Prevalence and factors associated with burnout among health professionals of a public hospital network during the COVID-19 pandemic.

Burnout is most commonly defined as a syndrome characterized by emotional exhaustion, cynicism, and ineffectiveness, which occurs in response to chronic stressors at work. It can adversely affect health workers' physical and mental health, and the quality of care provided. The COVID-19 pandemic increased stressors and could impact burnout prevalence in this group. There is a lack of information regarding the prevalence of burnout among hospital health workers in Brazil. A newer definition of burnout has been proposed that considers three different clinical profiles: the frenetic, underchallenged and worn-out subtypes. This differentiation could lead to interventions tailored for each subtype. The present study aimed to estimate the prevalence of burnout, its subtypes, and associated factors in workers of a public hospital network in Brazil, during the pandemic. A total of 143 randomly selected participants answered an online form that included sociodemographic and occupational items, and the Burnout Clinical Subtypes Questionnaire, a summarized version. This questionnaire evaluates three burnout dimensions (overload, lack of development, neglect) that can be used to discriminate the three burnout subtypes (frenetic, underchallenged, worn-out, respectively); higher scores indicate higher burnout levels. The prevalence of burnout was high (53.85%), similar to other studies during the pandemic. The most common subtypes were 'frenetic' (34.97%), characterized by increased efforts to meet work demands, to the point of neglecting personal needs, and 'lack of development' (23.78%), characterized by a sense that work is uninteresting and does not contribute to personal development, and a perfunctory behavior towards tasks. Age was associated with burnout: workers with less than 51 years presented higher levels of burnout. These findings indicate the need for effective interventions to prevent and/or treat burnout. The assessment of burnout subtypes can allow managers to better understand the processes affecting employees, and inform actions to improve workforce health.

Air Medical Transportation Provided by Norte Novo Regional Urgency Mobile Service: What Is the Current Scenario?

OBJECTIVE: The aim of this study was to investigate, describe, and analyze the Norte Novo regional air medical service provided by the Brazilian Emergency Medical Rescue Service. METHODS: This was a retrospective and descriptive study with a quantitative approach of the incidents registered from November 2016 to December 2019. For general patient classification, descriptive statistics of the following variables were performed: sex, age/age group, type of diagnosis, city where the incident took place, city of destination, length of patient care, ventilatory support, use of sedation, and use of vasoactive drugs. All analyses were performed using the XLSTAT program (Version 19.4; Addinsoft, New York, NY), considering a significance level of 5%. RESULTS: There were 1,677 responses divided into clinical (60.8%), traumatic (37.8%), organ transport (1.2%), and interhospital transference (0.2%). The most frequent diagnoses were acute myocardial infarction and stroke (clinical care) and polytrauma (trauma care). The average waiting time until the helicopter arrived at the scene was 25 minutes. CONCLUSION: This study shows the importance and relevance of this air medical service for the area it covers. Further research is needed to address the profile of this service in our country, which will allow us to elucidate scenarios and develop strategies to assist the population and, thus, design training and simulation exercises for emergency service teams based on local realities.

Optimal Standardized Ileal Digestible Total Sulfur Amino Acids to Lysine REQUIREMENTS Are Increased in Nursery Pigs Raised under Antibiotic-Free Feeding Regime.

This study aimed to investigate the effect of increasing the standardized ileal digestible (SID) total sulfur amino acid to lysine (TSAA:Lys) on the growth performance of nursery pigs raised with or without antibiotics (AGP) and to determine the optimal SID TSAA:Lys in nursery pigs raised without AGP. In Exp. 1, 924 nursery pigs (7.9 ± 1.3 kg), blocked by initial BW and sex, were randomly allotted to one of six treatments, with seven pens per treatment and twenty-two pigs per pen. The treatments were arranged in a 2 × 3 factorial design, with two AGP levels (0 or 50 mg/kg Carbodox) and three levels of SID TSAA:Lys (51.0, 58.5 or 66.0%). In Exp. 2, 990 weaned piglets (5.1 ± 0.9 kg), blocked by initial BW and sex, were randomly allotted to one of five dietary treatments (SID TSAA:Lys at 51, 58, 65, 72 or 79%) in the absence of AGP, with nine pens per treatment and twenty-two pigs per pen. Competing heteroskedastic models including broken-line linear (BLL), broken-line quadratic (BLQ), and quadratic polynomial (QP) were fitted for the growth performance data to estimate the optimal TSAA:Lys. In Exp. 1, AGP supplementation increased (p < 0.05) ADG and ADFI during the 21 d period. Increasing SID TSAA:Lys in the diets with AGP did not affect growth performance; however, increasing SID TSAA:Lys in the diets without AGP resulted in a linear increase (p < 0.05) in ADG and G:F. In Exp. 2, the best-fitting models for ADG and G:F from d 0 to 21 post-weaning were BLL, which yielded the optimal SID TSAA:Lys of 62% and 72%, respectively. The best-fitting models for ADG and G:F from d 21 to 42 post-weaning were BLL, which yielded the optimal SID TSAA:Lys of 59% and 58%, respectively. In conclusion, SID TSAA to Lys requirements under an antibiotic-free feeding regime during the first 21 d post-weaning were 62% and 72% in terms of ADG and G:F, respectively, whereas an SID TSAA:Lys of approximately 58% was required to maximize ADG and G:F for the late nursery phase.

Effects of increasing standardized ileal digestible lysine during gestation on reproductive performance of gilts and sows.

Limited information is available on lysine requirement estimates of modern, high-producing gestating sows Therefore, the objective of this study was to evaluate the effects of increasing standardized ileal digestible (SID) lysine during gestation on piglet birthweight and reproductive performance of gilts and sows. A total of 936 females (498 gilts, 438 sows; Camborough®, PIC, Hendersonville, TN) were group-housed (approximately 275 females per pen) and individually fed with electronic sow feeders. Females were moved from the breeding stall to pens on d 4 of gestation and allotted to one of four dietary treatments on d 5. Dietary treatments included increasing SID lysine intake (11.0, 13.5, 16.0, and 18.5 g/d). Gilts (parity 1) and sows (parity 2+) received 2.1 and 2.3 kg (22.2 and 24.3 MJ net energy per day) of feed throughout the entire gestation period, respectively. Dietary treatments were achieved by different blends of low (0.48% SID lysine) and high (0.88% SID lysine) lysine diets, prepared by changing the amount of corn and soybean meal in these two diets. Female weight and backfat were recorded on d 4 and 111 of gestation. Individual piglet weight was obtained within 12 h of birth on litters from 895 females. Final weight, and calculated maternal BW, body lipid, and body lean at d 111 of gestation increased (linear, P < 0.01) for gilts and sows as SID lysine increased. There was no evidence for differences in final backfat depth. Average total born for gilts and sows was 15.3 and 16.0 pigs with no evidence for differences among treatments. The percentage of pigs born alive increased (P = 0.01) with increasing SID lysine intake for sows, but not in gilts as a result of a treatment by parity group interaction (P = 0.04) for percentage of stillborn pigs. Increasing SID lysine intake during gestation did not affect the percentage of mummified fetuses, total born, or birthweight of piglets born alive in this study. In addition, increasing SID lysine intake during gestation did not affect subsequent reproductive performance. In conclusion, increasing dietary SID lysine intake in gestation increased female BW, without changing backfat depth. The minimal effects on female reproductive performance and piglet birthweight suggest that 11 g/day of SID lysine intake appears to be adequate for gestating gilts and sows; however, providing sows with 18.5 g/d SID lysine reduced (P = 0.01) stillbirth rate by 2.3 percentage points.

Impact of feed intake in early gestation on maternal growth and litter size according to body reserves at weaning of young parity sows.

The effect of increasing the feed level (1.8, 2.5, and 3.2 kg/d) during early gestation in parity 1 (PO1) and parity 2 (PO2) sows on maternal growth and litter size was evaluated. A total of 361 sows were group-housed and fed a diet based on a corn-soybean meal (3.15 Mcal Metabolizable Energy (ME) per kg and 0.68% standardized ileal digestible lysine) from day 6 of gestation until day 30. Sows were weighed at weaning and on day 30 of gestation. Farrowing rate, number of total piglets born, piglets born alive, stillborn piglets, and mummified fetuses were recorded at farrowing. The effect of feed level on the total number of piglets born was also evaluated according to classes of body weight (BW), body condition score (BCS), backfat (BF), and caliper unit at weaning for each parity order. There was no evidence for significant effect of the interaction between feed level × parity on the variables related to maternal growth and reproductive performance (P ≥ 0.128). Greater feed levels linearly increased the gains in body condition (i.e., BW, BCS, BF, and caliper unit) between weaning and day 30 of gestation (P < 0.001). Farrowing rate was not influenced by the feed level (P ≥ 0.200) and parity (P ≥ 0.209). The number of total piglets born decreased linearly as the feed level increased (P = 0.041), whereas no evidences for differences were observed on piglets born alive among treatments (P ≥ 0.317), neither between parities (P ≥ 0.904). For PO1 sows, the total piglets born on BW classes (≤183 vs. >183 kg) and on classes of BF (≤11.5 vs. > 11.5 mm) were quadratically affected by the feed levels (P ≤ 0.041). In contrast, the number of total piglets born was marginally affected (linear; P ≤ 0.094) by the feed level in the different classes of BW, BCS, and caliper unit in PO2 sows. There was no evidence for differences for the interaction of feed level and classes of body condition (P ≥ 0.199) for PO2 sows. Similarly, no interactions between feed level and classes of BW, BCS, and BF at weaning were observed (P ≥ 0.233) for PO1 sows; however, the total piglets born were affected by an interaction between feed level and caliper unit class (P = 0.042). In conclusion, increased feed intake from day 6 of gestation until day 30 resulted in increased maternal BW gain but reduced the number of total piglets born. Furthermore, lighter and in a poor BCS PO1 sows at weaning produced fewer total born piglets with no benefits from greater amounts of feed.

Impact of increasing weaning age on pig performance and belly nosing prevalence in a commercial multisite production system.

The effects of increasing weaning age in a commercial production system on nursery and finishing performance were evaluated. A total of 1,176 pigs (PIC 337 × Camborough) were used in a 136-d growth trial with 14 and 10 replications/weaning age on the nursery and finishing phases, respectively. Treatments included weaning litters at 19, 22, 25, or 28 d of age. In the nursery, as weaning age increased, initial (5.04, 5.70, 6.52, and 7.26 kg) and final body weight (BW) (18.2, 19.8, 23.0, and 25.1 kg) increased (linear, P < 0.001). Increasing the weaning age reduced (linear, P < 0.001) the prevalence of pigs exhibiting belly nosing (27.6%, 15.0%, 6.5%, and 1.4%) during the first 3 wk. The percentage of pigs losing weight during the first week after weaning (35.1%, 28.7%, 12.4%, and 9.2%) decreased (linear, P < 0.001) as weaning age increased. Average daily gain (ADG; 295, 320, 374, 406 g/d) and average daily feed intake (493, 534, 619, 661 g/d) increased (linear, P < 0.001), while feed efficiency (G:F) (596, 599, 604, and 615) tended to increase (linear, P = 0.081) with weaning age. Removal rate (8.01%, 3.79%, 2.29%, and 1.65%) declined (linear, P = 0.001) as weaning age increased, while there was no evidence of difference (P = 0.463) in mortality rate (0.71%, 0.36%, 0.96%, 1.04%). In the finishing period, BW at 136 d post-weaning (114.9, 117.8, 124.7, and 126.5 kg) and ADG (1.02, 1.04, 1.08, and 1.07 kg/d) improved (linear, P < 0.001). There was no evidence of differences (P > 0.24) in removal (1.5%, 2.4%, 1.0%, and 0.0%) or mortality rates (0.9%, 1.0%, 1.0%, and 1.4%) with changes in weaning age. When performance was analyzed at a common day of life (164 d of age), no effects of weaning age (P > 0.25) were found for BW (125.2, 124.4, 128.0, and 126.5 kg) and lifetime ADG (growth rate from birth to market) (754, 751, 774, and 762 g/d). The BW sold per pig weaned increased (linear, P < 0.001) with weaning age. Even though the slope indicated a linear response, the magnitude of improvement was high until 25 d, before exhibiting diminishing returns from 25 to 28 d. Thus, the study suggests that increasing the weaning age can be an effective strategy to improve the overall performance in a commercial system. Although lifetime performance was not affected by the weaning age range studied, the consistent effect in the nursery and the increment in the number of pigs reaching the market facilitated by the improvement in the removal rate in the nursery phase imply that 25 d is the optimal weaning age.

Feeding level and diet type during the wean-to-estrus interval on the reproductive performance of sows / Efeito da quantidade e tipo de dietas durante o intervalo desmame-estro sobre o desempenho reprodutivo de matrizes suínas

ABSTRACT: This study was conducted to evaluate how the amount and type of diet consumed during the wean-to-estrus interval (WEI) affects reproductive performance and WEI duration in sows. A total of 542 sows were distributed into the following treatment groups based on a 2 × 2 factorial design: feed amount during WEI (2.75 or 3.75 kg/day) and diet (gestation [G] or lactation [L]) groups. Dietary treatments were as follows: high supply of G diet (GH), low supply of G diet (GL), high supply of L diet (LH), and low supply of L diet (LL). Sows were randomly allocated to groups according to their body score Caliper and birth order. There was an interaction (P < 0.05) between the factors for WEI duration, which was 0.2 days shorter in the GH and LL groups than in the other groups. No difference was observed between treatments (P>0.05) for the birth rate, total births, stillbirths, or total litter weight. There was a trend (P<0.10) toward a higher rate of live births in sows fed with G diet and sows receiving a low diet supply, with an average of 91.95% for both groups. In addition, there was a positive trend (P < 0.10) for live weight of the litter, where GH and LL treatments resulted in higher birth weight (17.9 and 17.7 kg, respectively) than other treatments. In conclusion, a supply of 3.75 kg/day or the use of a more energetic feed (lactation) during the WEI did not improve the reproductive performance of the subsequent cycle of sows in good body condition.

RESUMO: Este experimento foi conduzido com o objetivo de avaliar os efeitos da quantidade e tipo de dieta consumida durante o intervalo desmame-estro (IDE) sobre o desempenho ao parto subsequente e tempo de IDE de fêmeas suínas. Foram utilizadas 542 fêmeas, distribuídas em um delineamento fatorial 2×2 com duas quantidades de alimento fornecido durante o IDE (2,75 ou 3,75 kg/dia) e dois tipos de dieta (gestação - G ou lactação - L), sendo: Alto fornecimento de dieta G (GA), menor fornecimento de G (GM), alto fornecimento de L (LA) e menor fornecimento de L (LM). As fêmeas foram aleatoriamente distribuídas entre os tratamentos em blocos de acordo com o escore corporal Caliper e ordem de parto. Houve interação para tempo de IDE (P<0,05) entre a quantidade de ração e o tipo da dieta consumida durante o período, o qual foi 0,2 dias mais curto nos grupos GA e LM. Não houve diferença entre os tratamentos (P>0,05) sobre a taxa de parto, total de nascidos, natimortos e peso total da leitegada. Houve uma tendência para maior taxa de nascidos vivos (P<0,10) nas fêmeas que consumiram a dieta G, e nas fêmeas que receberam o menor fornecimento de ração, com média de 91,95%, para ambos os fatores. Além disso, foi observada tendência positiva (P<0,10) para o peso vivo da leitegada, em que GA e LM apresentaram maior peso ao nascer (17,9 e 17,7 kg, respectivamente). Em conclusão, o fornecimento de 3,75 kg/dia, ou o uso de uma dieta mais energética (lactação) durante o IDE, não melhora o desempenho reprodutivo do ciclo subsequente de fêmeas suínas em boa condição corporal.

Standardized total tract digestible phosphorus requirement of 24- to 130-kg pigs1,2.

A study was conducted to determine the standardized total tract digestible phosphorus (STTD P) requirement for 24- to 130-kg finishing pigs housed under commercial conditions. A total of 1,130 barrows and gilts (PIC 359 × 1050, Hendersonville, TN; initially 24.2 kg) were used, with 26 to 27 pigs per pen with 7 replicates per treatment. Pens of pigs were allotted to treatments in a randomized complete block design with body weight (BW) as the blocking factor. The dietary treatments were fed in 4 phases and were formulated to contain 80%, 90%, 100%, 115%, 130%, and 150% of the National Research Council (NRC) requirement estimate for finishing pigs within each phase. Weight ranges for each phase were: 27 to 49, 49 to 76, 76 to 90, and 90 to 130 kg. Treatments were achieved by increasing the amount of monocalcium phosphate at the expense of corn in the diet with no added phytase. All diets were formulated to contain a similar 1.14:1 to 1.16:1 total Ca:P ratio across treatments in all phases. Increasing STTD P resulted in a quadratic response (P < 0.05) in average daily gain (ADG), gain-to-feed ratio (G:F), and final BW. The greatest improvement was observed with STTD P at 130% of NRC for ADG and final BW and at 115% STTD P for G:F. Average daily feed intake increased linearly (linear, P < 0.05) with the inclusion of STTD P. Increasing STTD P resulted in an increase (quadratic, P < 0.05) in hot carcass weight (HCW) and carcass ADG with the greatest response observed with STTD P at 130% of NRC. There was a marginally significant response (quadratic, P < 0.10) in carcass G:F, with the greatest improvement with STTD P at 115% of NRC. Carcass yield decreased (linear, P < 0.05) with increasing STTD P, while there was a marginally significant (linear, P < 0.10) decrease in backfat and increase in fat-free lean. At the end of the study, a metacarpal was collected and analyzed for bone ash. Increasing STTD P resulted in an increase (linear, P < 0.05) in bone ash weight and percentage ash. For ADG and G:F, the quadratic model demonstrated the best fit. The maximum response in ADG and G:F was estimated at 122% and 116% of NRC STTD P, respectively. The broken-line linear model best fit the data for percentage bone ash, with a plateau achieved at 131% of the NRC STTD P. In conclusion, the estimated STTD P requirement of 24 to 130 kg ranged from 116% to 131% of the NRC publication (2012) requirement estimate.

Calcium to phosphorus ratio requirement of 26- to 127-kg pigs fed diets with or without phytase1,2.

Two experiments were conducted to determine the effects of calcium to phosphorus (Ca:P) ratio in diets adequate in standardized total tract digestible (STTD) P on performance of 26- to 127-kg pigs fed diets with or without phytase. Pens of pigs (n = 1,134 in Exp. 1 and n = 1,215 in Exp. 2, initially 26.3 and 25.3 kg) were blocked by body weight (BW) and allotted to treatments in a randomized complete block design. There were 27 pigs per pen with 7 and 9 replicates per treatment in Exp. 1 and Exp. 2, respectively. Treatments were formulated to contain 0.75:1, 1.00:1, 1.25:1, 1.50:1, 1.75:1, and 2.00:1 analyzed Ca:P ratios in Exp. 1, and 0.75:1, 1.00:1, 1.25:1, 1.50:1, and 2.00:1 analyzed Ca:P ratios in Exp. 2. These correspond to a range of 0.96:1 to 2.67:1 and 0.95:1 to 2.07:1 STTD Ca:STTD P ratios in Exp. 1 and Exp. 2, respectively. Experiment 2 diets contained 1,000 phytase units of Ronozyme HiPhos 2500 (DSM Nutritional Products, Inc., Parsippany, NJ) with release values of 0.132% STTD P, 0.144% total Ca, and 0.096% STTD Ca. Diets contained 122% of NRC (2012) STTD P estimates for the weight range across 4 phases. In Exp. 1, increasing Ca:P ratio increased (quadratic, P < 0.05) average daily gain (ADG) and average daily feed intake (ADFI). Feed efficiency (G:F) worsened (quadratic, P < 0.05) at the highest ratio. Hot carcass weight (HCW) and bone ash increased (quadratic, P < 0.05) while carcass yield decreased (linear, P < 0.10) with increasing Ca:P ratio. The maximum responses in ADG, HCW, and bone ash were estimated at 1.38:1, 1.25:1, and 1.93:1 analyzed Ca:P and at 1.82:1, 1.64:1, and 2.57:1 STTD Ca:STTD P, respectively. In Exp. 2, increasing Ca:P ratio increased (quadratic, P < 0.05) ADG and bone ash, and improved G:F (linear, P < 0.05). There was a quadratic increase (P < 0.05) in HCW and decrease in carcass yield (P < 0.10). The maximum responses in ADG, HCW, and bone ash were estimated at 1.63:1, 1.11:1 to 1.60:1, and 1.25:1 analyzed Ca:P and at 1.75:1, 1.28:1 to 1.71:1, and 1.40:1 STTD Ca:STTD P, respectively. Expressing ADG on a STTD Ca:STTD P basis provided a more consistent estimate of the ideal Ca:P ratio among the 2 studies than analyzed Ca to analyzed P ratio. A STTD Ca:STTD P ratio between 1.75:1 to 1.82:1 can be used for 26- to 127-kg pigs that are fed diets adequate in STTD P with or without added phytase to maximize growth rate without reducing bone ash.

Effects of standardized total tract digestible phosphorus on growth performance of 11- to 23-kg pigs fed diets with or without phytase1,2.

Two experiments were conducted to determine the standardized total tract digestible phosphorus (STTD P) requirement for 11- to 23-kg nursery pigs fed diets with or without phytase. A total of 1,080 and 2,140 pigs (PIC 359 × Camborough, Hendersonville, TN; initially 11.4 ± 0.29 and 11.1 ± 0.24 kg) were used in Exp. 1 and Exp. 2, respectively. There were 23 to 27 pigs per pen with 6 and 12 replicate pens per treatment in Exp. 1 and Exp. 2, respectively. After weaning, pigs were fed a common pelleted diet with 0.45% STTD P for 7 d, and a common phase 2 meal diet with 0.40% STTD P for 14 d in Exp. 1 and 18 d in Exp. 2. Pens of pigs were then allotted to dietary treatments in a randomized complete block design with body weight (BW) as the blocking factor. In Exp. 1, dietary treatments consisted of 0.26%, 0.30%, 0.33%, 0.38%, 0.43%, 0.48%, and 0.53% STTD P. Treatments were achieved with the inclusion of monocalcium phosphate at the expense of corn. In Exp. 2, diets contained 1,000 phytase units (FYT; Ronozyme Hiphos 2500, DSM Nutritional Products, Inc., Parsippany, NJ) with assumed release value 0.132% STTD P, and treatments consisted of 0.30%, 0.33%, 0.38%, 0.43%, 0.48%, 0.53%, and 0.58% STTD P. These STTD P concentrations included the expected phytase release of 0.132% STTD P. In both experiments, a similar 1.17:1 Ca:P ratio was maintained across treatments. Statistical models included linear model (LM), quadratic polynomial (QP), broken-line linear (BLL), and broken-line quadratic (BLQ). In Exp. 1, increasing STTD P increased (linear, P < 0.001) ADG, ADFI, G:F, final BW, and grams of STTD P intake per day and per kilogram of gain. There was also a marginal quadratic response for G:F (P < 0.066). In Exp. 2, ADG and G:F increased quadratically (P < 0.05), whereas ADFI increased linearly (P = 0.060) with increasing STTD P. The BLL and QP model provided similar fit to G:F in Exp. 1, estimating the requirement for maximum G:F at 0.34% and 0.42%, respectively. The BLL was the best fitting model for ADG and G:F in Exp. 2, estimating the breakpoint at 0.40% and 0.37% STTD P, respectively. The BLL and BLQ models estimated the breakpoint for ADG as a function of STTD P intake in grams per day at 2.92 and 3.02 g/d, respectively. These data provide empirical evidence that for 11- to 23-kg pigs, the NRC (2012) accurately estimates the STTD P requirement on a g/d basis. As a percentage of the diet, the STTD P requirement for diets without or with 1,000 FYT added phytase ranged from 0.34% to 0.42%.

Evaluation of the optimal standardized ileal digestible threonine:lysine ratio in lactating sow diets.

Camborough PIC sows (n = 291) were fed 1 of 5 dietary treatments to evaluate the standardized ileal digestible (SID) Thr:Lys requirement during lactation. Sows were blocked by parity (1, 2, and 3+) and randomly allotted to 1 of 5 SID Thr:Lys ratios (52, 60, 68, 76, and 84). SID Lys was formulated to 1.03% and SID methionine and cystine (M + C):Lys was 55%. Sows were allowed 5.45 kg feed/day starting on the day of farrowing. All other nutrients met or exceeded the NRC (2012) requirements. Sows were allowed ad libitum access to water, and piglets were cross-fostered within treatment within 24 h of birth. Data collected during the study included sow prefarrow BW, sow weaning weight, starting litter weight, weaning litter weight, piglet mortality, weaning-to-estrus interval, and subsequent total born piglets. Data were analyzed as a randomized complete block design using PROC MIXED with sow as the experimental unit and treatment and parity as fixed effects. Requirement estimation models evaluated were quadratic polynomial, broken-line linear, and broken-line quadratic (BLQ) using PROC NLMIXED. Models that differed in their Bayesian information criterion (BIC) values by at least 2 points were considered to have meaningful differences in their data fit. The best-fit model was based on the best BIC value. As the SID Thr:Lys ratio increased, there was a quadratic response on ADFI (4.73, 4.57, 4.67, 4.55, and 4.60 kg/d; P = 0.001) and percent of sow BW loss (-6.4, -7.89, -7.35, -6.19, and -5.81; P = 0.004). In addition, there was a trend for weaning-to-estrus interval to be affected by the ratio (5.4, 4.4, 4.6, 4.5, and 4.8; P = 0.07). Daily litter gain was also quadratically improved as the SID Thr:Lys ratio increased (2.67, 2.67, 2.78, 2.77, and 2.68 kg/d; P-value = 0.001). For daily litter gain, the BLQ model was determined to be the best fit with an estimated SID Thr:Lys requirement of 65%. In conclusion, the optimal SID Thr:Lys ratio for litter growth was 65.

Evaluation of the optimal standardized ileal digestible valine:lysine ratio in lactating sow diets1.

An experiment was conducted with 430 sows to evaluate the ideal standardized ileal digestible (SID) Val:Lys on sow and litter performance during an 18.6-d lactation period. The SID Val:Lys ratios measured were based on the previously published literature and then values above and below reported values. Sows were randomly allotted within parity block (parity 1, parity 2, and parity 3+) to one of five corn-soybean meal-based lactation diets formulated to contain different levels of SID Val:Lys (0.50, 0.62, 0.75, 0.88, and 1.00, respectively). All diets were formulated to be isocaloric (3.35 ME Mcal/kg) with 0.95% SID Lys and contained vitamins and minerals that exceeded recommendations (NRC, 2012). Experimental diets were given to sows from 112 d of pregnancy throughout the 23-d lactation period. Litters were standardized within 48 h after farrowing. Sows were fed with the Howema computerized feeding system that mixed the high and low diets to create the intermediate diets, weighed the feed for each sow and then delivered the feed to each individual feeding hopper to record daily sow feed intake during lactation. Data were analyzed as a randomized complete block design using the PROC MIXED procedure of SAS with sow as the experimental unit and treatment as a fixed effect and parity as the random effect. Results were considered significant at P ≤ 0.05 and considered a trend at P > 0.05 and P ≤ 0.10. Sow ADFI was not significantly different (5.2, 5.2, 5.2, 5.0, and 5.4 ± 0.15 kg/d, respectively). On average, sows consumed ~45 g of SID Lys per day. Sow wean to estrus (5.2, 4.7, 5.3, 5.5, and 4.5 ± 0.32 d, respectively) was not different as the Val:Lys ratio changed. Increasing the Val:Lys ratio resulted in no differences (2.66, 2.64, 2.76, 2.61, and 2.62 ± 0.08 kg; P > 0.10) in average daily litter gain. There were no differences in sow weight loss or subsequent total born across the dietary treatments. Overall, increasing levels of SID Val:Lys did not change sow reproductive performance or piglet growth rate.

Investigating causal biological relationships between reproductive performance traits in high-performing gilts and sows1.

Efficient management of swine production systems requires understanding of complex reproductive physiological mechanisms. Our objective in this study was to investigate potential causal biological relationships between reproductive performance traits in high-producing gilts and sows. Data originated from a nutrition experiment and consisted of 200 sows and 440 gilts arranged in body weight blocks and randomly assigned to dietary treatments during late gestation at a commercial swine farm. Reproductive performance traits consisted of weight gain during late gestation, total number born and number born alive in a litter, born alive average birth weight, wean-to-estrous interval, and total litter size born in the subsequent farrowing. Structural equation models combined with the inductive causation algorithm, both adapted to a hierarchical Bayesian framework, were employed to search for, estimate, and infer upon causal links between the traits within each parity group. Results indicated potentially distinct reproductive networks for gilts and for sows. Sows showed sparse connectivity between reproductive traits, whereas the network learned for gilts was densely interconnected, suggesting closely linked physiological mechanisms in younger females, with a potential for ripple effects throughout their productive lifecycle in response to early implementation of tailored managerial interventions. Cross-validation analyses indicated substantial network stability both for the general structure and for individual links, though results about directionality of such links were unstable in this study and will need further investigation. An assessment of relative statistical power in sows and gilts indicated that the observed network discrepancies may be partially explained on a biological basis. In summary, our results suggest distinctly heterogeneous mechanistic networks of reproductive physiology for gilts and sows, consistent with physiological differences between the groups. These findings have potential practical implications for integrated understanding and differential management of gilts and sows to enhance efficiency of swine production systems.

Impact of feed intake during late gestation on piglet birth weight and reproductive performance: a dose-response study performed in gilts.

The effects of increasing feed intake (1.8, 2.3, 2.8, and 3.3 kg/d) during late gestation of gilts on piglet birth weight and female reproductive performance were evaluated. A total of 977 gilts were fed a diet based on corn-soybean meal (3.29 Mcal ME per kg and 0.64% standardized ileal digestible lysine) from day 90 of gestation until farrowing. Gilts were weighed on days 90 and 112 of gestation, at farrowing and weaning. Born alive and stillborn piglets were weighed within 12 h of birth. Colostrum yield (CY), lactation feed intake, and litter growth rate were measured in a randomly selected subsample of 245 gilts. The data were analyzed using generalized linear mixed models. As expected, gains in body weight (BW) were different at day 112 (P < 0.001) with the greatest values observed in the 3.3 kg/d treatment. As feed intake increased during late gestation, BW, body condition score (BCS), backfat (BF), and Caliper unit also increased between day 112 and weaning (P < 0.001). No differences were found among treatments in total number of piglets born, mummified fetuses, sum of born alive and stillborn piglets, and within-litter birth weight CV (P > 0.05). Tendencies for quadratic effect of feed intake were observed for born alive piglets (P = 0.079), average birth weight of piglets (P = 0.083), and litter weight (P = 0.059). Gilts with lower feed intake during late gestation had reduced percentages of stillborn piglets than gilts with greater feed intakes. The CY decreased linearly (P < 0.05) as the feed intake was increased. No differences among treatments were found at weaning in individual piglet weight and litter weight, as well as in percentage of weaned piglets (P > 0.05). Lactation feed intake decreased as gestation feeding level increased (P < 0.05). No differences in the subsequent cycle were observed among treatments for farrowing rate, retention rate up to the next farrowing, number of total piglets born, born alive, stillborn piglets, and mummified fetuses (P > 0.05). In conclusion, increased feed intake from day 90 of gestation until farrowing resulted in increased maternal BW gain and stillborn rate, but reduced CY and lactation feed intake. A slight increase in birth weight was observed for the 2.3 kg/d treatment. Furthermore, litter growth and subsequent female reproductive performance were not affected by feed intake during late gestation.

Regression analysis to predict the impact of dietary neutral detergent fiber on carcass yield in swine.

Research has shown that carcass yield in swine is reduced when ingredients with high neutral detergent fiber (NDF) content. Carcass yield reduction from feeding high-fiber ingredients results from an increase in the weight of intestinal contents. NDF has been shown to result in the digestive contents to swell in the large intestine by absorbing water thus increasing the fecal volume in the large intestine. Considering the financial implications of changing carcass yield, the objective of this project was to develop a regression equation to estimate carcass yield from dietary NDF and strategies where high-NDF ingredients are taken out of the diet in the last dietary phases before slaughter (withdrawal period; WP). Data from 8 experiments (43 observations) originated from 6 journal articles and 1 technical memo were used to develop the regression equation. The WP of high NDF ingredients was either none or ranged from 5 to 63 d in the experiments. Treatment diets of each trial were reformulated to obtain dietary nutrient content using the NRC ingredient library (NRC, Nutrient requirements of swine. 11th ed, 2012). Composition of experimental diets was used to calculate dietary net energy, crude protein, crude fiber, NDF, and acid detergent fiber in the last two dietary phases. These dietary compositions along with the number of days of WP were used to develop regression equations. The model was determined using a step-wise selection procedure starting with guided forward selection through individual predictor variables, with a statistical significance at P < 0.05 used to determine inclusion of terms in the final model. The regression analysis showed that WP, NDF level in the dietary phase prior to the final phase (NDF1), NDF level in the last dietary phase before marketing (NDF2), and the interaction between NDF2 and WP were the most important variables in the dataset to predict carcass yield. The resulting regression equation was as follows: carcass yield, % = 0.03492 ± 0.02633 × WP (d) - 0.05092 ± 0.02862 × NDF1 (%) - 0.06897 ± 0.02931 × NDF2 (%) - 0.00289 ± 0.00216 × (NDF2 [%] × WP [d]) + 76.0769 ± 1.33730. In conclusion, high levels of NDF up to slaughter had a negative impact on carcass yield. Increasing the length of the WP improved carcass yield; however, the effect of WP was dependent on the level of NDF2. The equation herein provides a tool to estimate of the impact of dietary NDF on carcass yield.

Two different feeding levels during late gestation in gilts and sows under commercial conditions: impact on piglet birth weight and female reproductive performance.

The increase in the litter size in past decades has caused reduction in the individual piglet birth weight. Therefore, nutritional strategies employed in the last third of gestation in order to improve the piglet birth weight have been studied. This study aimed to evaluate the effects of 2 different feeding levels (1.8 and 2.2 kg/d) in the last third of gestation on the piglet birth weight and the female reproductive performance. A total of 407 females were fed on a diet based on corn-soybean meal (3.25 Mcal ME per kg and 0.65% standardized ileal digestible lysine) from day 90 of gestation until farrowing. The females were weighed on day 90 and day 112 of gestation, and at weaning. Born alive and stillborn piglets were weighed within 12 h of birth. The lactation feed intake and the litter growth rate were measured in a randomly selected subsample of 53 sows from each treatment. The data were analyzed using the generalized linear mixed models, considering the females as the experimental unit. Parity, treatment, and their interaction were analyzed for all responses. The females fed on 2.2 kg/d of diet from day 90 to day 112 exhibited greater body weight gain compared to the females fed on 1.8 kg/d (P < 0.001). No evidence of the effects of feeding levels on the individual piglet birth weight and on the within-litter CV were observed, for both gilts and sows (P ≥ 0.90). Similarly, when the classes of the total born piglets were considered in the analysis (<15 and ≥15 for gilts; <16 and ≥16 for sows), no positive effects of increasing the feeding level were observed on the individual piglet birth weight and the within-litter CV (P ≥ 0.47). Also, no differences in the stillborn rate, mummified-fetus rate, and percentage of piglets weighing less than 1,000 g at birth were observed between the treatments (P ≥ 0.28). The females fed on 1.8 kg/d of diet exhibited greater feed intake during lactation, compared to the females fed on 2.2 kg/d (P < 0.05). Weaning weight, weaning-to-estrus interval, subsequent litter size, and culling rate were not affected by the dietary levels (P ≥ 0.23). In conclusion, increasing the feed intake from day 90 of gestation until farrowing increased the body weight gain in sow, demonstrated no effect on the piglet birth weight, and reduced the lactation feed intake. Furthermore, there was no evidence of the effects of the treatments on the litter growth rate or on the subsequent female reproductive performance.

Effects of dietary calcium to phosphorus ratio and addition of phytase on growth performance of nursery pigs.

Two studies were conducted to evaluate the growth performance and percentage bone ash of nursery pigs fed various combinations of Ca and P provided by inorganic sources or phytase. In Exp. 1, pens of pigs (n = 720, initially 6.1 ± 0.98 kg) were blocked by initial BW. Within blocks, pens were randomly assigned to one of six treatments (12 pens per treatment) in a three-phase diet regimen. Treatments were arranged in a 2 × 3 factorial with main effects of Ca (0.58% vs. 1.03%) and standardized total tract digestible (STTD) P (0.33% and 0.45% without phytase, and 0.45% with 0.12% of the P released by phytase). During treatment period, Ca × P interactions were observed for all growth criteria (P < 0.05). When diets had low Ca, pigs fed 0.45% STTD P with phytase had greater (P < 0.01) ADG and ADFI than those fed 0.33% or 0.45% STTD P without phytase. When high Ca was fed, ADG and ADFI were similar among pigs fed 0.45% STTD P with or without phytase and were greater than those fed 0.33% STTD P. Gain:feed was reduced (P < 0.01) when high Ca and low STTD P were fed relative to other treatments. On d 21, radiuses were collected from 1 pig per pen for bone ash analysis. Pigs fed 0.33% STTD P had decreased (P < 0.05) percentage bone ash than those fed 0.45% STTD P with or without phytase when high Ca was fed, but this P effect was not observed for low Ca diets (Ca × P interaction, P = 0.007). In Exp. 2, 36 pens (10 pigs per pen, initially 6.0 ± 1.08 kg) were used in a completely randomized design. Treatments were arranged in a 2 × 3 factorial with the main effects of STTD P (at or above NRC [NRC. 2012. Nutrient Requirements of Swine. 11th rev. ed. Washington (DC): National Academic Press.] requirement estimates) and total Ca (0.65, 0.90, and 1.20%). Experimental diets were fed during phases 1 and 2, followed by a common phase 3 diet. Diets at NRC (2012) P level contained 0.45% and 0.40% STTD P, compared with 0.56% and 0.52% for diets greater than the NRC (2012) estimates, in phase 1 and 2, respectively. During treatment period, increasing Ca decreased (linear, P = 0.006) ADG, but increasing STTD P marginally increased (P = 0.084) ADG, with no Ca × P interaction. When diets contained NRC (2012) P levels, pigs fed 1.20% Ca had decreased (P < 0.05) G:F than those fed 0.65% or 0.90% Ca; however, when high STTD P were fed, G:F was not affected by Ca (Ca × P interaction, P = 0.018). In conclusion, excess Ca decreased pig growth and percentage bone ash when diets were at or below NRC (2012) requirement for STTD P, but these negative effects were alleviated by adding monocalcium P or phytase to the diet.

Standardized ileal digestible valine:lysine dose response effects in 25- to 45-kg pigs under commercial conditions.

Two experiments were conducted to estimate the standardized ileal digestible valine:lysine (SID Val:Lys) dose response effects in 25- to 45-kg pigs under commercial conditions. In experiment 1, a total of 1,134 gilts (PIC 337 × 1050), initially 31.2 kg ± 2.0 kg body weight (BW; mean ± SD) were used in a 19-d growth trial with 27 pigs per pen and seven pens per treatment. In experiment 2, a total of 2,100 gilts (PIC 327 × 1050), initially 25.4 ± 1.9 kg BW were used in a 22-d growth trial with 25 pigs per pen and 12 pens per treatment. Treatments were blocked by initial BW in a randomized complete block design. In experiment 1, there were a total of six dietary treatments with SID Val at 59.0, 62.5, 65.9, 69.6, 73.0, and 75.5% of Lys and for experiment 2 there were a total of seven dietary treatments with SID Val at 57.0, 60.6, 63.9, 67.5, 71.1, 74.4, and 78.0% of Lys. Experimental diets were formulated to ensure that Lys was the second limiting amino acid throughout the experiments. Initially, linear mixed models were fitted to data from each experiment. Then, data from the two experiments were combined to estimate dose-responses using a broken-line linear ascending (BLL) model, broken-line quadratic ascending (BLQ) model, or quadratic polynomial (QP). Model fit was compared using Bayesian information criterion (BIC). In experiment 1, ADG increased linearly (P = 0.009) with increasing SID Val:Lys with no apparent significant impact on G:F. In experiment 2, ADG and ADFI increased in a quadratic manner (P < 0.002) with increasing SID Val:Lys whereas G:F increased linearly (P < 0.001). Overall, the best-fitting model for ADG was a QP, whereby the maximum mean ADG was estimated at a 73.0% (95% CI: [69.5, >78.0%]) SID Val:Lys. For G:F, the overall best-fitting model was a QP with maximum estimated mean G:F at 69.0% (95% CI: [64.0, >78.0]) SID Val:Lys ratio. However, 99% of the maximum mean performance for ADG and G:F were achieved at, 68% and 63% SID Val:Lys ratio, respectively. Therefore, the SID Val:Lys requirement ranged from73.0% for maximum ADG to 63.2% SID Val:Lys to achieve 99% of maximum G:F in 25- to 45-kg BW pigs.

Conquistas e desafios dos Grupos de Pesquisa da Fundação Hospitalar do Estado de Minas Gerais / Achievements and challenges of the Hospital Foundation of Minas Gerais research groups

Introdução: A reunião de pesquisadores em torno de projetos tende a originar Grupos de Pesquisa liderados por um pesquisador mais experimentado. A área de pesquisa na Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) tem caminhado em busca de maior qualidade em seus produtos e na formação de recursos humanos para a pesquisa.Objetivo: Descrever os Grupos de Pesquisa credenciados pela FHEMIG com ênfase na descrição do perfil dos líderes dos grupos. Métodos: Os dados sobre os Grupos de Pesquisa e seus líderes foram coletados no site do Conselho Nacional de Desenvolvimento Científico eTecnológico (CNPq), nos bancos de dados do Núcleo de Apoio ao Pesquisador da FHEMIG e nos relatórios da Comissão Interna do Programa de Bolsas de Iniciação Científica e Tecnológica (PIBIC). Resultados: A instituição possui 74 linhas de pesquisa em 29 Grupos de Pesquisa constituídos por 375 pessoas, dentre as quais 42 são líderes de grupos. Os Grupos de Pesquisa e os bolsistas do PIBIC concentram-se nos Hospitais de Ensino da Rede FHEMIG, porém os médicos residentes ainda não aderiram a esses grupos conforme o esperado. Metade dos grupos tinha o cadastro atualizado no sítio do CNPq. Conclusões: Desde a implantação dos Grupos de Pesquisa, houve crescimento e consolidação da atividade de pesquisa na Fundação, mas de maneira geral, ainda é necessário o desenvolvimento de estratégias de estímulo à atividade de pesquisa assim como de melhor estruturação dos grupos e de maior compromisso em manter as informações atualizadas.

Introduction: The reunion of investigators around specific projects tends to originate study groups led by a more experienced researcher. The Teaching and Research Department of the Hospital Foundation of Minas Gerais (FHEMIG) has developed in search of higher quality of its products and the training of human resources for research. Objective: Describe the research groups accredited by FHEMIG, with emphasis on the characterization of the profile of group leaders. Methods: Data on Research Groups and their leaders were collected at the National Council for Scientific and Technological Development (CNPq) website, in the databases of the FHEMIG's Teaching and Research Department, and in reports of the Internal Committee of the Fellowship Program for Scientific and Technological Initiation (PIBIC). Results: FHEMIG has 74 lines of research in 29 research groups, consisting of 375 investigators, with 42 group leaders. Research Groups and PIBIC fellows concentrated in theteaching hospitals, but medical residents have not yet acceded to these groups as expected. Currently, only half of the groups had its records updated on the CNPq website. Conclusions: Since the implementation of Research Groups, research activity at FHEMIG grew and consolidated, but there is a need for strategies to stimulate research activity, as well as to better structure the groups and assure greater commitment keeping its registries updated.

Custos da internação por dependência à cocaína/crack: estudo comparativo entre hospital psiquiátrico e hospital geral / Costs of admissions for cocaine/crack abuse: comparing general hospital and psychiatric hospital settings

INTRODUÇÃO: O modelo nacional vigente de atenção ao dependente químico não distingue o atendimento em hospital psiquiátrico e em hospital geral. Não há informações sobre os custos diferenciais dessas duas modalidades de internação. OBJETIVO: Comparar os custos estimados da internação por dependência à cocaína/crack em hospital psiquiátrico com os da internação em hospital geral, no contexto da saúde pública do Estado de Minas Gerais. MÉTODOS: estimativas dos custos diretos médios diários e totais da internação por dependência à cocaína/crack, pelo método de custeio por absorção, em hospital psiquiátrico e hospital geral públicos de Minas Gerais. RESULTADOS: O custo médio diário da internação em hospital psiquiátrico foi estimado em R$ 368,65 e, no hospital geral, em R$ 484,52, correspondendo a uma diferença de 31,4%. Esta diferença foi primordialmente relativa a custos com pessoal e serviços. CONCLUSÃO: Os custos da internação por dependência a cocaína/crack são mais elevados no hospital geral que no psiquiátrico, no contexto da saúde pública de Minas Gerais.

The current Brazilian model for the assistance of drug dependents does not differentiate admissions in psychiatric or general hospitals. There is no information on the distinct costs of those two modes of hospitalization. Aim: To compare the estimated costs of hospitalization for cocaine/crack dependence in a psychiatric hospital and in a general hospital, in the context of public healthcare in the state of Minas Gerais, Brazil. Methods: Estimates of the daily average total direct costs of admissions for cocaine/crack dependence, using the method of activity based costs, in a public psychiatric hospital and in a public general hospital, in Minas Gerais, Brazil. Results: The average daily cost of hospitalization in a psychiatric hospital was estimated at R$ 368.65, and in a general hospital, at R$ 484.52, a difference of 31.4%. This difference was primarily due to staffing and services related costs. Conclusion: The costs of hospitalization for cocaine/crack dependence are higher in the general hospital than in the psychiatric hospital, in the context of public healthcare in Minas Gerais, Brazil.