The beta thalassaemia trait in Jamaica.

The objective of this study was to review the prevalence and features of the beta thalassaemia trait in Jamaican populations. Screening of 221,306 newborns over the last 46 years has given an indication of the distribution and prevalence of beta thalassaemia genes, and screening of 16,612 senior school students in Manchester parish, central Jamaica, has provided their haematological features. The prevalence of the beta thalassaemia trait predicted from double heterozygotes was 0.8% of 100,000 babies in Kingston, 0.9% of 121,306 newborns in southwest Jamaica, and 0.9% of school students in Manchester. Mild beta+ thalassaemia variants (-88 C>T, -29 A>G, -90 C>T, polyA T>C) accounted for 75% of Kingston newborns, 76% of newborns in southwest Jamaica, and 89% of Manchester students. Severe beta+ thalassaemia variants were uncommon. Betao thalassaemia variants occurred in 43 patients and resulted from 11 different variants of which the IVSII-849 A>G accounted for 25 (58%) subjects. Red cell indices in IVSII-781 C>G did not differ significantly from HbAA, and this is probably a harmless polymorphism rather than a form of beta+ thalassaemia; the removal of 6 cases in school screening had a minimal effect on the frequency of the beta thalassaemia trait. Red cell indices in the beta+ and betao thalassaemia traits followed established patterns, although both were associated with increased HbF levels. The benign nature of beta+ thalassaemia genes in Jamaica means that cases of sickle cell-beta+ thalassaemia are likely to be overlooked, and important clinical questions such as the role of pneumococcal prophylaxis remain to be answered.

The haematology of Jamaicans: red cell indices in HbAA, HbAS, HbAC, and HbA-HPFH genotypes.

Based in the parish of Manchester in central Jamaica, the Manchester Project offered free detection of haemoglobin genotype to senior classes in 15 secondary schools between 2008 and 2013. Restricting the database to 15,103 students aged 15.0-19.9 years provided an opportunity to examine the red cell characteristics of the different haemoglobin genotypes, including normal (HbAA) in 85.0%, the sickle cell trait (HbAS) in 9.7%, HbC trait (HbAC) in 3.5% and hereditary persistence of foetal haemoglobin (HbA-HPFH) in 0.4%. Compared to the normal HbAA phenotype, HbAS had significantly increased mean cell haemoglobin concentration (MCHC), red cell count (RBC), and red cell distribution width (RDW) and decreased mean cell volume (MCV) and mean cell haemoglobin (MCH), these differences being even more marked in HbAC. Compared to HbAA, the HbA-HPFH had significantly increased RDW, but there were no consistent differences in other red cell indices, and there were no significant differences in haematological indices between the two common deletion HPFH variants, HPFH-1 and HPFH-2. Although these changes are unlikely to be clinically significant, they contribute to an understanding of the haematological spectrum of the common haemoglobin genotypes in peoples of African origin.

Utilization of Observational Data as a Proxy Cohort for Comparison Purposes with Open-Label Study Results: An Example from Alzheimer's Disease.

BACKGROUND: Randomized placebo-controlled trials in the development of disease-modifying treatments for Alzheimer's disease are typically of short duration (12-18 months), and health economic modeling requires extrapolation of treatment effects beyond the trial period. OBJECTIVES: To investigate whether observational data can be used to extrapolate data from open-label trials, we compared outcomes (cognition, function, behavior) over 36 months for patients with mild Alzheimer's disease dementia in the GERAS observational study (proxy for placebo control) with those of the mild Alzheimer's disease population on active treatment (solanezumab) in two 18-month randomized placebo-controlled trials (EXPEDITION and EXPEDITION2) and the additional 18-month open-label extension study (EXPEDITION-EXT). DESIGN AND SETTING: Analysis of longitudinal data from patients with mild Alzheimer's disease dementia in the GERAS observational study (conducted in France, Germany and the United Kingdom) and the EXPEDITION program (conducted in Europe, North America, South America, Asia and Australia). PARTICIPANTS: European and North American community-living patients, aged ≥55 years, with probable Alzheimer's disease dementia and their caregivers. Mild Alzheimer's disease dementia was defined as a Mini-Mental State Examination score of 20-26 in EXPEDITION and 21-26 in GERAS. INTERVENTION: Active treatment in both randomized placebo-controlled trials and the open-label extension study was intravenous solanezumab 400 mg every 4 weeks. Patients in GERAS were receiving treatment as part of standard care. MEASUREMENTS: Between-group differences for changes from baseline over 36 months in cognitive function, ability to perform activities of daily living, and behavioral and psychological symptoms of dementia were assessed using models stratified by propensity score. RESULTS: At baseline, patients and caregivers participating in GERAS were significantly older than those in the EXPEDITION studies, and the GERAS patient cohort had fewer years of education and a shorter time since diagnosis of Alzheimer's disease. The baseline mean Mini-Mental State Examination score of the GERAS cohort was significantly higher (indicating better cognition) than that of patients receiving placebo or active treatment in the pooled EXPEDITION studies Baseline functional ability scores were significantly lower for the GERAS cohort, indicating poorer functioning. Propensity score stratification achieved a good balance in the baseline variables between GERAS and the two EXPEDITION arms. Over 18 months, least squares mean changes from baseline in outcome measures were similar in the GERAS cohort and the pooled placebo groups from the randomized controlled trials. Also, the 18-month results for the comparison between the GERAS cohort and the pooled active treatment groups from the randomized controlled trials were generally similar to those reported for the comparison with the control group in the randomized trial. Comparison of active treatment (EXPEDITION-EXT) and observational study (GERAS, as proxy control) results over 36 months of the open-label trial showed a significantly smaller decline in activities of daily living (instrumental and basic) in the active treatment group, reflecting better functioning, but no between-group differences at 36 months for cognitive function or behavioral and psychological symptoms of dementia. CONCLUSIONS: Comparing results from clinical trials and observational studies (real-world data) may be a useful methodological approach for informing long-term outcomes in Alzheimer's disease drug development and could be used to inform health economic modeling. Further research using this methodological approach is needed.

Newborn Screening for Sickle Cell Disease: Jamaican Experience.

OBJECTIVES: To review the history of newborn screening for sickle cell disease with especial reference to Jamaica. METHODS: A summary was done of the history, the development of associated laboratory technology and the implementation of newborn screening for sickle cell disease in Jamaica. RESULTS: Screening was initiated at Victoria Jubilee Hospital, Kingston from 1973-1981, reactivated in 1995 and extended to the University Hospital of the West Indies in 1997 and to Spanish Town Hospital in 1998. From August 2008, there was a progressive recruitment of 12 hospitals in the south and west of Jamaica which has raised the frequency of islandwide newborn coverage from 25% in 1973 to 81%. The results of this extended programme in southwest Jamaica are presented. Dried blood spots collected from the umbilical cord proved stable, cheap and efficient; mean sample collection rates were 98%, maternal contamination occurred in < 1% and caused diagnostic confusion in < 0.1%. By March 31, 2015, a total of 54 566 births have been screened, detecting 161 with homozygous sickle cell (SS) disease, 125 with sickle cell-haemoglobin C (SC) disease and 36 with sickle cell-beta thalassaemia. Of the 327 babies with clinically significant sickle cell syndromes, all except five who died within seven days of birth were confirmed by four to six weeks and recruited to local sickle cell clinics. CONCLUSION: Early detection of sickle cell disease and recruitment to clinics is known to reduce its morbidity and mortality. The methods currently detailed provide an effective and economic model of newborn screening which may be of value elsewhere.

Excess health care costs of obesity in adults with diabetes mellitus: a claims data analysis.

BACKGROUND: Body weight management is a key factor in diabetes mellitus. However, both behavioral and pharmacological innovations to manage obesity may imply additional costs. In order to provide further insights into the role of obesity in diabetes-associated resource consumption, this study aims to estimate incremental costs of concomitant obesity in German adult patients (≥ 18 years) with different types of diabetes. METHODS: Adopting a third-party payer perspective, claims data from a German statutory sickness fund (N=1,094,496) were analyzed for costs of annual drug prescriptions and out- and inpatient care in adult beneficiaries with diabetes in 2004. Using diagnostic information, 37,570 beneficiaries with diabetes were identified. Concomitant obesity was assessed by ICD-10-codes (E66) in the claims data. Adjusting for sex, age, and micro- and macro-vascular complications, one generalized gamma regression model with the log link was performed for type 2 diabetes patients (N=24,562), type 1 diabetes patients (N=5,663), and an unclassified group (N=7,345), respectively. RESULTS: Overall, 33% of the patients with diabetes were identified as obese (type 2 diabetes: 34%, type 1 diabetes: 20%, unclassified: 38%). Affirming descriptive analyses, the generalized gamma regression models revealed that obesity is associated with significant increments in health care costs regardless of type of diabetes (type 2 diabetes: € 454, type 1 diabetes: € 812, unclassified: € 532). The interaction of obesity and macro-vascular complications was numerically stronger in type 1 than in type 2 diabetes but reached statistical significance only in type 2 diabetes (and the unclassified group). Moreover, concurrent macro- and micro-vascular complications were associated with higher incremental costs in all groups. CONCLUSIONS: Concomitant obesity is independently associated with incremental health care costs in adult patients with type 2 diabetes and, even more so, type 1 diabetes. Results are discussed with respect to the fact that in this sample, concurrent micro- and macro-vascular complications were more frequent in type 1 diabetes. At any rate, in light of these health care costs, obesity seems relevant in both types of diabetes. Due to claims data limitations, it was not possible to distinguish obesity classes based on body height and weight information. Further research should identify adiposity thresholds for increased resource consumption using both primary and secondary data.

Evaluation of exenatide vs. insulin glargine in type 2 diabetes: cost-effectiveness analysis in the German setting.

OBJECTIVES: The objective of this analysis was to determine the cost-effectiveness of exenatide vs. insulin glargine in patients with type 2 diabetes failing to achieve glycaemic control with oral antidiabetic agents, in the German setting, from a third-party payer perspective. METHODS: Data from a published randomized controlled trial were used in combination with a published, validated computer simulation model of type 2 diabetes to project clinical and cost outcomes over a time horizon of 10 years. Cost data were obtained from published literature and expert opinion. Clinical and cost outcomes were discounted at 5% per annum. Sensitivity analyses were performed to establish key drivers and parameters. RESULTS: Treatment with exenatide compared with insulin glargine was projected to be associated with improvements in life expectancy of 0.016 years and quality-adjusted life expectancy of 0.280 quality-adjusted life years (QALYs), increased lifetime direct medical costs of euro 3854 (euro 22 095 vs. euro 18 242) and an incremental cost-effectiveness ratio (ICER) of euro 13 746 per QALY. If quality of life was not taken into account, exenatide was associated with an ICER of euro 238 201 per life year gained vs. insulin glargine. Sensitivity analyses revealed that outcomes were most sensitive to changes in assumptions for (dis)utility values relating to weight change and the rate of self-monitored blood glucose testing. CONCLUSIONS: Exenatide was projected to be associated with similar clinical outcomes and increased costs compared with insulin glargine. Analysis of cost-effectiveness from a third-party perspective suggests that exenatide is likely to represent good value for money in the German setting.

Longitudinal change in HbA1c in patients with type 2 diabetes: comparison of short-acting, biphasic and basal insulin.

OBJECTIVE: To evaluate the annual change in HbA1c values among patients with type 2 diabetes in primary care practices comparing different insulin regimens. RESEARCH DESIGN AND METHODS: Longitudinal data from 666 nationwide general and internal medicine practices in Germany (Disease Analyser, IMS HEALTH) from 7/2004 to 6/2006 were analysed, including 348 patients (mean age+/-SD: 61+/-11 years) with continuous short-acting (regular insulin or analogues), 1 906 with biphasic (72+/-9 years), 439 with basal-bolus (68+/-10 years), and 1 719 with basal insulin therapy (65+/-10 years). The mean of the individual relative changes in HbA1c (level in 2006 divided by level in 2005) were compared between insulin groups, adjusting for age, sex, BMI, diabetes duration, oral antidiabetics, comorbidity, health insurance, visits, hospitalisations, and practice type using general linear models. RESULTS: There was only a small difference in baseline HbA1c values (range 7.3-7.5%) between the four insulin groups (p=0.008). Substantial group differences were observed for age, diabetes duration, and additional prescriptions of oral antidiabetics (p<0.0001). After adjusting for potential confounders, the relative annual increase in HbA1c was highest for biphasic insulin (1.021; 95%CI 1.016-1.025), followed by basal-bolus therapy (1.017; 1.012-1.022), and basal insulin (monotherapy) (1.012; 1.002-1.021). No significant change in HbA1c was found for short-acting insulin (1.006; 0.996-1.016). CONCLUSIONS: Although many options for insulin therapy are now available, a progression of glycemia still occurs in the majority of insulin-treated type 2 diabetic patients in primary care.

[Overall burden to society caused by hyperkinetic syndrome (HKS) and attention deficit hyperactivity disorder (ADHD)]. / Die gesamtgesellschaftliche Belastung durch die hyperkinetische Störung (HKS) bzw. Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS).

OBJECTIVE: The purpose of this work was to provide an analysis of medical costs for HKS/ADHD on the basis of a cost-of-illness study. METHODS: A systematic literature review concerning the direct and indirect costs of HKS/ADHD and its related implications was complemented by a special analysis of the German Federal Office of Statistics on ICD-10 F 90. RESULTS: An analysis of overall medical costs by the Federal Office of Statistics results in expenses of 142 million euro in 2002 corresponding to ca. 630 euro per patient per year. These values are considerably below the values calculated for the USA. Increased indirect costs related to different implications of the indication were stated in international studies. CONCLUSION: A first estimate of the direct costs for HKS/ADHS in Germany has been conducted. A reduction of the difference between the German and the US direct cost values may be expected. An increased level of the indirect costs related to HKS/ADHD may be assumed for Germany and requires further research.

Direct costs and health-related resource utilisation in the 6 months after insulin initiation in German patients with type 2 diabetes mellitus in 2006: INSTIGATE study.

OBJECTIVE: To assess direct costs and describe resource utilisation associated with the first 6 months of insulin therapy in German patients with type 2 diabetes mellitus (DM). RESEARCH DESIGN AND METHODS: This is an ongoing pan-European, non-interventional, prospective study observing the normal course of diabetes therapy of adult patients with type 2 DM in a diabetologic practice setting, and initiating insulin therapy in 2006. Diabetes therapy 6 months prior to initiation of insulin therapy was assessed retrospectively. For German patients (n = 256), direct costs associated with health-care resource utilisation prior to and after the insulin initiation were assessed and compared from the German statutory health insurance perspective. RESULTS: The percentage of patients using blood glucose monitoring increased from 76.4 to 99.6%; 42.1% of patients remained on oral anti-diabetic medication, with metformin used most frequently (36.5%). Total average cost of resource use related to diabetes care per patient for the 6-month period prior to and 6 months after insulin initiation increased from Euro 579 to Euro 961. Mean total costs of diabetes care during 6 months after insulin initiation in the subgroup of obese patients with worse prognosis at baseline (HbA(1c)> or = 7.5% and BMI > or = 30 kg/m(2)) were Euro 1047 [95% CI 965; 1128] vs. Euro 903 [95% CI 840; 965] in other patients. CONCLUSIONS: Resource utilisation and costs related to diabetes increased in the 6 months following insulin initiation, mainly driven by specialist care resource use, insulin, and blood glucose monitoring. Total direct costs of diabetes care of the patients with a less favourable profile of BMI and HbA(1c) at baseline are higher compared to other patients.

The economic burden of nephropathy in diabetic patients in Germany in 2002.

OBJECTIVE: The objective was to describe the resource use and costs due to predefined stages of nephropathy in diabetic patients and to evaluate its economical impact in Germany. DESIGN AND METHODS: In this retrospective, observational study information about socio-demographics, clinical characteristics and resource use on adult type 1 and type 2 patients with nephropathy in diabetic patients were collected from 23 general practitioners, 10 internists and 24 diabetologists, who were randomly selected from a physicians' database. Based on these results average costs per patient were evaluated for each complication stage from the societal perspective and the perspective of the health insurance. RESULTS: The costs due to nephropathy in diabetic patients increase dramatically with the progression of the disease. The main cost drivers were dialysis and hospitalization which accounted for 68% of the total costs due to nephropathy in diabetic patients. The total estimated costs related to nephropathy in diabetic patients were euro1332 (from the perspective of the health insurance) and euro2019 from the societal perspective. CONCLUSION: Patients at high risk should be identified as early as possible and intensive diabetic case management should be provided to them to prevent or decelerate the expensive complications of nephropathy in diabetic patients.

Cross-sectional analysis of adult diabetes type 1 and type 2 patients with diabetic microvascular complications from a German retrospective observational study.

OBJECTIVE: To obtain epidemiological data on the prevalence of predefined stages of diabetic microvascular complications from a representative cross-section of patients with existing microvascular complications of type 1 or type 2 diabetes in Germany. RESEARCH DESIGN AND METHODS: A cross-sectional, retrospective study of medical records of 705 type 1 and 1910 type 2 adult diabetic patients with a diagnosis of retinopathy and/or peripheral neuropathy and/or nephropathy before 2002 and treated in 2002 in Germany. RESULTS: Of 376 patients with type 1 diabetes having retinopathy, 59.3% had mild or moderate non-proliferative retinopathy without macular oedema, 27.1% had macular oedema, and 13.6% had severe retinopathy without macular oedema. In 862 patients with type 2 diabetes, the distribution of retinopathy/maculopathy classes was 56.8%, 35.5%, and 7.7%, respectively. Of 381 type 1 diabetes patients with observed peripheral neuropathy, 81.4% had sensorimotor neuropathy, 8.9% had diabetic foot conditions, and 9.7% had lower extremity amputations because of diabetes. In 1005 patients with type 2 diabetes, the distribution of neuropathy classes was 78.2%, 12.1%, and 9.7%, respectively. The proportions of patients with renal insufficiency in type 1 and type 2 diabetes groups were 15.3% versus 13.5%, respectively. CONCLUSIONS: The study suggests that there are considerable proportions of patients with progressive stages of microvascular complications related to type 1 and type 2 diabetes in Germany. This underlines the importance of improvement of optimal quality of care and frequent screening for preventing late diabetic microvascular complications and the necessity of effective intervention strategies to tackle this major public health problem.

KORA--a research platform for population based health research.

KORA (Cooperative Health Research in the Region Augsburg) is a regional research platform for population-based surveys and subsequent follow-up studies in the fields of epidemiology, health economics, and health care research. KORA was established in 1996 to continue and expand the MONICA project in Augsburg, including the Acute Myocardial Infarction (AMI) Registry. The available pool of study participants allows for cohort, case-control and family studies. We present the KORA infrastructure, aspects of data management and quality control, and the concept of cooperative research. The increasing use of the MONICA/KORA cohorts for a variety of research topics, with a recent focus on genetic epidemiology, indicates the attractiveness of this concept.

Utilization of out- and inpatient health services by obese adults: a population-based study in the Augsburg region, Germany.

The aim of this study is to compare out- and inpatient health services utilization by obese and normal weight adults. In a subsample of the KORA-Survey S4 1999/2001 in the Augsburg region, Germany (n = 947, age: 25-74 years), number of visits to general practitioners (GP) and inpatient hospital days were self-reported in three computer-aided telephone interviews (CATI) over half a year. Body mass index, based on measured body height and weight, was used to define obesity according to WHO classification. Participants, stratified in normal weight (18.5 < or = BMI < 25), preobese (25 < r = BMI < 30), obese class 1 (30 < or = BMI < 35) and obese classes 2-3 (BMI > or = 35), were compared via logistic, zero-truncated negative binomial, and multinomial models to elucidate obesity's associations with utilization at all, its frequency, and high utilization. Sex, age, social class, health insurance, and place of residence were adjusted for in all models. Respondents in obesity class 1 were more prone to report at least one visit to a GP than those normal weight (OR = 1.84, p < 0.01), while obesity classes 2-3 were associated with frequent (IRR = 1.63, p < 0.05) and high utilization (OR = 3.57, p < 0.05). Regarding days in hospital, only the extremely obese (i. e. classes 2-3) reported significantly more utilization than those normal weight (days if hospitalized at all: IRR = 3.24, p < 0.05; high utilization: OR = 5.4, p < 0.01). Sex did not play a significant role in any model. Older respondents reported more utilization in terms of GP-visits, while only tending to do so regarding inpatient utilization. Both those with statutory (vs. private) health insurance and rural (vs. urban) place of residence had higher odds to visit a GP at all. Results point to an excess utilization of out- and inpatient health services by especially extremely obese adults, and underline the need to contrast obesity classes 2-3 vs. 1 in health services utilization research.

Priorities and prospect theory.

Whose preferences are to be used for cost-effectiveness analysis? It has been recommended that community preferences for health states are the most appropriate ones for use in a reference case analysis. However, critics maintain that persons are not able properly to judge a health state if they have not experienced the condition themselves. This problem is analyzed here in the framework of Prospect Theory. It can be argued that the differing reference points of patients and the general public are responsible for deviating results. In addition, we argue that risk attitudes with respect to health-related quality of life are an indicator of reference points. If patients and the general public refer to the same reference point, i.e., they have the same risk attitude, the hypothesis is that deviations no longer significantly differ. Evaluations of the health condition of tinnitus by 210 patients and 210 unaffected persons were compared. The Time Tradeoff and Standard Gamble methods were applied to elicit preferences. Risk attitude was measured with the question of whether participants would undergo a treatment that could either improve or worsen their health condition, both with an equal chance (five possible answers between "in no case" and "in any case"). Affected persons indicated significantly higher values for tinnitus-related quality of life according to the Standard Gamble method. The difference between Time Tradeoff values was less dramatic but still significant. In addition, nonaffected persons are more risk-averse than affected persons. However, differences in evaluations are not significant considering single risk groups (e.g., those who answered "in no case"). Prospect Theory is a reasonable framework for considering the question of whose preferences count. If this result can be generalized for other diseases as well, it allows the mathematical combination of "objective" evaluations by the general public with the illness experience of patients. These evaluations should be weighted with patients' risk attitudes, i.e., community preferences can be used if they are corrected for risk attitudes.

Apparent nitrogen digestibility data: AACC-ASTM collaborative study.

Apparent nitrogen digestibility data were obtained from 4 laboratories for 6 protein sources and 2 diet levels, 6 and 10% protein, after a 2-day adaptation period during the AACC-ASTM protein efficiency ratio (PER) and net protein ratio (NPR) collaborative studies. For 5 protein sources fed as 10% of the diet, the interlaboratory variation as measured by coefficient of variation (CV) values was low (1.5-3.5%), indicating high precision of the method. Wheat flour (6% protein diet) had the highest variation and, therefore, the lowest precision (CV of 7.10%). The interlaboratory variation (CV value) for 3 of the 4 laboratories was considerably lower, less than half that for the 4 laboratories. An analysis of variance of apparent nitrogen digestibility data indicated significant (P less than 0.05) effects for the 4-laboratory group due to laboratories and protein diets at both 10 and 6% protein levels, and for the 3-laboratory group at the 10% protein level. The 3-laboratory ANOVA for the 6% diets indicated a significant effect (P less than 0.05) due to diet only.

Net protein ratio data: AACC-ASTM collaborative study.

Seven- and 14-day net protein ratio (NPR) data were obtained from 7 laboratories for 6 protein sources: ANRC casein, lean beef, lactalbumin, textured vegetable protein, and peanut flour were fed as 10% protein (N X 6.25) in the test diet. Wheat flour, casein, and textured vegetable protein were fed as 6% protein (N X 6.25) in the test diet. Weighed dry ingredients for each diet were sent to each collaborator , who mixed the dry ingredients, then added specified amounts of corn oil and water and mixed each complete diet thoroughly. Rats were adapted for 0, 2, or 4 days, and then were fed the test diets for 28 days for protein efficiency ratio (PER) diets. The animal weight gain and feed consumption data obtained after 7 or 14 days of feeding were used to calculate NPR values. Analyses of data were done before [net protein ratio (NPR)] and after (R-NPR [relative-NPR]) adjustment of the data from each laboratory by its results for the reference protein casein. From the analysis of variance for NPR, significant (P less than 0.05) interactions were observed among laboratories, protein sources, and adaptation times of the animals (0, 2, or 4 days). Inter- and intralaboratory variability were decreased by use of 14-day values compared with 7-day values. Adjustment of the NPR data to R-NPR did not lower the intralaboratory variability but did lower the interlaboratory variability of the data. Increasing adaptation time did not consistently decrease interlaboratory or intralaboratory variability or decrease coefficients of variation (CV) of R-NPR values.(ABSTRACT TRUNCATED AT 250 WORDS)

Composition and protein efficiency ratio of meat samples partially defatted with petroleum ether, acetone, or ethyl ether.

Freeze-dried beef samples were partially defatted with either petroleum ether, acetone, or ethyl ether before determination of protein efficiency ratio (PER) to study the extraction effects on the composition and protein nutritional quality of the extracted beef. Defatting a protein source, such as meat or a meat product, may often be necessary to produce a test diet that contains 10% protein and 8% fat. Amino acid, carnosine, anserine, creatine, creatinine, inosine, and proximate compositions were determined on the extracted samples. Resulting data were compared to the composition and PER data of the beef that had no solvent treatment. Although the chemical analysis data from the study showed some variation between the proteins and other nitrogenous components of the unextracted and the extracted beef, these variations were too small to affect the protein nutritional quality of the beef as measured by PER.

Protein efficiency ratio: AACC/ASTM collaborative study.

Eight laboratories (7 of the laboratories conducted animal experiments) participated in a collaborative study to standardize some of the methodology associated with animal bioassays for determining protein efficiency ratios and to suggest improvements which would reduce the variation among laboratories. One-, 2-, 3-, and 4-week protein efficiency ratios (PER) with 0-, 2-, or 4-day adaptation periods were obtained from each laboratory, respectively, for 6 protein sources: casein, lean beef, lactalbumin, textured vegetable protein, peanut flour, and wheat flour. Analyses were computed for PER and adjusted PER (APER). From the analysis of variance for PER and APER, significant (P less than 0.05) effects were observed due to laboratories, adaptation length, protein sources, and/or interactions among these variables. In general, APER values show much less variation among laboratories than PER values. The reproducibility and repeatability variances were significantly (P less than 0.05) greater for an assay length of 2 weeks than they were for 3- or 4-week assays. Two protein sources, casein and textured vegetable protein, were fed at both high (10%) and low (6%) levels of protein. Analysis of variance of PER values shows a significant (P less than 0.05) laboratory by protein level by assay length interaction.

Comparative analysis of meat samples prepared with food chopper and bowl cutter.

Analyses of meat samples after preparation with either a bowl cutter or by the official procedure with a food chopper were compared for homogeneity of comminution and for differences in fat, moisture, and protein content. Cutting time in the bowl cutter was limited to minimize temperature rise in samples. Beef chuck, pork shoulder, and beef shank, cheek, and tongue were used in the study. Variances of replicate analysis data for the 5 meat types were pooled for either cutter or chopper treatment and for each analyzed component. Sample portions cut and mixed by using the bowl cutter were more homogeneous than those ground with a food chopper. Comparative accuracy was indicated by fat and moisture means: 5 were in good agreement and 5 differed significantly; 3 of 5 paired protein means differed significantly but were within 0.3% protein. Results on precision and accuracy as well as the simplicity and convenience of the bowl cutter procedure favor its use as an alternative to a food chopper for preparing meat samples for analysis.