Thermodilution and esophageal Doppler ultrasound in the assessment of blood flow changes induced by endotoxin and dobutamine

BACKGROUND: Intermittent (IT) and continuous (CT) thermodilution and esophageal Doppler (ED), are all used for hemodynamic monitoring. The aim of this study was to test the agreement between these methods during endotoxin (ET) and dobutamine infusion. METHODS: Twenty-two pigs (39 +/- 1.8 kg body weight) were randomized to general anesthesia and either continuous ET (n = 9) or placebo (PL, n = 13) infusion. After 18 hours of ET or PL infusion, the animals were further randomized to receive dobutamine (n = 3 in ET, n = 5 in PL) or PL. A set of measurements using the three methods were obtained every hour, and the relative blood flow changes between two subsequent measurements were calculated. RESULTS: Bias or limits of agreement for flows were 0.73 L/min or 1.80 L/min for IT and CT, -0.33 L/min or 4.29 L/min for IT and ED, and -1.06 or 3.94 for CT and ED (n = 515, each). For flow changes they were 1% or 44%, 2% or 59%, and 3% or 45%, respectively. Bias and limits of agreement did not differ in ET- and PL-treated animals or in animals with or without dobutamine. Despite significant correlation between any two methods, the respective correlation coefficients (r) were small (IT vs. CT: 0.452; IT vs. ED: 0.042; CT vs. ED: 0.069; all p < 0.001). The same directional changes were measured by any two methods in 49%, 40%, and 50%. When IT flows >5 L/min were compared with IT flows 5 L/min.

Improved safety and reduction in stent thrombosis associated with biodegradable polymer-based biolimus-eluting stents versus durable polymer-based sirolimus-eluting stents in patients with coronary artery disease: final 5-year report of the LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) randomized, noninferiority trial

OBJECTIVES This study sought to report the final 5 years follow-up of the landmark LEADERS (Limus Eluted From A Durable Versus ERodable Stent Coating) trial. BACKGROUND The LEADERS trial is the first randomized study to evaluate biodegradable polymer-based drug-eluting stents (DES) against durable polymer DES. METHODS The LEADERS trial was a 10-center, assessor-blind, noninferiority, "all-comers" trial (N = 1,707). All patients were centrally randomized to treatment with either biodegradable polymer biolimus-eluting stents (BES) (n = 857) or durable polymer sirolimus-eluting stents (SES) (n = 850). The primary endpoint was a composite of cardiac death, myocardial infarction (MI), or clinically indicated target vessel revascularization within 9 months. Secondary endpoints included extending the primary endpoint to 5 years and stent thrombosis (ST) (Academic Research Consortium definition). Analysis was by intention to treat. RESULTS At 5 years, the BES was noninferior to SES for the primary endpoint (186 [22.3%] vs. 216 [26.1%], rate ratio [RR]: 0.83 [95% confidence interval (CI): 0.68 to 1.02], p for noninferiority <0.0001, p for superiority = 0.069). The BES was associated with a significant reduction in the more comprehensive patient-orientated composite endpoint of all-cause death, any MI, and all-cause revascularization (297 [35.1%] vs. 339 [40.4%], RR: 0.84 [95% CI: 0.71 to 0.98], p for superiority = 0.023). A significant reduction in very late definite ST from 1 to 5 years was evident with the BES (n = 5 [0.7%] vs. n = 19 [2.5%], RR: 0.26 [95% CI: 0.10 to 0.68], p = 0.003), corresponding to a significant reduction in ST-associated clinical events (primary endpoint) over the same time period (n = 3 of 749 vs. n = 14 of 738, RR: 0.20 [95% CI: 0.06 to 0.71], p = 0.005). CONCLUSIONS The safety benefit of the biodegradable polymer BES, compared with the durable polymer SES, was related to a significant reduction in very late ST (>1 year) and associated composite clinical outcomes. (Limus Eluted From A Durable Versus ERodable Stent Coating [LEADERS] trial; NCT00389220).

Children's and adolescent's self - assessment of metabolic control versus professional judgment: a cross-sectional retrospective and prospective cohort study

BACKGROUND Morbidity and mortality in T1DM depend on metabolic control, which is assessed by HbA1c measurements every 3-4 months. Patients' self-perception of glycemic control depends on daily blood glucose monitoring. Little is known about the congruence of patients' and professionals' perception of metabolic control in T1DM. OBJECTIVE To assess the actual patients' self-perception and objective assessment (HbA1c) of metabolic control in T1DM children and adolescents and to investigate the possible factors involved in any difference. METHODS Patients with T1DM aged 8 - 18 years were recruited in a cross-sectional, retrospective and prospective cohort study. Data collection consisted of clinical details, measured HbA1c, self-monitored blood glucose values and questionnaires assessing self and professionals' judgment of metabolic control. RESULTS 91 patients participated. Mean HbA1c was 8.03%. HbA1c was higher in patients with a diabetes duration > 2 years (p = 0.025) and in patients of lower socioeconomic level (p = 0.032). No significant correlation was found for self-perception of metabolic control in well and poorly controlled patients. We found a trend towards false-positive memory of the last HbA1c in patients with a HbA1c > 8.5% (p = 0.069) but no difference in patients' knowledge on target HbA1c between well and poorly controlled patients. CONCLUSIONS T1DM patients are aware of a target HbA1c representing good metabolic control. Ill controlled patients appear to have a poorer recollection of their HbA1c. Self-perception of actual metabolic control is similar in well and poorly controlled T1DM children and adolescents. Therefore, professionals should pay special attention that ill controlled T1DM patients perceive their HbA1c correctly.

Gynaecologists' awareness of bone healthcare in Switzerland

PRINCIPLES To assess gynaecologists' awareness of bone healthcare in women and the prevalence of application of national recommendations on bone healthcare in Switzerland. METHODS During the annual meeting of the Swiss Society of Gynaecology and Obstetrics 2012, the Swiss Association against Osteoporosis (SVGO) performed standardised interviews with conference participants (n = 210). Questions addressed responsibility for bone healthcare, and whether diagnostic procedures, initiation of bone-specific treatment and follow-up were performed in accordance with SVGO recommendations. RESULTS The majority of respondents were aged 30-50 years (60%), female (70%) and working as board-certified gynaecologists (69%). Ninety-three percent of respondents considered care for bone health as part of the gynaecologist's expertise. As diagnostic procedures, 44% recommended performing bone densitometry (DXA) only, 34% ordered additional laboratory testing. Seventy-two percent of respondents initiated a bone-specific treatment. Predictors for not performing diagnostic procedures and not initiating a bone-specific treatment were physician's age below 30, being a trainee gynaecologist, and working at a university clinic. Particularly, young trainee gynaecologists working at a university clinic were especially unlikely to initiate a bone-specific treatment (regression coefficient = -2.68; odds ratio [OR] 0.069, 95% confidence interval [CI] 0.01-0.61; p = 0.16). Follow-ups were performed by 77% of respondents, but were less likely to be by female physicians (OR 0.27, 95% CI 0.09-0.84; p = 0.024). CONCLUSIONS Although the majority of board-certified gynaecologists follow national recommendations on bone healthcare, current medical training in obstetrics and gynaecology does not sufficiently cover the subject of women's health. However, since this is a small study our findings may not reflect the findings in the total population.

Nutritive value of palm kernel meal in diets for growing rabbits

The aim of this work was to determine the nutritive value of palm kernel meal (PKM) in diets for growing rabbits. In Experiment 1, 20 New Zealand × Californian growing rabbits 50 d-old were used to determine energy, crude protein, fibre and fat digestibility of PKM. The nutritive value was estimated by the difference method using a basal diet and another diet made by substituting 200 g/kg of basal diet with PKM. Energy, crude protein, ether extract and neutral detergent fibre of PKM digestibilities were, respectively, 0.549 (±0.056, SE), 0.541 (±0.069), 0.850 (±0.048) and 0.430 (±0.101), and the digestible energy concentration was 10.9 MJ/kg (±1.03) DM. In Experiment 2, 412 rabbits were allocated at random to the two experimental diets to measure growing performance. Inclusion of 200 g PKM/kg in the diet did not affect feed or digestible energy intake but decreased slightly (by around 5%) average daily gain (P = 0.003) and feed efficiency (P < 0.001). Neither mortality nor Clostridium perfringens counts in soft faeces were affected by type of diet. Palm kernel meal can be considered a palatable source of fibre, protein and fat for rabbits and can substitute significant amounts of other fibrous ingredients in the diet without adverse effects on growth performance.

Identification of the method to quantify soluble fibre and the effect of the source of fibre on the ileal and faecal digestibility of soluble and insoluble fibre in rabbits = Identificación del método para cuantificar la fibra soluble y el efecto de la fuente de fibra en la digestibilidad ileal y fecal de la fibra soluble e insoluble en conejos

La presente tesis constituye un avance en el estudio de los métodos para cuantificar la fibra soluble y los efectos de las fracciones de fibra y las fuentes de fibra sobre la digestión de las diferentes fracciones de fibra (soluble e insoluble) en el conejo. Hay un efecto positivo de la fibra soluble sobre la salud intestinal de los conejos y, por ende, una reducción de la mortalidad en animales destetados. Pese a esto, no está claro si estos efectos se deben específicamente a la fracción soluble. Por lo que los objetivos generales de esta tesis fueron: 1) comparar diferentes metodologías químicas e in vitro para cuantificar la fibra soluble y estudiar las posibles interferencias en la cuantificación de la fibra soluble por las mucinas, y viceversa, 2) determinar los efectos de la fibra, el lugar de fermentación, el método para valorar la fibra soluble e insoluble, y la corrección de la fibra soluble por el contenido intestinal de mucinas sobre la digestibilidad de las distintas fracciones de la fibra y 3) evaluar los efectos individuales de las fracciones soluble e insoluble de la fibra de pulpa de remolacha y de manzana, sobre la digestibilidad de la fibra soluble e insoluble y los parámetros digestivos. Para ello se llevaron a cabo 4 estudios. En el primer estudio se compararon diferentes metodologías químicas e in vitro para valorar la fibra soluble de diferentes alimentos y se estudió la posible interferencia en la determinación de la fibra soluble y mucinas. Para ello se utilizaron seis ingredientes (pulpa de remolacha, pectinas de pulpa de remolacha, pulpa de remolacha lavada, paja de cereal, cascarilla de girasol y lignocelulosa) y siete piensos de conejos con diferentes niveles de fibra soluble. En un primer experimento se analizó la fibra dietética total (FDT), la fibra dietética insoluble (FDI), la fibra dietética soluble (FDS), la fibra neutro detergente corregida por cenizas y proteínas (aFNDmo-pb), y la digestibilidad in vitro 2 pasos pepsina/pancreatina (residuo corregido por cenizas y proteína, ivMSi2) de los ingredientes y piensos. Además la fibra soluble se calculó mediante la diferencia entre FDT-FDI (FDSFDI), FDT- ivMSi2 (FDSivMSi2), y FDT - aFNDmo-pb (FDSaFNDmo-pb). Cuando la fibra soluble se determinó directamente como FDS o se calculó como FDT-FDI no se observaron diferencias (109 g/kg MS, en promedio). Sin embargo, cuando la fibra soluble se calculó como FDT - aFNDmo-pb su valor fue un 40% menor (153 g/kg MS. P < 0,05), mientras que la FDSFDI (124 g/kg MS) no fue diferente a ninguna de las otras metodologías. La correlación entre los tres métodos fue elevada (r > 0,96. P < 0,001. n = 13), pero disminuyó o incluso desapareció cuando la pulpa o las pectinas de la remolacha fueron excluidas del análisis. En un segundo experimento, se comparó el método ivDMi2 usando crisoles (método de referencia) con una modificación del mismo usando bolsas ANKOM digeridas individualmente o en colectivo para simplificar la determinación de la FDSivMSi2. La FDSivMSi2 no difirió entre los métodos comparados. En un tercer experimento, se analizó la posible interferencia entre la determinación de la fibra soluble y las mucinas intestinales. Se observó un contenido de FDT y de mucinas elevado en las muestras de pectinas de remolacha (994 y 709 g/kg MS), así como en el moco intestinal de conejo (571 y 739 g/kg MS) cuando se aplicó el método de mucinas por precipitación con etanol. Sin embargo, después de aplicar una pectinasa en el material precipitado, la cantidad de mucinas recuperadas en las muestras de pectinas de remolacha fue cercana a cero, mientras que en el moco intestinal fue similar a los resultados previos al uso de la enzima. Con los resultados de este ensayo se estimaron los carbohidratos de mucinas retenidos en los contenidos digestivos y se propuso una corrección para la determinación de la digestibilidad de la FDT y fibra soluble. En conclusión, la contaminación de las mucinas de la digesta con fibra soluble se soluciona usando pectinasas. El segundo estudio se centró en estudiar: 1) el efecto del tipo de fibra, 2) el sitio de fermentación, 3) el método para cuantificar fibra y 4) la corrección por mucinas sobre la digestibilidad de la fibra. Para ello se formularon tres piensos con diferentes niveles de fibra soluble (FDT-aFNDmo-pb). Un pienso bajo en fibra soluble (LSF. 85 g/kg DM), un pienso medio en fibra soluble (MSF. 102 g/kg DM), y un pienso alto en fibra soluble (HSF. 145 g/kg DM). Estos piensos se obtuvieron reemplazando un 50% del heno del alfalfa en el pienso MSF por una mezcla de pulpa de manzana y remolacha (HSF) o por una mezcla de cascarilla de avena y proteína de soja (LSF). Se utilizaron 30 conejas canuladas para determinar la digestibilidad ileal y fecal. La digestibilidad cecal se calculó mediante diferencia entre la digestibilidad fecal e ileal. La fibra insoluble se determinó como aFNDmo-pb, IDF, e ivMSi2, mientras que la fibra soluble se calculó como FDSFDI, FDSaFNDmo-pb, y FDSivMSi2. La digestibilidad de la FDT y la fibra soluble se corrigieron por las mucinas. La concentración de mucinas en la digesta ileal y fecal, aumento desde el grupo LSF hasta el grupo con el pienso HSF (P < 0,01). La corrección por mucinas aumentó las digestibilidades de la FDT y la fibra soluble a nivel ileal, mientras que a nivel cecal las redujo. (P < 0.01). El coeficiente de digestibilidad ileal de FDT aumentó desde el grupo LSF al grupo HSF (0,12 vs. 0,281. P < 0,01), sin diferencias en el coeficiente de digestibilidad cecal (0,264), por lo que la tendencia a nivel fecal entre los grupos se mantuvo. El coeficiente de digestibilidad ileal de la fibra insoluble aumento desde el grupo con el pienso LSF al grupo con el pienso HSF (0,113 vs. 0,210. P < 0,01), sin diferencias a nivel cecal (0,139) y sin efecto del método usado, resultando en una digestibilidad elevada a nivel fecal, con tendencias similares a las observadas a nivel ileal. El coeficiente de digestibilidad de la FND fue elevada en comparación con la FDI o la ivMSi2 (P > 0.01). El coeficiente de la digestibilidad ileal de la fibra soluble fue mayor en el grupo LSF respecto al grupo LSF (0,436 vs. 0,145. P < 0,01) y el método no afectó a esta determinación. El coeficiente de la digestibilidad cecal de la fibra soluble se redujo desde el grupo LSF hasta el grupo HSF (0,721 vs. 0,492. P < 0,05). El valor más bajo de digestibilidad cecal y fecal de fibra soluble fue medido con el método FDSaFNDmo-pb (P < 0,01). Se observó una alta correlación entre las digestibilidades de la fibra soluble determinada como FDSFDI, FDSaFNDmo-pb, y FDSivMSi2, por lo tanto la información proporcionada por una u otra metodología fueron similares. Sin embargo, cuando se compararon con efectos fisiológicos (producción de mucinas y peso del ciego y pH del ciego de un trabajo previo), la FDSaFNDmo-pb globalmente mostró estar mejor correlacionado con estos parámetros fisiológicos. En conclusión, la corrección por mucinas es necesaria para determinar la digestibilidad ileal de la FDT y fibra soluble, mientras que la elección de uno u otro método es menos relevante. La inclusión de pulpa de manzana y remolacha incrementa la cantidad de FDT que desaparece antes de llegar al ciego. En el tercer estudio se estudió el efecto de la fracción fibrosa soluble e insoluble de la pulpa de remolacha y el método de cuantificación de la fibra soluble e insoluble sobre la digestibilidad de la fibra y algunos parámetros digestivos. Para ello se formularon cuatro piensos con niveles similares de fibra insoluble (315g aFNDmo-pb/kg MS) y proteína (167 g/kg MS). El pienso control contuvo el nivel más bajo de fibra soluble (30,3 g/kg, con cascarilla de girasol y paja como fuente de fibra). Un segundo pienso se obtuvo mediante la sustitución de 60 g de almidón/kg del pienso control por pectinas de remolacha (82,9 g fibra soluble/kg MS). Los otras dos piensos resultaron de la sustitución parcial de las fuentes de fibra del pienso control por la fracción insoluble de la pulpa de remolacha y la pulpa de remolacha entera (42.2 y 82.3 g fibra soluble/kg MS, respectivamente). Cincuenta y seis conejos en cebo (14/pienso), de 2,4  0.21 kg de peso, fueron usados para determinar la digestibilidad ileal y fecal de la FDT, FDI, aFNDmo-pb, FDSFDI, y FDSaFNDmo-pb. La concentración de mucinas en el íleon y heces se utilizaron para corregir la digestibilidad de la FDT y fibra soluble. También se midió el peso de diferentes segmentos del tracto digestivo y el pH del contenido digestivo. Los conejos alimentados con el pienso de fibra insoluble de pulpa de remolacha mostraron los consumos más bajos con respecto a los demás grupos (124 vs. 139 g/d, respectivamente. P < 0,05). El flujo de mucinas ileales fue más alto (P < 0.05) en el grupo alimentado con el pienso de pectinas de remolacha (9,0 g/d en promedio) que los del grupo control (4,79 g/d), mostrando los otros dos grupos valores intermedios, sin detectarse diferencias a nivel fecal. La digestibilidad ileal de la FDT (corregida por mucinas) y la fibra insoluble no se vieron afectadas por el tipo de pienso. El método usado para determinar la fibra insoluble afectó su digestibilidad ileal (0,123 para FDI vs. 0,108 para aFNDmo-pb. P < 0.01). De todas formas, los métodos no afectaron al cálculo de la fibra fermentada antes del ciego (4,9 g/d en promedio). Los conejos alimentados con el pienso de pulpa de remolacha y con el pienso con la fracción insoluble de la pulpa de remolacha mostraron las digestibilidades fecales más altas de la fibra insoluble (0,266 en promedio vs. 0,106 del grupo control), mientras que en los animales del pienso con pectinas esta digestibilidad fue un 47% mayor respecto al pienso control (P < 0,001). La digestibilidad fecal de la fibra insoluble fue un 20% más alta cuando se usó la FND en lugar de FDI para determinarla (P < 0.001). Esto hizo variar la cantidad de fibra insoluble fermentada a lo largo del tracto digestivo (9,5 ó 7,5 g/d cuando fue calculada como FDI o aFNDmo-pb, respectivamente. P < 0,001). Las digestibilidades ileales de la fibra soluble fueron positivas cuando los análisis de fibra soluble de los contenidos ileales fueron corregidos por mucinas, (P < 0,001) excepto para la digestibilidad ileal de la FDSIDF del grupo control. Una vez corregidas por mucinas, los conejos alimentados con los piensos que contuvieron la fracción soluble de la pulpa de remolacha (pienso de pectina y pulpa de remolacha) mostraron una mayor digestibilidad ileal de la fibra soluble, respecto al grupo control (0,483 vs. -0,010. P = 0.002), mientras que el grupo del pienso de fibra insoluble de pulpa de remolacha mostró un valor intermedio (0,274). La digestibilidad total de la fibra soluble fue similar entre todos los grupos (0.93). Los conejos alimentados con pulpa de remolacha y su fracción insoluble mostraron los pesos relativos más altos del estómago respecto a los del pienso control y de pectinas (11 y 56 % respectivamente; P < 0,05). Por otra parte, el peso relativo del ciego aumentó en los animales que consumieron tanto la fracción soluble como insoluble de la pulpa de remolacha, siendo un 16% más pesados (P < 0,001) que el grupo control. El pH del contenido cecal fue más bajo en los animales del grupo de pulpa de remolacha que en los del grupo control (5,64 vs. 6,03; P < 0,001), mientras que los del grupo de pectinas y de fibra insoluble de pulpa de remolacha mostraron valores intermedios. En conclusión, el efecto positivo de la pulpa de remolacha en el flujo de mucinas a nivel ileal se debe a la fracción soluble e insoluble de la pulpa de remolacha. La mitad de la fibra soluble de la pulpa de remolacha desaparece antes de llegar al ciego, independientemente si esta proviene de pectinas puras o de la pulpa de remolacha. El pH cecal esta mejor correlacionado con la cantidad de FDT que desaparece antes del ciego más que con la que se degrada en el ciego. En el último estudio se estudiaron los efectos de la fibra soluble e insoluble de la pulpa de manzana sobre la digestibilidad de la fibra y algunos parámetros digestivos. Cuatro dietas fueron formuladas con niveles similares de fibra insoluble (aFNDmo-pb 32,4%) y proteína (18,6% ambos en base seca). El pienso control contuvo el nivel más bajo de fibra soluble (46 g de fibra soluble/kg, con cascarilla de girasol y paja de cereales como la fuentes de fibra). Un segundo pienso fue obtenido mediante la sustitución de 60 g de almidón/kg del pienso control por pectinas de manzana (105 g fibra soluble/kg). Los otros dos piensos se obtuvieron por la substitución de parte de las fuentes de fibra del pienso control por pulpa de manzana o pulpa de manzana despectinizada (93 y 71 g de fibra soluble/kg, respectivamente). La digestibilidad fecal fue determinada en 23 conejos/pienso con 1.68 ± 0.23 kg de peso vivo, los cuales fueron sacrificados a los 60 d edad para recolectar su contenido digestivo para determinar digestibilidad ileal y otros parámetros digestivos. La fibra soluble de manzana (pectinas y pulpa entera) estimuló el flujo ileal de mucinas (P = 0,002), pero no asi la pulpa despectinizada. La corrección por mucinas incrementó la digestibilidad de la FDT y la fibra soluble a nivel fecal, y especialmente a nivel ileal. Cerca de la mitad de la fibra soluble proveniente de los piensos con cualquiera de las fracciones de la pulpa de manzana fue degradada a nivel ileal, sin mostrar diferencias entre los grupos (46 y 86% en promedio a nivel ileal y fecal respectivamente). La inclusión de pulpa despectinizada de manzana mejoró la digestibilidad de la FND a nivel fecal (P < 0,05) pero no a nivel ileal. El contenido cecal de los conejos alimentados con la pulpa de manzana tuvieron el pH cecal más ácido que los del pienso control (5,55 vs. 5,95. P < 0,001), mientras que los animales con el pienso de pectinas de manzana y de pulpa de manzana despectinizada mostraron valores intermedios. En conclusión los efectos positivo de la pulpa de manzana en el flujo de mucinas se debió principalmente a la fracción soluble de la pulpa de manzana. La mitad de la fibra soluble fue degradada antes del ciego independientemente de si esta provino de las pectinas o de la pulpa de manzana. El pH cecal estuvo mejor correlacionado con la cantidad de FDT fermentada en todo el tracto digestivo y antes de llegar al ciego que con la que se degradó en el ciego. Al integrar los resultados de los estudio 2, 3 y 4 se concluyó que la corrección de mucinas de los contenidos digestivos al determinar FDT y fibra soluble es necesaria para ajustar los cálculos de su digestibilidad. Esta corrección es mucho más importante a nivel ileal y en dietas bajas en fibra soluble. Por otra parte, la FDT desapareció en proporciones importantes antes de llegar al ciego, especialmente en piensos que contienen pulpa de remolacha o de manzana o alguna fracción soluble o insoluble de las mismas y estas diferencias observadas entre los piensos a nivel ileal se correlacionaron mejor con el pH cecal, lo que indicaría que la FDT se solubilizó antes de llegar al ciego y una vez en esté fermentó. Estos resultados implican que determinar la fibra soluble como FDSaFNDmo-pb es la mejor opción y que en la determinación de la digestibilidad de la FDT y fibra soluble se debe considerar la corrección por mucinas especialmente a nivel ileal y en piensos bajos en fibra soluble. ABSTRACT The present thesis constitutes a step forward in advancing the knowledge of the methods to quantify soluble fibre and the effects of the fibre fractions and source of fibre on the site the digestion of different fractions of fibre (soluble and insoluble) in the rabbit. There is a positive effect of soluble fibre on rabbit digestive health and therefore on the reduction of mortality in weaning rabbits. Nevertheless, it is no so clear that the effects of soluble fibre on rabbits are due particularly to this fraction. This thesis aims: 1) to compare the quantification of soluble fibre in feeds using different chemical and in vitro approaches, and to study the potential interference between soluble fibre and mucin determinations, 2) to identify the effects of type of fibre, site of fermentation, method to quantify insoluble and soluble fibre, and correction of the intestinal soluble fibre content for intestinal mucin on the digestibility of fibre fractions and 3) to evaluate the individual effect of soluble and insoluble fibre from sugar beet pulp and apple pulp on ileal and faecal soluble and insoluble digestibility and digestive traits. These objectives were developed in four studies: The first study compared the quantification of soluble fibre in feeds using different chemical and in vitro approaches, and studied the potential interference between soluble fibre and mucin determinations. Six ingredients, sugar beet pulp (SBP), SBP pectins, insoluble SBP, wheat straw, sunflower hulls and lignocellulose, and seven rabbit diets, differing in soluble fibre content, were evaluated. In experiment 1, ingredients and diets were analysed for total dietary fibre (TDF), insoluble dietary fibre (IDF), soluble dietary fibre (SDF), aNDFom (corrected for protein, aNDFom-cp) and 2-step pepsin/pancreatin in vitro DM indigestibility (corrected for ash and protein, ivDMi2). Soluble fibre was estimated by difference using three procedures: TDF - IDF (SDFIDF), TDF - ivDMi2 (SDFivDMi2), and TDF - aNDFom-cp (SDFaNDFom-cp). Soluble fibre determined directly (SDF) or by difference, as SDFivDMi2 were not different (109 g/kg DM, on average). However, when it was calculated as SDFaNDFom-cp the value was 40% higher (153 g/kg DM, P < 0.05), whereas SDFIDF (124 g/kg DM) did not differ from any of the other methods. The correlation between the four methods was high (r ≥ 0.96. P ≤ 0.001. n = 13), but it decreased or even disappeared when SBP pectins and SBP were excluded and a lower and more narrow range of variation of soluble fibre was used. In experiment 2, the ivDMi2 using crucibles (reference method) were compared to those made using individual or collective ankom bags in order to simplify the determination of SDFivDMi2. The ivDMi2 was not different when using crucibles or individual or collective ankom bags. In experiment 3, the potential interference between soluble fibre and intestinal mucin determinations was studied using rabbit intestinal raw mucus, digesta and SBP pectins, lignocelluloses and a rabbit diet. An interference was observed between the determinations of soluble fibre and crude mucin, as the content of TDF and apparent crude mucin were high in SBP pectins (994 and 709 g/kg DM) and rabbit intestinal raw mucus (571 and 739 g/kg DM). After a pectinase treatment, the coefficient of apparent mucin recovery of SBP pectins was close to zero, whereas that of rabbit mucus was not modified. An estimation of the crude mucin carbohydrates retained in digesta TDF is proposed to correct TDF and soluble fibre digestibility. In conclusion, the values of soluble fibre depend on the methodology used. The contamination of crude mucin with soluble fibre is avoided using pectinase. The second study focused on the effect of type of fibre, site of fermentation, method for quantifying insoluble and soluble dietary fibre, and their correction for intestinal mucin on fibre digestibility. Three diets differing in soluble fibre were formulated (85 g/kg DM soluble fibre, in the low soluble fibre [LSF] diet; 102 g/kg DM in the medium soluble fibre [MSF] diet; and 145 g/kg DM in the high soluble fibre [HSF] diet). They were obtained by replacing half of the dehydrated alfalfa in the MSF diet with a mixture of beet and apple pulp (HSF diet) or with a mix of oat hulls and soybean protein (LSF diet). Thirty rabbits with ileal T-cannulas were used to determine total tract apparent digestibility (CTTAD) and ileal apparent digestibility (CIAD). Caecal digestibility was determined by difference between CTTAD and CIAD. Insoluble fibre was measured as aNDFom-cp, IDF, and ivDMi2, whereas soluble fibre was calculated as SDFaNDFom-cp, SDFIDF, SDFivDMi2. The intestinal mucin content was used to correct the TDF and soluble fibre digestibility. Ileal and faecal concentration of mucin increased from the LSF to the HSF diet group (P < 0.01). Once corrected for intestinal mucin, The CTTAD and CIAD of TDF and soluble fibre increased whereas caecal digestibility decreased (P < 0.01). The CIAD of TDF increased from the LSF to the HSF diet group (0.12 vs. 0.281. P < 0.01), with no difference in the caecal digestibility (0.264), resulting in a higher CTTAD from the LSF to the HSF diet group (P < 0.01). The CIAD of insoluble fibre increased from the LSF to the HSF diet group (0.113 vs. 0.21. P < 0.01), with no difference in the caecal digestibility (0.139) and no effect of fibre method, resulting in a higher CTTAD for rabbits fed the HSF diet compared with the MSF and LSF diets groups (P < 0.01). The CTTAD of aNDFom-cp was higher compared with IDF or ivDMi2 (P < 0.01). The CIAD of soluble fibre was higher for the HSF than for the LSF diet group (0.436 vs. 0.145. P < 0.01) and fibre method did not affect it. Caecal soluble fibre digestibility decreased from the LSF to the HSF diet group (0.721 vs. 0.492. P < 0.05). The lowest caecal and faecal soluble fibre digestibility was measured using SDFaNDFom-cp (P < 0.01). There was a high correlation among the digestibilities of soluble fibre measured as SDFaNDFom-cp, SDFIDF, and SDFivDMi2. Therefore, these methodologies provide similar information. However, the method that seems to be globally better related to the physiological traits (ileal flow of mucins, and relative weight of the caecum and caecal pH from previous work) was the SDFaNDFom-cp. In conclusion, a correction for intestinal mucin is necessary for ileal TDF and soluble fibre digestibility whereas the selection of the fibre method has a minor relevance. The inclusion of sugar beet and apple pulp increased the amount of TDF fermented in the small intestine. The third study examined the effect of fibre fractions of sugar beet pulp (SBP) and the method for quantifying soluble and insoluble fibre on soluble and insoluble fibre digestibility and digestive traits. Four diets were formulated with similar level of insoluble fibre (aNDFom-cp: 315 g/kg DM) and protein (167 g/kg DM). Control diet contained the lowest level of soluble fibre (30.3 g/kg DM, including sunflower hulls and straw as sole sources of fibre). A second diet was obtained by replacing 60 g starch/kg of control diet with SBP pectins (82.9 g soluble fibre/kg DM). Two more diets were obtained by replacing part of the fibrous sources of the control diet with either insoluble SBP fibre or SBP (42.2 and 82.3 g soluble fibre/kg DM, respectively). Fifty six (14/diet) rabbits weighing 2.40  0.213 kg were used to determine faecal and ileal digestibility of total dietary fibre (TDF), insoluble dietary fibre (IDF), neutral detergent fibre corrected for ash and CP (aNDFom-cp) and soluble fibre estimated as SDFaNDFom-cp and SDFIDF. Faecal and ileal mucin content was used to correct TDF and soluble fibre digestibility. It was also recorded weight of digestive segments and digesta pH. Rabbits fed insoluble SBP showed the lowest feed intake with respect to the other 3 diets (124 vs. 139 g/d, respectively. P < 0.05). Ileal mucin flow was higher (P < 0.05) in animals fed pectin and SBP diets (9.0 g/d, as average) than those fed control diet (4.79 g/d), showing InsSBP group an intermediate value. No differences on mucin content were detected at faecal level. There was no diet effect on the CIAD of TDF (corrected for mucin) and insoluble fibre. Fibre methodology influenced the CIAD of insoluble fibre (0.123 for IDF vs. 0.108 for aNDFom-cp. P < 0.01). Anyway, the amount of insoluble fibre fermented before the caecum did not differ between both methods (4.9 g/d, on average). Rabbits fed insoluble SBP and SBP diets showed the highest CTTAD of insoluble fibre (0.266 on average vs. 0.106 for control group), whereas those fed pectin diet had an intermediate value (0.106. P < 0.001). The CTTAD of insoluble fibre measured with IDF was higher than that measured with aNDFom-cp (by 20%. P < 0.001). It led that the amount of insoluble fibre fermented along the digestive tract were different (9.5 or 7.5 g/d when calculated as IDF or aNDFom-cp, respectively; P < 0.001). When the CIAD of soluble fibre was corrected for mucin they became positive (P < 0.001) except for control group measured as SDFIDF. Once corrected for mucin content, rabbits fed soluble fibre from SBP (pectin and SBP groups) showed higher CIAD of soluble fibre than control group (0.483 vs. -0.019. respectively), whereas the value for insoluble SBP group was intermediate 0.274. The CTTAD of soluble fibre (mucin corrected) was similar among diets 0.93. Rabbits fed with SBP and insoluble SBP diets showed higher total digestive tract and stomach relative weight than those fed pectin and control diets (by 11 and 56 %. respectively, P < 0.05). The caecal relative weight did not differ in rabbits fed pectin, insoluble SBP, and SBP diets (62 g/kg BW, as average) and they were on average 16% higher (P < 0.001) than in control group. Caecal content of rabbits fed SBP diet was more acid than those fed control diet (5.64 vs. 6.03. P < 0.001), whereas those from pectin and insoluble SBP diets showed intermediate values. In conclusion, the positive effect of SBP fibre on ileal mucin flow was due to both its soluble and insoluble fibre fraction. Half of the soluble SBP fibre was degraded before the caecum independently it came from pectin or SBP. The caecal pH correlated better with the ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. The last study examined the effect of soluble and insoluble fibre of apple pulp on fibre digestibility and digestive traits. Four diets were formulated with similar level of insoluble fibre (aNDFom-cp: 324 g/kg DM) and protein (18.6 g/kg DM). Control diet contained the lowest level of soluble fibre (46 g soluble fibre/kg DM, including oat hulls and straw as sole sources of fibre). A second diet was obtained by replacing 60 g starch/kg of control diet with apple pectins (105 g soluble fibre/kg DM). Two more diets were obtained by substituting part of the fibrous sources of the control diet by either apple pulp or depectinized apple pulp (93 and 71 g soluble fibre/kg, respectively). The CTTAD was determined in 23 rabbits/diet weighing 1.68  0.23 kg BW, and 23 rabbits/diet were slaughtered at 60 d of age to collect ileal digesta to determine CIAD and record other digestive traits. Soluble fibre from apple stimulated ileal flow of mucin (P = 0.002), but depectinized apple pulp did not. The correction for mucin increased the digestibility of crude protein, total dietary fibre, and soluble fibre at faecal, but especially at ileal level, depending in this case on the diet. Around half of the soluble fibre in diets containing any fibre fraction from apple was degraded at ileal level, with no differences among these diets (0.46 vs. 0.066 for control group, P=0.046). Faecal soluble fibre digestibility was 0.86 on average for all groups). Inclusion of the apple insoluble fibre improved NDF digestibility at faecal (0.222 vs. 0.069. P < 0.05) but not at ileal level. Caecal content of rabbits fed apple pulp diet was more acid than those fed control diet (5.55 vs. 5.95. P < 0.001), whereas those from pectin and depectinised apple pulp diets showed intermediate values. In conclusion, the positive effect of apple fibre on ileal mucin flow was mainly due to its soluble fibre fraction. Half of the soluble apple fibre was degraded before the caecum independently it came from pectin or apple pulp. The caecal pH correlated better with the total and ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. The results obtained in the studies 2, 3 and 4 were considered together. These results showed that the mucin correction is necessary when the TDF and soluble fibre digestibility is determined, and it correction is more important at ileal level and in diets with low level of soluble fibre. On another hand, incrementing the soluble fibre using sugar beet and apple pulp increased the amount of TDF disappear before the caecum. Moreover, the caecal pH correlated better with the ileal amount of fermented TDF in the digestive tract rather than with that fermented in the caecum. This suggests that an ileal fibre solubilisation may occur rather than ileal fermentation. Therefore the implications of this work were that: the estimation of soluble fibre as SDFaNDFom-cp is an adequate method considering its correlation with the physiological effects; and the TDF and soluble fibre digestibility must be corrected with intestinal mucins, especially when the ileal digestibility is determined.

Purification of ribonucleotide reductase subunits Y1, Y2, Y3, and Y4 from yeast: Y4 plays a key role in diiron cluster assembly

Ribonucleotide reductases (RNRs) catalyze the conversion of nucleotides to deoxynucleotides. Class I RNRs are composed of two types of subunits: RNR1 contains the active site for reduction and the binding sites for the nucleotide allosteric effectors. RNR2 contains the diiron-tyrosyl radical (Y⋅) cofactor essential for the reduction process. Studies in yeast have recently identified four RNR subunits: Y1 and Y3, Y2 and Y4. These proteins have been expressed in Saccharomyces cerevisiae and in Escherichia coli and purified to ≈90% homogeneity. The specific activity of Y1 isolated from yeast and E. coli is 0.03 μmol⋅min−1⋅mg−1 and of (His)6-Y2 [(His)6-Y2-K387N] from yeast is 0.037 μmol⋅min−1⋅mg−1 (0.125 μmol⋅min−1⋅mg−1). Y2, Y3, and Y4 isolated from E. coli have no measurable activity. Efforts to generate Y⋅ in Y2 or Y4 using Fe2+, O2, and reductant have been unsuccessful. However, preliminary studies show that incubation of Y4 and Fe2+ with inactive E. coli Y2 followed by addition of O2 generates Y2 with a specific activity of 0.069 μmol⋅min−1⋅mg−1 and a Y⋅. A similar experiment with (His)6-Y2-K387N, Y4, O2, and Fe2+ results in an increase in its specific activity to 0.30 μmol⋅min−1⋅mg−1. Studies with antibodies to Y4 and Y2 reveal that they can form a complex in vivo. Y4 appears to play an important role in diiron-Y⋅ assembly of Y2.

Propriedades fotoquímicas de alguns complexos de ferro(II) e rênio(I)

Neste trabalho, foram estudadas as propriedades fotoquímica e/ou fotofísica de alguns compostos de coordenação de rênio(l) e ferro(I I). A irradiação dos complexos fac-[Re(CO)3(NN)(trans-L)]+, NN= 4,7-difenil-1,10- fenantrolina (ph2phen) ou 5-cloro-1,10-fenantrolina (Clphen) e L = 1,2-bis(4-piridil)etileno (bpe) ou 4-estirilpiridina (stpy), em acetonitrila ou em filme de poli(metacrilato de metila) (PMMA) resulta em variações espectrais condizentes com a fotoisomerização trans-cis do ligante coordenado. A determinação dos rendimentos quânticos para a fotorreação pela variação espectral resultou em valores aparentes, uma vez que o reagente e o fotoproduto absorvem na mesma região. Para a determinação do rendimento quântico real, Φreal, utilizou-se a técnica de 1H RMN, na qual os sinais do fotoproduto e do reagente são observados em regiões distintas com diferentes constantes de acoplamento. Os valores de Φreal obtidos para fac-[Re(CO)3h(NN)(trans-bpe)]+ (ph2phen: Φ313= 0,43 ± 0,03; Φ365= 0,44 ± 0,02; Φ404= 0,43 ± 0,02; Clphen: Φ313= 0,56 ± 0,03; Φ365= 0,55 ± 0,04; Φ404= 0,57 ± 0,06) são independentes do comprimento de onda de irradiação, indicando a existência de um único canal para a população do estado excitado 3ILtrans-bpe. Por outro lado, para fac-[Re(CO)3(NN)(trans-stpy)]+, os valores de Φreal sob irradiação a 404 nm são menores que os determinados para os demais comprimentos de onda de irradiação (ph2phen: Φ313= 0,60 ± 0,05; Φ365= 0,64 ± 0,09; Φ404= 0,42 ± 0,03; Clphen: Φ313= 0,52 ± 0,05; Φ365= 0,58 ± 0,02; Φ404= 0,41 ± 0,06), indicando que, a energias maiores, em que o Iigante absorve significativamente, deve existir a contribuição de outro canal para a população do estado excitado 3ILtrans-stpy. A eficiência do fotoprocesso foi avaliada por meio da substituição dos ligantes NN e/ou L, e a diferença nos valores de Φreal entre os complexos deve estar relacionada principalmente com as distintas eficiências de cruzamento intersistemas. o fotoprocesso altera as propriedades fotofísicas desses complexos. Os isômeros trans apresentam fraca ou nenhuma emissão a 298 K, enquanto os fotoprodutos, fac-[Re(CO)3(NN)(cis-L)]+, apresentam intensa luminescência dominada pelo estado excitado 3MLCTRe→NN, que é sensivel à rigidez do meio. A reatividade fotoquímica dos pentacianoferratos(II) [Fe(CN)5 (NN)]3-, NN= 2aminobenzilamina (aba), 2-aminobenzamida (ab), 2-(dimetilaminometil)-3-hidroxipiridina (dmampy), 2-aminometilpiridina (ampy), 2-aminoetilpiridina (aepy) ou 2-(2metilaminoetil) piridina (maepy), também foi investigada. A irradiação desses complexos resulta na fotossubstituição do CN-, a qual só pode ser detectada quando o ligante possui um segundo grupo coordenante nas proximidades da esfera de coordenação. Os rendimentos quânticos da fotossubstituição são dependentes do comprimento de onda de irradiação (Φ313= 0,13 ± 0,01; Φ334= 0,091 ± 0,001; Φ365= 0,056 ± 0,002; Φ404= 0,022 ± 0,002; Φ436= 0,015 ± 0,001, por exemplo, para NN = aba) e indicam a existência de canais distintos pelos quais a fotorreação ocorre ou as diferentes eficiências de cruzamento intersistema para a população do estado excitado reativo. A eficiência do fotoprocesso também depende do Iigante utilizado (λirr= 365 nm: Φaba= 0,056, Φab= 0,14, Φampy= 0,046, Φaepy= 0,066, Φmaepy= 0,069 e Φdmampy= 0,12). Na série das diaminas, o rendimento quântico é maior para [Fe(CN)5(ab)]3-, que possui dois sítios para ocorrer o fechamento do anel. Na série das aminopiridinas, observa-se a influência do comprimento da cadeia na eficiência do fechamento do anel. A presença de metilas ligadas ao nitrogênio alifático deve ter pouca ou nenhuma influência na eficiência do fotoprocesso.

Alkenones and SST of surface sediments (Appendix)

We have analysed alkenones in 149 surface sediments from the eastern South Atlantic in order to establish a sediment-based calibration of the U37K' paleotemperature index. Our study covers the major tropical to subpolar production systems and sea-surface temperatures (SST's) between 0° and 27°C. In order to define the most suitable calibration for this region, the U37K' values were correlated to seasonal, annual, and production-weighted annual mean atlas temperatures and compared to previously published culture and core-top calibrations. The best linear correlation between U37K' and SST was obtained using annual mean SST from 0 to 10 m water depth (U37K' = 0.033 T + 0.069, r**2 = 0.981). Data scattering increased significantly using temperatures of waters deeper than 20 m, suggesting that U37K' reflects mixed-layer SST and that alkenone production at thermocline depths was not high enough to significantly bias the mixed-layer signal. Regressions based on both production-weighted and on actual annual mean atlas SST were virtually identical, indicating that regional variations in the seasonality of primary production have no discernible effect on the U37K' vs. SST relationship. Comparison with published core-top calibrations from other oceanic regions revealed a high degree of accordance. We, therefore, established a global core-top calibration using U37K' data from 370 sites between 60°S and 60°N in the Atlantic, Indian, and Pacific Oceans and annual mean atlas SST (0-29°C) from 0 m water depth. The resulting relationship (U37K' = 0.033 T + 0.044, r**2 = 958) is identical within error limits to the widely used E. huxleyi calibrations of and attesting their general applicability. The observation that core-top calibrations extending over various biogeographical coccolithophorid zones are strongly linear and in better accordance than culture calibrations suggests that U37K' is less species-dependent than is indicated by culture experiments. The results also suggest that variations in growth rate of algae and nutrient availability do not significantly affect the sedimentary record of U37K' in open ocean environments.

Survey bottom trawl data of Micromesistius poutassou (blue whiting) in Bay of Biscay and Celtic Sea from the EVHOE time series (1997-2011)

Data were collected during various groundfish surveys carried out by IFREMER from October to December between 1997 and 2011, on the eastern continental shelf of the Bay of Biscay and in the Celtic Sea (EVHOE series). The sampling design was stratified according to latitude and depth. A 36/47 GOV trawl was used with a 20 mm mesh codend liner. Haul duration was 30 minutes at a towing speed of 4 knots. Fishing was restricted to daylight hours. Catch weights and catch numbers were recorded for all species and body size measured. The weights and numbers per haul were transformed into abundances per km**2 by considering the swept area of a standard haul (0.069 km**2).

Evaluation of a One-Day Meditech Magic Training Program for Registered Nurses and Licensed Practical Nurses in a long term care program

Background: An evaluation was completed on the One-Day Meditech Magic Training Program for Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) developed for the Long Term Care (LTC) Program. Methods: Both a literature review and consultation with stakeholders were completed to determine possible evaluation methods, expected outcomes, and ways to measure the effectiveness of the education program. A pretest/posttest design and questionnaire were chosen as the evaluation tools for this project. Results: No significant difference was found between the pretest and posttest total scores indicating that learners retained information from the orientation session (Z = -1.820, p = 0.069). Additional Wilcoxon matched-pairs signed rank tests were performed on the individual sections of the tests and revealed a significant decrease in the posttest scores for entering a Diagnostic Imaging requisition (Z = -1.975, p = 0.048). No other significant findings were present. Questionnaires were also analyzed revealing that most participants were pleased with the Meditech documentation education they received and did not indicate barriers that would affect electronic documentation. Conclusions: Further testing is required to ensure reliability and validity of the evaluation tools. Finally, caution is needed due to a small sample size. However, problematic documentation tasks were identified during the evaluation, and as a result both the training session and support materials will be improved as a result of this project.