ABSTRACT
We aimed to determine the optimal inclusion level of sunflower cake (0, 90, 180, and 270 g/kg total DM) as a partial replacement of soybean meal and corn ground in young bulls' diets by examining nutrient intake and digestibility, ingestive behavior, nitrogen balance, metabolic serum profile, growth performance, and carcass traits. Thirty-two intact Nellore bulls (BW 374 ± 42.5) were distributed in a completely randomized design. The experiment lasted 90 days. The final BW of the animals was 515.25 ± 24.7. There was a linear decrease effect in the intake of DM, crude protein and nonfibrous carbohydrates, eating and rumination efficiency, N-urinary, N-total excretion, and blood urea nitrogen. Sunflower cake did not affect the NDF digestibility, nitrogen (N)-fecal excretion, blood metabolites, Longissimus lumborum muscle area, or subcutaneous fat deposition. There were linear and quadratic effects on the eating and rumination time, microbial protein production and efficiency, gamma-glutamyl transferase and cholesterol serum concentrations, and muscle carcass tissue. There was a quadratic effect on ether extract intake, final BW, and total gain with the inclusion of sunflower cake in the young bull's diet. The replacement of soybean meal and corn ground with sunflower cake at the level of 90 g/kg of DM in the diet of young bulls is recommended because it reduces the DM intake and digestibility, increases microbial protein synthesis and muscle tissue deposition, and consequently improves the performance, feed efficiency, and carcass traits.
ABSTRACT
Introduction Simulation in neurosurgery is a growing trend in medical residency programs around the world due to the concerns there are about patient safety and the advancement of surgical technology. Simulation training can improve motor skills in a safe environment before the actual setting is initiated in the operating room. The aim of this review is to identify articles that describe Brazilian simulators, their validation status and the level of evidence (LoE). Methodology This study was conducted using the Preferred Reported Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search was performed in the Medline, Scielo, and Cochrane Library databases. The studies were evaluated according to the Medical Education Research Quality Instrument (MERSQI), and the LoE of the study was established according to the classification system of the Oxford Centre for Evidence-Based Medicine (OCEBM), which has been adapted by the European Association of Endoscopic Surgery. Results Of all the studies included in this review, seven referred to validated simulators. These 7 studies were assigned an average MERSQI score of 8.57 from 18 possible points. None of the studies was randomized or conducted in a high-fidelity environment. The best evidence was provided by the studies with the human placenta model, which received a score of 2b and a degree of recommendation of 3. Conclusion Brazilian simulators can be reproduced in the different laboratories that are available in the country. The average MERSQI score of Brazilian studies is similar to the international average score. New studies should be undertaken to seek greater validation of the simulators and carry out randomized controlled trials.
