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Abstract Background For market approval of genetically modified plants (GMPs), the evaluation of agronomic and phenotypic plant traits is a standard requirement and part of the comparative assessment of the GMP and its conventional counterpart. This comparative assessment is a starting point for environmental risk assessment (ERA) and should inform all areas of risk. We scrutinize frequently used approaches to characterize GMPs in EU market applications and discuss their usefulness for drawing conclusions on risks related to the plant’s ability to survive, persist or become invasive. Results Our analysis shows that the agronomic and phenotypic characterization of GMPs, although based on guidelines, is confined to plant traits and test designs that are relevant for the quality control and agronomic performance of genetically modified (GM) crops. We provide evidence of how methodological approaches frequently applied during the agronomic and phenotypic characterization of the GMP could be improved and complemented to better inform on potential phenotypic changes relevant to assessing environmental risks. These approaches refer to (i) the assessment of the survival of GM seeds and plants (e.g., volunteers); (ii) the consideration of environmental exposure and (iii) improved methodological approaches for the assessment of biotic and abiotic stress responses for GMPs. Conclusions The comparative assessment of agronomic and phenotypic plant traits currently does not provide suitable data to draw conclusions on environmental risks relating to the persistence and invasiveness of the GMP. Ecologically more realistic assessments should be part of the phenotypic characterization of GMPs and need guidance and decision criteria to be implemented in ERA. This is of considerable importance, as new genomic techniques are expected to increase the diversity and complexity of GM plants and traits, particularly stress tolerance, which may affect the survival of GMPs in the environment.

Abstract Background Mucosal melanomas account for 17% of melanomas, and less than 1% affect the urogenital tract. Primary urethral melanoma is extremely rare; less than 200 cases have been reported so far since it was first described. The clinical presentation is usually delayed, and the prognosis is generally poor. Case presentation. An 86-year-old female was referred to urology due to the presence of a three-month-old violaceous mass in the urethral meatus protruding through the vagina. On physical examination, a pedunculated, hyperpigmented, friable, and tender lesion was seen in the urethral meatus bulging between the labia minora. After initial diagnostic studies, the patient was taken to surgical resection of the lesion. The pathology report identified the lesion as a malignant melanoma of the urethra, and staging studies revealed regional lymph node metastases. After discussing the treatment options with the patient, palliative therapy with nivolumab was started. In follow-up at 26 months, the patient had evidence of extensive lymph node involvement, but a conserved performance status and no visceral metastases. Conclusion Primary melanoma of the female urethra is an uncommon disease with a poor prognosis. Despite the deficiency in literature regarding its management, it is important to consider patient expectations and preferences when treating this rare disease.

Abstract The current study sought to determine whether public perceptions of other vaccines and diseases than COVID-19 have been impacted by the COVID-19 pandemic. We longitudinally examined whether there had been a change from before the COVID-19 pandemic to during the pandemic in: (a) influenza vaccination behaviour and intentions; (b) the perceived benefit of childhood vaccines and influenza vaccines; (c) the perceived safety of childhood vaccines and influenza vaccines; (d) the perceived severity of measles and influenza; and (e) trust in healthcare professionals in two samples of Finnish adults (N = 205 in Study 1 and N = 197 in Study 2). The findings showed that during the pandemic, more people than before had received or wanted to receive the influenza vaccine. The respondents also believed that influenza was more dangerous during the pandemic and that vaccinations were safer and more beneficial. On the other hand, for childhood vaccines only perceived safety increased. Finally, in one of the studies, people had more confidence in medical professionals during the pandemic than they had before. Together, these findings imply a spillover of the COVID-19 pandemic on how people view other vaccines and illnesses.

Aims. We analyzed the mortality risk and its predictors in patients hospitalized for heart failure (HF). Methods. Patients discharged from hospitalization for acute decompensation of HF in 2010-2020 and younger than 86 years were followed (n=4097). We assessed the incidence and trends of all-cause death, its main predictors, and the pharmacotherapy recommended at discharge from the hospital. Results. The 30 days all-cause mortality was in discharged patients 3.2%, while 1-year 20.4% and 5-years 55.4%. We observed a modest trend to decreased 1-year mortality risk over time. Any increase of year of hospitalization by one was associated with about 5% lower risk in the fully adjusted model. Regarding predictors of 1-year mortality risk, a positive association was found for age over 65, history of malignancy, and peak brain natriuretic peptide during hospitalization ≥10times higher than normal concentration. In contrast, as protective factors, we identified LDL ≥1.8 mmol/L, treatment with beta-blockers, renin-angiotensin axis blockers, statins, and implanted cardioverter in the same regression model. The ejection fraction category and primary etiology of HF (coronary artery disease vs. others) did not significantly affect the mortality risk in a fully adjusted model. Conclusions. Despite advances in cardiovascular disease management over the last two decades, the prognosis of patients hospitalized for heart failure remained highly unfavorable.

Vaccine hesitancy has become a threat to public health, especially as it is a phenomenon that has also been observed among healthcare professionals. In this study, we analyzed the relationship between endorsement of complementary and alternative medicine (CAM) and vaccination attitudes and behaviors among healthcare professionals, using a cross-sectional sample of physicians with vaccination responsibilities from four European countries: Germany, Finland, Portugal, and France (total N = 2,787). Our results suggest that, in all the participating countries, CAM endorsement is associated with lower frequency of vaccine recommendation, lower self-vaccination rates, and being more open to patients delaying vaccination, with these relationships being mediated by distrust in vaccines. A latent profile analysis revealed that a profile characterized by higher-than-average CAM endorsement and lower-than-average confidence and recommendation of vaccines occurs, to some degree, among 19% of the total sample, although these percentages varied from one country to another: 23.72% in Germany, 17.83% in France, 9.77% in Finland, and 5.86% in Portugal. These results constitute a call to consider health care professionals’ attitudes toward CAM as a factor that could hinder the implementation of immunization campaigns.

Background: Personal continuity — having a GP who knows their patients and keeps track of them — is an important dimension of continuity of care and is associated with lower mortality rates, higher quality of life, and reduced healthcare costs. In recent decades it has become more challenging for GPs to provide personal continuity owing to changes in society and health care. Aim: To investigate GPs’ and older patients’ views on personal continuity and how personal continuity can be improved. Design & setting: Cross sectional survey study in The Netherlands. Method: A digital and postal survey was sent to 499 GPs and 1599 patients aged 65 years or older. Results were analysed using descriptive statistics for quantitative data and thematic analysis for open questions. Results: In total, 249 GPs and 582 patients completed the surveys. A large majority of GPs (92–99%) and patients (91–98%) felt it was important for patients to see their own GP for life events or psychosocial issues. GPs and patients provided suggestions on how personal continuity can be improved. The thematic analysis of these suggestions identified nine themes: 1) personal connection, 2) GP accessibility and availability, 3) communication about (dis)continuity, 4) GP responsibility, 5) triage, 6) time for the patient, 7) actions by third parties, 8) team continuity, and 9) GP vocational training. Conclusion: Both GPs and older patients still place high value on personal continuity in the context of a changing society. GPs and patients provided a wide range of suggestions for improving personal continuity. The authors will use these suggestions to develop interventions for optimising personal continuity in general practice.

The 3Rs principle of replacing, reducing and refining the use of animals in science has been gaining widespread support in the international research community and appears in transnational legislation such as the European Directive 2010/63/EU, a number of national legislative frameworks like in Switzerland and the UK, and other rules and guidance in place in countries around the world. At the same time, progress in technical and biomedical research, along with the changing status of animals in many societies, challenges the view of the 3Rs principle as a sufficient and effective approach to the moral challenges set by animal use in research. Given this growing awareness of our moral responsibilities to animals, the aim of this paper is to address the question: Can the 3Rs, as a policy instrument for science and research, still guide the morally acceptable use of animals for scientific purposes, and if so, how? The fact that the increased availability of alternatives to animal models has not correlated inversely with a decrease in the number of animals used in research has led to public and political calls for more radical action. However, a focus on the simple measure of total animal numbers distracts from the need for a more nuanced understanding of how the 3Rs principle can have a genuine influence as a guiding instrument in research and testing. Hence, we focus on three core dimensions of the 3Rs in contemporary research: (1) What scientific innovations are needed to advance the goals of the 3Rs? (2) What can be done to facilitate the implementation of existing and new 3R methods? (3) Do the 3Rs still offer an adequate ethical framework given the increasing social awareness of animal needs and human moral responsibilities? By answering these questions, we will identify core perspectives in the debate over the advancement of the 3Rs.

Introduction: We aimed to evaluate the prognostic impact of renal insufficiency and fluctuation of glomerular filtration observed during hospitalization for heart failure (HF). Methods: We followed 3,639 patients hospitalized for acute HF and assessed the mortality risk associated with moderate or severe renal insufficiency, either permanent or transient. Results: After adjustment, severe renal failure defined as estimated glomerular filtration (eGFR)

Objectives: Vitamin K deficiency consistently associates with worse clinical outcome in COVID-19 patients. However, whether this is due to increased expenditure during inflammation or poor vitamin K status prior to infection remained unknown. Methods: Dp-ucMGP levels of 128 individuals were measured for the post-MONICA study and were compared to SARS-CoV-2 PCR testing results. Results: Dp-ucMGP levels prior to COVID-19 infection were not significantly different comparing PCR-negative, PCR-positive and not hospitalized, and PCR-positive and hospitalized patients. Conclusion: In this study, we demonstrate normal vitamin K status prior to infection in SARS-CoV-2 positive patients, supporting the theory of increased utilisation during disease.

Purpose Liddle syndrome is a hereditary form of arterial hypertension caused by mutations in the genes coding of the epithelial sodium channel – SCNN1A, SCNN1B and SCNN1G. It is characterised by early onset of hypertension and variable biochemical features such as hypokalaemia and low plasma concentrations of renin and aldosterone. Phenotypic variability is large and, therefore, LS is probably underdiagnosed. Our objective was to examine a family suspected from Liddle syndrome including genetic testing and evaluate clinical and biochemical features of affected family members. Materials and methods Thirteen probands from the Czech family, related by blood, underwent physical examination, laboratory tests, and genetic testing. Alleles of SCNN1B and SCNN1G genes were examined by PCR amplification and Sanger sequencing of amplicons. Results We identified a novel mutation in the β-subunit of an epithelial sodium channel coded by the SCNN1B gene, causing the nonsense mutation in the protein sequence p.Tyr604*. This mutation was detected in 7 members of the family. The mutation carriers differed in the severity of hypertension and hypokalaemia which appeared only after diuretics in most of them; low aldosterone level (< 0.12 nmol/l) was, however, present in all. Conclusions This finding expands the spectrum of known mutations causing Liddle syndrome. Hypoaldosteronemia was 100% sensitive sign in the mutation carriers. Low levels are observed especially in the Caucasian population reaching 96% sensitivity. Assessment of plasma aldosterone concentration is helpful for differential diagnosis of arterial hypertension. CONDENSED ABSTRACT Liddle syndrome is a hereditary form of arterial hypertension caused by mutations in the genes encoding the epithelial sodium channel’s α-, β- and γ-subunit. It is usually manifested by early onset of hypertension accompanied by low potassium and aldosterone levels. We performed a physical examination, laboratory tests and genetic screening in 13 members of a Czech family. We found a new mutation of the SCNN1B gene which encodes the β-subunit of the epithelial sodium channel. We describe the variability of each family member phenotype and point out the relevance of using aldosterone levels as a high sensitivity marker of Liddle syndrome in Caucasians.

Aims. Studies on the incidence, acute and subsequent mortality from myocardial infarction are limited mostly to selected clinical cohorts and populations and cover relatively short periods. Our aim was to describe and analyse long-term trends on a national scale. Methods. Acute myocardial infarction (AMI) was defined by the International Classification of Diseases (ICD)10; codes I21 and I22. Our natiowide 1994-2016 data on AMI mortality were obtained from the official mortality statistics (Czech Bureau of Statistics), data on morbidity (hospitalizations) from the National Register of Hospitalizations (Institute for Health Information and Statistics). For further analyses, data from the Czech EUROASPIRE I-V and Czech IMPACT studies were used. Results. Over the 1994-2016 period the total number of AMI cases per year decreased from 34,084 to 19,015, that of patients hospitalized for AMI from 22,373 to 15,419, the total number of deaths due to AMI from 14,834 to 4,673, in those treated because of AMI from 3,794 to 1,137, and hospital fatality in patients treated for AMI decreased from 17% to 7.5%. Over the years 1997-2016, the one-year all-cause mortality rate after AMI declined from 25.1 to 17.9%, cardiovascular (CV) mortality from 22.3 to 14.2%, five-year all-cause mortality from 41.7 to 34%, and CV mortality from 34.1 to 23.6%. Conclusion. The Czech Republic has witnessed a pronounced decrease in AMI incidence and fatality and, consequently, long-term mortality. The decreasing incidence and improving course of AMI are due to progress in primary prevention, in acute coronary care and interventional cardiology, and in secondary coronary heart disease (CHD) prevention.

BackgroundHypertension is the most common cardiovascular disease which substantially increases cardiovascular morbidity and mortality. Despite the broad availability of antihypertensive medication, control of hypertension is not satisfactory worldwide.ObjectiveThe study aim was to assess longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension in a representative population sample of the Czechia from 1985 to 2016/2017, focusing on sex differences.MethodsA total of 7,606 men and 8,050 women aged 25–64 years were screened for major CV risk factors in seven independent cross-sectional surveys run consistently in the same six country districts of the Czechia between 1985 and 2016/2017. The population samples were randomly selected.ResultsOver a study period of 31/32 years, there was a significant decline in systolic and diastolic blood pressure in both sexes, whereas the prevalence of hypertension decreased only in women. There was an increase in hypertension awareness in both sexes over the entire study period with consistently higher rates in women. The proportion of individuals treated with antihypertensive drugs increased significantly in both sexes throughout the study, again with consistently higher rates in women. Control of hypertension increased significantly over the study period with consistently higher rates in women. The age-adjusted trends in blood pressure, prevalence, awareness, and treatment of hypertension were significantly different in men and women, always in favor of women. The age-adjusted trends in control of hypertension in treated patients were equally poor in both sexes.ConclusionThere are significant differences in longitudinal trends in blood pressure, prevalence, awareness, treatment, and control of hypertension between men and women, always in favor of women except for the control of hypertension in treated patients, where it is equally poor in both sexes.

Background: Severe hypercholesterolemia is associated with an increase in the risk of developing atherosclerotic cardiovascular disease. The aim of this analysis was to assess longitudinal trends in severe dyslipidemia (defined as total cholesterol > 8 mmol/L or LDL-cholesterol > 5 mmol/L) in a representative population sample of the Czech Republic and to analyze the longitudinal trends in the basic characteristics of individuals with severe dyslipidemia. Methods: Seven independent cross-sectional surveys were organized in the Czech Republic to screen for major cardiovascular risk factors (from 1985 to 2015–2018). A total of 20,443 randomly selected individuals aged 25–64 years were examined. Results: The overall prevalence of severe dyslipidemia was 6.6%, with a significant downward trend from the fifth survey onwards (2000/2001). Over the study period of 30+ years, the individuals with severe dyslipidemia became older, increased in BMI, and did not change their smoking habits. Total cholesterol and non-HDL-cholesterol decreased significantly in both sexes throughout the duration of the study. Conclusions: Despite a significant improvement in lipids in the Czech Republic from 1985, substantially contributing to the decline in cardiovascular mortality, the number of individuals with severe dyslipidemia remained high, and in most cases, they were newly detected during our screening examinations and were thus untreated.

Abstract Regular PCR testing of nasopharyngeal swabs from symptomatic individuals for SARS-CoV-2 virus has become the established method by which health services are managing the COVID-19 pandemic. Businesses such as AstraZeneca have also prioritised voluntary asymptomatic testing to keep workplaces safe and maintain supply of essential medicines to patients. We describe the development of an internal automated SARS-CoV-2 testing programme including the transformative introduction of saliva as an alternative sample type.

A key factor in limiting global warming is the conversion of conventional electricity generation to renewable energy sources. However, a major obstacle is that renewable energy generation and energy demand often do not coincide in time, and energy must therefore be stored temporarily. Vehicle to grid (V2G) can be used to store excess renewable energy in battery electric vehicles (BEVs) and feed it back into the electric grid when needed. For effective V2G operation, the grid may have to be expanded, as the energy needs to be transported to BEVs. However, the grid should only be strengthened where renewable energy demand exceeds current grid capacity due to high grid expansion costs. This requires a method that determines the spatial distribution of V2G potential at a high resolution. Since such a method has not yet been reported in the existing literature, and so is developed in this paper. The method is demonstrated for the city of Berlin and its 448 sub-districts. For each sub-district, the method allows determining the percentage of residential and BEV energy demand that can be met by renewables if V2G is deployed, and answers the question of whether a full renewable supply is possible. The results show that BEVs can be effectively used as intermediate storage for renewable energy. If 30% of the BEVs participate in V2G, more than 99% of the energy demand of households and BEVs in Berlin can be covered by renewables on certain days. On the other hand, V2G deployment increases the average peak load in the districts by up to 100% and results in a nearly double load on vehicle batteries. High shares of renewable energy can be observed in districts with a high degree of motorization, which are predominantly found in the outskirts of the city.

The business is undergoing many changes including the media used as promotion. The existence of advertisements on television began gradually abandoned and shifted to a new strategy, namely advertising on social media. The rapid growth of social media users in Indonesia has become one of the factors in the change. This study aims to determine the extent of the impact of using influencers as a promotion strategy on social media, especially Instagram. This study uses a qualitative netnographic method by collecting data through observation of social media accounts and in-depth interviews from informants. The results of this study include illustrating that there are positive and negatif impacts from the use of influencer services. Companies must be smart in choosing influencers that are in line with product segmentation, price, and influencer's background because people are now getting smarter at making purchases.

Analysis of exchange processes is time consuming by two-dimensional exchange NMR spectroscopy. Here the authors demonstrate a single-scan ultrafast Laplace NMR approach based on spatial encoding to measure molecular diffusion, with an increase by a factor six in the sensitivity per unit time.

Purpose: Advanced glycation end products (AGEs) are a heterogeneous group of highly oxidant compounds which can potentiate microvascular and macrovascular complications through the formation of irreversible cross-links between molecules in the basal membrane and also by engaging the receptor for AGEs (RAGE). Soluble receptor for AGEs (sRAGE) is suggested to have a protective role neutralizing the toxic action of AGEs. We aimed to investigate differences in plasma levels of sRAGE alongside with classic cardiovascular risk factors between offspring of patients with early onset of coronary heart disease (CHD) and healthy controls. Materials and methods: In a cross-sectional design, we examined 114 adult offspring of patients with premature CHD and 194 controls. Concentrations of soluble RAGE were quantified by ELISA methods. Aortic PWV was measured using Sphygmocor device. Multivariate logistic regressions were used to compare differences between the offspring and controls. Results: In the offspring group there were more men (p = 0.023), both groups had similar age (28.5 vs. 28.9 years; p = 0.51). After adjustment for covariates, we observed significantly higher aPWV (6.17 vs. 5.82 m s−1; p = 0.001) and lower sRAGE (1308.11 vs. 1475.59; p = 0.009) in the offspring group compared to controls. The significant determinants of the intergroup difference were sRAGE (p = 0.0017), aPWV (p = 0.011) and current smoking (p = 0.0053). Conclusion: Offspring of patients with early onset of CHD compared to age-matched healthy controls had significantly lower sRAGE levels suggesting a shift in the oxidative balance between stressors and defence mechanisms that may influence a higher cardiovascular risk in the future. The measurement of sRAGE might be a valuable predictor for more precise stratification of cardiovascular risk.

ObjectivesThe aim of this review is to establish the effectiveness of psychological relapse prevention interventions, as stand-alone interventions and in combination with maintenance antidepressant treatment (M-ADM) or antidepressant medication (ADM) discontinuation for patients with remitted anxiety disorders or major depressive disorders (MDD).MethodsA systematic review and a meta-analysis were conducted. A literature search was conducted in PubMed, PsycINFO and Embase for randomised controlled trials (RCTs) comparing psychological relapse prevention interventions to treatment as usual (TAU), with the proportion of relapse/recurrence and/or time to relapse/recurrence as outcome measure.ResultsThirty-six RCTs were included. During a 24-month period, psychological interventions significantly reduced risk of relapse/recurrence for patients with remitted MDD (RR 0.76, 95% CI: 0.68-0.86, pConclusionsIn patients with remitted MDD, psychological relapse prevention interventions substantially reduce risk of relapse/recurrence. It is recommended to offer these interventions to remitted MDD patients. Studies on anxiety disorders are needed.Systematic review registration numberPROSPERO 2018: CRD42018103142.

ABSTRACT The coronavirus pandemic led society to adopt measures to contain its spread that generate impacts in the social, economic and psychological spheres, mainly due to social isolation. Some authors point out that social changes have generated changes in the various forms of trauma and violence. For this study, data collection for the years 2019 and 2020 was carried out on DATASUS - TABNET and on the website of the Secretariat of Public Security - SSP, considering various types of trauma and violence, with subsequent correlation analysis using the Kendall coefficient and correlation test. There was statistical significance, allowing a correlation with the negative pandemic for the rates of body injury due to traffic accidents, gunshot injuries, stab wounds, sexual violence, bodily injuries and interpersonal violence. As factors possibly associated with a reduction in the incidence of these variables, the literature presents some changes resulting from the pandemic, such as adherence to isolation, with a reduction in the flow of people on the street, and a decrease in reports of violence. The present study indicates that the findings may serve as a warning for future changes and for the adoption of preventive measures, however they represent the initial situation of the pandemic in São Paulo and, therefore, further investigations must be carried out with the course of the pandemic, which still remains.

Background: Advanced glycation end products (AGEs) are involved into several pathophysiologic processes in vascular diseases, including progressive loss of elasticity of vessel wall (arterial stiffness). Circulating soluble receptor for AGEs (sRAGE) act as a decoy and counterbalanced the harmful properties of AGEs as the natural protective factor [1,2]. We compared the role of circulating or skin-deposed AGEs and sRAGE regarding natural course of arterial stiffening. Methods: In a prospective cohort study, we longitudinally followed 536 general-population-based subjects (subsample of Czech post-MONICA study). Aortic pulse wave velocity (PWV) was measured twice (at baseline and after ∼8 years of follow-up) using a SphygmoCor device (AtCor Medical Ltd.), and the intraindividual change in PWV per year (ΔPWV/year) was calculated. Concentrations of sRAGE and carboxylmethyl lysine (circulating AGEs) were assessed at follow-up visit by ELISA, while skin AGEs were measured using autofluorescence-based device AGE Reader. Results: Using multiple regressions, we found significant association between ΔPWV/year as dependent variable and both, sRAGE and skin AGEs as independent ones (each on its own model). However, the closest association to ΔPWV/year were found for ratio of these two factors (skin AGEs/sRAGE) [coeff = 0.0747 (SE 0.0189), p < 0.0001]. In categorized manner, subjects with skin AGEs/sRAGE ratio ≥3.3 showed about two-fold higher risk having PWV/year ≥0.2 m/sec [adjusted odds ratio was 2.09 (95% CI: 1.35-3.22), p = 0.001]. In contrast neither circulating AGEs nor circulating AGEs/sRAGE showed any significant relation to PWV/ year. Conclusions: Skin AGEs/sRAGE ratio seems to be more sensitive biomarker of vascular ageing than these single factors themselves or circulation status of AGEs [3].

BACKGROUND:Compared with Western Europe, the decline in cardiovascular (CV) mortality has been delayed in former communist countries in Europe, including the Czech Republic. We have assessed longitudinal trends in major CV risk factors in the Czech Republic from 1985 to 2016/17, covering the transition from the totalitarian regime to democracy. METHODS:There were 7 independent cross-sectional surveys for major CV risk factors conducted in the Czech Republic in the same 6 country districts within the WHO MONICA Project (1985, 1988, 1992) and the Czech post-MONICA study (1997/98, 2000/01, 2007/08 and 2016/2017), including a total of 7,606 males and 8,050 females. The population samples were randomly selected (1%, aged 25-64 years). RESULTS:Over the period of 31/32 years, there was a significant decrease in the prevalence of smoking in males (from 45.0% to 23.9%; p < 0.001) and no change in females. BMI increased only in males. Systolic and diastolic blood pressure decreased significantly in both genders, while the prevalence of hypertension declined only in females. Awareness of hypertension, the proportion of individuals treated by antihypertensive drugs and consequently hypertension control improved in both genders. A substantial decrease in total cholesterol was seen in both sexes (males: from 6.21 ± 1.29 to 5.30 ± 1.05 mmol/L; p < 0.001; females: from 6.18 ± 1.26 to 5.31 ± 1.00 mmol/L; p < 0.001). CONCLUSIONS:The significant improvement in most CV risk factors between 1985 and 2016/17 substantially contributed to the remarkable decrease in CV mortality in the Czech Republic.

ObjectiveThe aim of the present study was to investigate whether anti-vaccination attitudes and behavior, and positive attitudes to complementary and alternative medicine (CAM), are driven by trait reactance and a distrust in medical doctors.MethodsThe sample consisted of 770 Finnish parents who filled out an online survey. Structural equation modeling (SEM) was used to examine if trait reactance plays a role in vaccination decisions, vaccine attitudes, and in the use of CAM, and whether that relationship is mediated by trust in medical doctors.ResultsParents with higher trait reactance had lower trust in doctors, more negative attitudes to vaccines, a higher likelihood of not accepting vaccines for their children and themselves, and a higher likelihood to use CAM treatments that are not included in evidence-based medicine. Our analyses also revealed associations between vaccination behavior and CAM use and vaccine attitudes and CAM use, but there was no support for the previous notion that these associations would be explained by trait reactance and trust in doctors.ConclusionsTaken together, higher trait reactance seems to be relevant for attitudes and behaviors that go against conventional medicine, because trait reactance is connected to a distrust in medical doctors. Our findings also suggest that high trait reactance and low trust in doctors function differently for different people: For some individuals they might be associated with anti-vaccination attitudes and behavior, while for others they might be related to CAM use. We speculate that this is because people differ in what is important to them, leading them to react against different aspects of conventional medicine.

Introduction: Penile fracture is a rare urological emergency associated in up to 30% of cases with injury to the anterior urethra. Recent data suggest that early surgical intervention is the best treatment strategy. This investigation describes a case of bilateral corpora cavernosa injury associated with complete rupture of the anterior urethra and presents current concepts about its management. Case presentation: 39-year-old man with bilateral corpora cavernosa injury and complete rupture of the anterior urethra, who received early surgical treatment with satisfactory early clinical outcomes. A literature review was made in PubMed and Embase, limiting the search to scientific articles published in the past 10 years using the MeSH terms “Penile diseases”, “Genital diseases, male”, “Wounds and injuries”. Some references were included given their clinical relevance. In this case, similar to international experiences, early surgical management of corpora cavernosa fractures allowed achieving adequate clinical outcomes in the patient. Conclusions: The diagnosis of penile fracture is based on clinical findings. Early surgical management should be considered as a therapy of choice. Conservative management has a higher complication rate versus early surgical management. The case described here had an adequate clinical evolution after 3 months of follow-up.

Resumo: Na tentativa de compreender o dilema entre "os valores da civilização alemã e as forças destruidoras no seio do mesmo povo que os criou", Carpeaux refuta três teorias então vigentes e considera Nietzsche, o "Dionísio Crucificado", como aquele que experimentou e antecipou as forças contraditórias do espírito alemão. Após fazer um balanço dos mal-entendidos em torno da recepção de Nietzsche tanto na Alemanha quanto na Europa até o ano de 1942, o autor então parte da tese de que o pensador alemão seria simultaneamente poeta, filósofo e profeta, algo que somente seria possível no interior de um "homo religiosus", daquele que vivenciaria o conflito oriundo da antiga barbárie nórdica e da barbárie dos novos burgueses alemães. Dotado de um intelecto que possuía uma "estrutura heraclítica", tal como o de Hegel, Nietzsche, no entanto, na qualidade de "profeta do niilismo europeu", teria não somente descoberto "a estrutura heraclítica do espirito alemão", mas, sobretudo "o caminho da autodestruição deste espírito". Ou seja, antecipado "o caminho do nacionalismo e do socialismo à fusão no nacional-socialismo".

ABSTRACT Background: The pyogenic liver abscess has an incidence of 1.1/1,000 habitants. Mortality can reach 100%. The use of less invasive procedures diminish morbidity and hospital stay. Aim: Identify risk factors in patients who underwent percutaneous drainage guided by ultrasound as treatment. Method: Were analyzed 10 patients submitted to the method. Epidemiological characteristics, laboratory markers and imaging exams (ultrasound and CT) were evaluated. Results: The majority of the patients were men with mean age of 50 years old. Liver disease, alcoholism and biliary tract disease were the most common prodromes. Abdominal pain (90%), fever (70%) and jaundice (40%) were the most common clinical manifestations. Mortality of 20% was observed in this series. Hypoalbuminemia and days of hospitalization had a statistically significant positive association with death. Conclusion: The pyogenic liver abscess has subacute evolution which makes the diagnosis difficult. Image exams have high sensitivity in diagnosis, particularly computed tomography. Percutaneous drainage associated with antibiotic therapy is safe and effective therapeutic resource.

ABSTRACT The present study examined the effect of aflatoxin (AFB1) and fumonisin (FB1) at the levels of 2 mg kg−1 AFB1 and 100 mg kg−1 FB1 and the efficiency of use of different levels of adsorbent based on sodium and calcium aluminosilicate on growth performance, hematological parameters, and biochemical parameters of broilers. A total of 1,440 Cobb broilers were distributed into the following treatments: positive control (PC) - no mycotoxin and adsorbent (AD); PC+3AD - no mycotoxin, with 3 g kg−1 adsorbent in feed; negative control (NC) - only mycotoxin; NC+1AD - with mycotoxin and 1 g kg−1 adsorbent in feed; NC+2AD - with mycotoxin and 2 g kg−1 adsorbent in feed; and NC+3AD - with mycotoxin and 3 g kg−1 adsorbent in feed. The amounts of AFB1 and FB1 added to NC reduced weight gain (35%) and feed intake (50%) compared with PC; however, inclusion of 2 or 3 g kg−1 adsorbent to NC alleviated such losses. Birds fed NC showed anemia, immunosuppression, and impaired liver function, observed by reduced cholesterol and increased gamma glutamyl-transferase activity compared with PC; values returned to normal levels when 2 or 3 g kg−1 of the adsorbent (as fed) were used. Mycotoxins cause adverse effects on most of the parameters studied, and the use of adsorbent at the levels of 2 and 3 g kg−1 of the adsorbent as fed partially negates the adverse effect of mycotoxicosis.

Background: The liver is the most injured organ in abdominal trauma. Currently, the treatment in most cases is non-operative, but surgery may be necessary in severe abdominal trauma with blunt liver damage, especially those that cause uncontrollable bleeding. Despite the damage control approaches in order to achieve hemodynamic stability, many patients develop hypovolemic shock, acute liver failure, multiple organ failure and death. In this context, liver transplantation appears as the lifesaving last resource Aim: Analyze the use of liver transplantation as a treatment option for severe liver trauma. Methods: Were reviewed 14 articles in the PubMed, Medline and Lilacs databases, selected between 2008-2014 and 10 for this study. Results: Were identified 46 cases undergoing liver transplant after liver trauma; the main trauma mechanism was closed/blunt abdominal trauma in 83%, and severe trauma (>grade IV) in 81 %. The transplant can be done, in this context, performing one-stage procedure (damaged organ removed with immediate transplantation), used in 72% of cases. When the two-stage approach is performed, end-to-side temporary portacaval shunt is provided, until new organ becomes available to be transplanted. If two different periods are considered - from 1980 to 2000 and from 2000 to 2014 - the survival rate increased significantly, from 48% to 76%, while the mortality decreased from 52% to 24%. Conclusion: Despite with quite restricted indications, liver transplantation in hepatic injury is a therapeutic modality viable and feasible today, and can be used in cases when other therapeutic modalities in short and long term, do not provide the patient survival chances.

Progressive myoclonus epilepsy of Unverricht–Lundborg type (EPM1) is an autosomal recessively inherited disorder characterized by incapacitating stimulus-sensitive myoclonus and tonic-clonic epileptic seizures with onset at the age of 6 to 16 years. EPM1 patients also exhibit a range of skeletal changes, e.g., thickened frontal cranial bone, arachnodactyly and scoliosis. Mutations in the gene encoding cystatin B (CSTB) underlie EPM1. CSTB is an inhibitor of cysteine cathepsins, including cathepsin K, a key enzyme in bone resorption by osteoclasts. CSTB has previously been shown to protect osteoclasts from experimentally induced apoptosis and to modulate bone resorption in vitro. Nevertheless, its physiological function in bone and the cause of the bone changes in patients remain unknown. Here we used the CSTB-deficient mouse (Cstb−/−) model of EPM1 to evaluate the contribution of defective CSTB protein function on bone pathology and osteoclast differentiation and function. Micro-computed tomography of hind limbs revealed thicker trabeculae and elevated bone mineral density in the trabecular bone of Cstb−/− mice. Histology from Cstb−/− mouse bones showed lower osteoclast count and thinner growth plates in long bones. Bone marrow-derived osteoclast cultures revealed lower osteoclast number and size in the Cstb−/− group. Cstb−/− osteoclasts formed less and smaller resorption pits in an in vitro assay. This impaired resorptive capacity was likely due to a decrease in osteoclast numbers and size. These data imply that the skeletal changes in Cstb−/− mice and in EPM1 patients are a result of CSTB deficiency leading to impaired osteoclast formation and consequently compromised resorptive capacity. These results suggest that the role of CSTB in osteoclast homeostasis and modulation of bone metabolism extends beyond cathepsin K regulation.

ABSTRACT Background: The search for less traumatic surgical procedures without compromising efficacy and safety, together with the technological advances and greater experience of the teams, led to the development of operative techniques with increasingly smaller incisions, the so-called “minimally invasive surgeries”. Aim: To evaluate the technical aspects and results of single port cholecystectomy. Method: Were analyzed 170 patients between 18-74 years submitted to videolaparoscopic cholecystectomies by single port, regardless of elective or urgent indication, without restriction of patient selection. Results: Among the 170 operations, 158 were exclusively performed by single port, and the conversion rate was 7% (inclusion of other accessory trocars or conversion to multiportal). Conversion to open surgery occurred in three cases (1.76%). The mean surgical time was 67.97 min, showing a marked decrease when was reached close to 50 cases and a stabilization after 100 surgeries. The overall complication rate was 10%, with minor complications such as: incisional pain, hematomas, granulomas, port access hernias (9.41%). Conclusion: Single port cholecystectomy can, after standardization and surgical team training, be a safe surgical procedure associated with a recognized aesthetic advantage.

Background: Accumulation of advanced glycation end-products (AGEs) is one of pathophysiological processes, responsible for progressive stiffening of vessel wall. In contrast, soluble isoform of receptor for AGEs (sRAGE) act as “decoy” and physiological defense against circulating AGEs. We hypothesized that low levels of sRAGE might be associated with accelerated age-dependent arterial stiffening. Methods: We followed 429 population-based subjects (mean age 50.8 (±11.7) years, 41.5% males) in prospective study. Aortic pulse wave velocity (aPWV) was measured using a Sphygmocor device. sRAGE concentrations were assessed in frozen samples by ELISA methods (R&D Systems). Baseline examination was done in 2008/9, while follow-up visit in 2016/17 (median time of follow-up was 7.6 years) Results: Mean intra-individual increase of aPWV during follow-up was 1.37 (±1.88) m/sec and was inversely associated with baseline sRAGE concentration – the aPWVV difference [follow-up minus baseline] across its quintiles was 2.08((±1.89), 1.51(±2.16), 1.20(±2.10), 0.99(±1.70), 1.13(±1.21) in 1st–5th quintiles of sRAGE, resp.; p = 0.003 (adjusted for age, gender and baseline mean arterial pressure) Baseline concentration of sRAGE

Current experiment established different criteria to evaluate the requirements of digestible isoleucine for 22- and 42-day-old broilers by different regression models (quadratic, exponential and Linear Response Plateau) and, in the case of statistical significance, the comparison of means by Duncan’s test at 5% probability. A total of 1,920 Cobb 500 male broilers were used in an entirely randomized experimental design, with 6 treatments (6 digestible isoleucine levels: 0.6118; 0.6655; 0.7192; 0.7729; 0.8265 and 0.8802%) and 8 replications, with 40 broilers each. Data on performance and carcass characteristics were evaluated. Level 0.7192% of digestible isoleucine was considered standard. The digestible isoleucine level recommended for 22- and 42-day-old broilers is 0.7729%, corresponding to a digestible isoleucine:lysine ratio of 72%.

The aim of this study was to evaluate the action of the phytase enzyme in diets formulated with variations in the crude protein content on performance and egg quality of commercial layers. A total of 336 commercial layers were housed at eight birds per cage in a 3 × 2 factorial arrangement with seven replicates. Treatments consisted of four crude-protein levels (17, 15, and 13%) and two enzyme levels (0 and 500 FTU kg-1 diet), distributed in a completely randomized design. Feed intake, egg production, feed conversion per dozen eggs and per kilogram, egg weight and mass, specific gravity, eggshell thickness, and Haugh unit were measured over five 28-day periods. The performance of commercial layers fed the diet containing 13% crude protein worsened, irrespective of phytase addition. However, at 15% crude protein, phytase inclusion did not affect feed conversion or egg weight. Inclusion of phytase leads to equal egg-quality and performance results at the dietary crude protein levels of 17 and 15%. The crude protein content of 13%, with or without phytase, is not recommended for the diet of brown-egg layers.

The effects of mannanase-hydrolyzed copra meal (MCM) and MCM + probiotic Bacillus cereus var. toyoi (TY) on growth performance and gut morphometry of broiler chickens were investigated. A total of 1120-one-day-old Cobb chicks were distributed in a completely randomized design with 4 diet treatment groups. Dietary treatments were (1) negative control; (2) positive control (avilamycin 10 ppm); (3) 0.1% MCM for basal diets (4) 0.1% MCM + 0.05% TY. The best feed conversion ratio (FCR), body weight (BW), productivity index (PI) was obtained with 0.1% MCM + 0.05% TY at 42 days of age. With regard to productivity index, every supplementation group had a better rate when compared to that in negative group. Although 0.1% MCM supplemented alone is worse than positive group, it reveals a significantly better value than when it is combined with 0.1% MCM and 0.05% TY. The combination of mannanase-hydrolyzed copra meal with Bacillus cereus var. toyoi improved broiler performance and duodenum and jejunum mucous morphometry, when compared to the negative, positive and 0.1% MCM alone supplementation groups. The combination of MCM and TY probiotics is capable of improving intestinal morphology by behaving like a good growth promoter, with possibility of being an alternative to antibiotics.

The paper discusses issues about the revitalisation of spoil tips, socio-economic polarisation and social exclusion in the field of municipal recreational activities based on an example of the largest post-industrial region in Europe – the Ruhr area in Germany. Revitalisation of brownfield areas very often leads to the creation of leisure facilities of various types (with a range of entrance fees) and because of this it may mitigate, or exacerbate, the severity of these negative phenomena. In the Ruhr area there are 104 spoil tips of different origins (mine tips, slag heaps, rubbish dumps), sizes and shapes (from conical heaps, through table mountains shaped tips and intentionally shaped for landscape tips, to major tips) and state of preservation. The research has shown that it is possible to use the majority of these spoil tips in the Ruhr area (87 of them) as leisure facilities as they have been changed into green areas, parks, playgrounds, locations for sports activities and tourist attractions after their restoration. Furthermore, they are mostly accessible free of charge and may serve a wide range of people – from locals to visitors, from children to senior citizens etc., regardless of their income. As such they may mitigate the socio-economic polarisation tendencies in the region.

The paper concerns the relation between revitalisation projects and socio-economic polarisation, and discusses the potential of new urban spaces for social inclusion. The phenomenon is considered on the example of recreational facilities that have emerged from brownfields located in the Ruhr region (Germany). It was ascertained that the diversity of implemented projects was important in terms of the significance of revitalisation processes for social polarisation tendencies. It allowed regional authorities to create income-generating facilities and spaces that can be used regardless of income, and to resolve deficits in urban recreational facilities. It was also noted that the Ruhr examples could provide guidance for the recently begun revitalisation processes in the Upper Silesian industrial area (Poland).

Current experiment established different criteria to evaluate the requirements of digestible valine for broilers from 22 and 42 days of age, by different regression models (quadratic, exponential and Linear Response Plateau) and, in the case of statistical significance, the comparison of means byDuncantest at 5% probability. A total of 1,920 Cobb 500 male broilers were used and distributed in an entirely randomized experimental design, with 6 treatments (6 digestible valine levels: 0.7192, 0.7729, 0.8265, 0.8802, 0.9339 and 0.9876%) and 8 replications, with 40 broilers each. Data on performance and carcass characteristics were evaluated. The level of 0.8265% digestible valine was considered standard. The inclusion of 0.816, 0.848 and 0.903% of digestible valine levels, corresponding to digestible valine:lysine ratios of approximately 76.00%, 79.00% and 84.12%, provided best feed intake, weight gain and feed conversion ratio, respectively for broiler from 22 to 42 days of age.

The author examines the relationship between the aesthetics of Romanticism and theories developed within the 20th century structuralist tradition. In the first part of the article he shows that there are affinities between the broad Romantic concept of the unifying symbol and the way linguistic entities are considered as self-contained units within certain theories of classical structuralism. In the last part he shows how poststructuralism tends to focus on rhetorical devices that display disruption rather than integration and unity, theorists such as Paul de Man taking a philosophical stance that amplifies the rupture between man – as a creature that allegedly relates to reality exclusively through linguistic means – and a multifaceted world that, according to the author, deserves better.

We show that ultrafast electron diffuse (inelastic) scattering provides a detailed, momentum-resolved view of electron-phonon and phonon-phonon coupling across the entire Brillouin zone. Ultrafast time-resolution and scattering selection rules can distinguish between phonon branches without energy-resolution.

A novel laser-RF cavity synchronization scheme was developed for ultrafast electron diffraction instruments. The approach directly generates a synchronized microwave tone by retrieving a phase-locked high-harmonic by photodetection. The radio-frequency cavity which performs electron pulse compression is detuning compensated using an active phase stabilization loop. Timing stability improved from 100 fs to 5 fs RMS and long-term time-zero stability improved to below our measurement resolution of 50 fs determined by pulse streaking.

The objective of this experiment was to establish different criteria to evaluate the requirements of digestible tryptophan for broilers from 22 to 42 d of age, using different regression models (quadratic, exponential and Linear Response Plateau) and in case of statistical significance the comparison of means by Duncan test at 5% probability was also adopted. A total of 1,920 Cobb 500 male broilers were distributed in a completely randomized experimental design, with 6 treatments (6 digestible tryptophan levels: 0.1395, 0.1610, 0.1825, 0.2040, 0.2255 and 0.2470%) and 8 replications containing 40 broilers each. Performance and carcass characteristics were evaluated. The level of 0.2255% of digestible tryptophan numerically improves feed conversion, and the 0.1919% estimated by the quadratic equation significantly improves carcass yield.

The aim of the paper was to consider the extent of the impact of revitalization on the evolution of post-industrial sites, which manifests itself in morphological and functional changes of urban space. Research was performed on three former iron and steel works areas located in the Ruhr region in Germany: one of the Thyssen's ironworks in Duisburg - Meiderich, the area of steelworks complex Gute-Hoffnungs-Hütte in Oberhausen and the area of the iron and steel works Phönix in Dortmund - Hörde. Methods were applied specific to urban morphology. For each object of study a comparative analysis of the town plan was carried out. Town plans were compared before and after the revitalization process and special attention was paid to land use. This allowed us to observe morphological and functional changes which occurred as a result of the revitalization of the study areas. The research showed that the revitalization of post-industrial space may be conducted in many different directions but irrespective of that it has a huge impact on the evolution of urban space in both a morphological and a functional way. The extent to which revitalization affects morphological and functional structure of urban space depends on the future plan for the spatial development of the site and its attitude to its post-industrial heritage.

This experiment was conducted to evaluate the use of different energy levels and amino acid recommendations on performance, carcass yield and intestinal morphometry of broilers from 42 to 57 days of age. We used 1,600 one-day old male broilers (Cobb 500) in a completely randomized design arranged in a 2x4 factorial scheme with 3,200 and 3,600 kcal ME/kg and four different feed programs. The metabolizable energy levels and the feed programs did not determine significant differences in carcass characteristics for choosing a level of energy or a feed program, thus the energy level and the recommendations of amino acids that determine the highest cost-benefit ratio should prevail. It was observed that 3,600 kcal ME/kg resulted in some improvement on performance and morphometry of the intestinal mucosa, also the fractioning of digestible amino acid requirements during two periods resulted in worse performance and intestinal villi height.

Um experimento foi realizado com o objetivo de estabelecer critérios de avaliação das exigências de treonina digestível para frangos de corte de 22 a 42 dias de idade utilizando-se diferentes modelos de regressão (quadrático, exponencial e de retas segmentadas ou Linear Response Plateau). Foram utilizados 1.920 frangos de corte machos com 22 dias de idade, distribuídos em delineamento inteiramente ao acaso, com seis tratamentos (seis níveis de treonina digestível: 0,5904; 0,6441; 0,6977; 0,7514; 0,8051 e 0,8588%) e oito repetições de 40 aves. Utilizou-se como padrão o nível de 0,6977% de treonina digestível. Foram avaliados dados de desempenho e características de carcaça. Com base nos dados, o nível de 0,7642% de treonina digestível, correspondente às relação treonina:lisina digestível de 71,19%, promoveu o melhor resultado de conversão alimentar de acordo com o modelo Linear Response Plateau.The objective of this experiment was to establish different criteria for evaluation of the requirements of digestible threonine for broilers from 22 to 42 d of age, using different regression models (quadratic, exponential, and Linear Response Plateau). A total of 1,920 22-day-old male Cobb broilers were distributed in randomized experimental design, with six treatments (six threonine levels: 0.5904, 0.6441, 0.6977, 0.7514, 0.8051, and 0.8588%) and 8 replications containing 40 broilers each one. The level of 0.6977% digestible threonine was used as standard. Data on performance and carcass characteristics were evaluated. Based on the data, the threonine level of 0.7642%, corresponding to the threonine:digestible lysine ratio of 71.19% had the best result for feed conversion, according to the Linear Response Plateau model.

The objective of this experiment was to evaluate the effect of the sodium gluconate addition on performance (feed intake, body weight, weight gain, feed conversion, livability and productive efficiency), carcass characteristics (carcass, breast, thigh and drumstick, wing and back yield), and morphometry of duodenum, jejunal and ileum of broilers from 22 to 42 days of age. A total of 1,200 Cobb male broilers were distributed in a completely randomized design with five treatments (0.00, 0.10, 0.20, 0.30 and 0.40% sodium gluconate), and eight replications of 30 broilers each. The inclusion of sodium gluconate did not affect the broiler performance and carcass characteristics. However, the morphometry of duodenum and jejunal mucosa showed beneficial effects.O presente estudo teve por objetivo avaliar o efeito da utilização de níveis crescentes do gluconato de sódio sobre o desempenho, o rendimento de carcaça e de partes e a morfometria da mucosa intestinal de frangos de corte de 22 a 42 dias de idade. Foram utilizados 1200 frangos de corte da linhagem Cobb, distribuídos em um delineamento inteiramente casualizado, envolvendo cinco tratamentos (0,00; 0,10; 0,20; 0,30 e 0,40% de gluconato de sódio) com oito repetições de 30 aves cada parcela. As variáveis foram submetidas à análise de variância e em caso de significância estatística foram realizadas análises de regressão pelos modelos polinomial e quadrático. A inclusão do gluconato de sódio não afetou o desempenho e o rendimento de carcaça e de partes. Entretanto, exerceu efeito benéfico sobre a morfometria da mucosa intestinal do duodeno e do jejuno.

The objective of this experiment was to evaluate the effect of the sodium gluconate addition on performance (feed intake, body weight, weight gain, feed conversion, livability and productive efficiency), carcass characteristics (carcass, breast, thigh and drumstick, wing and back yield), and morphometry of duodenum, jejunal and ileum of broilers from 22 to 42 days of age. A total of 1,200 Cobb male broilers were distributed in a completely randomized design with five treatments (0.00, 0.10, 0.20, 0.30 and 0.40% sodium gluconate), and eight replications of 30 broilers each. The inclusion of sodium gluconate did not affect the broiler performance and carcass characteristics. However, the morphometry of duodenum and jejunal mucosa showed beneficial effects

An experiment was conducted to evaluate the performance, bonedensitometry and carcass yield of broilers chicks, using different levels of phytase enzyme. Nine hundred and sixty male one-day-old broiler chicks were used. The birds were distributed in a completely randomized experimental design, involving five treatments andsix replications of 32 chicks each. The treatments consisted of a control diet for each phase, and four other diets were formulated adding growing levels of the phytase enzyme (250, 500, 750 and 1,000 FTU of phytase kg-1 feed). When adding the phytase enzyme, thenutritional matrix was valued to guarantee the same nutritional levels as the control diet. In general, the addition of phytase enzyme determined a linear decrease on the performance of the birds. However, the performance obtained with the level of 250 FTU phytase kg-1 feed were no different from the control treatment. The best bone density results were observed in the control treatment with no phytase, and the highest leg and thigh yield were obtainedat the level of 514 FTU phytase kg-1.Um experimento foi realizado com o objetivo de avaliar a inclusão de diferentes níveis da enzima fitase, sobre o desempenho, a densitometria óssea e o rendimento de carcaça e partes de frangos de corte nas diferentes fases de criação. Foram utilizados 960 pintainhos de corte com um dia de idade, da marca comercial Ross, distribuídos em um delineamento inteiramente casualizado, com quatro tratamentos mais uma testemunha (quatro níveis da enzima fitase -250, 500, 750 e 1.000 FTU de fitase kg-1 de ração + testemunha) e seis repetições de 32 aves cada. Ao adicionar a enzima fitase, a matriz nutricional da mesma foi valorizada para garantir os mesmos níveis nutricionais da dieta testemunha. Foram avaliados os índices dedesempenho, de densitometria óssea e o rendimento de carcaça e de partes nas diferentes fases de criação. De maneira geral o aumento na inclusão da enzima fitase determinou declínio linear sobre o desempenho das aves. Entretanto, até o nível de 250 FTU de fitasekg-1 de ração não foram observadas diferenças expressivas em relação ao tratamento isento de fitase. Os melhores resultados de densitometria óssea foram observados no tratamento controle sem a adição da enzima fitase e o maior rendimento de coxa+sobrecoxa foi obtido com o nível de 514 FTU de fitase kg-1 de ração.

Cento e oitenta poedeiras comerciais Isa Brown, com 60 semanas de idade, foram distribuídas em delineamento inteiramente ao acaso, em esquema fatorial 2 õ 2, com dois níveis de fitase (0 e 500 ftu/kg de ração) e dois de farelo de girassol (4 e 8%), totalizando cinco dietas, avaliadas com seis repetições de seis aves. As dietas foram formuladas a partir de uma ração controle, à base de milho e farelo de soja, isenta de fitase e farelo de girassol, valorizando na formulação das dietas a matriz nutricional da fitase. O período experimental foi dividido em quatro ciclos de 28 dias cada. A matriz nutricional preconizada para fitase permitiu o atendimento pleno das exigências das aves, mesmo quando as dietas foram formuladas com níveis nutricionais reduzidos, isso quando desconsiderados os nutrientes presentes na matriz nutricional da enzima, de acordo com recomendação da empresa produtora. A adição de fitase na dieta reduz a excreção de fósforo pelas aves e melhora os parâmetros econômicos. A inclusão de farelo de girassol no nível de 8% prejudica a produção de ovos, mas não afeta os demais parâmetros de desempenho e qualidade dos ovos.One hundred and eighty Isa Brown laying hens at 60 weeks of age were arranged in a completely randomized design in a 2 õ 2 factorial scheme, with two levels of phytase (0 and 500 ftu/kg ration) and two levels of sunflower meal (4 and 8%) totalizing five diets, evaluated with six replicates with six birds. Diets were formulated from a control ration based on corn and soybean meal free from phytase and sunflower meal, valuing the nutritional phytase matrix in diets formulation. The experimental period was divided in four 28-day cycles. The nutritional matrix suggested for phytase completely met the requirement by hens, even when diets were formulated with reduced nutritional levels when the nutrients present in the enzyme nutritional matrix were not considered accordingly to recommendations by the manufacturer. Addition of phytase in the diet reduces excretion of phosphorus by the birds and it improves the economical parameters. Inclusion of sunflower meal at 8% level negatively affects egg production, but it does not affect the other performance parameters and egg quality.