Soluble plantain nonstarch polysaccharides, although increasing caecal load, reduce systemic invasion of Salmonella Gallinarum in the chicken.

UNLABELLED: Soluble plantain (Musa paradisiaca) nonstarch polysaccharides (NSPs) have previously been shown to prevent pathogenic interaction with the intestinal epithelium. Here, we examined whether plantain NSP could prevent the invasion of the intestinal mucosa by Salmonella enterica Gallinarum, a causative agent of fowl typhoid. In vitro assays using B1OXI cells were performed with monolayers pretreated with/without plantain NSP, before inoculation with Salm. Gallinarum 287/91. Chicks were fed from hatch on a pellet diet containing 50 mg day(-1) plantain NSP, followed by oral inoculation with Salm. Gallinarum 287/91 at the age of 6 days. Bacteria were enumerated from the liver, spleen and caecal contents 3 days postinfection. Adhesion and invasion of Salm. Gallinarum to B1OXI cells were inhibited by 10 mg ml(-1) plantain NSP (reduction in invasion 52%; 95% CI 27-77; P < 0.05). In vivo diet supplemented with 50 mg day(-1) plantain NSP reduced the invasion of Salm. Gallinarum in the chick liver (control 4.05 Log10 CFU g(-1) , SE 0.28, vs plantain 2.07 Log10 CFU g(-1) , SE 0.65; P < 0.01) and nonsignificantly in the spleen. Conversely, CFUs were significantly increased in the caeca (control 1.27 Log10 CFU g(-1), SE 0.65, vs plantain 6.04 Log10 CFU g(-1) , SE 0.17; P < 0.001). Plantain NSP feed reduced the systemic infection by Salm. Gallinarum and may have potential in reducing the impact of the disease in avian salmonellosis. The caveat is the increased caecal load of Salm. Gallinarum, although this may reflect both the reduced intestinal invasion and the bacterial multiplication in the caeca. SIGNIFICANCE AND IMPACT OF THE STUDY: Nonstarch polysaccharide (NSP) derived from the plantain (Musa paradisiaca) inhibits interaction with epithelial cells by Salmonella enterica Gallinarum, a causative agent of the disease fowl typhoid. Incorporation of plantain NSP into the poultry feed reduced Salm. Gallinarum levels in the spleen and liver of chicks following experimental infection, although their numbers in the caeca increased. These data demonstrate that alternatives to antimicrobials such as NSP may be useful in the control of invasive salmonellosis in poultry.

Determination of phytic acid disappearance, ileal P digestibility at different dietary Ca levels, and relative P bioavailability in soybean meal, canola meal, distillers dried grains with solubles, corn fermented protein, and wheat middlings.

Three experiments were conducted to evaluate P utilization in soybean meal (SBM), canola meal (CM), distillers dried grains with solubles (DDGS), corn fermented protein (CFP), and wheat middlings (WM) using different assays. In Experiment 1, phytic acid disappearance (myo-inositol 1,2,3,4,5,6-hexakis; InsP6D) and inositol phosphate disappearance (InsP-PD) were determined using precision-fed cecectomized Leghorn roosters. Roosters were precision-fed 20 to 25 g of SBM, CM, DDGS, CFP, and WM. In Experiment 2, InsP6D, InsP-PD, and standardized ileal digestibility (SID) of P at different Ca levels were determined using ad libitum-fed broiler chickens. Semi-purified cornstarch-dextrose-based diets containing SBM, CM, DDGS, CFP, and WM as the sole source of P were fed. All diets contained 0.21% P and limestone was added at the expense of dextrose to provide 0.30, 0.45, 0.60, and 0.75% Ca. In Experiment 3, P bioavailability relative to KH2PO4 was determined based on tibia bone ash. Experiments contained 5 to 6 replicates per treatment. In Experiment 1 with precision-fed roosters, InsP6D and InsP-PD ranged from 8 to 71% among feedstuffs, with the lowest (P < 0.05) disappearance being observed in SBM. In Experiment 2 with ad libitum-fed chickens, there was a Ca × ingredient interaction (P < 0.05) whereby increasing Ca linearly decreased (P < 0.05) InsP6D, InsP-PD, and SID of P for all feedstuffs, excluding CFP. Estimated P digestibility calculated using InsP6D in Experiment 1 was in good agreement with SID in Experiment 2 determined at 0.75% Ca, except for SBM. In Experiment 3, regression of bone ash content (mg/tibia) on supplemental P intake yielded P bioavailability values ranging from 30 to 81% among feedstuffs relative to KH2PO4, with the highest (P < 0.05) bioavailability being observed for DDGS and CFP. In conclusion, 1) InsP6D in precision-fed roosters can provide preliminary indications of P digestibility in plant-based feedstuffs, 2) SID determined at 0.75% Ca was in good agreement with other bioassays, and 3) P in DDGS and CFP was highly available compared with other feedstuffs.

Research Note: Evaluation of phytic acid disappearance, ileal P digestibility, and total tract P retention in canola meal supplemented with increasing levels of exogenous phytase using conventional and cecectomized precision-fed roosters and growing chicks.

Apparent ileal digestibility (AID) of P, apparent total tract retention (ATTR) of P, and phytic acid disappearance in canola meal were evaluated in the presence of increasing levels of exogenous phytase. In Experiment 1, a precision-fed rooster assay was used to determine phytic acid (myo-inositol 1,2,3,4,5,6-hexakis; InsP6) and inositol phosphate (InsP6-3; InsP-P) disappearance in conventional and cecectomized Leghorn roosters. Roosters were crop intubated with 25 g of canola meal mixed with 0, 500, 1,000, or 2,000 FTU/kg of exogenous phytase. In Experiment 2, InsP6 and InsP-P disappearance and AID and ATTR of P were determined using ad libitum-fed broiler chickens. Treatments consisted of semi-purified diets containing 45% canola meal as the sole source of P. Phytase was added to increase phytase activity by 0, 500, 1,000, or 2,000 FTU/kg. Experiments contained 6 replicates per treatment. Canola meal contained a high phytase activity (1,630 FTU/kg as-fed) due to contamination with a commercially available phytase at the feed mill from which the canola meal was sourced. In Experiment 1 with precision-fed roosters, there was no effect (P > 0.05) of phytase or bird type on InsP6 and InsP-P disappearance; however, phytase linearly reduced (P < 0.05) InsP3 concentrations in excreta. In Experiment 2 with ad libitum-fed chickens, phytase linearly increased (P < 0.05) ileal InsP6 and InsP-P disappearance, and phytase had a quadratic effect (P < 0.05) on excreta InsP6 and InsP-P disappearance. Increasing dietary phytase activity resulted in a linear increase (P < 0.05) in AID of P and phytase had a quadratic effect (P < 0.05) on ATTR of P. In conclusion, titration of high levels of phytase (1,600 to 3,600 FTU/kg as-fed) reduced InsP3 concentrations in precision-fed roosters but did not affect overall phytic acid hydrolysis, which was 78% or greater for all treatments; however, increasing the total phytase activity from 700 to 2,700 FTU in ad libitum-fed broiler chickens increased phytic acid disappearance and P digestibility.

Determination of calcium digestibility and bioavailability in 5 limestone sources using commercial broiler and crossbred chickens.

Three experiments were conducted to determine effect of feeding 5 commercial limestones varying in solubility (88-97%), mean particle size (500-700 microns), and geographical origin on Ca bioavailability and digestibility in commercial broiler and crossbred chickens. In Experiment 1, both crossbred and commercial chickens were used to measure the effect of dietary Ca level on tibia bone ash to develop a slope-ratio Ca bioavailability assay. Chickens were fed diets that contained Ca levels ranging from 0.20% to 0.95% from 9 to 22 d-of-age. Regressions of bone ash (mg/tibia and %) on supplemental Ca intake yielded large linear responses in both types of chickens in Experiment 1. In Experiment 2, relative bioavailability of Ca in 5 limestones using bone ash as primary response criterion was determined. Thirteen diets were fed to commercial Ross 308 male broilers which were either a Ca-deficient diet (0.30% Ca) or that diet supplemented 0.15 or 0.30% Ca from either reagent grade calcium carbonate (RCaCO3) or 1 of the 5 commercial limestones from 9 to 22 d-of-age. Bioavailability of Ca in limestones relative to RCaCO3 was determined using multiple linear regression of bone ash (mg/tibia and %) on supplemental Ca intake, which yielded slope-ratio relative Ca bioavailability values ranging from 90% to 106% in Experiment 2. In Experiment 3, apparent ileal digestibility (AID) and apparent total tract retention (TTR) of Ca in broiler chickens was measured for the 5 limestones using corn-based diets. The AID and TTR of Ca at 21 d-of-age were low and variable with a range of 20 to 34% for AID of Ca and 12 to 31% for TTR of Ca. Results from these studies indicate that a slope-ratio bone ash assay with either crossbred or modern commercial chickens can be used to measure relative bioavailability of Ca in limestones and there were few consistent differences in relative Ca bioavailability, AID of Ca, and TTR of Ca among 5 commercial limestones evaluated herein.

Research Note: Relative bioavailability of zinc in zinc hydroxychloride for chicks.

A chick assay was conducted to determine the effects of Zn source on performance and to establish a Zn relative bioavailability value (RBV) for a new source of Zn hydroxychloride. In the assay, 8-day-old chicks were fed a Zn-deficient soy protein concentrate diet supplemented with 0, 7, and 15 mg Zn/kg from feed grade ZnSO4 monohydrate for 14 d to establish a standard response curve. The same basal diet was supplemented with 3, 7, and 10 mg Zn/kg from a new Zn hydroxychloride (SAMZn). A second source of Zn hydroxychloride (IBZn) was supplemented at 10 mg Zn/kg as a direct comparison to the highest level of SAMZn. Weight gain increased (P < 0.05) with increasing Zn level, regardless of source. Weight gain of chicks fed 7 mg Zn/kg from SAMZn was not different (P > 0.05) from chicks fed 15 mg Zn/kg from ZnSO4. Weight gain was not different (P > 0.05) when comparing the 2 sources of Zn hydroxychloride supplemented at 10 mg Zn/kg. Tibia ash Zn and total tibia Zn were increased (P < 0.05) by all Zn sources and responded linearly (P < 0.05) to Zn supplementation from ZnSO4 and SAMZn. Total tibia Zn concentration was not different (P > 0.05) for chicks fed 10 mg Zn/kg from either source of Zn hydroxychloride. Multiple linear regression of total tibia Zn on supplemental Zn intake (R2 = 0.95) resulted in a RBV of 115% for SAMZn compared with ZnSO4 (set at 100%). The RBV of SAMZn was higher (P < 0.05) than ZnSO4. In conclusion, relative bioavailability of Zn (based on tibia Zn) in Zn hydroxychloride from SAMZn was higher than feed grade ZnSO4 based on multiple regression slope-ratio analysis and was similar to that of IBZn Zn hydroxychloride based on tibia Zn responses to 10 mg/kg supplemental dietary Zn.

Infection of chickens with antimicrobial-resistant Salmonella enterica Typhimurium DT193 and monophasic Salmonella Typhimurium-like variants: an emerging risk to the poultry industry?

Antimicrobial-resistant Salmonella enterica poses a particular risk to public health, and in particular isolates belonging to clonal lineages such as Salmonella Typhimurium DT104 cause epidemics across species including poultry. In recent years, antimicrobial-resistant S. Typhimurium DT193 and specifically the monophasic S. Typhimurium-like variants of this phage type, serotypes 4,12:i:- and 4,5,12:i:-, have become an increasing risk to public health in Europe and the USA and now account for nearly one-half of human S. Typhimurium infections in the UK. Unlike S. Typhimurium that possesses two forms of flagella which can vary between phase 1 and phase 2 during infection, monophasic variants possess only phase 1 flagella. These monophasic antimicrobial-resistant variants have become a major problem in pig production but human cases have also been associated with poultry consumption and have been found in UK flocks through surveillance schemes since 2010. In this study we determined the ability of antimicrobial-resistant DT193 serotype 4,12:i:- and 4,5,12:i:- isolates from pigs to infect chickens. All isolates were found to colonize the caeca and liver. All but one isolate of serotype 4,5,12:i:- also infected the spleen. Levels of infection and pathology were comparable with those found with the virulent S. Typhimurium isolate 4/74. These findings indicate that both S. Typhimurium DT193 and monophasic variants of this phage type usually associated with pigs are capable of colonizing the chicken. This shows that both S. Typhimurium DT193 and monophasic variants represent a significant and potential emerging threat to poultry production from "spill-over" of these isolates from the pig industry or other sources.

Burden of spinal cord injury-related neuropathic pain in the United States: retrospective chart review and cross-sectional survey.

STUDY DESIGN: Cross-sectional, observational study. OBJECTIVES: Characterize demographic and clinical characteristics, health status, pain, function, productivity and economic burden in spinal cord injury-related neuropathic pain (SCI-NeP) subjects, by pain severity. SETTING: United States. One hundred and three subjects diagnosed with SCI-NeP recruited during routine primary care or specialty physician office visits completed a questionnaire to assess patient-reported outcomes. Physicians completed a case report form on inclusion/exclusion criteria, subject clinical characteristics and health-care resource use (HRU) based on 6-month retrospective chart review. RESULTS: Subjects' mean age was 48.7, 69.9% were male and 48.5% were unable to walk. The most frequently reported comorbidities were sleep disturbance/insomnia (28.2%), depressive symptoms (25.2%) and anxiety (23.3%). Subjects' mean pain severity score was 5.3 (0-10 scale), and 77.7% reported moderate or severe pain. On a 0-10 scale, subjects' reported moderate pain interference with function: mean 5.4. Subjects' health status, as measured by the EuroQol 5-dimensions health-state utility, was 0.49 (-0.11 to 1.00 scale). Pain interference with function and health status were significantly worse among subjects with more severe pain (P<0.0005). Among employed subjects (13.6%), overall work impairment was 38.0%. The proportion of subjects who were prescribed ≥1 medication was 94.2%, and the mean number of physician office visits in past 6 months due to SCI-NeP was 2.2. Total annualized cost per subject was $26 270 (direct: $8636, indirect: $17 634). CONCLUSION: SCI-NeP subjects exhibited high pain levels, despite active management. Pain levels were associated with poor function, low health status and lost productivity. HRU was prevalent, and costs, particularly indirect, were substantial, highlighting unmet need. SPONSORSHIP: This study was supported by Pfizer, Inc.

Standardized amino acid digestibility and true metabolizable energy for several increased protein ethanol co-products produced using back-end fractionation systems.

Precision-fed rooster trials were conducted to evaluate standardized AA digestibility and TMEn of the increased protein ethanol co-products corn fermented protein (CFP), high protein-distillers dried grains with solubles (HP-DDGS), and reduced fiber high protein-DDGS (RFHP-DDGS) produced using post-fermentation back-end fractionation systems. The TMEn was determined using conventional adult Leghorn roosters, while cecectomized roosters were used to determine standardized AA digestibility. Three to 6 roosters were fasted per treatment for 26 h prior to crop intubation with 27 g of sample and excreta were collected for 48 h post-feeding. Statistical analyses were conducted using a one-way ANOVA for a completely randomized design. Eight samples of CFP were found to contain a mean of 56% CP (DM basis) compared with a mean of 32% for conventional DDGS. The mean TMEn of CFP (3,556 kcal/kg) was greater (P < 0.05) than conventional DDGS1 and 2 (2,767 kcal/kg DM); mean standardized AA digestibility for CFP was similar to conventional DDGS and ranged from 88 to 94%. The mean digestible Lys, Met+Cys, and Thr concentrations for conventional DDGS were 0.79, 1.12, and 0.94%, respectively, whereas those for CFP were 1.74, 2.06, and 1.88%, respectively (DM basis). Two samples of HP-DDGS contained a mean of 51% CP (DM basis), a mean TMEn of 3,325 kcal/kg DM, a mean standardized AA digestibility of 90%, and mean concentrations of digestible Lys, Met+Cys, and Thr, which were 1.53, 1.77, and 1.60%, respectively (DM basis). The mean CP content of 2 RFHP-DDGS was 48% and the mean TMEn was 3,711 kcal/kg DM, which was greater (P < 0.05) than conventional DDGS3 and 4 (2,920 kcal/kg DM). Mean standardized AA digestibility of RFHP-DDGS was 90% and mean digestible Lys, Met+Cys, and Thr concentrations increased from 0.82, 1.01, and 0.95% for conventional DDGS, respectively, to 1.00, 1.59, and 1.44% for RFHP-DDGS, respectively (DM basis). Results indicate these high protein corn ethanol co-products have increased nutritional value for poultry compared with conventional DDGS.

Determination of TMEn, standardized amino acid digestibility, phosphorus digestibility, and phosphorus bioavailability in conventional and reduced phosphorus distillers dried grains with solubles.

The TMEn, amino acid (AA) digestibility, and P availability in 2 conventional corn distillers dried grains with solubles (C-DDGS1 and 2; 0.86 to 1.14% P, DM basis) and reduced phosphorus DDGS (RP-DDGS; 0.39% P) were evaluated. The TMEn of C-DDGS1 and 2 and RP-DDGS were determined in Experiment 1 using conventional adult Leghorn roosters, while standardized AA digestibility was determined in Experiment 2 using cecectomized roosters. Apparent ileal digestibility (AID) of P at different Ca levels was determined using precision-fed (crop intubation) broiler chickens in Experiments 3 and 4. The AID and total tract retention of P in C-DDGS2 were evaluated in Experiment 5 using ad libitum-fed broilers. Phosphorus bioavailability in C-DDGS2 relative to KH2PO4 based on bone ash was determined in Experiment 6. Experiments contained 4 to 5 replicates per treatment. In Experiment 1, the TMEn of C-DDGS1 and RP-DDGS was 3,428 and 2,840 kcal/kg, respectively (DM basis). In Experiment 2, there were no differences (P > 0.05) in rooster AA digestibility values between C-DDGS1 and RP-DDGS. In Experiment 3 with precision-fed chicks, AID of P in C-DDGS1 and RP-DDGS was 81 and 59%, respectively; there was no effect (P > 0.05) of increasing dietary Ca level from 0.04 to 1.0% for C-DDGS1 or reducing Ca from 1.5 to 1.0% for RP-DDGS. The AID of P in precision-fed chicks for C-DDGS2 in Experiment 4 was 48 and 80% at 1.3 and 0.3 Ca:total P ratios, respectively (P < 0.05). In Experiment 5, AID of P in C-DDGS2 at Ca:total P ratios of 1.3 and 2.5 was 63 and 42%, respectively, in precision-fed chicks. Regression of bone ash content (mg/tibia) on supplemental P intake in Experiment 6 yielded a P bioavailability of 61% relative to KH2PO4 for C-DDGS2. In conclusion, total and digestible P content in RP-DDGS was greatly reduced compared with C-DDGS, and the digestibility and bioavailability of the P in C-DDGS was affected by type of experimental assay and dietary Ca level.

Research Note: Evaluation of a precision-fed rooster assay for determination of phytic acid disappearance in feedstuffs.

The objective of this study was to evaluate a precision-fed rooster assay that is suitable for determination of phytic acid (myo-inositol 1,2,3,4,5,6-hexakis; InsP6) disappearance in plant-based feed ingredients. A 48-h precision-fed rooster assay was used to measure InsP6 disappearance using conventional White Leghorn roosters. A minimum of 4 individually-caged roosters per treatment were fasted for 26 h prior to crop intubation with 15 to 30 g of sample, and excreta were quantitatively collected for 48 h. Soybean meal, soybean hulls, canola meal, conventional distillers dried grains with solubles (DDGS), palm kernel meal (PKM), and wheat bran were evaluated in Experiment 1, whereas wheat middlings (WM) and rice bran (RB) were evaluated without and with 1,000 and 1,800 U/kg phytase in Experiment 2. Data from Experiment 1 were subjected to a one-way ANOVA for a completely randomized design, while data from Experiment 2 were subjected to two-way ANOVA for a 2 × 3 factorial arrangement of treatments. In Experiment 1, InsP6 disappearance ranged from 3 to 95% among all ingredients. The InsP6 disappearance for conventional DDGS (95%) was the highest (P < 0.05), wheat bran and soybean hulls were intermediate (47-48%), PKM was low (24%), and soybean meal and canola meal were very low (3-5%). In Experiment 2, there was a significant ingredient × phytase interaction (P < 0.05). Phytase inclusion at both 1,000 and 1,800 U/kg resulted in a significant improvement (P < 0.05) in InsP6 disappearance for RB; however, only the addition of 1,800 U/kg resulted in an increase in InsP6 disappearance for WM. The addition of 1,800 U/kg phytase increased the InsP6 disappearance from 58 to 74% for WM and from 26 to 53% for RB. These results suggest the precision-fed rooster assay can be used to evaluate phytic acid disappearance in plant-based feed ingredients and the assay was able to detect a significant effect of 1,800 U/kg of exogenous phytase on phytic acid disappearance for WM and RB.

Quantification of secretory IgA and mucin excretion and their contributions to total endogenous amino acid losses in roosters that were fasted or precision-fed a nitrogen-free diet or various highly digestible protein sources.

The objective of this study was to quantify total secretory IgA (sIgA) and mucin excretion via excreta in roosters fed diets containing highly digestible protein sources and to determine their proportional contributions to total endogenous amino acid (AA) losses. Precision-fed rooster assays with 24 h excreta collections were conducted using conventional White Leghorn roosters (4-8 roosters per treatment). In Experiment 1, roosters were fasted or precision-fed 30 g (crop intubation) of a nitrogen-free (NF) or semi-purified diet containing 10% casein. Roosters in Experiment 2 received a NF or semi-purified diet containing either 10% casein, 17% whole egg, 10% egg white, 9.8% soy protein isolate, 10.2% chicken breast meat, 11.2% spray-dried animal plasma (SDAP), or an AA mixture containing the same AA as casein. A Latin square design was used in Experiment 3, where roosters received NF or semi-purified diets containing either 10% casein, 17% whole egg, or 9.6% of a crystalline AA mixture to evaluate both diet and individual bird effects. In Experiment 1, mucin excretion did not differ (P > 0.05) among treatments; however, total sIgA excretion was lower for fasted birds, intermediate for the NF diet, and highest for casein (P < 0.05). Total endogenous AA losses (proportion of the total) from sIgA were higher for roosters fed casein, whereas mucin contributions were higher for fasted roosters (P < 0.05). In Experiment 2, sIgA excretion did not differ (P > 0.05) among treatments; however, mucin excretion was reduced for NF, whole egg, egg white, and chicken breast compared with casein and SDAP. In Experiment 3, sIgA and mucin excretion did not differ (P > 0.05) among treatments; however, sIgA excretion differed among individual roosters (7-27 mg/24 h; P < 0.05). Overall, fasting reduced sIgA excretion and sIgA and mucin excretion were affected by dietary protein source. Further, roosters excreted a substantial amount of sIgA, and sIgA and mucin were considerable contributors to total endogenous AA losses.

How does the urothelium affect bladder function in health and disease? ICI-RS 2011.

The urothelium is a multifunctional tissue that not only acts as a barrier between the vesical contents of the lower urinary tract and the underlying tissues but also acts as a sensory organ by transducing physical and chemical stresses to the attendant afferent nervous system and underlying smooth muscle. This review will consider the nature of the stresses that the urothelium can transduce; the transmitters that mediate the transduction process; and how lower urinary pathologies, including overactive bladder syndrome, painful bladder syndrome and bacterial infections, are associated with alterations to this sensory system. In particular, the role of muscarinic receptors and the TRPV channels system will be discussed in this context. The urothelium also influences the contractile state of detrusor smooth muscle, both through modifying its contractility and the extent of spontaneous activity; potential pathways are discussed. The potential role that the urothelium may play in bladder underactivity is introduced, as well as potential biomarkers for the condition that may cross the urothelium to the urine. Finally, consideration is given to vesical administration of therapeutic agents that influence urinary tract function and how the properties of the urothelium may determine the effectiveness of this mode of delivery.

Metabolizable energy and amino acid digestibility in spray-dried animal plasma using broiler chick and precision-fed rooster assays.

Four experiments were conducted to determine ME and amino acid (AA) digestibility of spray-dried animal plasma (SDAP) and soybean meal (SBM). The 48-h precision-fed adult rooster assay was used in 2 experiments; TMEn and standardized AA digestibility were determined using conventional and cecectomized roosters, respectively, 50 weeks of age and weighing approximately 2,200 g. Eight individually-caged roosters (4 per diet) were fasted for 26 h, then precision-fed 30 g of SDAP mixture (containing 50% corn) or SBM mixture (containing 50% corn). The TMEn and AA digestibility for SDAP and SBM were calculated by the difference procedure. The TMEn for SDAP was greater (P < 0.05) than SBM (3,743 and 2,669 kcal/kg DM, respectively). Similarly, mean AA digestibility of SDAP was greater (P < 0.05) than SBM (94 and 86%, respectively). Two assays were conducted using Ross male broilers to determine AMEn and apparent (AIAAD) and standardized (SIAAD) ileal AA digestibility of SDAP and SBM. A 3 × 2 factorial arrangement of treatments was used to determine AMEn; 126 chicks (6 replicate pens of 7 chicks) were fed a corn-SBM-based reference diet, a diet containing 30% SDAP, or a diet containing 30% SBM from d 7 to 10 and 18 to 21. A 2 × 2 factorial arrangement of treatments was used to determine AIAAD and SIAAD; 168 chicks (12 replicate pens of 7 chicks) were fed a semi-purified diet containing 25% SDAP or a semi-purified, isonitrogenous diet containing 41% SBM from d 7 to 10 and 18 to 21. The AMEn for SDAP was greater (P < 0.05) than SBM at d 10 (3,851 and 2,089 kcal/kg DM, respectively) and d 21 (4,239 and 2,849 kcal/kg DM, respectively). The second assay showed an increase (P < 0.05) in AIAAD and SIAAD for SDAP compared with SBM at d 10 (mean SIAAD for SDAP and SBM were 96% and 84%, respectively) and d 21 (97% and 87%, respectively). Regardless of assay or age, these results indicate SDAP is a highly digestible feed ingredient with high ME and AA digestibility.

Novel approaches and future directions in castration-resistant prostate cancer.

Recent advances in the treatment of castration-resistant prostate cancer (CRPC) have started to change the therapeutic landscape allowing clinicians to choose from a broad range of treatment options. Understanding the mechanisms that transform prostate cancer (PCA) into a castration-resistant state has enabled investigators to explore critical pathways involved in such process allowing for rational therapeutic design. These novel therapies complement the modest success that chemotherapy has demonstrated in recent years. In this review, we discuss the different mechanisms that render PCA castration resistant and elaborate on the nonchemotherapy approaches evolving in CRPC. These include agents targeting the epidermal growth factor receptor, endothelin receptor antagonists, angiogenesis inhibitors, immunomodulatory agents, immunotherapy, novel antiandrogens, and delivery of cytotoxic agents via therapeutic antibodies. This timely review coincides with the identification of newer therapies in this setting affirming our steady movement towards better disease control.

Effects of changing work patterns on general surgical training over the last decade.

BACKGROUND There is concern across all medical specialties that shift patterns and reduced working hours are detrimental to training, and that craft specialties have been most affected. This study aimed to examine the effects of these changes to training on the quantity of operating performed by surgical trainees in a UK teaching hospital. METHODS This retrospective study of prospectively collected computerised theatre data examined elective and emergency general surgical operations performed over four time periods: 1996 (Calman), 2001 (New Deal), 2004 and 2009 (European Working Time Directive). Procedures were analysed according to grade of surgeon and time of day. RESULTS In 1996, most appendicectomies (72.2%) were performed by senior house officers (SHOs), compared with 3.8% in 2009. By 2009, SHOs did not perform any emergency procedures other than abscess drainage and appendicectomy. The proportion of emergency operating performed by specialist registrar (SpRs) has remained constant, but elective operating has reduced from 34.6% (1996) to 15.7% (2009). Supervision of both SHOs and SpRs has increased between 1996 and 2009 in both elective and emergency work. CONCLUSIONS The proportion of operating performed by SpRs and SHOs has fallen over the last decade, coinciding with implementation of structural changes to training, the advent of minimally invasive techniques, and the drive for a consultant led health service. Trainees may therefore require increased supervision as well as protected theatre sessions to balance operative training with ward based duties. Education must be integrated into working practice in order for trainees to achieve expected competencies and ultimately produce adequately experienced consultants.

Typing of Campylobacter jejuni isolates from dogs by use of multilocus sequence typing and pulsed-field gel electrophoresis.

Campylobacter is a major cause of human gastroenteritis worldwide. Risk of Campylobacter infection in humans has been associated with many sources, including dogs. This study aimed to investigate whether C. jejuni carried by dogs could potentially be a zoonotic risk for humans and if there were common sources of C. jejuni infection for both humans and dogs. Multilocus sequence typing (MLST) together with macrorestriction analysis of genomic DNA using SmaI and pulsed-field gel electrophoresis (PFGE) were both used to analyze 33 C. jejuni isolates obtained from various dog populations, including those visiting veterinary practices and from different types of kennels. MLST data suggested that there was a large amount of genetic diversity between dog isolates and that the majority of sequence types found in isolates from these dogs were the same as those found in isolates from humans. The main exception was ST-2772, which was isolated from four samples and could not be assigned to a clonal complex. The most commonly identified clonal complex was ST-45 (11 isolates), followed by ST-21 (4 isolates), ST-508 (4 isolates), and ST-403 (3 isolates). The profiles obtained by macrorestriction PFGE were largely in concordance with the MLST results, with a similar amount of genetic diversity found. The diversity of sequence types found within dogs suggests they are exposed to various sources of C. jejuni infection. The similarity of these sequence types to C. jejuni isolates from humans suggests there may be common sources of infection for both dogs and humans. Although only a small number of household dogs may carry C. jejuni, infected dogs should still be considered a potential zoonotic risk to humans, particularly if the dogs originate from kennelled or hunt kennel dog populations, where the prevalence may be higher.

Venus tectonics: initial analysis from magellan.

Radar imaging and altimetry data from the Magellan mission have revealed a diversity of deformational features at a variety of spatial scales on the Venus surface. The plains record a superposition of different episodes of deformation and volcanism; strain is both areally distributed and concentrated into zones of extension and shortening. The common coherence of strain patterns over hundreds of kilometers implies that many features in the plains reflect a crustal response to mantle dynamic processes. Ridge belts and mountain belts represent successive degrees of lithospheric shortening and crustal thickening; the mountain belts also show widespread evidence for extension and collapse both during and following crustal compression. Venus displays two geometrical patterns of concentrated lithospheric extension: quasi-circular coronae and broad rises with linear rift zones; both are sites of significant volcanism. No long, large-offset strike-slip faults have been observed, although limited local horizontal shear is accommodated across many zones of crustal shortening. In general, tectonic features on Venus are unlike those in Earth's oceanic regions in that strain typically is distributed across broad zones that are one to a few hundred kilometers wide, and separated by stronger and less deformed blocks hundreds of kilometers in width, as in actively deforming continental regions on Earth.

Validity and reliability of the Migraine-Treatment Optimization Questionnaire.

Our aim was to establish the validity and reliability of a patient-rated Migraine Treatment Optimization Questionnaire (M-TOQ) in primary care. Patients who met International Classification of Headache Disorders, 2nd edn criteria for migraine completed a 19-item questionnaire containing candidate items for the M-TOQ, and three questionnaires designed to test convergent/construct validity [Migraine Disability Assessment Scale (MIDAS), Headache Impact Test (HIT)-6 and Migraine-Specific Quality of Life Scale (MSQoL)]. A 15-item (M-TOQ-15) and a five-item (M-TOQ-5) questionnaire were derived. Two hundred and fifty-three adult patients were recruited. Five treatment optimization domains were identified: functioning, rapid relief, consistency of relief, risk of recurrence and tolerability; with Cronbach alphas of 0.70-0.84. The Cronbach alpha for M-TOQ-15 was 0.85, and it correlated well with MIDAS, HIT-6 and MSQoL (r = 0.33-0.44). The Cronbach alpha for M-TOQ-5 was 0.66, and it also correlated well with the three questionnaires (r = 0.33-0.41). The utility of the M-TOQ for assessing treatment benefit in research (M-TOQ-15) and primary care (M-TOQ-5) should be further validated.

Relationship between enteric pathogens and acute gastroenteritis disease severity: a prospective cohort study.

OBJECTIVES: To evaluate the relationship between individual bacterial and viral pathogens and disease severity. METHODS: Children <18 years with three or more episodes of vomiting and/or diarrhoea were enrolled in two Canadian paediatric emergency departments between December 2014 and August 2016. Specimens were analysed employing molecular panels, and outcome data were collected 14 days after enrolment. The primary outcome was severe disease over the entire illness (symptom onset until 14-day follow-up), quantified employing the Modified Vesikari Scale (MVS) score. The score was additionally analysed in two other time periods: index (symptom onset until enrolment) and follow-up (enrolment until 14-day follow-up). RESULTS: Median participant age was 20.7 (IQR: 11.3, 44.2) months; 47.4% (518/1093) and 73.4% (802/1093) of participants had index and total MVS scores ≥11, respectively. The most commonly identified pathogens were rotavirus (289/1093; 26.4%) and norovirus (258/1093; 23.6%). In multivariable analysis, severe disease over the entire illness was associated with rotavirus (OR = 9.60; 95%CI: 5.69, 16.19), Salmonella (OR = 6.61; 95%CI: 1.50, 29.17), adenovirus (OR = 2.53; 95%CI: 1.62, 3.97), and norovirus (OR = 1.43; 95%CI: 1.01, 2.01). Pathogens associated with severe disease at the index visit were: rotavirus only (OR = 6.13; 95%CI: 4.29, 8.75), Salmonella (OR = 4.59; 95%CI: 1.71, 12.29), adenovirus only (OR = 2.06; 95%CI: 1.41, 3.00), rotavirus plus adenovirus (OR = 3.15; 95%CI: 1.35, 7.37), and norovirus (OR = 0.68; 95%CI: 0.49, 0.94). During the follow-up period, rotavirus (OR = 2.21; 95%CI: 1.50, 3.25) and adenovirus (OR = 2.10; 95%CI: 1.39, 3.18) were associated with severe disease. CONCLUSIONS: In children presenting for emergency department care with acute gastroenteritis, pathogens identified were predominantly viruses, and several of which were associated with severe disease. Salmonella was the sole bacterium independently associated with severe disease.