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An experiment was conducted to estimate the nutritional requirements of calcium (Ca) and available phosphorus (aP) for Japanese quails (Coturnix coturnix japonica) in the egg-laying stage (64–168 D). The experiment was an entirely randomized design, in a factorial scheme (Ca = 1.70, 2.40, 3.10, and 3.80% and aP = 0.15, 0.30, 0.45, and 0.60%), with 3 replicates and 10 quails per experimental unit. No interactions were found for quail body weight and daily feed intake (DFI) (P > 0.05). However, body weight decreased linearly (P < 0.05) as the levels of Ca increased, whereas DFI exhibited a quadratic effect (P < 0.05) for both Ca and aP. The lowest values of DFI were estimated in 2.79 and 0.36% for Ca and aP, respectively. Egg production, egg mass, and feed conversion ratio per egg dozen presented significant interaction in which all of them had a quadratic effect (P < 0.05), with estimations for maximum yield in feed containing 2.74, 2.71, 2.75, and 2.74% Ca and 0.40, 0.39, 0.39, and 0.40% aP. The concentration of Ca in the eggshell increased linearly as per the levels of Ca studied, having a quadratic effect for aP levels, with a maximum point of 0.44%. In relation to the bone parameters, there was a linear interaction for Ca and aP in bone density and bone resistance (BR) of the femur, with a quadratic effect in BD estimating 2.84 and 0.50% for Ca and aP, respectively. In BR, the estimation was 3.27% Ca, with linear increase for aP. The BR of the tibiotarso increased linearly as per the Ca levels, obtaining the same Ca concentration response in this bone. As conclusion, when considering the estimations obtained through overlapped contour plots, the best responses to the effects of Ca and aP on productive characteristics were estimated at 2.68% Ca and 0.38% aP to produce feed for egg-laying Japanese quails.

Background: Critically ill patients frequently encounter disruptions in their circadian rhythms in the intensive care unit (ICU) environment. New lighting systems have been developed to enhance daytime light levels and to promote circadian alignment., Objectives: To investigate the impact of implementing an innovative lighting technology that mimics natural light and reproduce the colour of the sky., Design: Prospective, observational, non-randomized comparative trial. ICU patients were exposed to either a cutting-edge lighting system based on new technology (intervention group) or a conventional lighting system using fluorescent bulbs (control group)., Setting: An Italian intensive care unit with ten beds and five windowless rooms, thereby denying access to natural light. Three rooms had new lighting technology., Main Outcome Measures: The two groups were compared to assess the prevalence or absence of delirium and the need for sedatives during ICU stay. The secondary aim was to assess the presence of anxiety, depression, and post-traumatic stress disorder in patients at 3, 6, and 12 months after ICU discharge., Results: 86 patients were included: 52 (60 %) in the intervention group and 34 (40 %) in the control group. Seventy-nine patients (82 %) were alive at ICU discharge. Fourteen patients (16 %) developed delirium (intervention group: n = 8 [15 %] vs. control group: n = 6 [18 %] in the control group, (P=0.781). The use of sedative drugs and neuromuscular blocking agents was similar in both the groups. No differences in the incidence of anxiety, depression, or post-traumatic stress disorders were observed among patients who underwent follow-up visits., Conclusions: Compared to traditional fluorescent tube lighting, the innovative lighting system did not provide any significant benefit in reducing the frequency of delirium or the necessity for sedative medications., Implications for Clinical Practice: A single intervention, the use of lights that mimic sunny light and the sky, did not result in a statistically significant reduction in the incidence of delirium. Delirium has a multifactorial aetiology, necessitating interventions that are multifaceted and address different domains., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background and Problem: Existing healthcare systems have been put under immense pressure during the COVID-19 pandemic. Disruptions in essential maternal and newborn services have come from even high-income countries within the World Health Organization (WHO) European Region., Aim: To describe the quality of care during pregnancy and childbirth, as reported by the women themselves, during the COVID-19 pandemic in Sweden, using the WHO 'Standards for improving quality of maternal and newborn care in health facilities'., Methods: Using an anonymous, online questionnaire, women ≥18 years were invited to participate if they had given birth in Sweden from March 1, 2020 to June 30, 2021. The quality of maternal and newborn care was measured using 40 questions across four domains: provision of care, experience of care, availability of human/physical resources, and organisational changes due to COVID-19., Findings: Of the 5003 women included, n = 4528 experienced labour. Of these, 46.7% perceived a poorer quality of maternal and newborn care due to the COVID-19. Fundal pressure was applied in 22.2% of instrumental vaginal births, 36.8% received inadequate breastfeeding support and 6.9% reported some form of abuse. Findings were worse in women undergoing prelabour Caesarean section (CS) (n = 475). Multivariate analysis showed significant associations of the quality of maternal and newborn care to year of birth (P < 0.001), parity (P < 0.001), no pharmacological pain relief (P < 0.001), prelabour CS (P < 0.001), emergency CS (P < 0.001) and overall satisfaction (P < 0.001)., Conclusion: Considerable gaps over many key quality measures and deviations from women-centred care were noted. Findings were worse in women with prelabour CS. Actions to promote high-quality, evidence-based and respectful care during childbirth for all mothers are urgently needed., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To evaluate the imaging features of routine admission chest X-ray in patients referred for novel Coronavirus 2019 infection., Methods: All patients referred to the emergency departments, RT-PCR positive for SARS-CoV-2 infection were evaluated. Demographic and clinical data were recorded. Two radiologists (8 and 15 years of experience) reviewed all the X-ray images and evaluated the following findings: interstitial opacities, alveolar opacities (AO), AO associated with consolidation, consolidation and/or pleural effusion. We stratified patients in groups according to the time interval between symptoms onset (cut-off 5 days) and X-ray imaging and according to age (cut-off 60 years old). Computed tomography was performed in case of a discrepancy between clinical symptoms, laboratory and X-ray findings, and/or suspicion of complications., Results: A total of 468 patients were tested positive for SARS-CoV-2. Lung lesions primarily manifested as interstitial opacities (71.7%) and AO opacities (60.5%), more frequently bilateral (64.5%) and with a peripheral predominance (62.5%). Patients admitted to the emergency radiology department after 5 days from symptoms onset, more frequently had interstitial and AO opacities, in comparison to those admitted within 5 days, and lung lesions were more frequently bilateral and peripheral. Older patients more frequently presented interstitial and AO opacities in comparison to younger ones. Sixty-eight patients underwent CT that principally showed the presence of ground-glass opacities and consolidations., Conclusions: The most common X-ray pattern is multifocal and peripheral, associated with interstitial and alveolar opacities. Chest X-ray, compared to CT, can be considered a reliable diagnostic tool, especially in the Emergency setting., (Copyright © 2020 Elsevier Ltd. All rights reserved.)