Effect of increasing dietary inclusion of whole cottonseed on nutrient digestibility and milk production of high-producing dairy cows.

We determined the effects increasing dietary inclusion of whole cottonseed (WCS) on nutrient digestibility and milk production responses of high-producing dairy cows. Twenty-four multiparous Holstein cows (mean ± SD; 52.7 ± 2.63 kg/d of milk; 104 ± 23 DIM) were randomly assigned to treatment sequences in a replicated 4 × 4 Latin square design with 21-d periods. Treatments were increasing doses of WCS at 0, 8, 16, and 24% DM, with WCS replacing soybean meal and hulls to maintain similar diet nutrient composition (%DM) of NDF (32%), forage NDF (21%), starch (27%), and CP (17%). Total fatty acid (FA) content of each treatment was 1.70, 2.96, 4.20, and 5.40%DM, respectively. Three preplanned contrasts were used to test the linear, quadratic, and cubic effects of increasing dietary WCS. Increasing dietary WCS from 0 to 24% DM quadratically influenced intakes of DM and NDF, with the highest value being for the 8% WCS, and intakes of 16- and 18-carbon, and total FA, with maximum values obtained up to 24% WCS. Increasing dietary WCS affected digestibility of DM (cubic) and NDF (quadratic), with the lowest values being for the 8% WCS. Increasing WCS increased 16-carbon digestibility (quadratic) but decreased digestibility of 18-carbon and total FA (both quadratic), with highest and lowest values for the 24% WCS, respectively. Increasing dietary WCS quadratically increased absorbed 16- and 18-carbon, and total FA, with maximum values obtained for 24% WCS. Increasing dietary WCS quadratically increased yields of milk, milk fat, milk protein, milk lactose, 3.5% fat corrected milk, and energy corrected milk, and linearly increased body weight gain. The source of milk FA was affected by dietary WCS, with a quadratic decrease in the yield of de novo and mixed milk FA and a quadratic increase in preformed milk FA. Increasing dietary WCS linearly increased trans-10 C18:1 milk FA content. As dietary WCS increased, plasma insulin linearly decreased, and plasma gossypol levels linearly increased. Despite the decrease in total FA digestibility, increasing dietary WCS from 0 to 24% DM increased FA absorption. Increasing dietary inclusion of WCS up to 16% DM increased milk production responses and DM intake. Under the current dietary conditions, high-producing dairy cows benefited best from a diet containing 8-16% DM inclusion of WCS.

Long-term effects of abomasal infusion of linoleic and linolenic acids on the enrichment of n-6 and n-3 fatty acids into plasma lipid fractions of lactating cows.

Our objective was to compare abomasal infusions of linoleic (18:2n-6) and α-linolenic (18:3n-3) acids on the enrichment of n-6 and n-3 fatty acids (FA) into the plasma lipid fractions of lactating dairy cows and evaluate their potential carryover effects in plasma lipid fractions post-infusion. Six rumen-cannulated multiparous Holstein cows (252 ± 33 d in milk) were fed the same diet and assigned to 1 of 2 treatments in a completely randomized design with repeated measures. Treatments were abomasal infusions (67 g/d total FA) of 1) n-6 FA blend (N6) to provide approximately 43 g/d 18:2n-6 and 8 g/d of 18:3n-3; or 2) n-3 FA blend (N3) providing 43 g/d 18:3n-3 and 8 g/d 18:2n-6. Treatments were dissolved in ethanol, and the daily dose for each treatment was divided into 4 equal infusions, occurring every 6 h. The treatment period lasted from d 1 to 20, and the carryover period lasted from d 21 to 40. Results are presented as FA contents within each of the 4 main plasma lipid fractions: cholesterol esters (CE), phospholipids (PL); triglycerides (TG), and plasma nonesterified fatty acids. Concentrations of individual lipid fractions in plasma were not quantified. Plasma CE and PL had the highest content of polyunsaturated FA (PUFA) during both the treatment and carryover periods. In plasma PL, N3 increased the contents of total n-3 FA (134%), 18:3n-3 (267%), and eicosapentaenoic acid (96.3%, 20:5n-3), and decreased total n-6 FA (8.14%) and 18:2n-6 (8.16%) from d 4 to 20 compared with N6. In plasma CE, N3 increased the contents of total n-3 FA (191%) from d 4 to 20, 18:3n-3 from d 2 to 20 (178%), and 20:5n-3 from d 6 to 20 (59.9%), while N3 decreased total n-6 FA from d 4 to 20 (11.2%) and 18:2n-6 from d 2 to 20 (10.5%) compared with N6. In addition, compared with N6, N3 decreased arachidonic acid (20:4n-6) at d 2 (45%) and from d 10 to 20 (14.7%) in PL and tended to decrease 20:4n-6 without interacting with time for CE. Phospholipids were the only lipid fraction with detectable levels of docosahexaenoic acid (22:3n-6) in all samples, but we did not observe differences between treatments. In plasma TG, N3 increased the contents of total n-3 FA (135%) and 18:3n-3 (146%) from d 4 to 20, increased 20:5n-3 from d 12 to 20 (89%), decreased or tended to decrease total n-6 FA content from d 6 and 8 (26.9%), and tended to decrease 18:2n-6 at d 8 compared with N6. A similar pattern was observed for plasma nonesterified fatty acids. We observed positive carryover effects for both N3 and N6 at different degrees in all lipid fractions, with N3 promoting more consistent outcomes and increasing total n-3 FA throughout the carryover period (from d 22 to 40) in both PL (52.8%) and CE (68.6%) compared with N6. It is important to emphasize that the higher magnitude responses observed for n-3 FA are also influenced by the content of n-3 FA being much lower than those of n-6 FA in all lipid fractions. While these data provide important and robust information, future research quantifying changes in concentrations of individual lipid fractions in plasma and the entry and exit rates of specific FA will further enhance our understanding. In conclusion, abomasally infusing N3 and N6 increased the contents of n-3 and n-6 FA, respectively, in all plasma lipid fractions. These responses were more evident in PL and CE. We also observed positive carryover effects in all lipid fractions, where N3 had more consistent outcomes than N6. Our results indicate that dairy cows have a robust mechanism to conserve essential FA, with a pronounced preference for n-3 FA.

Comparison of rumen and abomasal infusions of an exogenous emulsifier on fatty acid digestibility of lactating dairy cows.

We evaluated the effects of infusing an exogenous emulsifier (polysorbates-C18:1) either into the rumen or abomasum on fatty acid (FA) digestibility and production responses of lactating dairy cows. Nine ruminally cannulated multiparous Holstein cows (170 ± 13.6 d in milk) were assigned to a treatment sequence in replicated 3 × 3 Latin squares with 18-d periods consisting of 7 d of washout and 11 d of infusion. Treatments were abomasal infusions of water carrier only into the rumen and abomasum (control, CON), 30 g/d polysorbate-C18:1 (T80) infused into the rumen (RUM), or 30 g/d T80 infused into the abomasum (ABO). Emulsifiers were dissolved in water and delivered at 6-h intervals (total daily infusion was divided into 4 equal infusions per day). Cows were fed the same diet that contained [% diet dry matter (DM)] 32.2% neutral detergent fiber (NDF), 16.1% crude protein, 26.5% starch, and 3.41% FA (including 1.96% FA from a saturated FA supplement containing 28.0% C16:0 and 54.6% C18:0). Two orthogonal contrasts were evaluated: (1) the overall effect of T80 {CON vs. average of the T80 infusions [1/2 (ABO + RUM)]}, and (2) the effect of ABO versus RUM infusion. Compared with CON, infusing T80 increased the digestibilities of NDF (2.85 percentage units), total (4.35 percentage units), 16-carbon (3.25 percentage units), and 18-carbon FA (4.60 percentage units), and tended to increase DM digestibility and total and 18-carbon FA absorption. Compared with RUM, ABO decreased the intakes of total (28 g/d), 16-carbon (7 g/d), and 18-carbon FA (19 g/d); tended to increase the digestibility of total and 18-carbon FA; and had no effect on the absorption of total, 16-carbon, or 18-carbon FA. Production responses did not change among our treatments. In conclusion, infusing 30 g/d polysorbates-C18:1 increased NDF and total, 16-carbon, and 18-carbon FA digestibility. Compared with RUM, ABO tended to increase the digestibilities of total and 18-carbon FA; however, this may be related to the fact that ABO reduced the intakes of total, 16-carbon, and 18-carbon FA, not necessarily due to better emulsifying action per se. In summary, ABO and RUM both improved FA absorption.

Abomasal infusion of oleic acid and exogenous emulsifier alter fatty acid digestibility and production responses of lactating dairy cows.

We evaluated the effects of abomasal infusion of cis-9 C18:1 (oleic acid) and an exogenous emulsifier (polysorbate-C18:1) on fatty acid (FA) digestibility and production responses of dairy cows. Eight rumen-cannulated multiparous cows (96 ± 23 d in milk) were assigned to a 2 × 2 factorial arrangement of treatments in 4 × 4 Latin squares with 18-d periods consisting of 7 d of washout and 11 d of infusion. Treatments were abomasal infusions of water carrier only (CON), 45 g/d oleic acid (OA), 20 g/d polysorbate-C18:1 (T80), or both 45 g/d OA and 20 g/d T80 (OA+T80). The OA treatments were dissolved in ethanol and the T80 treatments in water. To deliver the daily dose for each treatment, the infusate solution was divided into 4 equal infusions per day, occurring every 6 h. Cows were fed the same diet, which contained (% of dry matter [DM]) 30.3% neutral detergent fiber (NDF), 16.3% crude protein, 30% starch, and 3.2% FA (including 1.8% DM from a FA supplement containing 34.4% C16:0 and 47.7% C18:0). Infusion of T80 increased NDF digestibility compared with all other treatments (3.57 percentage units), whereas OA+T80 decreased NDF digestibility compared with CON (3.30 percentage units). Compared with CON, OA (4.90 percentage units) and T80 (3.40 percentage units) increased total FA digestibility, whereas OA+T80 had no effect on total FA digestibility. We did not observe differences between OA and T80 for total FA digestibility. Infusion of OA (3.90 percentage units) and T80 (2.80 percentage units) increased 16-carbon FA digestibility compared with CON. Digestibility of 16-carbon FA did not differ between OA and T80 or between CON and OA+T80. Compared with CON, OA increased (5.60 percentage units) and T80 tended to increase 18-carbon FA digestibility. Digestibility of 18-carbon FA did not differ between OA and T80 or between CON and OA+T80. Compared with CON, all treatments increased or tended to increase the absorption of total and 18-carbon FA. Infusion of OA and T80 increased the yields of milk fat (both increased 0.10 kg/d), 3.5% fat-corrected milk (1.90 and 2.50 kg/d), and energy-corrected milk (1.80 and 2.60 kg/d) compared with CON. We did not observe differences between OA and T80 or between CON and OA+T80 for yields of milk fat, 3.5% fat-corrected milk, or energy-corrected milk. Infusing OA tended to increase plasma insulin concentration compared with CON. Compared with the other treatments, OA+T80 decreased the yield of de novo milk FA (31.3 g/d). Compared with CON, OA tended to increase the yield of de novo milk FA. Compared with OA+T80, CON and OA tended to increase the yield of mixed milk FA, whereas T80 increased it (83 g/d). Compared with CON, all emulsifier treatments increased the yield of preformed milk FA (52.7 g/d). In conclusion, abomasally infusing either 45 g of OA or 20 g of T80 improved digestibility and similarly favored the production parameters of dairy cows. In contrast, providing both (45 g of OA + 20 g of T80) had no additional benefits and moderated the positive responses observed in the individual treatments with OA and T80.

Videolaryngoscopy vs. direct Macintosh laryngoscopy in tracheal intubation in adults: a ranking systematic review and network meta-analysis.

Videolaryngoscopes are thought to improve glottic view and facilitate tracheal intubation compared with the Macintosh direct laryngoscope. However, we currently do not know which one would be the best choice in most patients undergoing anaesthesia. We designed this systematic review with network meta-analyses to rank the different videolaryngoscopes and the Macintosh direct laryngoscope. We conducted searches in PubMed and a further five databases on 11 January 2021. We included randomised clinical trials with patients aged ≥16 years, comparing different videolaryngoscopes, or videolaryngoscopes with the Macintosh direct laryngoscope for the outcomes: failed intubation; failed first intubation attempt; failed intubation within two attempts; difficult intubation; percentage of glottic opening seen; difficult laryngoscopy; and time needed for intubation. We assessed the quality of evidence according to GRADE recommendations and included 179 studies in the meta-analyses. The C-MAC and C-MAC D-Blade were top ranked for avoiding failed intubation, but we did not find statistically significant differences between any two distinct videolaryngoscopes for this outcome. Further, the C-MAC D-Blade performed significantly better than the C-MAC Macintosh blade for difficult laryngoscopy. We found statistically significant differences between the laryngoscopes for time to intubation, but these differences were not considered clinically relevant. The evidence was judged as of low or very low quality overall. In conclusion, different videolaryngoscopes have differential intubation performance and some may be currently preferred among the available devices. Furthermore, videolaryngoscopes and the Macintosh direct laryngoscope may be considered clinically equivalent for the time taken for tracheal intubation. However, despite the rankings from our analyses, the current available evidence is not sufficient to ensure significant superiority of one device or a small set of them over the others for our intubation-related outcomes.

Increasing levels of calcium salts of palm fatty acids affect production responses during the immediate postpartum and carryover periods in dairy cows.

Our objective was to determine the dose-response effects of calcium salts of palm fatty acids (CSPF) on nutrient digestibility and production responses of early-lactation dairy cows grazing on tropical pastures and to evaluate carryover effects throughout mid and late lactation. Forty multiparous dairy cows (Jersey × Holstein) with (mean ± standard error of the mean) 20 ± 1.69 kg of milk/d and 20 ± 5.0 d in milk were used in a randomized complete block design. During the treatment period, all cows were kept in a grazing system. The treatments were offered for 90 d (treatment period) and consisted of 4 increasing levels of CSPF: 0 (0 kg/d), 0.2 (0.2 kg/d), 0.4 (0.4 kg/d), and 0.6 (0.6 kg/d). Each treatment had 10 animals. Increasing CSPF from 0 to 0.6 kg/d replaced an equivalent amount of a corn-based concentrate supplement offered at 10 kg/d on an as-fed basis (8.96 kg/d as a dry matter basis). All cows were housed and received a diet without fat inclusion fed as total mixed ration once a day from 91 to 258 d of the experiment (carryover period). During the treatment period, increasing CSPF linearly decreased dry matter intake (1.20 kg/d), linearly increased neutral detergent fiber digestibility (3.90 percentage units), and quadratically increased total fat digestibility (6.30 percentage units at 0.4 kg/d CSPF). Increasing CSPF linearly increased the yields of milk (4.10 kg/d), milk fat (0.11 kg/d), milk lactose (0.19 kg/d), energy-corrected milk (ECM; 3.30 kg/d), and feed efficiency (ECM/dry matter intake, 0.34 kg/kg), and linearly decreased milk protein content (0.38 g/100 g), body weight change (0.05 kg/d), and body condition score (0.37). We observed interactions between CSPF and time during the carryover period. Overall, CSPF supplementation linearly increased or tended to increase milk yield until 202 d of the experiment with a similar pattern observed for all the other yield variables. In conclusion, supplementing CSPF from 0 to 0.6 kg/d during 90 d increased neutral detergent fiber and total fat digestibility and the yields of milk, milk fat, and ECM in early-lactation dairy cows grazing on tropical pastures. Most production measurements linearly increased during the treatment period, indicating that 0.6 kg/d CSPF was the best dose. Also, supplementing CSPF from 0 to 0.6 kg/d for 90 d during early lactation had positive carryover effects across mid and late lactation.

Nutrient digetibility and production responses of lactating dairy cows when saturated free fatty acid supplements are included in diets: A meta-analysis.

Our objective was to perform a series of meta-analyses to evaluate the effects of diets supplemented with saturated free fatty acid (FA) supplements (SFAA) compared with nonfat supplemented control diets (CON) on nutrient digestibility and production responses of lactating dairy cows and to determine whether experimental design affects responses to SFFA. We divided SFFA into C16:0-enriched supplements (PALM, FA supplements with ≥80% C16:0) and C16:0+C18:0-enriched supplements (MIX, FA supplements with ≥80% C16:0+C18:0). The database was formed from 32 peer-reviewed publications with SFFA supplemented at ≤3% diet dry matter (DM). We completed 3 different meta-analyses to meet our objectives. We analyzed the interaction between experimental design (continuous vs. change-over) and treatments (CON vs. SFFA; Meta.1). Regardless of experimental design, we evaluated the effect of treatment (CON vs. PALM vs. MIX; Meta.2) and the effect of 1-percentage-unit increase of MIX and PALM in diet DM (Meta.3). In Meta.1, there was no interaction between treatments and experimental design for any variable. In Meta.2, compared with CON, MIX had no effect on NDF digestibility, milk protein yield and energy corrected milk (ECM), increased the yields of milk (1.20 kg/d) and milk fat (0.04 kg/d), and decreased FA digestibility (5.20 percentage units). Compared with CON, PALM increased NDF digestibility (4.50 percentage units), the yields of milk (1.60 kg/d), milk fat (0.10 kg/d), milk protein (0.04 kg/d), and ECM (2.00 kg/d), and had no effect on FA digestibility. Compared with MIX, PALM tended to increase FA digestibility (3.20 percentage units), increased NDF digestibility (3.50 percentage units), milk fat yield (0.06 kg/d), and ECM (1.20 kg/d). In Meta.3, for each 1-percentage-unit increase of supplemental FA in diet DM, MIX had no effect on NDF digestibility, decreased FA digestibility, increased the yields of milk and milk fat, had no effect on milk protein yield, ECM and milk fat content, and decreased milk protein content. For each 1-percentage-unit increase of supplemental FA in diet DM, PALM increased NDF digestibility, had no effect on FA digestibility, increased the yields of milk, milk fat, ECM and milk fat content, tended to increase milk protein yield, and had no effect on milk protein content. Our results indicate no reason for the restrictive use of change-over designs in saturated FA supplementation studies and meta-analyses. Lactating dairy cows responded better to a FA supplement enriched in C16:0 compared with one containing C16:0 and C18:0.

Effects of calcium salts of palm fatty acids on nutrient digestibility and production responses of lactating dairy cows: A meta-analysis and meta-regression.

Our primary objective was to perform a meta-analysis and meta-regression to evaluate the effects of diets supplemented with calcium salts of palm fatty acids (CSPF) compared with nonfat supplemented control diets (CON) on nutrient digestibility and production responses of lactating dairy cows. Our secondary objective was to perform a meta-analysis to evaluate whether experimental design affects production responses to supplemental CSPF. The data set was formed from 33 peer-reviewed publications with CSPF supplemented at ≤3% diet dry matter. We analyzed the interaction between experimental design (continuous vs. change-over) and treatments (CON vs. CSPF) to evaluate whether experimental design affects responses to CSPF (Meta.1). Regardless of experimental design, we evaluated the effects of CSPF compared with CON on nutrient digestibility and production responses of lactating dairy cows by meta-analysis (Meta.2) and meta-regression (Meta.3) approaches. In Meta.1, there was no interaction between treatments and experimental design for any variable. In Meta.2, compared with CON, CSPF reduced dry matter intake [DMI, 0.56 ± 0.21 kg/d (±SE)] and milk protein content (0.05 ± 0.02 g/100 g), increased neutral detergent fiber (NDF) digestibility (1.60 ± 0.57 percentage units), the yields of milk (1.53 ± 0.56 kg/d), milk fat (0.04 ± 0.02 kg/d), and 3.5% fat corrected milk (FCM, 1.28 ± 0.60 kg/d), and improved feed efficiency [energy corrected milk (ECM)/DMI, 0.08 kg/kg ± 0.03]. There was no effect of treatment for milk protein yield, milk fat content, body weight, body weight change, or body condition score. Compared with CON, CSPF reduced the yield of de novo milk fatty acids (FA) and increased the yields of mixed and preformed milk FA. In Meta.3, we observed that each 1-percentage-unit increase of CSPF in diet dry matter reduced DMI, increased NDF digestibility, tended to increase FA digestibility, increased the yields of milk, milk fat, and 3.5% FCM, reduced the content of milk protein, reduced the yield of de novo milk FA, and increased the yields of mixed and preformed milk FA. In conclusion, our results indicate no reason for the restrictive use of change-over designs in CSPF supplementation studies or meta-analysis. Feeding CSPF increased NDF digestibility, tended to increase FA digestibility, and increased the yields of milk, milk fat, and 3.5% FCM. Additionally, CSPF increased milk fat yield by increasing the yields of mixed and preformed milk FA.

Abomasal infusion of oleic acid increases fatty acid digestibility and plasma insulin of lactating dairy cows.

Our objective was to determine whether abomasal infusions of increasing doses of oleic acid (cis-9 C18:1; OA) improved fatty acid (FA) digestibility and milk production of lactating dairy cows. Eight rumen-cannulated multiparous Holstein cows (138 d in milk ± 52) were randomly assigned to treatment sequence in a replicated 4 × 4 Latin square design with 18-d periods consisting of 7 d of washout and 11 d of infusion. Production and digestibility data were collected during the last 4 d of each infusion period. Treatments were 0, 20, 40, or 60 g/d of OA. We dissolved OA in ethanol before infusions. The infusate solution was divided into 4 equal infusions per day, occurring every 6 h, delivering the daily cis-9 C18:1 for each treatment. Animals received the same diet throughout the study, which contained (percent diet dry matter) 28% neutral detergent fiber, 17% crude protein, 27% starch, and 3.3% FA (including 1.8% FA from a saturated FA supplement containing 32% C16:0 and 52% C18:0). Infusion of OA did not affect intake or digestibility of dry matter and neutral detergent fiber. Increasing OA from 0 to 60 g/d linearly increased the digestibility of total FA (8.40 percentage units), 16-carbon FA (8.30 percentage units), and 18-carbon FA (8.60 percentage units). Therefore, increasing OA linearly increased absorbed total FA (162 g/d), 16-carbon FA (26.0 g/d), and 18-carbon FA (127 g/d). Increasing OA linearly increased milk yield (4.30 kg/d), milk fat yield (0.10 kg/d), milk lactose yield (0.22 kg/d), 3.5% fat-corrected milk (3.90 kg/d), and energy-corrected milk (3.70 kg/d) and tended to increase milk protein yield. Increasing OA did not affect the yield of mixed milk FA but increased yield of preformed milk FA (65.0 g/d) and tended to increase the yield of de novo milk FA. Increasing OA quadratically increased plasma insulin concentration with an increase of 0.18 µg/L at 40 g/d OA, and linearly increased the content of cis-9 C18:1 in plasma triglycerides by 2.82 g/100 g. In conclusion, OA infusion increased FA digestibility and absorption, milk fat yield, and circulating insulin without negatively affecting dry matter intake. In our short-term infusion study, most of the digestion and production measurements responded linearly, indicating that 60 g/d OA was the best dose. Because a quadratic response was not observed, improvements in FA digestibility and production might continue with higher doses of OA, which deserves further attention.

Spotting intruders: Species distribution models for managing invasive intertidal macroalgae.

Invasive macroalgae represent one of the major threats to marine biodiversity, ecosystem functioning and structure, as well as being important drivers of ecosystem services depletion. Many such species have become well established along the west coast of the Iberian Peninsula. However, the lack of information about the distribution of the invaders and the factors determining their occurrence make bioinvasions a difficult issue to manage. Such information is key to enabling the design and implementation of effective management plans. The present study aimed to map the current probability of presence of six invasive macroalgae: Grateloupia turuturu, Asparagopsis armata, Colpomenia peregrina, Sargassum muticum, Undaria pinnatifida, and Codium fragile ssp. fragile. For this purpose, an extensive field survey was carried out along the coast of the north-western Iberian Peninsula. Species distribution models (SDMs) were then used to map the presence probability of these invasive species throughout the study region on the basis of environmental and anthropogenic predictor variables. The southern Galician rias were identified as the main hotspots of macroalgal invasion, with a high probability of occurrence for most of the species considered. Conversely, the probability of presence on the Portuguese coast was generally low. Physico-chemical variables were the most important factors for predicting the distribution of invasive macroalgae contributing between 57.27 and 85.24% to the ensemble models. However, anthropogenic factors (including size of vessels, number of shipping lines, distance from ports, population density, etc.) considerably improved the estimates of the probability of occurrence for most of the target species. This study is one of the few to include anthropogenic factors in SDMs for invasive macroalgae. The findings suggest that management actions aimed at controlling these species should strengthen control and surveillance at ports, particularly in southern Galician rias. Early detection should be of main concern for risk assessment plans on the Portuguese coast.

Pre-operative voice evaluation as a hypothetical predictor of difficult laryngoscopy.

We examined the potential for voice sounds to predict a difficult airway as compared with prediction by the modified Mallampati test. A total of 453 patients scheduled for elective surgery under general anaesthesia with tracheal intubation were studied. Five phonemes were recorded and their formants analysed. Difficult laryngoscopy was defined as the Cormack-Lehane grade 3 or 4. Univariate and multivariate logistic regression were used to examine the association between some variables (mouth opening, sternomental distance, modified Mallampati and formants) and difficult laryngoscopy. Difficult laryngoscopy was reported in 29/453 (6.4%) patients. Among five regression models evaluated, the model achieving better performance to predict difficult laryngoscopy, after a variable selection criteria (stepwise, multivariate) and included a modified Mallampati classification (OR 2.920; 95%CI 1.992-4.279; p < 0.001), first formant of /i/(iF1) (OR 1.003; 95%CI 1.002-1.04; p < 0.001), and second formant of /i/(iF2) (OR 0.998; 95%CI 0.997-0.998; p < 0.001). The receiver operating curve for a regression model that included both formants and Mallampati showed an area under curve of 0.918, higher than formants alone (area under curve 0.761) and modified Mallampati alone (area under curve 0.874). Voice presented a significant association with difficult laryngoscopy during general anaesthesia showing a 76.1% probability of correctly classifying a randomly selected patient.

Lower levels of dehydroepiandrosterone sulfate are associated with more advanced liver fibrosis in chronic hepatitis C.

Chronic infection with the hepatitis C virus induces liver fibrosis, but it is unknown why some patients progress to advanced fibrosis while others remain with mild disease. Recently, an inverse association between serum levels of dehydroepiandrosterone sulphate (DHEA-S) and liver fibrosis in patients with nonalcoholic fatty liver disease was described, and it was postulated that dehydroepiandrosterone (DHEA) has antifibrotic effects. Our aim was to compare serum DHEA-S levels with liver fibrosis in hepatitis C patients. We collected serum samples from hepatitis C patients at the same day they underwent a liver biopsy. S-DHEA was compared to different stages of fibrosis. Binary logistic regression models were applied to evaluate independent variables associated to fibrosis. We included 287 patients (43.9% male). According to fibrosis stages 0, 1, 2, 3 and 4, median serum DHEA-S levels were 103 (26-462), 73 (5-391), 46 (4-425), 35 (6-292) and 28 (2-115) µg/dL, respectively (P < .001). Median serum DHEA-S levels were 74 (5-462) vs 36 (2-425) µg/dL for mild (F0-1) vs significant (F2-4) fibrosis, respectively (P < .001). Median serum DHEA-S levels were 64 (4-462) vs 31 (2-292) µg/dL for non advanced (F0-2) vs advanced fibrosis (F3-4), respectively (P < .001). The same association was found when the subgroup of HCV patients with and without steatosis or steatohepatitis was analysed. The association between lower DHEA-S levels and advanced fibrosis was independent of age, gender, diabetes mellitus, obesity and steatosis. Lower circulating DHEA-S levels are associated with more advanced stages of liver fibrosis in hepatitis C patients.

Comparison of the effect of two sports training methods on the flexibility of rhythmic gymnasts at different levels of biological maturation.

AIM: The present study aimed to assess the effects of two different sports training methods - traditional and maturational - on the flexibility of female rhythmic gymnasts at different levels of biological maturation. METHODS: The sample consisted of 120 children, randomly divided (by draw) into six groups of 20 children (eight and nine-years old): traditional training group (TG); maturational training group (MG); and the control group (CG). These were subdivided into early, normal and late, based on biological maturation assessment by hand/wrist X-ray examination. Flexibility was evaluated by angle goniometer testing, applying the LABIFIE protocol. A Lafayette Goniometer Set and Hoorn-Brasil exercise mat were used and the following exercises were performed: external shoulder rotation (ESR) and lumbar flexion (LF). Both the TG and MG participated in twice-weekly, 45-minute rhythmic gymnastics classes over 16 weeks. The TG used the traditional sports training method while the MG executed sporting activities according to biological maturation. The CG received no special treatment. RESULTS: The results showed a significant improvement (P<0.001) in the subgroups (late, normal and early) for both variables (∆ESR=7.54º and ∆LF=7.51º) in the eight and nine-year age groups. Moreover, in relation to division by biological maturity, better results were recorded in the early subgroups. CONCLUSION: Thus, it can be inferred that, due to the changes in important physical parameters as a result of maturation, selecting children for physical education should not be based solely on chronological, but primarily on biological maturation.

Case report. Familial balanced translocation leading to an offspring with phenotypic manifestations of 9p syndrome.

We report two similarly affected cousins (children of monozygotic twin sisters) with phenotypic features consistent with 9p deletion syndrome, including dysmorphic craniofacial features (trigonocephaly, midface hypoplasia, upward-slanting palpebral fissures and long philtrum), intellectual disability and disorders of sex development. Initial cytogenetic examination showed normal karyotypes in the probands and their respective parents, though multiplex ligation probe amplification revealed a 1q terminal duplication and a 9p terminal deletion in both affected children. Further analysis by fluorescence in situ hybridization, identified a familial balanced cryptic translocation t(1;9)(q44;p23) in the mothers, showing the importance of the association of molecular cytogenetic techniques in clinical genetics, given the implications for the care of patients and for genetic counseling.

Impact of 48-h water and feed deprivation and hydroxychloride sources of copper and zinc on the metabolism and performance of grazing Nellore cattle during the dry period.

Procedures such as transport and marketing can subject animals to water and feed deprivation and impair animal health and performance. Maintaining the mineral status of animals under these conditions can bring benefits to health and performance. The use of hydroxychloride mineral sources can improve mineral status, nutrient digestibility and performance. Two studies were conducted to investigate how the supplementation of 02 trace mineral sources of Cu and Zn and 48-hour water/feed deprivation would affect the performance and metabolism of grass-fed beef cattle. In the first study, 20 castrated and rumen-canulated Nellore steers (BW = 350 ±â€¯132 kg; 20 m) were distributed in individual pens, in a 2 × 2 factorial arrangement: supplemental Cu and Zn sources from inorganic vs hydroxychloride (HTM) and 48-hours deprivation (WFD) vs unrestricted (WFU) access to water and feed. The 57d of study was divided into two periods: (1) Adaptation from -21d to -1d and (2) evaluation from 0d to 36d. Interaction between deprivation × period was detected (P < 0.05) for digestibility of DM (DMD), organic matter (OMD), neutral detergent fiber (NDFD), and acid detergent fiber (ADFD). Deprivation increased DMD, OMD, NDFD, and ADFD immediately after the deprivation period (3-5d), but impaired digestibility at longer periods such as 11-13d and 32-34d. DM (DMI) and nutrient intake (P = 0.075), as well as NDFD were higher in HTM. Several ruminal parameters were affected by deprivation: short-chain fatty acids concentration decreased, while rumen pH increased (deprivation × time; P < 0.05); decreased propionate, butyrate and increased isobutyrate, isovalerate, and valerate in WFD (deprivation × time; P < 0.05), respectively. In the second study, eighty-four intact Nellore males (BW = 260 ±â€¯35 kg) were blocked by BW and randomly assigned to Urochloa brizantha cv. Marandu paddocks for 131d in a 2 × 2 factorial arrangement. Liver Cu was higher in WFU/HTM animals (mineral × deprivation; P < 0.05). Interaction between deprivation × period (P < 0.05) was detected for BW and average daily gain (ADG). On 2d and 12d after deprivation, WFD increased ADG and recovered the BW lost. In conclusion, water and feed deprivation imposed in these trials were able to impact several nutrient digestibility and ruminal fermentation parameters in short- and long-term. Performance was not affected by the studied factors. Furthermore, supplementation with sources of Cu and Zn hydroxychloride increased Cu in the liver and tended to increase DMI and NDFD.

Urinary tract infection analysis in a spinal cord injured population undergoing rehabilitation--how to treat?

STUDY DESIGN: Cross sectional study, including 38 outpatients. Standardized questionnaire was used and urine cultures were performed. OBJECTIVES: To study spinal cord-injured (SCI) patients bladder management, clinical aspects that symptomatic urinary tract infection (SUTI) may present and asymptomatic bacteriuria (AB) incidence with its antimicrobial susceptibility profile. SETTING: Spinal cord injury outpatient rehabilitation clinic. RESULTS: Clean intermittent catheterization is used by 71% of the patients. SUTI may have atypical clinical presentation (shivers, spasticity increase, headaches). In total, 65.7% (N=25) of the patients presented AB. Among these, the microorganisms isolated were resistant mainly to Ampicillin, Sulfamethoxazole-Trimethoprim and Norfloxacin, whose resistance rates were, respectively 73.3%, 60% and 33.3%. CONCLUSION: Special attention should be given to possible atypical symptoms for SUTI. Although a small amount of urine samples was analyzed, resistance rates against Ampicillin, Sulfamethoxazole-Trimethoprim, Ciprofloxacin and Nitrofurantoin appear to be higher among SCI patients compared to the general population, thus demonstrating the need for continuous monitoring of microorganisms susceptibility, in order to avoid therapeutic failure when dealing with this specific population.

Effects of lumbosacral epidural ketamine and lidocaine in xylazine-sedated cats.

In order to determine the analgesic and cardiovascular effects of the combination of epidural ketamine and lidocaine, 6 sedated cats were studied. Six healthy, young cats were used in a prospective randomised study. Each cat underwent 3 treatments, at least 1 week apart, via epidural injection: (1) ketamine (2.5 mg/kg), (2) lidocaine (4.0 mg/kg), and (3) ketamine (2.5 mg/kg) plus lidocaine (4.0 mg/kg). Epidural injections were administered through the lumbosacral space. Analgesia, motor block, sedation, heart rate, arterial blood pressure, respiratory rate and arterial oxygen saturation were measured. Rectal temperature was compared before and after sedation as well as after epidural administration of the drugs. Epidural administration of the ketamine/lidocaine combination induced prolonged analgesia extending from the coccygeal to the T13-L1 dermatomes, leading to severe ataxia. Cardiovascular effects were significant in all treatments: heart rate decreased, but there was a minimal reduction in arterial pressure. It was concluded that adding a dose of ketamine to epidural lidocaine in cats is feasible and effective.

Response of intertidal macrobenthic communities to long term human induced changes in the Eo estuary (Asturias, Spain): implications for environmental management.

Long term macrobenthos data together with physical habitat parameters were analysed to investigate spatial and temporal changes at an estuary under different anthropogenic pressures, mainly increasing shellfish farming. The aim was to assess the possible impacts of these pressures on the macrobenthic communities by comparing a period before and after changes in these pressures. Benthic samples were seasonally collected in 1990 (before major anthropogenic changes), 2000 and 2005 at the same sampling stations located on three different habitats in the Eo estuary (Northern Spanish coast). Multivariate and univariate methods were used to assess spatial variability of benthic assemblages and to compare community changes over time. Data from 1990 was assumed as the reference situation to appraise the subsequent impacts. We observed a significant spatial variability of the benthic assemblages in the system as a function of habitat heterogeneity in relation to sediment composition, presence/absence and density of seagrasses, and hydrodynamic regime. Changes were detected in the community composition at all sites during this 15 year period. The extent of changes was related to initial community conditions, rather than the intensity of the pressure. The results suggest that the responses of the benthic communities to human induced perturbations occurring in the system are largely dependent on its intrinsic buffer capacity, and that these communities have been able to cope with an increasing environmental stress (organic enrichment). In conclusion, to keep shellfish farming at a sustainable level without undesirable impacts, the disturbance intensity must be kept below the system carrying capacity. This will allow natural communities to cope with pressures and thus avoid further deterioration in ecological quality.