A catalogue of PROMs in sports science: Quality assessment of PROM development and validation.

Choosing the most adequate PROM for a study is a non-trivial process. The aim of this study was to provide a catalogue with analyses of content and construct validity of PROMs relevant to research in sports science, including all published local translations. The most commonly used PROMs in sports research were selected from a PubMed search "patient reported outcome measures sports", identifying 439 articles and 194 different PROMs. Articles describing development of the 61 selected PROMs were assessed for content validity, and all articles regarding construct validity of each PROM and all published translations (in total 622 articles) were analyzed. A catalogue with assessments of the 61 PROMs was produced. The majority were of inferior validity, with few exceptions. The most common reason for this was that the PROM had not been developed by methods that ensure high content validity. Another major reason for inferior validity was that construct validity had not been secured by adequate statistical methods. In conclusion, this catalogue provides a tool for researchers to facilitate choosing the most valid PROM for studies in sports research. Furthermore, it shows for popular PROMs where further validation is needed, and for fields in musculoskeletal medicine where valid PROMs are lacking. It is suggested that a targeted effort is made to develop valid PROMs for major conditions in musculoskeletal research. The current method is easier to practice compared with assessment after COSMIN guidelines.

Reduction in Diarrhoea and Modulation of Intestinal Gene Expression in Pigs Allocated a Low Protein Diet without Medicinal Zinc Oxide Post-Weaning.

Weaning comprises a challenging period for pigs, but dietary tools can be implemented to avoid excess antibiotics usage. Therefore, we tested the effect of a 17.6% crude protein (CP) diet on growth and diarrhoea and investigated the effect of a 15.5% CP diet post-weaning on transcriptomic responses, growth, and diarrhoea-related antibiotic treatments. At weaning, pigs were divided into five dietary treatment groups in a three-phase diet from weaning to 30 kg bodyweight. The diets included a positive control group (PC) with medicinal zinc oxide, a negative control group (NC), a 17.6% CP diet based on soy protein concentrate (SP), a 17.6% CP diet based on soybean meal (SB), and a 15.5% CP diet with additional amino acids (XLA). Growth performance and the occurrence of diarrhoea were similar between the SP and SB groups. The XLA pigs had a reduced weight gain and fewer antibiotics treatments caused by diarrhoea, as well as a reduced level of blood proteins. Intestinal tissue samples from the XLA pigs displayed decreased expression of genes involved in nutrient metabolism and immune responses relative to the PC group. In conclusion, a very low CP diet reduces antibiotics treatments, but also adapts gut nutrient metabolism and reduces growth performance.

A high dietary concentration of inulin is necessary to reduce the incidence of swine dysentery in pigs experimentally challenged with Brachyspira hyodysenteriae.

A total of sixty surgically castrated male pigs (Large White × Landrace) weighing 31·2 (sd 4·3) kg were used in a randomised block experiment to examine the effect of added dietary inulin (0, 20, 40 and 80 g/kg) on the occurrence of swine dysentery (SD) and on fermentation characteristics in the large intestine after experimental challenge with the causative spirochaete Brachyspira hyodysenteriae. The pigs were allowed to adapt to the diets for 2 weeks before each pig was challenged orally four times with a broth culture containing B. hyodysenteriae on consecutive days. Increasing dietary levels of inulin linearly (P = 0·001) reduced the risk of pigs developing SD; however, eight out of fifteen pigs fed the diet with 80 g/kg inulin still developed the disease. The pH values in the caecum (P = 0·072) tended to decrease, and in the upper colon, the pH values did decrease (P = 0·047) linearly with increasing inulin levels in the diets, most probably due to a linear increase in the concentration of total volatile fatty acids in the caecum (P = 0·018), upper colon (P = 0·001) and lower colon (P = 0·013). In addition, there was a linear reduction in the proportion of the branched-chain fatty acids isobutyric acid and isovaleric acid in the caecum (P = 0·015 and 0·026) and upper colon (P = 0·011 and 0·013) with increasing levels of dietary inulin. In conclusion, the present study showed that a diet supplemented with a high level of inulin (80 g/kg) but not lower levels reduced the risk of pigs developing SD, possibly acting through a modification of the microbial fermentation patterns in the large intestine.

A Very Low CP Level Reduced Diarrhoea and Productivity in Weaner Pigs, but No Differences between Post-Weaning Diets Including Soybean Meal or Soy Protein Concentrate Were Found.

Soy protein concentrate improves nutrient utilization and growth performance compared to soybean meal, and diets with a low crude protein (CP) level decreases diarrhoea. The objectives were to (1) test a low CP diet based on different soy products, and (2) to test a very-low CP diet (15.1%) with amino acids (AA) on diarrhoea and productivity. A total of 5,635 weaned pigs (~28 days), were assigned to five dietary treatments; PC (positive control): Standard CP levels (192, 189, 191 g/kg CP) with 2500 ppm ZnO; NC (negative control): Same as PC without ZnO; SP (Soy protein concentrate): Low CP levels (176, 174, 191 g/kg CP); SB (Soybean meal): Low CP levels (177, 176, 191 g/kg CP); and XLA (X-low CP + AA): Very low CP levels (154, 151, 191 g/kg CP) with AA. The PC and XLA diets reduced diarrhoea by 41 and 61%, respectively, compared to the NC group, while no difference between SB and SP were observed. The XLA diet reduced feed intake and daily gain compared with PC and NC, where SP, SB, and XLA had a poorer feed conversion compared with PC. Conclusively, the SP and SB low-protein diets did not reduce diarrhoea or growth performance, whereas the XLA diet decreased both diarrhoea and performance.

The Stomach Capacity is Reduced in Intrauterine Growth Restricted Piglets Compared to Normal Piglets.

Selection for increased litter sizes have decreased the average birth weight of piglets and up to 30% of newborn piglets in Danish herds show signs of intrauterine growth restriction (IUGR). It has been reported that around 48% of liveborn piglets dying between birth and weaning have empty stomachs, and that IUGR piglets do not ingest the recommended amount of colostrum to survive. The aim of this study was to investigate how much colostrum could be administrated depending on whether they were IUGR compared to normal piglets. Seventy-two piglets within 24 h of farrowing were classified as either IUGR or normal based on their head morphology. Stomach weight, length and capacity were measured along with bodyweight (BW). The results displayed a decreased BW, empty stomach weight and capacity in IUGR piglets, as well as a decreased relative stomach capacity in IUGR compared with normal piglets. In conclusion, birth weight is not the only factor influencing stomach capacity, and IUGR piglets have a smaller stomach capacity compared with normal piglets. It is estimated that IUGR piglets have the capacity to be given a bolus of 25 mL per kg/BW, whereas a normal piglet have a higher capacity (30 mL per kg/BW).

Decreasing dietary particle size of lupins increases apparent ileal amino acid digestibility and alters fermentation characteristics in the gastrointestinal tract of pigs.

Two experiments were conducted to examine the effects of lupin particle size on amino acid (AA) and energy digestibility and fermentation characteristics in pigs. Expt 1 examined the effects of lupin variety (cv. Tanjil and Mandelup) and lupin particle size (746, 888, 1099 and 1136 mum) on the total-tract apparent digestibility of dietary components in 63.5 (sd 7.28) kg pigs. While variety had no effect on total-tract apparent digestibility, decreasing particle size of lupins linearly increased total-tract apparent digestibility of crude protein of diets containing 350 g lupins per kg (P < 0.01). Expt 2 examined the effect of lupin particle size (567, 995, 1198, 1250 and 1304 mum) on digestion and fermentation characteristics in 29.8 (sd 2.9) kg pigs. Pigs were fed the respective diets ad libitum for the first 2 weeks and fed at three times maintenance energy level in the third week. Pigs were euthanised under sedation at 46.7 (sd 4.21) kg to collect digesta samples along the intestinal tract. Decreasing particle size increased apparent ileal and total-tract digestible N (P < 0.01) and the apparent and standardised ileal digestible AA content (P < 0.05- < 0.001) of lupins. Decreasing particle size of lupins linearly decreased the molar proportion of straight-chain volatile fatty acids (sum of acetic, propionic and butyric acids; VFAAPB), while branched-chain fatty acids (sum of valeric, caproic, isobutyric and isovaleric acids) were linearly increased (P < 0.001). The results demonstrated that particle size of lupins is a critical factor influencing nutrient, especially AA, utilisation efficiency and fermentation characteristics in the gastrointestinal tract of pigs.

Effect of dietary supplementation with inulin and/or benzoic acid on the incidence and severity of post-weaning diarrhoea in weaner pigs after experimental challenge with enterotoxigenic Escherichia coli.

The purpose of this study was to evaluate the effects of feeding pigs with inulin and/or benzoic acid on post-weaning diarrhoea (PWD), indices of fermentation in the gastrointestinal tract, and production in pigs experimentally infected with an enterotoxigenic strain of Escherichia coli (ETEC). Forty-eight entire male pigs (Large White×Landrace) aged 21 ± 3 days of age and weighing 4.97 ± 0.08 kg (mean ± SE) were used in a 2×2 factorial experiment, with the respective factors being inulin (0 versus 8%) and benzoic acid (0 vs. 0.5%). Feeding inulin-supplemented diets improved (p = 0.022) the faecal consistency (FC) and reduced (p = 0.001) the incidence of PWD; however, the use of benzoic acid had no effects on PWD or faecal ETEC shedding. Wet faeces (a higher FC score) were associated with increased faecal ETEC shedding (R(2) = 0.394, p = 0.001). Inulin reduced the total concentrations of short chain fatty acids (p = 0.029) in the proximal colon. The total concentration of lactic acid was increased by inulin in the caecum (p = 0.007) and proximal colon (p = 0.002). Feeding inulin or benzoic acid had no effects on production after weaning.

Glucose Injections at Birth, Warmth and Placing at a Nurse Sow Improve the Growth of IUGR Piglets.

Intrauterine growth-restricted piglets (IUGR) have a lower rectal temperature, whole-blood glucose, and lower glycogen storages at birth than normal piglets, giving them less energy to maintain body temperature and compete at the udder. The present paper investigated the effects of giving an energy supplementation three times after birth on rectal temperature, glucose levels, and growth until weaning in an on-farm trial. Eighty-eight newborn piglets were classified as IUGR (based on head morphology), placed under a heating lamp for one hour and allocated to one of four treatments-warmed water (WATER), glucose injection (GLUC), colostrum bolus (COLOS; porcine colostrum), and colostrum bolus and glucose injection (GLUC + COLOS)-before being placed at a nursing sow. Weight differences were found at day 21, with GLUC and GLUC + COLOS groups being the heaviest. Piglets in GLUC + COLOS had higher glucose levels at t = 3, 6, and 9 h compared to the other treatments (p = 0.027), but from t = 24 h and onwards, no difference was observed. For rectal temperature, no differences were observed. Collectively, these findings suggest that glucose injections at birth (i.e., as an energy source), one hour's exposure to warmth and the placement of piglets with a nurse sow to reduce competition, enhance the growth of IUGR piglets.

Dietary stimulation of the endogenous somatotropic axis in weaner and grower-finisher pigs using medium chain triglycerides and cysteamine hydrochloride.

BACKGROUND: Three experiments were conducted to examine the overall hypothesis that addition of medium chain triglycerides (MCT) and cysteamine hydrochloride (CSH) into the diets of young and growing pigs would stimulate the endogenous somatotropic axis to improve growth and performance. RESULTS: In Experiment 1, weaner pigs were given either a 5 d dietary supplement of 5 % MCT (n = 8) or a control diet (n = 8). MCT increased the plasma concentration of growth hormone (GH; P < 0.05) and the GH secretagogue, ghrelin (P < 0.05). Additionally, the MCT treatment reduced scouring (P < 0.05), maintained villous height in the small intestine (P < 0.05) and stabilised daily weight gain (P < 0.05), compared to the controls. Experiment 2 compared the effects of 4 levels (0, 1, 3 and 6 % v/v) of MCT supplementation in grower-finisher male pigs, of approximately 35 kg live weight (n = 15 per treatment). Blood samples taken after 7 wk of treatment showed that the MCT supplementation increased circulating ghrelin (P < 0.001), GH (P < 0.01) and insulin (P < 0.05) concentrations in a dose-dependent manner. Daily weight gain, feed intake and feed conversion ratio were not affected by the MCT diets. In Experiment 3, 64 female pigs of approximately 60 kg live weight were allocated to one of three dietary treatments: control (n = 20); 6 % MCT (n = 21); and 70 mg/kg CSH (n = 21). After 3 wk of supplementation, the MCT treated pigs had a higher plasma concentration of ghrelin compared to the control and CSH pigs (P < 0.05). Plasma concentrations of GH and weight were not affected by any of the dietary treatments. CONCLUSIONS: Evidence is provided in Experiment 1 to support the use of dietary MCT supplements, perhaps acting via stimulation of somatotropic endocrine pathways, to minimise weaning-associated disorders such as slowing of growth and diarrhoea. In Experiments 2 and 3, although there was no effect on weight gain or feed conversion ratio in either experiment, MCT and CSH increased endocrine components of the somatotropic axis.

Malnutrition induces gut atrophy and increases hepatic fat infiltration: studies in a pig model of childhood malnutrition.

Childhood malnutrition is a problem in developing countries, and pathological changes in digestive organs such as the intestine and liver are poorly understood. An animal model to study the progression of severe acute malnutrition could elucidate pathological changes in the intestine and liver. We sought to characterize growth and clinical changes during malnutrition related to structural and functional indices in the intestine and liver. Newly weaned piglets were given ad libitum access to a maize flour diet (MAIZE, n=9) or a nutritionally optimized reference diet (REFERENCE, n=12) for 7 weeks. Growth, hematology and clinical biochemistry where recorded weekly. After 7 weeks, the MAIZE pigs had lower body weights than the REF pigs (8.3 kg vs. 32.4 kg, P < 0.001), indicating severe stunting and moderate to severe wasting. This was paralleled by lower values for hematocrit, hemoglobin and mean cell volume in MAIZE vs. REFERENCE (P < 0.01), indicating anemia. Although the observed temporal changes in MAIZE were associated with atrophy of the small intestinal mucosa (P < 0.001), digestive enzyme activity was only marginally reduced. Serum alanine aminotransferase, bilirubin and albumin were increased in the MAIZE pigs (P < 0.001), and the liver had a vacuolated appearance and tendency toward increased triglyceride content (P=0.054). We conclude that liver and intestinal indices are compromised during malnutrition and are associated with temporal changes in growth and hematological and biochemical endpoints. The pig model is relevant for malnourished infants and can act as a valuable tool for understanding the pathophysiology of malnutrition.