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This work describes spectral distributions of neutrons obtained as function of energy and direction at four workplace fields at the Krümmel reactor in Germany. Values of personal dose equivalent Hp(10) and effective dose E are determined for different directions of a person's orientation in these fields and readings of personal neutron dosemeters—especially electronic dosemeters—are discussed with respect to Hp(10) and E. [ABSTRACT FROM AUTHOR]

Aims Because the elderly are increasingly referred for operation, we reviewed the results of cardiac surgery in patients of 80 years or older.Methods and Results Records of 182 consecutive octogenarians who had had cardiac operations between 1992 and 1998 were reviewed. Follow-up was 100% complete. Seventy patients had coronary grafting (CABG), 70 aortic valve replacement, 30 aortic valve replacement+CABG, and 12 mitral valve repair/replacement. Rates of hospital death, stroke, and prolonged stay (>14 days) were as follows: CABG: 7 (10%), 2 (2·8%) and 41 (58%); aortic valve replacement: 6 (8·5%), 2 (2·8%) and 32 (45·7%); aortic valve replacement+CABG: 8 (26·5%), 1 (3·8%) and 14 (46·6%); mitral valve repair/replacement: 3 (25%), 1 (8·3%) and 5 (41·6%). Multivariate predictors (P<0·05) of hospital death were New York Heart Association functional class, urgent procedure, prolonged cardiopulmonary bypass time, and, after aortic valve replacement, previous percutaneous aortic valvuloplasty. Ascending aortic atheromatous disease was predictive of stroke, while pre-operative myocardial infarction was predictive of prolonged hospital stay. Actuarial 5-year survival was as follows: CABG, 65·8±8·8%; aortic valve replacement, 63·6±7·1%; aortic valve replacement+CABG, 62·4±6·8%; mitral valve repair/replacement, 57·1±5·6%; and total, 63·0±5·6%. Multivariate predictors of late death were pre-operative myocardial infarction, and urgent procedure. Ninety percent of long-term survivors were in New York Heart Association class I or II, and 87% believed having a heart operation after age 80 years was a good choice.Conclusion Cardiac operations are successful in most octogenarians with increased hospital mortality, and longer hospital stay. Long-term survival and quality of life are good. [ABSTRACT FROM PUBLISHER]

Prompt recognition and management of critical events is pivotal for the provision of safe anesthetic care. This requires a well-functioning team that focuses on effective communication, timely decision-making, and escalation of potential complications. We believe that variation in bedside care leads to "near-misses," adverse outcomes, and serious safety events (SSEs). The principles of an escalation culture have been used successfully in other highly reliable industries such as aviation, military, and manufacturing. We discuss here the introduction of a unique and compelling thought-process for developing an intraoperative escalation protocol that is specifically tailored for our institution. Inspired by a critical intraoperative event, this departmental protocol was developed based on an analysis of multispecialty literature and expert opinion to decrease the incidence of SSEs. It includes a stepwise approach and incorporates patient-specific information to guide team members who encounter dynamic clinical situations. The implementation of the protocol has facilitated continuous quality improvement through iterative education, improving communication, and enhancing decision-making. Concurrently, we have plans to incorporate technology and electronic decision support tools to enhance real-time communication, monitor performance, and foster a culture of safety., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 International Anesthesia Research Society.)

There is a rapidly growing interest in how the avian intestine is affected by dietary components and feed additives. The paucity of physiologically relevant models has limited research in this field of poultry gut health and led to an over-reliance on the use of live birds for experiments. The development of complex 3D intestinal organoids or "mini-guts" has created ample opportunities for poultry research in this field. A major advantage of the floating chicken intestinal organoids is the combination of a complex cell system with an easily accessible apical-out orientation grown in a simple culture medium without an extracellular matrix. The objective was to investigate the impact of a commercial proprietary blend of organic acids and essential oils (OA+EO) on the innate immune responses and kinome of chicken intestinal organoids in a Salmonella challenge model. To mimic the in vivo prolonged exposure of the intestine to the product, the intestinal organoids were treated for 2 days with 0.5 or 0.25 mg/mL OA+EO and either uninfected or infected with Salmonella and bacterial load in the organoids was quantified at 3 hours post infection. The bacteria were also treated with OA+EO for 1 day prior to challenge of the organoids to mimic intestinal exposure. The treatment of the organoids with OA+EO resulted in a significant decrease in the bacterial load compared to untreated infected organoids. The expression of 88 innate immune genes was investigated using a high throughput qPCR array, measuring the expression of 88 innate immune genes. Salmonella invasion of the untreated intestinal organoids resulted in a significant increase in the expression of inflammatory cytokine and chemokines as well as genes involved in intracellular signaling. In contrast, when the organoids were treated with OA+EO and challenged with Salmonella , the inflammatory responses were significantly downregulated. The kinome array data suggested decreased phosphorylation elicited by the OA+EO with Salmonella in agreement with the gene expression data sets. This study demonstrates that the in vitro chicken intestinal organoids are a new tool to measure the effect of the feed additives in a bacterial challenge model by measuring innate immune and protein kinases responses., Competing Interests: Author ES and LL were employed by the company Jefo Nutrition Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare that this study received funding from Jefo Nutrition Inc. .Jefo Nutrition Inc. provided research support and played role in the decision to publish and study design, but not in the data collection and analysis. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Mitchell, Sutton, Elango, Borowska, Perry, Lahaye, Santin, Arsenault and Vervelde.)

The intestinal wall has on its surface, protrusions called villi that are responsible for the absorption of nutrients. Commonly, these structures have their dimensions measured to related more area surface with better absorption. However, the measurement of these villi neglects the inflammation and the presence of immature cells that increase the surface area but affect negatively the absorption and compromise the animal performance. The measurements of villi/crypt are traditional tools in animal research; however, they may overlook alterations that impact the mucosal functionality. This study aimed to compare the morphometry of the intestinal villi/crypt with the I See Inside (ISI) scoring methodology, exploring their correlation with zootechnical performance. Therefore, broilers were grouped as nonchallenged (NC) and challenged with Eimeria (CH) and jejunum samples were collected at 22 d for histological analysis. The same villi were submitted to the ISI methodology, which is based on the scoring of 8 parameters related to the inflammatory process, and the measurements of villus height (VH), villus width (VW), crypt depth (CD), crypt width (CW), VH:CD ratio and villi absorptive surface (VAS). The CH group presented higher ISI total score, VW, CD, CW and lower VH, VH:CD, and VAS in comparison to the NC group. While the villi/crypt morphometry did not exhibit correlations with performance, the presence of Eimeria oocysts and the ISI total score was positively correlated (P < 0.05) with the feed conversion ratio (FCR), demonstrating a statistical interaction between high ISI scores and worse performance. In conclusion, a larger villus is not related to better intestinal functionality when this enlargement is unleashed by the immune processes occurring inside. The scoring system that evaluates the type of alteration observed has a direct impact on the animal's zootechnical performance which is not observed with the single metric surface evaluation., Competing Interests: DISCLOSURES This statement is to certify that all authors have seen and approved the manuscript being submitted. The authors declare that there is no conflict of interest in this research., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

One-day-old male broiler chickens (Ross 308) were assigned to 3 dietary treatments in a completely randomized design with 8 replicates per treatment, and 4 birds per replicate. The control group was fed a basal control diet, and the 2 test groups were fed the basal control diet supplemented with 150 and 300 mg/kg of protected complex of biofactors and antioxidants [P(BF+AOX)], respectively. The P(BF+AOx) is a combination of vitamins, L-tryptophan and biofactors such as fermentation extracts (Jefo Nutrition Inc., Saint-Hyacinthe, QC, Canada). Dietary P(BF+AOX) did not affect growth performance and breast meat quality (water holding capacity, cooking loss, shear force, and texture profile analysis), but the addition of 150 mg/kg of P(BF+AOX) decreased the relative weight of liver, heart, and spleen (P < 0.05). The addition of 150 mg/kg of P(BF+AOX) tended to increase (P = 0.051) the cold carcass yield. The addition of 150 and 300 mg/kg of P(BF+AOX) decreased (P = 0.002) the cooler carcass shrink, but the relative weight of fat pad increased (P = 0.032) in chickens fed 300 mg/kg P(BF+AOx) than in those of birds fed the control diet. On the other hand, the addition of 300 mg/kg of P(BF+AOX) decreased (P = 0.041) the serum level of uric acid compared with those of birds fed the basal diet. Broiler chickens fed diets supplemented with 150 mg/kg of diet had higher (P < 0.05) mRNA expressions of jejunal SOD1 and interleukins 6 and 10 (IL-6, IL-10). The findings suggest that P(BF+AOX) could be considered as a functional nutrient in broiler diets up to a concentration of 150 mg/kg because of its favorable effects on maintaining intestinal barrier function as well as carcass traits, while excess levels (300 mg/kg) had exhibited superior effect on the serum level of uric acid compared with those of birds fed the control diet., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Addition of vitamins and antioxidants has been long associated with increased immunity and are commonly used in the poultry industry; however, less is known regarding their use in broiler breeder hens. The objective of this study was to determine if feeding a complex of protected biofactors and antioxidants composed of vitamins and fermentation extracts to broiler breeder hens conferred resistance against Salmonella enterica serovar Enteritidis (S. Enteritidis) in the progeny chicks. Three-day-old chicks from control- and supplement-fed hens were challenged with S. Enteritidis and necropsied 4- and 11-days postchallenge (dpc) to determine if there were differences in invasion and colonization. Serum and jejunum were evaluated for various cytokine and chemokine production. Fewer (P = 0.002) chicks from supplement-fed hens had detectable S. Enteritidis in the ceca (32.6%) compared to chicks from control-fed hens (64%). By 11 dpc, significantly (P < 0.001) fewer chicks from supplement-fed hens were positive for S. Enteritidis (liver [36%]; ceca [16%]) compared to chicks from the control hens (liver [76%]; ceca [76%]). The recoverable S. Enteritidis in the cecal content was also lower (P = 0.01) at 11 dpc. In additional to the differences in invasion and colonization, cytokine and chemokine production were distinct between the 2 groups of chicks. Chicks from supplement-fed hens had increased production of IL-16, IL-6, MIP-3α, and RANTES in the jejunum while IL-16 and MIP-1β were higher in the serum of chicks from the control-fed hens. By 11 dpc, production of IFN-γ was decreased in the jejunum of chicks from supplement-fed hens. Collectively, these data demonstrate adding a protected complex of biofactors and antioxidants to the diet of broiler breeder hens offers a measure of transgenerational protection to the progeny against S. Enteritidis infection and reduces colonization that is mediated, in part, by a robust and distinct cytokine and chemokine response locally at the intestine and systemically in the blood., (Published by Elsevier Inc.)

The objective of the present study was to evaluate the effect of protected organic acids (OA) and essential oils (EO) [P(OA + EO)] on the intestinal health of broiler chickens raised under field conditions. The study was conducted on four commercial farms. Each farm consisted of four barns, two barns under a control diet and two tested barns supplemented with P(OA + EO), totaling 16 barns [8 control and 8 under P(OA + EO)]. The control group was supplemented with antibiotic growth promoters [AGP; Bacitracin Methylene Disalicylate (50 g/ton) during starter, grower and finisher 1, and flavomycin (2 g/ton) during finisher 2]. The tested group was supplemented with 636, 636, 454, and 454 g/ton of P(OA + EO) during starter, grower, finisher 1 and 2, respectively. Eighty birds were necropsied (40/treatment; 20/farm; and 5/barn) to collect blood, jejunal tissue, and cecal contents. The data were submitted to analysis of variance (ANOVA) ( P < 0.05) or Kruskal-Wallis' test and the frequency of antimicrobial resistant (AMR) genes was analyzed by Chi-Square test ( P < 0.05). It was observed that the supplementation of P(OA + EO) reduced ( P < 0.05) the histopathology scores, such as the infiltration of inflammatory cells in the epithelium and lamina propria and tended ( P = 0.09) to reduce the serum concentration of calprotectin (CALP). The supplementation of P(OA + EO) reduced the serum concentration of IL-12 ( P = 0.0001), IL-16 ( P = 0.001), and Pentraxin-3 ( P = 0.04). Additionally, P(OA + EO) maintained a cecal microbiota similar to birds receiving AGP. The substitution of AGP by P(OA + EO) reduced ( P < 0.05) the frequency of four AMR genes, related to gentamicin (three genes), and aminoglycoside (one gene). Overall, the inclusion of P(OA + EO), and removal of AGP, in the diets of commercially raised broiler chickens beneficially changed the phenotype of the jejunum as shown by the lowered ISI scores which characterizes an improved intestinal health. Furthermore, P(OA + EO) significantly reduced the serum concentration of several inflammatory biomarkers, while maintaining the diversity and composition of the cecal microbiota similar to AGP fed chickens and reducing the prevalence of AMR genes., Competing Interests: CB, LL, JO, DD, and ES are employed by Jefo Nutrition, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bortoluzzi, Lahaye, Oxford, Detzler, Eyng, Barbieri, Santin and Kogut.)

Objectives: Little is known about the early recovery phase occurring at-home after anesthesia and surgery in ambulatory surgical patients. We studied quantitative oximetry and quality-of-life metrics in the first 48 hours after same-day orthopedic surgery examining the association between the recovery metrics and specific patient and procedural factors., Methods: We used the STOP-Bang score to quantify patient risk for obstructive sleep apnea in 50 adult patients at 2 centers using continuous portable oximetry and patient journaling. Parametric statistical procedures were used to assess relationships among patient and procedural factors and desaturation events., Results: Higher STOP-Bang scores were predictive of the number and duration of desaturation events below mild and severe thresholds for arterial oxygen saturation during their first 48 hours after discharge from ambulatory surgery. Older patients and patients with higher BMI in particular were at an increased risk of mild and severe arterial oxygen desaturation. Using a home CPAP reduced the number of desaturation events. Of interest, taking opiate analgesics decreased the number of desaturation events., Conclusions: Given the absence of systematic research of early ambulatory anesthesia/surgery recovery at home and concerns of postoperative respiratory events, our results have clear implications for patient safety. Our results imply that screening based on noninvasive STOP-Bang scores may allow for suggestions for recovery from ambulatory surgery, such as encouraging patients with high scores to use home CPAP and aggressive education regarding use of opiates., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.)

This study aimed to evaluate the effects of supplementing broiler diets with a dietary protease on growth performance, digestive function, intestinal morphology, and meat quality as compared with feeding diets with or without an antibiotic growth promoter (AGP). A total of 240 1-day-old male chicks (Cobb 500, 48.3 ± 3.3 g) were distributed to three treatments with eight replicates (10 birds per replicate). Three treatments were: 1) corn-soybean meal basal diets (CTRL), 2) basal diets with 0.003% avilamycin (AB), and 3) basal diets with 0.0125% protease (PRT). The diets were provided as mash form, and birds were fed ad libitum during the whole experimental period. On day 45, birds were euthanized, and tissue and digesta samples were collected. On day 46, the remaining birds were processed in a commercial slaughterhouse, and breast muscle samples were collected. Despite a trend for a decreased feed conversion ratio (FCR) in the AB group during the whole phase (P = 0.071), no significant differences in growth performance parameters and relative weights of organs were observed (P > 0.05) among the groups. The AB and PRT groups showed significantly greater apparent ileal digestibility of amino acids (AA) compared with the CTRL group (P < 0.05). The PRT group significantly improved the morphology of duodenum and jejunum (P < 0.05). No differences were detected for meat quality, white striping, and woody breast among the groups (P > 0.05). For the gene expressions, the AB group showed a greater level of B0-system neutral amino acid co-transporter 1 and excitatory amino acid transporter 1 mRNA abundance compared with PRT group, while a significantly lesser level of cationic amino acid transporter 1 mRNA abundance was observed in the AB group compared with CTRL group (P < 0.05). The PRT group had a lesser level of peptide transporter 1 mRNA abundance in the jejunum than the CTRL group (P < 0.05). The highest mRNA abundances of zonula occludens-1 and cadherin 1 were observed in the CTRL group (P < 0.05). In conclusion, supplementation of avilamycin tended to reduce FCR and significantly improved AA utilization, and supplementation of dietary protease significantly enhanced intestinal morphology and AA utilization in broilers. In that respect, exogenous protease use appears to be an interesting tool to be considered in AGP reduction strategies., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

This study evaluated the effects of micro-encapsulated (protected) organic acids (OA) and essential oils (EO) combination, P(OA + EO), and effects of a regular blend of free acids (FA) on the growth, immune responses, intestinal barrier and microbiota of weaned piglets challenged with enterotoxigenic Escherichia coli (ETEC) F4 (K88 + ). A total of 30 crossbred (Duroc × Landrace × Large White) weaned barrows (7.41 ± 0.06 kg, 28 d old) were assigned randomly to 5 treatments: 1) non-challenged positive control (PC), 2) ETEC F4 (K88 + )-challenged negative control (NC), 3) NC + kitasamycin at 50 mg/kg + olaquindox at 100 mg/kg + free acidifier (FA) at 5 g/kg, 4) NC + kitasamycin at 50 mg/kg + olaquindox at 100 mg/kg + P(OA + EO) at 1 g/kg (P1), 5) NC + kitasamycin at 50 mg/kg + olaquindox at 100 mg/kg + P(OA + EO) at 2 g/kg (P2). Each dietary treatment had 6 replicates of one piglet each and the study lasted for 3 wk. On d 7, pigs in NC, FA, P1 and P2 were orally dosed with 10 mL of ETEC F4 (K88 + ) culture (1 × 10 9  CFU/mL). From d 7 to 14 after the ETEC F4 (K88 + ) challenge, P1 increased gain-to-feed ratio (G:F) significantly ( P  < 0.05) compared with NC and FA groups. From d 14 to 21, P2 increased the average daily gain of pigs ( P  < 0.05) compared with NC and FA groups. Compared with NC, P2 reduced tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-10 concentrations ( P  < 0.05) in sera collected at 4 h later after ETEC F4 (K88 + ) challenge. On d 21, P1 increased occludin and zonula occludens-1 protein expression in ileum compared with NC ( P  < 0.05). After this 3-wk experiment, alpha diversity of gut microbiota was decreased by P2 compared with PC, and P1 increased the relative abundance of Lactobacillus in ileum, cecum and colon ( P  < 0.05). In conclusion, dietary P(OA + EO) additive at 2 g/kg combined with antibiotics could improve piglet performance and attenuate inflammation, and P(OA + EO) additive at 1 g/kg combined with antibiotics improved intestinal barrier and increased beneficial microbiota composition after an F4 (K88 + ) challenge., Competing Interests: We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the content of this paper., (© 2020 Chinese Association of Animal Science and Veterinary Medicine. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.)

The objective was to study the effects of microencapsulated organic acids (OA) and essential oils (EO) on growth performance, immune system, gut barrier function, nutrient digestion and absorption, and abundance of enterotoxigenic Escherichia coli F4 (ETEC F4) in the weaned piglets challenged with ETEC F4. Twenty-four ETEC F4 susceptible weaned piglets were randomly distributed to 4 treatments including (1) sham-challenged control (SSC; piglets fed a control diet and challenged with phosphate-buffered saline (PBS)); (2) challenged control (CC; piglets fed a control diet and challenged with ETEC F4); (3) antibiotic growth promoters (AGP; CC + 55 mg·kg-1 of Aureomycin); and (4) microencapsulated OA and EO [P(OA+EO); (CC + 2 g·kg-1 of microencapsulated OA and EO]. The ETEC F4 infection significantly induced diarrhea at 8, 28, 34, and 40 hr postinoculation (hpi) (P < 0.05) in the CC piglets. At 28 d postinoculation (dpi), piglets fed P(OA+EO) had a lower (P < 0.05) diarrhea score compared with those fed CC, but the P(OA+EO) piglets had a lower (P < 0.05) diarrhea score compared with those fed the AGP diets at 40 dpi. The ETEC F4 infection tended to increase in vivo gut permeability measured by the oral gavaging fluorescein isothiocyanate-dextran 70 kDa (FITC-D70) assay in the CC piglets compared with the SCC piglets (P = 0.09). The AGP piglets had higher FITC-D70 flux than P(OA+EO) piglets (P < 0.05). The ETEC F4 infection decreased mid-jejunal VH in the CC piglets compared with the SCC piglets (P < 0.05). The P(OA+EO) piglets had higher (P < 0.05) VH in the mid-jejunum than the CC piglets. The relative mRNA abundance of Na+-glucose cotransporter and B0AT1 was reduced (P < 0.05) by ETEC F4 inoculation when compared with the SCC piglets. The AGP piglets had a greater relative mRNA abundance of B0AT1 than the CC piglets (P < 0.05). The ETEC F4 inoculation increased the protein abundance of OCLN (P < 0.05), and the AGP piglets had the lowest relative protein abundance of OCLN among the challenged groups (P < 0.05). The supplementation of microencapsulated OA and EO enhanced intestinal morphology and showed anti-diarrhea effects in weaned piglets challenged with ETEC F4. Even if more future studies can be required for further validation, this study brings evidence that microencapsulated OA and EO combination can be useful within the tools to be implemented in strategies for alternatives to antibiotics in swine production., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Eugenol (4-allyl-2-methoxyphenol) is an essential oil component, possessing antimicrobial, anti-inflammatory, and antioxidative properties; however, the effect of eugenol on porcine gut inflammation has not yet been investigated. In this study, an in vitro lipopolysaccharide (LPS)-induced inflammation model in porcine intestinal epithelial cells (IPEC-J2) has been set up. Cells were pretreated with 100 μM (16.42 mg/L) eugenol for 2 h followed by 10 μg/mL LPS stimulation for 6 h. Proinflammatory cytokine secretion; reactive oxygen species; gene expression of proinflammatory cytokines, tight junction proteins, and nutrient transporters; the expression and distribution of zonula occludens-1 (ZO-1); transepithelial electrical resistance (TEER); and cell permeability were measured to investigate the effect of eugenol on inflammatory responses and gut barrier function. The results showed that eugenol pretreatment significantly suppressed the LPS-stimulated interleukin-8 level and the mRNA abundance of tumor necrosis factor-α and restored the LPS-stimulated decrease of the mRNA abundance of tight junction proteins, such as ZO-1 and occludin, and the mRNA abundance of nutrient transporters, such as B0 1 system ASC sodium-dependent neutral amino acid exchanger 2, sodium-dependent glucose transporter 1, excitatory amino acid transporter 1, and peptide transporter 1. In addition, eugenol improved the expression and even redistribution of ZO-1 and tended to increase TEER value and maintained the barrier integrity. In conclusion, a low dose of eugenol attenuated inflammatory responses and enhanced selectively permeable barrier function during LPS-induced inflammation in the IPEC-J2 cell line., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Society of Animal Science. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Essential oils (EO) are defined as plant-derived natural bioactive compounds, which can have positive effects on animal growth and health due to their antimicrobial and antioxidative properties. However, EO are volatile, can evaporate quickly, and be rapidly absorbed in the upper gastrointestinal tract. Also, due to their labile nature, the stability of EO during feed processing is often questionable, leading to variations in the final concentration in feed. Encapsulation has become one of the most popular methods of stabilizing EO during feed processing, storage, and delivery into the lower gut. The objectives of the present study were to 1) evaluate the stability of thymol microencapsulated in combination with organic acids in commercially available lipid matrix microparticles during the feed pelleting process and storage; 2) validate and demonstrate the slow release of thymol from the lipid matrix microparticles in a simulated pig gastric fluid (SGF) and a simulated pig intestinal fluid (SIF); and 3) evaluate in vivo release of thymol from the lipid matrix microparticles along the pig gut. The results showed that thymol concentration was not significantly different in the mash and pelleted feeds ( P > 0.05). In the in vitro study, 26.04% thymol was released in SGF, and the rest of the thymol was progressively released in SIF until completion, which was achieved by 24 h. The in vivo study showed that 15.5% of thymol was released in the stomach, and 41.85% of thymol was delivered in the mid-jejunum section. Only 2.21% of thymol was recovered in feces. In conclusion, the lipid matrix microparticles were able to maintain the stability of thymol during a feed pelleting process and storage and allow a slow and progressive intestinal release of thymol in weaned pigs., (© The Author(s) 2019. Published by Oxford University Press on behalf of the American Society of Animal Science.)

It is well-known that essential oil thymol exhibits antibacterial activity. The protective effects of thymol on pig intestine during inflammation is yet to be investigated. In this study, an in vitro lipopolysaccharide (LPS)-induced inflammation model using IPEC-J2 cells was established. Cells were pretreated with thymol for 1 h and then exposed to LPS for various assays. Interleukin 8 (IL-8) secretion, the mRNA abundance of cytokines, reactive oxygen species (ROS), nutrient transporters, and tight junction proteins was measured. The results showed that LPS stimulation increased IL-8 secretion, ROS production, and tumor necrosis factor alpha (TNF-α) mRNA abundance ( P < 0.05), but the mRNA abundance of sodium-dependent glucose transporter 1 (SGLT1), excitatory amino acid transporter 1 (EAAC1), and H + /peptide cotransporter 1 (PepT1) were decreased ( P < 0.05). Thymol blocked ROS production ( P < 0.05) and tended to decrease the production of LPS-induced IL-8 secretion ( P = 0.0766). The mRNA abundance of IL-8 and TNF-α was reduced by thymol pretreatment ( P < 0.05), but thymol did not improve the gene expression of nutrient transporters ( P > 0.05). The transepithelial electrical resistance (TEER) was reduced and cell permeability increased by LPS treatment ( P < 0.05), but these effects were attenuated by thymol ( P < 0.05). Moreover, thymol increased zonula occludens-1 (ZO-1) and actin staining in the cells. However, the mRNA abundance of ZO-1 and occludin-3 was not affected by either LPS or thymol treatments. These results indicated that thymol enhances barrier function and reduce ROS production and pro-inflammatory cytokine gene expression in the epithelial cells during inflammation. The regulation of barrier function by thymol and LPS may be at post-transcriptional or post-translational levels.

Antibiotics have been widely supplemented in feeds at subtherapeutic concentrations to prevent postweaning diarrhea and increase the overall productivity of pigs. However, the emergence of antimicrobial-resistant bacteria worldwide has made it urgent to minimize the use of in-feed antibiotics. The development of promising alternatives to in-feed antibiotics is crucial for maintaining the sustainability of swine production. Both medium-chain fatty acids (MCFA) and essential oils exhibit great potential to postweaning diarrhea; however, their direct inclusion has compromised efficacy because of several factors including low stability, poor palatability, and low availability in the lower gut. Therefore, the objective of this study was to develop a formulation of microparticles to deliver a model of essential oil (thymol) and MCFA (lauric acid). The composite microparticles were produced by the incorporation of starch and alginate through a melt-granulation process. The release of thymol and lauric acid from the microparticles was in vitro determined using simulated salivary fluid (SSF), simulated gastric fluid (SGF), and simulated intestinal fluid (SIF), consecutively. The microparticles prepared with 2% alginate solution displayed a slow release of thymol and lauric acid in the SSF (21.2 ± 2.3%; 36 ± 1.1%), SGF (73.7 ± 6.9%; 54.8 ± 1.7%), and SIF (99.1 ± 1.2%; 99.1 ± 0.6%), respectively, whereas, the microparticles without alginate showed a rapid release of thymol and lauric acid from the SSF (79.9 ± 11.8%; 84.9 ± 9.4%), SGF (92.5 ± 3.5%; 75.8 ± 5.9%), and SIF (93.3 ± 9.4%; 93.3 ± 4.6%), respectively. The thymol and lauric acid in the developed microparticles with or without alginate both exhibited excellent stabilities (>90%) during being stored at 4 °C for 12 weeks and after being stored at room temperature for 2 weeks. These results evidenced that the approach developed in the present study could be potentially employed to deliver thymol and lauric acid to the lower gut of pigs, although further in vivo investigations are necessary to validate the efficacy of the microparticles.

The alarming number of recently reported human illnesses with bacterial infections resistant to multiple antibacterial agents has become a serious concern in recent years. This phenomenon is a core challenge for both the medical and animal health communities, since the use of antibiotics has formed the cornerstone of modern medicine for treating bacterial infections. The empirical benefits of using antibiotics to address animal health issues in animal agriculture (using therapeutic doses) and increasing the overall productivity of animals (using sub-therapeutic doses) are well established. The use of antibiotics to enhance profitability margins in the animal production industry is still practiced worldwide. Although many technical and economic reasons gave rise to these practices, the continued emergence of antimicrobial resistant bacteria is furthering the need to reduce the use of medically important antibiotics. This will require improving on-farm management and biosecurity practices, and the development of effective antibiotic alternatives that will reduce the dependence on antibiotics within the animal industry in the foreseeable future. A number of approaches are being closely scrutinized and optimized to achieve this goal, including the development of promising antibiotic alternatives to control bacterial virulence through quorum-sensing disruption, the use of synthetic polymers and nanoparticles, the exploitation of recombinant enzymes/proteins (such as glucose oxidases, alkaline phosphatases and proteases), and the use of phytochemicals. This review explores the most recent approaches within this context and provides a summary of practical mitigation strategies for the extensive use of antibiotics within the animal production chain in addition to several future challenges that need to be addressed.

This review article summarizes the efficacy, feasibility and potential mechanisms of the application of essential oils as antibiotic alternatives in swine production. Although there are numerous studies demonstrating that essential oils have several properties, such as antimicrobial, antioxidative and anti-inflammatory effects, feed palatability enhancement and improvement in gut growth and health, there is still a need of further investigations to elucidate the mechanisms underlying their functions. In the past, the results has been inconsistent in both laboratory and field studies because of the varied product compositions, dosages, purities and growing stages and conditions of animals. The minimal inhibitory concentration (MIC) of essential oils needed for killing enteric pathogens may not ensure the optimal feed intake and the essential oils inclusion cost may be too high in swine production. With the lipophilic and volatile nature of essential oils, there is a challenge in effective delivery of essential oils within pig gut and this challenge can partially be resolved by microencapsulation and nanotechnology. The effects of essential oils on inflammation, oxidative stress, microbiome, gut chemosensing and bacterial quorum sensing (QS) have led to better production performance of animals fed essential oils in a number of studies. It has been demonstrated that essential oils have good potential as antibiotic alternatives in feeds for swine production. The combination of different essential oils and other compounds (synergistic effect) such as organic acids seems to be a promising approach to improve the efficacy and safety of essential oils in applications. High-throughput systems technologies have been developed recently, which will allow us to dissect the mechanisms underlying the functions of essential oils and facilitate the use of essential oils in swine production.

Background: Brachial plexus block has been associated with improved pain control and decreased length of stay in patients undergoing upper extremity arthroplasty. Continuous delivery is associated with a shorter length of stay; however, comparisons to single-shot delivery in this setting are scarce. As the paradigm shifts to outpatient arthroplasty in the era of bundled payments, there exists a strong impetus to identify the most effective mode of analgesia associated with the least risk to patients., Methods: This is a retrospective review of 697 patients undergoing upper extremity arthroplasty comparing the rate of complications and incidence of potential barriers to discharge and length of stay of patients receiving continuous vs. single-shot perineural brachial plexus block., Results: No difference was observed in the complication rate between indwelling (n = 63 [12%]) and single-shot groups (n = 30 [17%]; P = .137). The majority of complications were pulmonary, 72% attributable to oxygen desaturation. The indwelling catheter group had 1.61 times higher odds (95% confidence interval, 1.07-2.42; P = .023) of exhibiting any potential barrier to discharge and exhibited a longer length of stay (P = .002)., Conclusion: There was no demonstrated disparity in the rate of complications associated with single-shot vs. continuous brachial plexus block. However, the continuous indwelling catheter was associated with an increased incidence of potential barriers to discharge and an increased length of stay compared with patients receiving single-shot regional anesthesia., (Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.)

This study was conducted to investigate the effect of dietary protease supplementation on the growth performance, nutrient digestibility, intestinal morphology, digestive enzymes and gene expression in weaned piglets. A total of 300 weaned piglets (21 days of age Duroc × Large White × Landrace; initial BW = 6.27 ± 0.45 kg) were randomly divided into 5 groups. The 5 diets were: 1) positive control diet (PC), 2) negative control diet (NC), and 3) protease supplementations, which were 100, 200, and 300 mg per kg NC diet. Results indicated that final BW, ADG, ADFI, crude protein digestibility, enzyme activities of stomach pepsin, pancreatic amylase and trypsin, plasma total protein, and intestinal villus height were higher for the PC diet and the supplementations of 200 and 300 mg protease per kg NC diet than for the NC diet ( P  < 0.05). Supplementations of 200 and 300 mg protease per kg NC diet significantly increased the ratio of villus height to crypt depth (VH:CD) of duodenum, jejunum and ileum compared with NC diet ( P  < 0.05). Feed to gain ratio, diarrhea index, blood urea nitrogen, and diamine oxidase were lower for the PC diet and supplementations of 200 and 300 mg protease per kg NC diet than for the NC diet ( P  < 0.05). Piglets fed the PC diet had a higher peptide transporter 1 (PepT1) mRNA abundance in duodenum than piglets fed the NC diet ( P  < 0.05), and supplementations of 100, 200 and 300 mg protease per kg NC diet increased the PepT1 mRNA abundance in duodenum ( P  < 0.05) comparing with the NC diet. Piglets fed the PC diet had a higher b0,+AT mRNA abundance in jejunum than piglets fed the NC diet ( P  < 0.05), and supplementations of 200 and 300 mg protease per kg NC diet increased the b0,+AT mRNA abundance in jejunum and ileum comparing with the NC diet ( P  < 0.05). In summary, dietary protease supplementation increases growth performance in weaned piglets, which may contribute to the improvement of intestinal development, protein digestibility, nutrient transport efficiency, and health status of piglets when fed low digestible protein sources.

Campylobacter jejuni is an important zoonotic foodborne pathogen causing acute gastroenteritis in humans. Chickens are often colonized at very high numbers by C. jejuni, up to 10(9) CFU per gram of caecal content, with no detrimental effects on their health. Farm control strategies are being developed to lower the C. jejuni contamination of chicken food products in an effort to reduce human campylobacteriosis incidence. It is believed that intestinal microbiome composition may affect gut colonization by such undesirable bacteria but, although the chicken microbiome is being increasingly characterized, information is lacking on the factors affecting its modulation, especially by foodborne pathogens. This study monitored the effects of C. jejuni chicken caecal colonization on the chicken microbiome in healthy chickens. It also evaluated the capacity of a feed additive to affect caecal bacterial populations and to lower C. jejuni colonization. From day-0, chickens received or not a microencapsulated feed additive and were inoculated or not with C. jejuni at 14 days of age. Fresh caecal content was harvested at 35 days of age. The caecal microbiome was characterized by real time quantitative PCR and Ion Torrent sequencing. We observed that the feed additive lowered C. jejuni caecal count by 0.7 log (p<0.05). Alpha-diversity of the caecal microbiome was not affected by C. jejuni colonization or by the feed additive. C. jejuni colonization modified the caecal beta-diversity while the feed additive did not. We observed that C. jejuni colonization was associated with an increase of Bifidobacterium and affected Clostridia and Mollicutes relative abundances. The feed additive was associated with a lower Streptococcus relative abundance. The caecal microbiome remained relatively unchanged despite high C. jejuni colonization. The feed additive was efficient in lowering C. jejuni colonization while not disturbing the caecal microbiome.

Demands associated with the Trendelenburg position (TP) are well known yet there is little attention given to regional cerebral tissue O2 saturation (SctO2) in those undergoing robotic surgery in the TP with CO2 insufflation (C-INSF). This is the first study to report on SctO2 in a wide range of patients undergoing lengthy TP and robotic surgery. We measured SctO2 during robotic surgery in patients in the TP with C-INSF, as well as a control robotic thyroid surgery group who were supine with no C-INSF. We recorded relevant variables and periods of cerebral desaturation (CD). We studied 42 patients in 25°-45° of TP for ≥125 min. Management was at the providers' discretion. The INVOS(®) 5100C Cerebral Oximeter (Covidien, Boulder, CO) recorded SctO2. CD was defined as a >20 % decrease from baseline SctO2 or a value ≤55 % for ≥10 min. Patients were assessed for adverse outcome. The sample consisted of 13 males and 29 females aged 22-73, BMI 22-36 had general (N = 3), urological (N = 14) and gynecological (N = 25) surgery; two patients had CD lasting 150 and 190 min and two had episodic CD lasting 10-35 min. The four were female aged 22-60 in 38°-45° of TP. Eleven cases had multiple episodic CD for ≤15 min, 27 TP cases had no CD. Other observations included a consistent fall in SctO2 with phenylephrine; an increased SctO2 with ephedrine; and FiO2 and EtCO2 being generally strong, direct modifiers of SctO2. High MAP was inconsistently associated with high SctO2. BMI had no observed effect on SctO2. Pulse oximetry was ≥97 % in all cases. We observed no adverse cerebral events on follow-up. Additional clinical studies are warranted.

Aim: For the operative adjustment of a leg length shortening and for correcting an angular deformity, an external fixator is the most frequently used technique today. This method may, however, be complicated by painful soft tissue and muscle fixations, pin infections and psychic strain as well as by long treatment duration with the external fixator. The intramedullary skeletal kinetic distractor (ISKD) is an internal lengthening nail, which promises a postoperative course without further complications., Method: We used the ISKD nail in a 28-year-old traumatised motorcyclist, in whom, after removal of a comminuted femur bone fragment, a leg length shortening of 8 cm resulted., Results: After uneventful healing of all fractures and having performed implant removal, we implanted an ISKD nail for femoral lengthening. The following distraction resulted, without considerable complications, in a complete compensation of the leg difference., Conclusions: The ISKD nail is a suitable procedure to compensate for post-traumatic leg length differences, which exhibits, in contrast to the frequently used external fixator, a largely uncomplicated course. It cannot be used to correct a gross transverse or rotational deformity., (© Georg Thieme Verlag KG Stuttgart · New York.)

LASIK (laser in situ keratomileusis) surgery is the most frequently performed refractive procedure for correcting nearsightedness, farsightedness, and astigmatism. Its popularity increased over the late 1990's, rapidly replacing Radial Keratotomy (RK). The LASIK operation and excimer laser surface ablation procedures gained the rapid acceptance of refractive physicians and patients over the RK procedure because of greater predictability, precision, safety, and stable vision. In the mid 90's, when doctors first began performing LASIK, it was referred to implicitly as the "FLAP and ZAP" procedure. This of course was an overly confident misstatement as unfamiliar complications began to appear. One of the ultimate goals in performing any surgical procedure is to minimize less than desirable outcomes arising from both infectious and non-infectious contaminants entering the surgical field. This is especially true of all corneal procedures, such as LASIK, where the normal mechanisms for fighting contaminations are diminished.

Insertion of the reactive center loop in beta-sheet A in serpins has been typically inferred from the increased stability of the cleaved form to thermal- and urea-induced denaturation. We describe a convenient and rapid fluorescence-based method that differentiates the loop-inserted form from the loop-exposed form in ovalbumin, a prototypic noninhibitory serpin. Recombinant wild-type and R345A ovalbumins in the intact form bind ANS with equilibrium dissociation constants of 116 and 125 microM and a maximal fluorescence increase of 200 and 264%, respectively, in pH 6.8 buffer. Cleavage of the two proteins with porcine pancreatic elastase results in a 1.6- and 2.6-fold increase in the ANS-binding affinity. While cleavage of the reactive center loop in rR345A ovalbumin results in a approximately 200% increase in the ANS fluorescence, the rWT protein exhibits a approximately 50% decrease. Similar experiments with alpha(1)-proteinase inhibitor and antithrombin, two inhibitory serpins that exhibit reactive center loop insertion, show a decrease in ANS fluorescence on cleavage with porcine pancreatic elastase and thrombin, respectively. Denaturation studies in guanidinium hydrochloride indicate that the reactive center loop is inserted in the main body of the serpin in the cleaved form of rR345A mutant, while it is exposed in the cleaved form of rWT ovalbumin. These results demonstrate that ANS fluorescence change is an indicator of the loop-inserted or loop-exposed form in these recombinant ovalbumins, and thus could be advantageously used for probing reactive center loop insertion in ovalbumins. The major increase in fluorescence for the rR345A mutant on cleavage primarily arises from a change in ANS binding rather than from the generation of an additional ANS-binding site.

Contributions of erythrocytes and plasma to threonine and lysine transport across the PDV and the liver were determined in growing pigs successively fed a threonine deficient diet and a control well-balanced diet (experiment 1) or a lysine deficient or a well-balanced diet (experiment 2). The animals were surgically prepared for insertion of chronic catheters in the mesenteric vein (MV), the portal vein (PV), a hepatic vein (HV) and the carotid artery (CA). Plasma and whole blood AA concentrations in PV, HV and CA and PV and HV blood flows were determined during 6 hours of para-aminohippuric acid constant infusion. During this period the pigs were continuously fed (1 meal per hour). The contribution of plasma to lysine and threonine transport was higher in pigs fed the well balanced diets. More than 50% of threonine and lysine appearing in the PV and in the HV are transported by the plasma. Our results suggest that erythrocytes are probably little involved in lysine and threonine transfer across the liver and digestive tract of pig continuously fed.

Red blood cells were first observed in the mid-1600s and termed ruddy globules for their conspicuous shape and color. Since that time, the functional significance of this extraordinary membranous pouch of proteins and electrolytes has been carefully detailed. The architecture of the red blood cell, the biochemistry of hemoglobin, the mechanics of the oxygen-hemoglobin affinity-altering diphosphoglycerate compounds, and the variants of hemoglobin are reviewed. Far from being a simple transport vehicle of oxygen to and from tissues, the red blood cell is a multifunctional entity whose absence would make life as we know it impossible.

We report the case of a 55 year old patient presenting a discrete obstructive sub-aortic membrane. After clinical examination, complete echocardiographic evaluation and cardiac catheterisation, an operative procedure was decided and the sub-aortic membrane was resected. The results were satisfactory but the literature reports risks of re-obstruction of the left ventricular outflow tract. The article points out the importance of an early diagnosis and further stresses the major role played by transoesophageal echocardiography in the evaluation of the patient.