Legume-supplemented feed for children hospitalised with severe malnutrition: a phase II trial.

Children hospitalised with severe malnutrition have high mortality and readmission rates post-discharge. Current milk-based formulations target restoring ponderal growth but not the modification of gut barrier integrity or microbiome which increases the risk of gram-negative sepsis and poor outcomes. We propose that legume-based feeds rich in fermentable carbohydrates will promote better gut health and improve overall outcomes. We conducted an open-label phase II trial at Mbale and Soroti Regional Referral Hospitals, Uganda, involving 160 children aged 6 months to 5 years with severe malnutrition (mid-upper arm circumference (MUAC) < 11·5 cm and/or nutritional oedema). Children were randomised to a lactose-free, chickpea-enriched legume paste feed (LF) (n 80) v. WHO standard F75/F100 feeds (n 80). Co-primary outcomes were change in MUAC and mortality to day 90. Secondary outcomes included weight gain (> 5 g/kg/d), de novo development of diarrhoea, time to diarrhoea and oedema resolution. Day 90 MUAC increase was marginally lower in LF v. WHO arm (1·1 cm (interquartile range (IQR) 1·1) v. 1·4 cm (IQR 1·40), P = 0·09); day 90 mortality was similar (11/80 (13·8 %) v. 12/80 (15 %), respectively, OR 0·91 (95 % CI 0·40, 2·07), P = 0·83). There were no differences in any of the other secondary outcomes. Owing to initial poor palatability of the LF, ten children switched to WHO feeds. Per-protocol analysis indicated a trend to lower day 90 mortality and readmission rates in the LF (6/60 (10 %) and 2/60(3 %)) v. WHO feeds (12/71(17·5 %) and 4/71(6 %)). Further refinement of LF and clinical trials are warranted, given the poor outcomes in children with severe malnutrition.

Preoperative Feeding Fortification Among Infants with Congenital Heart Disease is Associated with Higher Growth Velocity in the First 30 Days Post-repair and Lower BMI Percentile for Age at 10 Years: A Retrospective Cohort Study.

It remains unclear how preoperative nutrition fortification impacts postoperative growth trajectories and nutritional status among infants with congenital heart disease. A single center retrospective cohort study was performed to evaluate measures of growth among patients who underwent cardiac repair at 0-18 months of age for atrial septal defect, ventricular septal defect, atrioventricular septal defect, or tetralogy of Fallot. Cohorts were analyzed at 0-30 and 31-60 days post-repair as well as at 2, 5, and 10 years of age. Records of 24 patients who received fortified nutrition and 60 patients who received unfortified nutrition preoperatively were reviewed. Those with fortified nutrition had higher growth velocities in the first 30 days post-repair compared to those with unfortified nutrition: 28.4 (23.8-83.3) grams per day versus 16.7 (7.1-21.4) grams per day, p = 0.004. Weight percentile for age was higher in the unfortified group at 2, 5, and 10 years of age (p = 0.02, p = 0.045, and p = 0.01). Body mass index (BMI) percentile for age was higher in the unfortified group at 5 and 10 years of age (p = 0.045 and p = 0.02) with a trend toward higher prevalence of either overweight or obesity compared to the fortified group (p = 0.13). reoperative nutrition fortification among infants with congenital heart disease is associated with higher growth velocity in the first 30 days post-repair and lower BMI percentile for age at 10 years. Further studies are needed to evaluate the association between preoperative nutrition fortification and postoperative outcomes, nutritional status, and prevalence of obesity in adolescence and adulthood.

Effect of Acacia mearnsii forage or tannin extract on rumen dry matter and crude protein degradation.

This study investigated rumen degradation kinetics of dry matter (DM) and crude protein (CP) in compound feed with different tannin extract inclusions and Acacia mearnsi forage (AMF) relative to dairy feeds (perennial ryegrass+white clover mixture pasture, maize silage, lucerne hay and Themeda triandra hay). The compound feed had 0.75%, 1.5% and 3% tannins extract inclusions while the control was a commercial compound feed. Triplicates of each feed per incubation period were incubated in two fistulated Jersey cows for 0, 6, 24, 48, 72, 96 and 120 h, resulting in six replicates per feed. Tannin extract inclusions in compound feed only affected (p < 0.05) the (a) fraction, degradation rate and potential degradability (PD) for DM degradation, and affected (p < 0.05) the (a) and (b) fractions, as well as PD for CP degradation. The (a) fraction and degradation rate for DM degradation changed linearly (p < 0.05). The (a) fraction, PD and effective degradability (ED) of DM degradation changed quadratically (p < 0.05). Except for the degradation rate, the feed type affected (p < 0.05) the degradation parameters in both DM and CP degradations. For DM and CP degradations, (a) fraction was similarly the least in Themeda triandra hay and AMF but similarly the highest in maize silage, perennial ryegrass+white clover mixture pasture and lucerne hay. The (b) fraction was the least in AMF for both DM and CP degradations but the highest for pasture's DM degradation and similarly the highest in maize silage, lucerne hay and T. triandra hay for CP degradation. The PD was the least in AMF for both DM and CP degradations and similarly the highest in pasture DM but similarly the highest in perennial ryegrass+white clover mixture pasture, maize silage and lucerne hay for CP degradation. Furthermore, the ED was the lowest in AMF and the highest for perrenial ryegrass + white clover mixture pasture for DM degradation and same trend was observed for CP degradation whereby perrenial ryegrass + white clover mixture pasture, maize silage and lucerne had the highest ED. Digestible undegraded protein was the highest in AMF and similarly the least in dairy feeds. Tannin source inclusion in ruminant diets should be moderate to prevent rumen DM or CP degradation limitation.

Wheat germ meal replaces cottonseed meal at different levels in diets of Ossimi lambs: Impact on growth performance, feed utilization and economic efficiency.

This experiment aimed to evaluate the replacement of cottonseed meal (CSM) with wheat germ meal (WGM) in diets of growing lambs on feed utilization and growth performance. Twenty-eight Ossimi male lambs (38 ± 0.8 kg weight), and 180 ± 5 days were divided randomly into four experimental groups in a complete randomized design for 105 days. Cottonseed meal was replaced with WGM at 0 (WGM0 treatment), 50 (WGM50 treatment), 75 (WGM75 treatment) and 100% (WGM100 treatment). The chemical analysis of the total essential and non-essential amino acids showed an increase at the WGM diet compared to CSM. The replacement of CSM with WGM linearly and quadratically improved (p ˂ 0.05) lambs' growth performance and feed conversion. The WGM50 and WGM100 treatments lowered (p ˂ 0.05) feed intake, without affecting nutrient digestibility or diets' nutritive. Feeding WGM increased (p ˂ 0.05) total protein, albumin, and urea-N concentrations in blood of lambs. The WGM100 treatment showed the highest relative percentage of net revenue compared to the other treatments. It is concluded that the complete replacement of CSM with WGM showed positive effects on lambs' performance and economic efficiency.

Assessing the combination efficiency of some unconventional feed resources with concentrates and Chloris gayana grass in mitigating ruminal methane production in vitro.

In a preliminary in vitro study, leaves of Acacia nilotica, Prosopis juliflora, Cajanus cajan, Leucaena leucocephala and seed kernel of Mangifera indica were identified as potential candidates in mitigating ruminal methane (CH4) production. The objective of the current study was to investigate the combination efficiency of these unconventional feeds with concentrate mix (CM) or Chloris gayana grass in CH4 reduction. Two feed combinations in different proportions were incubated in vitro with buffered rumen fluid at Hohenheim Gas test. In combination 1, C. gayana and CM were included as basal substrates, while in combination 2, A. nilotica, P. juliflora, C. cajan, L. leucocephala or M. indica seed kernel were included as CH4 reducing supplements at different proportions. The CH4 reducing potentials of feed combinations were presented as the ratio of CH4 to net gas production and expressed as percentage (pCH4). The pCH4 for CM and C. gayana was 16.7% and 16.9%, respectively, while it ranged from 3.18% in A. nilotica to 13.1% in C. cajan. The pCH4 was reduced (p < 0.05) from 14.6% to 9.39% when A. nilotica was combined with CM. In combination of L. leucocephala or C. cajan with CM, the pCH4 (p < 0.05) was reduced from 16.5% and 16.6% with the lowest proportion to 15.1% and 15.2% with the highest inclusion rate respectively. The combination of C. gayana with L. leucocephala or C. cajan reduced (p < 0.05) the pCH4 from 16.3% and 16.4% to 15.1% and 14.9% respectively. The pCH4 was reduced (p < 0.05) from 13.4% to 7.60% when A. nilotica was combined with C. gayana. Estimated digestible organic matter (dOM) and metabolizable energy (ME) increased (p < 0.05) with increasing proportions of M. indica seed kernel with CM or C. gayana. In conclusion, the combination of the basal substrates with unconventional supplements resulted in CH4 reduction without affecting the dOM and ME at lower inclusion rates. Animal-based experiments await to validate in vitro findings.

Nile tilapia and gilthead seabream dietary self-selection of alternative feeds.

Classical assessments of new fish feeds are anthropocentric, focusing mainly on growth. Although this methodology is accurate, it does not consider the fish' perspective. This study aimed to investigate the behavioural responses and feed preferences of Nile tilapia (Oreochromis niloticus) and gilthead seabream (Sparus aurata) through a self-selection trial using self-feeders. Both species were offered three feeds: a control (PD) commercial-like feed and two diets (ORG1 and ORG2) formulated with different inclusions of alternative ingredients to address some of the current environmental concerns and/or ethical issues often associated with commercial formulations. Three groups of tilapia with an average weight of 163.0 g ± 4.3 g (mean ± SD) and four groups of seabreams with 174.7 g ± 27.0 g were tested. Tilapia exhibited a preference for ORG2 (46.5%), influenced by the sensory properties of the feed and post-ingestion signals. Seabream did not show a preference for any feed. These findings highlight the effectiveness of self-selection experiments in allowing fish to express their feeding behaviour and preferences. Therefore, this approach should be considered in the initial screening and design of new aquaculture feeds and ingredients.

Micronutrient supplementation practices in relation to the World Health Organisation 2013 guidelines on management of severe acute malnutrition.

In 2013, the World Health Organisation (WHO) updated the recommendations for micronutrient deficiency correction in hospitalised under-5 children with complicated severe acute malnutrition (SAM). This study aimed to describe the micronutrient deficiency correction practices in relation to WHO 2013 recommendations. Data from medical records of under-5 children admitted for SAM management at two hospitals in South Africa and three tertiary hospitals in Ghana were extracted. Micronutrient correction practices were compared to the WHO 2013 recommendations by considering the dosage, timing of micronutrient supplementation (vitamin A, iron and folic acid) and therapeutic feeds administered. In total, 723 medical records were included. Nearly half (48.3%) of the children received at least one of the studied micronutrients as a supplement. Vitamin A was supplemented in 27.4% of the children, while iron and folic acid were supplemented in 9.5% and 34.9%, respectively. Among the children who received vitamin A, 60.1% received the first dose on Day 1 of admission. Also, 46.4% of the iron-supplemented children received iron within the first week of admission. Vitamin A, iron and folic acid were administered within the dose range of 100,000-180,000 IU, 3.1-7.7 mg per kg per day, and 3-5 mg per day, respectively. Additionally, 71.7% of the children reportedly received therapeutic feeds that met WHO recommendations. The micronutrient deficiency correction practices regarding dose and timing differed from the 2013 WHO guidelines. Qualitative studies investigating the reasons for the disparities are recommended.

In-vivo analysis of Protec™ and ß-glucan supplementation on innate immune performance and intestinal health of rainbow trout.

Functional diets are often given to fish during key stages to improve health through the interaction of the feed components with the host intestine. The additional factors added in these diets are known to modulate the immune response and as such may also offer protection against pathogenic challenges. The present study was undertaken to evaluate whether ß-glucan supplementation for 6 weeks can alter the magnitude of immune response to immunological challenges and subsequently offer an improved innate immune response to bacterial challenge in rainbow trout. Two experimental diets were used to study these effects: a basic commercial diet supplemented with ß-glucan and a commercially available functional diet (Protec™) that has ß-glucan as a functional component in addition to other components were compared to a basic commercial control diet. No significant differences were observed in biometric data. Histological analysis revealed a significantly greater number of goblet cells in the fish fed Protec™ and ß-glucan diets compared to those fed a control diet. Cell marker gene expression of distal intestine leucocytes indicated higher expression of T- and B-cells marker genes to both the ß-glucan containing diets in comparison to control. The Protec™ diet demonstrated modulation of innate immune markers after 6 weeks of feeding with key antimicrobial genes (SAA, HAMP, IL-1ß and TNFα) showing significant increases compared to the other diets. After stimulation with both PAMPs and an immune challenge with A. salmonicida fish fed the ß-glucan diet and the Protec™ exhibited modulation of the innate immune response. An immune challenge with A. salmonicida was carried out to identify if dietary composition led to differences in the innate immune response of rainbow trout. Modulation of the magnitude of response in some immune genes (SAA, IL-1ß and HAMP) was observed in both the distal intestine and head kidney in the Protec™ and ß-glucan fed fish compared to those fed the control diet.

Partial replacement of corn with chocolate byproducts or protected fat in diets of early lactating Holstein cows: feed utilization and lactational performance.

This study determined the effects of the partial replacement of corn with chocolate byproducts or protected fat on the performance of cows. Forty multiparous Holstein cows were assigned to four treatments in a completely randomized design for 90 d. The control diet was a complete diet containing 41.2% concentrate feed mixture, 41.2% corn silage, and 17.6% berseem hay. In the other experimental diets, each kg of crushed corn grain in the control diet (DM basis) was replaced with 600 g chocolate byproducts (CH), 400 g protected fat (PF), or 500 g of a mixture of chocolate byproducts and protected fat (1:1 DM basis) (CHPF). Both amounts of PF and CH had the same energy concentration as 1 kg of corn. The experimental treatments did not affect total intake; however, they increased (p < 0.001) daily production of milk, milk fat content, and feed efficiency. Moreover, treatments increased (p < 0.05) blood total protein, albumin, glucose, cholesterol, and triglyceride. The CH, PF, and CHPF treatments increased (p < 0.01) nutrient digestibility. It is concluded that replacing 1 kg of corn in the diet of lactating Holstein cows with PF at 400 g, followed by CHPF at 500 g, and CH at 600 g enhanced milk production and feed efficiency.

Feed rations fed by US dairy producers.

Feed rations used by US dairy producers are estimated using data from the USDA Agricultural Resource Management Survey. The 2016 dairy version of the survey was used, in which 955 respondents fully responded on feed usage. Surveyed farms milked ≥10 cows and were located in dairy states that together produced 96.5% of milk in the United States. Average feedstuff usage is estimated at the national level, as well as regional, production system, and farm size category levels. Significance of differences in feedstuff usage among the categories are determined using t-tests derived using the delete-a-group jackknife procedure. Results are compared with published university feed cost estimates. Differences in feedstuff usage are found by region, production system, and farm size categories.

Full-fat corn germ in diets for dairy cows as an alternative to ground corn.

The experiments reported in this research paper address the effects of replacing ground corn (GC) with full-fat corn germ (FFCG) on nutrient intake and digestibility, nitrogen utilization efficiency, performance, and predicted methane production in dairy cows fed cactus cladodes and sugarcane. We hypothesized that the inclusion of FFCG in the diet would not alter the performance of lactating cows but would reduce the predicted methane production in vivo. Ten multiparous Holstein cows at 90 ± 10 d of lactation and yielding 24.2 ± 3.5 kg milk/d were assigned to dietary treatments consisting of different levels of replacement of GC by FFCG (0; 25; 50; 75 and 100% of diet dry matter) in a replicated 5 × 5 Latin square design with 21-d periods. Methane production was predicted using an automated gas in vitro production system. Except for ether extract intake, which increased, the intake of all nutrients decreased linearly with the replacement of GC by FFCG. The digestibility of dry matter, organic matter and neutral detergent fiber reduced, whereas the digestibility of ether extract increased linearly with FFCG. There were no changes in the digestibility of crude protein. The nitrogen intake and daily excretion in urine and feces decreased, while nitrogen use efficiency increased linearly. There was no significant effect of diets on nitrogen balance or microbial protein synthesis and efficiency. The yield of protein, lactose and total solids in milk showed a quadratic behavior. On the other hand, milk fat yield and energy-corrected milk yield decreased linearly with the replacement of GC by FFCG. No effect on pH or ammonia nitrogen was observed. The production of methane (CH4, g/kg DM) and total CH4 (g/d), and CH4 intensity decreased linearly with the replacement of GC by FFCG. In conclusion, FFCG has been shown to be an effective source of fat to reduce methane production in dairy cows, partially supporting our initial hypothesis. However, as it decreases milk fat production, it is not recommended to replace more than 50% of GC by FFCG for lactating cows fed cactus cladodes and sugarcane.

Interconnect for Dense Electronically Scanned Antenna Array Using High-Speed Vertical Connector.

We present the design and the performance evaluation of a new interconnect for large-scale densely packed electronically scanned antenna arrays that utilize a high-speed digital board-to-board vertical connector. The application targets microwave tissue, imaging in the frequency range from 3 GHz to 8 GHz. The tissue-imaging arrays consist of hundreds of active antenna elements, which require low-reflection, low-loss, and low-crosstalk connections to their respective receiving and transmitting circuits. The small antenna size and the high array density preclude the use of coaxial connectors, which are also expensive and mechanically unreliable. Modern board-to-board high-speed connectors promise bandwidths as high as 12 GHz, along with high pin density, mechanical robustness, and low cost. However, their compatibility with the various transmission lines leading to/from the miniature printed antenna elements and microwave circuitry is not well studied. Here, we focus on the design of the transitions from coplanar waveguide transmission lines to/from a high-speed vertical connector. The performance of the interconnect is examined through electromagnetic simulations and measurements. Comparison is carried out with the expensive sub-miniature push-on sub-micro coaxial connectors commonly used in miniature radio-frequency electronics. The results demonstrate that high-speed vertical connectors can provide comparable performance in the UWB frequency range.

Interaction of low-level dietary supplementation of Chlorella vulgaris Beijerinck, 1890, and feeding duration on growth hormone, growth performance and serum biochemistry of red hybrid tilapia (Oreochromis mossambicus × Oreochromis niloticus).

Chlorella is one of the most widely accepted Chlorophyta used by many as livestock and aquaculture feed. Nonetheless, different studies on the overall performances of fish reported the unfavourable effect of high-level supplementations of Chlorella vulgaris. The current study determined the impact of low-level dietary supplementation of C. vulgaris alongside the different feeding durations and their interactions on the growth hormone (GH), growth performances, serum-biochemical indices, hepatic function and some immunological parameters of red hybrid tilapia. The fingerlings (mean weight: 14.25 ± 0.01 g, length: 13.5 ± 0.49 cm) were fed diets containing 0, 0.99%, 2.91% and 4.76% of C. vulgaris powder per kilogram dry diet for 90 days. GH, growth performance, serum-biochemical indices (total serum protein, albumin, globulin, glucose, aspartate aminotransferase and alanine aminotransferase) and some immunological (respiratory burst and lysozyme activities) parameters of the fish were examined after 30, 60 and 90 days of feeding. The results demonstrated that tilapia fed C. vulgaris-supplemented diets showed increased levels of respiratory burst, lysozyme, albumin and total protein, GH and growth performances (P < 0.05), and the effects were duration dependent. After the 90 days of feeding, there was no adverse effect on the hepatic function of the fish. Besides, low survivability was observed in the control group than in the group fed the experimental diets. The group fed the diet supplemented with 4.76% C. vulgaris had significantly higher (P < 0.05) lysozyme activity throughout the duration of the feeding experiment. These results indicate that C. vulgaris enhanced growth performances, GH concentration, serum-biochemistry and some immunological parameters of red hybrid tilapia.

Comparative evaluation of native top feeds of western Himalayas for utilization as goat's ration in mash and block form.

The current research was undertaken to scrutinize the effect of leaf meal mixture as concentrate mixture in the ration of goats. Leaf meal mixture (LMM) was prepared using equal quantities of ten top-foliages namely Acacia nilotica, Celtis australis, Ficus palmata, Ficus religiosa, Grewia optiva, Melia azadarach, Morus alba, Quercus incana, Salix alba and Zizyphus jujube obtained from district Poonch of Jammu region in western Himalayas. The LMM prepared was substituted for 15% in the concentrate mixture being fed to the goats. The study constituted of two trials. Concentrate mixture offered to the animals was in mash and multi-nutrient block in first and second trial respectively. A total of twelve non-descript, adult male goats were selected for each trial. Goats of 0-14 months age (27.71 ± 2.96 kg live body weight) of for first trial while goats of 12-16 months age (27.02 ± 2.93 kg live weight) for second trial were divided into control and treatment groups as per randomized block design and fed ad-lib wheat straw and concentrate mixture @ (20 g/kgW0.75). No significant variation was observed (p > 0.05) in body weight, feed and DM intake among all groups in both trials. Comparable intake as well as digestibility of various nutrients like DM, OM, CP, EE, CF, NFE, NDF, ADF and TDN were found between the two groups during individual trials. There was a positive nitrogen, calcium and phosphorus balance among all experimental animals in both the trials. Serum enzymes ALT, AST and haemato-biochemical parameters like total protein, albumin, globulin, albumin: globulin and blood urea nitrogen (BUN) showed no significant differences during both trials in all groups, being within normal physiological levels. However, haemoglobin concentration was significantly higher (P < 0.05) in treatment group with respect to the control group in first trial. On the basis of current results, it can be established that leaf meal mixture can successfully be used to replace concentrate mixture up to 15% in the ration of goats without expecting any adverse impacts on their growth and overall health.

New insights in improving sustainability in meat production: opportunities and challenges.

Treating livestock as senseless production machines has led to rampant depletion of natural resources, enhanced greenhouse gas emissions, gross animal welfare violations, and other ethical issues. It has essentially instigated constant scrutiny of conventional meat production by various experts and scientists. Sustainably in the meat sector is a big challenge which requires a multifaced and holistic approach. Novel tools like digitalization of the farming system and livestock market, precision livestock farming, application of remote sensing and artificial intelligence to manage production and environmental impact/GHG emission, can help in attaining sustainability in this sector. Further, improving nutrient use efficiency and recycling in feed and animal production through integration with agroecology and industrial ecology, improving individual animal and herd health by ensuring proper biosecurity measures and selective breeding, and welfare by mitigating animal stress during production are also key elements in achieving sustainability in meat production. In addition, sustainability bears a direct relationship with various social dimensions of meat production efficiency such as non-market attributes, balance between demand and consumption, market and policy failures. The present review critically examines the various aspects that significantly impact the efficiency and sustainability of meat production.

Lack of Enteral Feeding Associated with Mortality in Prematurity and Necrotizing Enterocolitis.

BACKGROUND: Necrotizing Enterocolitis (NEC) remains a significant cause of morbidity and mortality. Recently, there has been an increased recognition of the importance of intestinal immunity and the associations with antibiotics and enteral feeds in the pathophysiology of NEC. The primary purpose of this study is to examine the association of enteral feeds on the survival of premature neonates with NEC. MATERIAL AND METHODS: A retrospective review using the Vermont Oxford Network for a Level IV NICU from January 1, 2013 through December 31, 2019 was performed. All neonates had a gestational age between 22 to 29 weeks, weighed at least 300 grams (n = 653), had a reported enteral feed status and were treated for NEC (n = 43). Data analysis utilized two-tailed t-tests for NEC and infection rates then Fisher's exact tests for survival status. RESULTS: The incidence of NEC in the population was 6.6% (43/653). Of the 43 neonates treated for NEC, 27 were enterally fed, while the other 16 were not. All 27 neonates with NEC that were able to achieve enteral feeds survived and had an infection rate of 22.2%. Meanwhile, all 16 neonates with NEC that were unable to achieve enteral feeds died and had an infection rate of 62.5%. CONCLUSIONS: There is a significant association between enteral feeds and NEC, survival, and infection rates in premature neonates. These findings support the importance of intestinal immunity and the microbiota in NEC. Given the limitations of the retrospective review, the profound survival advantage with enteral feeds reinforces the need for further study.

Postoperative feeding in neonatal duodenal obstruction.

BACKGROUND: Findings from manometry studies and contrast imaging reveal functioning gastric physiology in newborns with duodenal atresia and stenosis. Stomach reservoir function should therefore be valuable in aiding the postoperative phase of gastric feeding. The aim of this study was therefore to compare the feasibility of initiating oral or large volume(s) gavage feeds vs small volume bolus feeds following operation for congenital duodenal anomalies. METHODS: Single-center electronic medical records of all babies with duodenal atresia and stenosis admitted to a university surgical center during January 1997-September 2021 were analyzed. A fast-fed group (FF) included newborns fed with oral or gavage feeds advanced at a rate of at least 2.5 ml/kg and then progressed more than once a day vs slow-fed group (SF) fed with gavage feeds at incremental rate less than 2.5 ml/kg/day for each time period of oral tolerance or by drip feeds. Total feed volume was limited to 120-150 ml/kg/day in the respective study cohort populations. RESULTS: Fifty-one eligible patients were recruited in the study - twenty-six in FF group and twenty-five in SF group. Statistically significant differences were observed in the (i) date of first oral feeds (POD 7.7 ± 3.2 vs 16.1 ± 7.7: p < 0.001), and (ii) first full feeds (POD 12.5 ± 5.3 vs 18.8 ± 9.7: p < 0.01) in FF vs SF study groups. CONCLUSION: Initial feeding schedules with oral or incremental gavage-fed rates of at least 2.5 ml/kg in stepwise increments and multi-steps per day is wholly feasible in the postoperative feeding regimens of neonates with congenital duodenal disorders. Significant health benefits are thus achievable in these infants allowing an earlier time to acquiring full enteral feeding and their hospital discharge.

Chlorella vulgaris Extracts as Modulators of the Health Status and the Inflammatory Response of Gilthead Seabream Juveniles (Sparus aurata).

This study aimed to evaluate the effects of short-term supplementation, with 2% Chlorella vulgaris (C. vulgaris) biomass and two 0.1% C. vulgaris extracts, on the health status (experiment one) and on the inflammatory response (experiment two) of gilthead seabream (Sparus aurata). The trial comprised four isoproteic (50% crude protein) and isolipidic (17% crude fat) diets. A fishmeal-based (FM), practical diet was used as a control (CTR), whereas three experimental diets based on CTR were further supplemented with a 2% inclusion of C. vulgaris biomass (Diet D1); 0.1% inclusion of C. vulgaris peptide-enriched extract (Diet D2) and finally a 0.1% inclusion of C. vulgaris insoluble fraction (Diet D3). Diets were randomly assigned to quadruplicate groups of 97 fish/tank (IBW: 33.4 ± 4.1 g), fed to satiation three times a day in a recirculation seawater system. In experiment one, seabream juveniles were fed for 2 weeks and sampled for tissues at 1 week and at the end of the feeding period. Afterwards, randomly selected fish from each group were subjected to an inflammatory insult (experiment two) by intraperitoneal injection of inactivated gram-negative bacteria, following 24 and 48 h fish were sampled for tissues. Blood was withdrawn for haematological procedures, whereas plasma and gut tissue were sampled for immune and oxidative stress parameters. The anterior gut was also collected for gene expression measurements. After 1 and 2 weeks of feeding, fish fed D2 showed higher circulating neutrophils than seabream fed CTR. In contrast, dietary treatments induced mild effects on the innate immune and antioxidant functions of gilthead seabream juveniles fed for 2 weeks. In the inflammatory response following the inflammatory insult, mild effects could be attributed to C. vulgaris supplementation either in biomass form or extract. However, the C. vulgaris soluble peptide-enriched extract seems to confer a protective, anti-stress effect in the gut at the molecular level, which should be further explored in future studies.

Standing-Wave Feeding for High-Gain Linear Dielectric Resonator Antenna (DRA) Array.

A novel feeding method for linear DRA arrays is presented, illuminating the use of the power divider, transitions, and launchers, and keeping uniform excitation to array elements. This results in a high-gain DRA array with low losses with a design that is simple, compact and inexpensive. The proposed feeding method is based on exciting standing waves using discrete metallic patches in a simple design procedure. Two arrays with two and four DRA elements are presented as a proof of concept, which provide high gains of 12 and 15dBi, respectively, which are close to the theoretical limit based on array theory. The radiation efficiency for both arrays is about 93%, which is equal to the array element efficiency, confirming that the feeding method does not add losses as in the case of standard methods. To facilitate the fabrication process, the entire array structure is 3D-printed, which significantly decreases the complexity of fabrication and alignment. Compared to state-of-the-art feeding techniques, the proposed method provides higher gain and higher efficiency with a smaller electrical size.

Impact of prelacteal feeds and neonatal introduction of breast milk substitutes on breastfeeding outcomes: A systematic review and meta-analysis.

The introduction of fluids other than breast milk during the first few days of life or later neonatal period has been identified as a risk factor for suboptimal breastfeeding (BF) outcomes in numerous studies using varying study designs. However, the relationship between early introduction of fluids other than breast milk and BF outcomes has not been systematically assessed using only prospective studies that can establish temporality, which is critical for determining whether observed associations are causal. We conducted a systematic review and meta-analysis of prospective studies to assess if there is a difference in BF outcomes as a result of the introduction of: (a) milk-based prelacteals, (b) water-based prelacteals and (c) breast milk substitutes (BMS) between 4 days and 4 weeks postpartum. We searched PubMed, Lilacs, Web of Science and other repositories for original research investigating the relationship between early introduction of prelacteals and/or BMS and BF outcomes. Forty-eight studies met the inclusion criteria for the systematic review. Of the 39 prelacteal feeding studies, 27 had the prerequisite statistical information for inclusion in the meta-analysis. Findings from the meta-analysis showed a relationship between prelacteals and exclusive BF cessation (RR 1.44; 1.29-1.60) and any BF cessation (2.23; 1.63-3.06) among infants under 6 months old. Nine studies focusing on the introduction of BMS during the neonatal period identified this practice as a statistically significant risk factor for a shorter BF duration. Effective interventions are needed to prevent the introduction of unnecessary milk-based prelacteals and BMS during the perinatal and neonatal periods to improve BF outcomes.