of AAGA in a standardized manner, especially for the development of an ongoing database of case reporting. This paper is a shortened version describing the protocols, methods, and data analysis from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home.

5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent, and medicolegal issues.

The 5th National Audit Project (NAP5) of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia (AAGA) yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients' experiences ranged from isolated auditory or tactile sensations to complete awareness. A striking finding was that 75% of experiences were for <5 min, yet 51% of patients [95% confidence interval (CI) 43-60%] experienced distress and 41% (95% CI 33-50%) suffered longer term adverse effect. Distress and longer term harm occurred across the full range of experiences but were particularly likely when the patient experienced paralysis (with or without pain). The patient's interpretation of what is happening at the time of the awareness seemed central to later impact; explanation and reassurance during suspected AAGA or at the time of report seemed beneficial. Quality of care before the event was judged good in 26%, poor in 39%, and mixed in 31%. Three-quarters of cases of AAGA (75%) were judged preventable. In 12%, AAGA care was judged good and the episode not preventable. The contributory and human factors in the genesis of the majority of cases of AAGA included medication, patient, and education/training. The findings have implications for national guidance, institutional organization, and individual practice. The incidence of 'accidental awareness' during sedation (~1:15,000) was similar to that during general anaesthesia (~1:19,000). The project raises significant issues about information giving and consent for both sedation and anaesthesia. We propose a novel approach to describing sedation from the patient's perspective which could be used in communication and consent. Eight (6%) of the patients had resorted to legal action (12, 11%, to formal complaint) at the time of reporting. NAP5 methodology provides a standardized template that might usefully inform the investigation of claims or serious incidents related to AAGA.

5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19,600 anaesthetics (95% confidence interval 1:16,700-23,450). However, there was considerable variation across subtypes of techniques or subspecialities. The incidence with neuromuscular block (NMB) was ~1:8200 (1:7030-9700), and without, it was ~1:135,900 (1:78,600-299,000). The cases of AAGA reported to NAP5 were overwhelmingly cases of unintended awareness during NMB. The incidence of accidental awareness during Caesarean section was ~1:670 (1:380-1300). Two-thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental, rapid sequence induction, obesity, difficult airway management, NMB, and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One-third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, mostly due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex, age (younger adults, but not children), obesity, anaesthetist seniority (junior trainees), previous awareness, out-of-hours operating, emergencies, type of surgery (obstetric, cardiac, thoracic), and use of NMB. The following factors were not risk factors for accidental awareness: ASA physical status, race, and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home.

Effects of phytase supplementation on reproductive performance, apparent total tract digestibility of Ca and P and bone characteristics in gestating and lactating sows / Efectos de la suplementación con fitasa sobre el comportamiento reproductivo, la digestibilidad aparente en tracto total de Ca y P y las características óseas en cerdas gestantes y lactantes / Efeitos da suplementação com fitasse sobre o desempenho reprodutivo, digestibilidade aparente no trato digestivo total de Ca e P e características ósseas em porcas gestantes e lactantes

Background: phytase supplementation to sow diets may improve digestibility of P and Ca and bone integrity of suckling piglets. Objective: two experiments were conducted to investigate the effect of phytase supplementation to gestation and lactation diets on reproductive performance, apparent total tract digestibility (ATTD) of P, Ca, and N in sows and bone characteristics in sows and piglets. Methods: in Experiment 1, a multistate study involving 204 sows was conducted at 3 cooperating research stations. Sows were assigned to 1 of 4 treatments at breeding: 1) negative control [low Ca and available P (aP) diet], 2) Treatment 1 plus 300 FTU of supplemental phytase/kg of diet, 3) Treatment 1 plus 600 FTU of supplemental phytase/kg of diet, and 4) positive control (normal Ca and aP diet). In Experiment 2, a total of 16 sows (Yorkshire × Landrace; average parity, 2.3) were randomly allotted to 1 of 3 treatments based on body weight (BW) and parity at d 34 to 52 of gestation. Treatments were: 1) low Ca and aP diet, 2) low Ca and aP diet with 500 FTU of supplemental phytase/kg of diet, and 3) normal Ca and aP diet. Results: in Experiment 1, the number of total born (p<0.05), live born (p=0.05), litter weight of live born (p<0.01) and weaning pigs (p<0.05) were increased in a quadratic manner by increasing phytase supplementation level up to 300 FTU/kg. There was a linear increase in piglet weaning weight (p<0.05) by increasing supplemental phytase levels. There were no differences in reproductive performance in Experiment 2 (p>0.10). In gestation the ATTD of P was lower for the low Ca and aP without phytase group than the normal Ca and aP (p<0.01) and phytase-supplemented (p<0.05) groups. The ATTD of Ca in the normal Ca and aP group was higher than that in low Ca and aP without phytase group (p<0.05). In lactation, the phytase-supplemented group had higher ATTD of P compared with the other groups (p<0.05) whereas the ATTD of Ca in phytase-supplemented group was higher than that in low Ca and aP without phytase group (p<0.10). When the digestibility data was pooled for both gestation and lactation periods, the ATTD of P in the phytase-supplemented group was the highest among dietary treatments (p<0.05). There were no phytase effects on sow bone ash content at weaning, and piglet bone strength and ash content at birth. However, piglets from the phytase-supplemented sows had higher bone strength (p<0.10) and ash content (p<0.05) at weaning compared with those from non-phytase sows. There were positive correlations at birth between piglet BW and bone strength (p<0.01) and between bone strength and ash content (p<0.001). Additionally, at weaning positive correlations between piglet BW and bone ash content (p<0.05), between piglet BW and bone strength (p<0.001), and between bone strength and ash content (p<0.05) were observed. Conclusion: phytase supplementation from mid-gestation through lactation increased the ATTD of P and Ca both for gestating and lactating sows, improved bone integrity of their progeny, and had potential to increase litter size and performance but did not affect bone characteristics of sows and newborn pigs.

Antecedentes: la adición de fitasa a la dieta de cerdas puede mejorar la digestibilidad del P y Ca, así como la integridad ósea de los cerdos lactantes. Objetivo: se realizaron dos experimentos para investigar el efecto de la suplementación con fitasa en dietas de gestación y lactancia sobre el rendimiento reproductivo, la digestibilidad aparente de tracto total (ATTD) del P, Ca y N en cerdas, y las características óseas de cerdas y lechones. Métodos: el Experimento 1 involucró 204 cerdas evaluadas en 3 centros de investigación norteamericanos. Las cerdas fueron asignadas a 1 de 4 tratamientos al momento del servicio: 1) Control negativo [dieta baja en Ca y P disponible (aP)], 2) Tratamiento 1 más 300 unidades de fitasa (FTU)/kg de dieta, 3) Tratamiento 1 más 600 FTU/kg de dieta, y 4) Control positivo (dieta con contenido normal de Ca y aP). En el Experimento 2, un total de 16 cerdas (Landrace × Yorkshire, de 2,3 partos en promedio) se asignaron al azar a 1 de 3 tratamientos en el d 34 a 52 de gestación, con base en su peso corporal (BW) y número de partos. Los tratamientos fueron: 1) dieta baja en Ca y aP, 2) dieta baja Ca y aP con 500 FTU de fitasa/kg de dieta, y 3) dieta con normal contenido de Ca y aP. Resultados: en el Experimento 1, el número de nacidos totales (p<0,05), nacidos vivos (p=0,05), peso de la camada de los nacidos vivos (p<0,01), y cerdos destetados (p<0.05) se incrementó cuadráticamente con la adición creciente de fitasa hasta el nivel de 300 FTU/kg. Hubo un aumento lineal en el peso al destete de los lechones (p<0,05) al incrementar el nivel de fitasa. En el Experimento 2 no hubo diferencias en rendimiento reproductivo (p>0,10). En gestación, la ATTD del P fue menor en el grupo de bajo Ca y aP sin fitasa que en el de normal Ca y aP (p<0,01) y que en los grupos suplementados con fitasa (p<0,05). La ATTD del Ca en el grupo de normal Ca y aP fue mayor que en el grupo de bajo Ca y aP sin fitasa (p<0,05). En lactancia, el grupo suplementado con fitasa tuvo una mayor ATTD del P en comparación con los otros grupos (p<0,05), mientras que la ATTD del Ca en el grupo suplementado con fitasa fue mayor que en el de bajo Ca y aP sin fitasa (p<0,10). Cuando los datos de digestibilidad se agruparon para los períodos de gestación y lactancia, la ATTD del P en el grupo con fitasa fue la más alta entre los tratamientos dietarios (p<0,05). No hubo efecto de la fitasa en el contenido de cenizas en hueso de las cerdas al destete ni en la resistencia ósea de los lechones o en las cenizas óseas al nacimiento. Sin embargo, los lechones de las cerdas suplementadas con fitasa tuvieron al destete mayor resistencia ósea (p<0,10) y contenido de cenizas (p<0,05) en comparación con los de las cerdas no suplementadas. Hubo correlaciones positivas al nacimiento entre el peso (BW) del lechón y su resistencia ósea (p<0,01), y entre la resistencia ósea y su contenido de cenizas (p<0,001). Además, se observaron correlaciones positivas al destete entre el BW del lechón y su contenido de ceniza en hueso (p<0,05), entre el BW del lechón y su resistencia ósea (p<0,001), y entre la resistencia y el contenido de cenizas óseas (p<0,05). Conclusión: la suplementación con fitasa desde la mitad de la gestación y durante la lactancia aumentó la ATTD del P y Ca, en cerdas tanto gestantes como lactantes, mejoró la integridad ósea de la progenie, y mostró potencial para aumentar el tamaño y rendimiento de la camada, pero no afectó las características óseas de las cerdas ni de los recién nacidos.

Antecedentes: a adição de fitasse na dieta de porcas pode melhorar a digestibilidade do P e Ca, assim como a integridade óssea dos leitões. Objetivo: realizaram-se dois pesquisas para conferir o efeito da suplementação da fitasse em dietas para os períodos de gestação e lactação sobre o desempenho reprodutivo, a digestibilidade aparente no trato digestivo total (ATTD) de P, Ca e N em porcas, e as características ósseas de porcas e leitões. Métodos: o experimento 1 envolveu 204 porcas avaliadas em 3 centros de pesquisa dos Estados Unidos. As porcas foram designadas para um de quatro tratamentos no momento do serviço: 1) controle negativo [dieta baixa em Ca e P disponível (aP)], 2) Tratamento 1 mais de 300 unidades de fitasse (FTU) / kg de ração, 3) Tratamento 2, mais de 600 FTU / kg de ração, e 4) controle positivo (dieta com teor normal de Ca e aP). No Experimento 2, um total de 16 matrizes suínas (Landrace × Yorkshire, de 2,3 nascimentos em média) foram randomizados para 1 de 3 tratamentos nos dias 34-52 de gestação, com base no peso corporal (PC) e número de partos. Os tratamentos foram: 1) dieta pobre em Ca e Pd, 2) dieta pobre em Ca e aP com 500 FTU de fitasse / kg de ração, e 3) dieta com teor normal de Ca e aP. Resultados: no Experimento 1, o número de nascimentos totais (p<0,05), nascidos vivos (p=0,05), peso da leitegada de nascidos vivos (p<0,01) e leitões desmamados (p<0,05) aumentou quadraticamente com a adição crescente de fitasse no nível de 300 FTU / kg. Houve um aumento linear do peso ao desmame de leitões (p<0,05) com os níveis crescentes de fitasse. No experimento 2, não houve diferença no desempenho reprodutivo (p>0,10). Na gravidez, o ATTD de P foi menor no grupo de baixo Ca e aP sem fitasse do que no grupo Ca normal e aP (p<0,01) e nos grupos de fitasse suplementado (p<0,05). O ATTD de Ca no grupo normal de Ca e aP foi maior do que no grupo de baixo Ca e aP sem fitasse (p<0,05). Na lactação, no grupo suplementado com fitasse apresentou um ATTD de P maior em relação aos outros grupos (p<0,05), enquanto o ATTD de Ca do grupo suplementado com fitasse foi maior do que no grupo baixo de Ca e Pd e sem fitasse (p<0,10). Quando os dados de digestibilidade foram agrupados para os períodos de gestação e lactação, a ATTD de P no grupo com fitasse foi maior entre os tratamentos dietéticos (p<0,05). Não houve efeito da fitasse no teor de cinzas de osso de porcas ao desmame ou a força dos ossos ou cinzas ósseas dos leitões ao nascimento. No entanto, os leitões de porcas suplementadas com fitasse tiveram uma maior resistência óssea ao desmame (p<0,10), e cinzas (p<0,05) em comparação com as porcas não suplementadas. Houve correlação positiva entre peso (BW) ao nascimento do leitão e a resistência óssea (p<0,01) e entre a força dos ossos e cinzas (p<0,001). Além disso, foi observada uma correlação positiva entre o desmame dos leitões BW e teor de cinzas ósseas (p<0,05), entre BW dos leitões e a resistência óssea (p<0,001), e entre a resistência óssea e os conteúdos e cinza nos ossos (p<0,05). Conclusão: a suplementação com fitasse na etapa media da gestação e durante a lactação aumentou a ATTD de P e Ca, tanto em porcas gestantes quanto lactantes, melhorou muito a integridade óssea da progênie, e mostrou potencial para aumentar o tamanho e desempenho da leitegada, mas não afetou as características ósseas das porcas nem dos leitões recém nascidos.

Development and Implementation of Health and Wellness CBT for Individuals with Depression and HIV.

Rates of depression are reported to be between 22-33% in adults with HIV, which is double that of the general population. Depression negatively affects treatment adherence and health outcomes of those with medical illnesses. Further, it has been shown in adults that reducing depression may improve both adherence and health outcomes. To address the issues of depression and non-adherence, Health and Wellness (H&W) Cognitive Behavioral Therapy (CBT) and medication management (MM) treatment strategies have been developed specifically for youth living with both HIV and depression. H&W CBT is based on other studies with uninfected youth and upon research on adults with HIV. H&W CBT uses problem-solving, motivational interviewing, and cognitive-behavioral strategies to decrease adherence obstacles and increase wellness. The intervention is delivered in 14 planned sessions over a 6-month period, with three different stages of CBT. This paper summarizes the feasibility and acceptability data from an open depression trial with 8 participants, 16-24 years of age, diagnosed with HIV and with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis of depression, conducted at two treatment sites in the Adolescent Trials Network (ATN). Both therapists and subjects completed a Session Evaluation Form (SEF) after each session, and results were strongly favorable. Results from The Quick Inventory of Depressive Symptomatology-Clinician (QIDS-C) also showed noteworthy improvement in depression severity. A clinical case vignette illustrates treatment response. Further research will examine the use of H&W CBT in a larger trial of youth diagnosed with both HIV and depression.

Pigbel in the 21st century: still here, and still in need of an effective surveillance system

Pigbel remains a likely significant cause of morbidity and mortality in the highlands of Papua New Guinea (PNG), two decades after the administration of pigbel vaccination ceased. There is a need for an effective surveillance program for pigbel to better understand the disease burden and to target communities for preventive strategies. This paper reviews the epidemiology, pathogenesis, recent history and current data on the burden of pigbel in PNG. We propose a surveillance program based on clinical recognition of likely cases and laboratory confirmation using an ELISA assay for Clostridium perfringens type C beta-toxin. Research aimed at validating this approach in the clinical setting is outlined.

Meeting the needs of families and carers on acute psychiatric wards: a nurse-led service.

The needs of families and carers are often not met by the busy staff on inpatient units. A nurse-led family and carers service was set up on three adult acute psychiatric wards. A four-session protocol was developed for structuring sessions with families and carers. Methods of engaging reluctant carers were developed. Satisfaction rates are high. Families and carers value the emotional support, improved communication, help and advice. About one quarter are referred on for further input after discharge. A nurse-run service for the families and carers can make a significant difference to those who use it, providing support, creating a working alliance and improving the two-way exchange of information.

Controlling Salmonella infection in weanling pigs through water delivery of direct-fed microbials or organic acids: Part II. Effects on intestinal histology and active nutrient transport.

The objective of this study was to evaluate the effects of water-delivered, direct-fed microbials (DFM) or organic acids on intestinal morphology and active nutrient absorption in weanling pigs after deliberate Salmonella infection. Pigs (n = 88) were weaned at 19 ± 2 d of age and assigned to 1 of the following treatments, which were administered for 14 d: 1) control diet; 2) control diet + DFM (Enterococcus faecium, Bacillus subtilis, and Bacillus licheniformis) in drinking water at 10(9) cfu/L for each strain of bacteria; 3) control diet + organic acid-based blend (predominantly propionic, acetic, and benzoic acids) in drinking water at 2.58 mL/L; and 4) control diet + 55 mg/kg carbadox. Pigs were challenged with 10(10) cfu Salmonella enterica var Typhimurium 6 d after commencement of treatments. Pigs (n = 22/d) were harvested before Salmonella challenge and on d 2, 4, and 8 after challenge. Duodenal, jejunal, and ileal mucosal tissues were sampled for measurement of villus height and crypt depth. Jejunal tissue was sampled for determination of active nutrient absorption in modified Ussing chambers. Duodenal villus height was greater in pigs fed in-feed antibiotic before infection (P < 0.05). Jejunal crypts were deeper in DFM- and acid-treated pigs on d 4 after infection compared with all other treatments (P < 0.05). Salmonella infection resulted in a linear decrease in phosphorus (P < 0.001) and glucose (P < 0.05) active transport, and an increase (P < 0.001) in glutamine uptake immediately after challenge. Salmonella infection reduced basal short-circuit current (I(sc)); however, water-delivered DFM or organic acid treatments caused greater basal I(sc) on d 2 after challenge than did carbadox. Carbachol-induced chloride ion secretion was greatest in negative control pigs before infection (P < 0.01) and DFM-treated pigs (P < 0.05) after infection. In conclusion, both the DFM and acidification treatments induced increases in basal active ion movement and jejunal crypt depth, which could be interpreted as responses consistent with increased Salmonella pathology, but none of the additives markedly affected intestinal absorptive and secretory function in response to Salmonella challenge.