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After 50 years of international experience and 15 years of use in France, the positive impact of drug replacement treatments on the care of patients with opiates dependence is now well established. Even though there is a vast literature on the two existing treatments (methadone and high-dosage buprenorphine), few works have focused on patients who have changed replacement therapy during follow-up.
Objectives and aims
The aim of our study was to analyze the follow-up of substituted patients throughout an 11-year period. Patients were characterized by the type of treatment: methadone only, high-dosage buprenorphine only, or both treatments.
These groups of patients were studied depending on their characteristics at the beginning of the treatment (sociodemographic data, addictive behaviours, psychiatric assessment) and in terms of healthcare and follow-up regularity. We also tried to bring to light predictive factors of unstable follow-ups at the point of entry in healthcare.
891 patients were included in our results. Patients having had two substitution treatments initially present with higher severity in terms of socio-professional integration, addictive behaviours and psychiatric comorbidity. Their treatment is more discontinued and they have longer healthcare.
Psychiatric comorbidities and poly-drug use seem to characterize unstable patients who jeopardize our treatments. They have to be identified very early in order to better adjust healthcare. This preliminary work underlines the necessity of carrying out a prospective study integrating better adapted assessment tools.
This study evaluated the effects of a diet containing yellow mealworm (Tenebrio molitor L.; TM) larva meal on quality parameters (pH24, color and drip losses), proximate composition and fatty acid (FA) profile of meat from free-range chickens. A total of 140 medium-growing hybrid female chickens were free-range reared and randomly allotted to two dietary treatments: a control group and a TM group, in which TM meal was included at 75 g kg−1 as fed in substitution of corn gluten meal. Each group consisted of five pens as replicates, with 14 chicks per pen. At 97 days of age, ten birds (two birds/pen) from each feeding group were slaughtered at a commercial abattoir. Quality parameters and proximate composition of breast and thigh meat were not affected by treatment. The effects of dietary TM larva meal on the FA profile of thigh meat were negligible. Breast meat from TM-fed chickens showed higher oleic and α-linolenic acid percentages as well as lower atherogenicity and thrombogenicity indexes. In conclusion, this study demonstrated that TM inclusion in diets for free-range chickens did not prejudice meat quality traits. The obtained results confirm that TM can be considered a promising insect protein source for the poultry feed industry.
Finding insect meals as alternative sources of poultry feedstuffs is a recent research topic; therefore, the present study aimed to evaluate the effects of defatted black soldier fly (Hermetia illucens L., HI) larvae meal in broiler chicken diets on the carcass characteristics and meat quality parameters, proximate composition, fatty acid profile and the heavy metal content of the breast meat. Four dietary treatments were designed: a control diet (HI0) and three experimental diets (HI5, HI10 and HI15), corresponding to 50, 100 and 150 g/kg HI inclusion levels, respectively. The inclusion of 50, 100 and 150 g HI meal per kg feed supply 16.56%, 33.01% and 49.63% of required crude protein. The broilers were slaughtered at day 35, the carcasses were weighed and the breast muscles were excised from 16 birds per each feeding group (two birds per replicate pens) and used for meat quality evaluation. Linear and quadratic responses were observed, for increasing HI meal levels, in the live and carcass weights (maximum for HI10). As far as the colour of the breast meat is concerned, redness (a*) showed a linear response, while yellowness (b*) linearly decreased with increasing HI meal levels (minimum for HI15). As the HI larvae meal increased in the diets, the moisture content linearly decreased and the protein content increased. The total saturated fatty acid and total monounsaturated fatty acid proportions rose to the detriment of the polyunsaturated fatty acid fraction. The HI larvae meal, used in the current study, represents a valuable protein source for broiler chickens when included by up to 100 g/kg in their diets, as an improved slaughtering performance was observed without any detrimental effects on meat quality parameters or heavy metal residues in the meat.
Agricultural by-products could be used as alternative raw materials in rabbit nutrition as they have been found to be highly nutritious and low cost feeding sources. The aim of this study was to estimate the nutritive value and potential use of bilberry pomace (BP) for growing rabbits. A total of 144 Grimaud rabbits (35 days old) were allotted to four groups and fed with a diet containing increasing level of BP: BP0 (basal diet), BP5, BP10 and BP15 containing 0, 50, 100 and 150 g/kg respectively. Growth trial lasted 48 days; apparent digestibility was evaluated, starting at 46 days of age, over 4 consecutive days. The nutritive value of BP was measured using the mean digestibility of the experimental diets. At 83 days of age, rabbits were slaughtered: blood, and liver and kidney samples were collected in order to determine the blood parameters and the antioxidant enzyme activities of the tissues. Moreover, caecal content was sampled and gut microbiota assessed by means of amplicon-based high-throughput 16S rRNA sequencing and PCR-denaturing gradient gel electrophoresis. The digestible protein was estimated to 104 g/kg of DM while digestible energy to 9.44 MJ/kg DM for incorporation rate up to 150 g/kg. During the finishing period, average daily feed intake and feed conversion ratio showed linear response to BP increase (P=0.008 and <0.001, respectively). During all the period, both parameters decreased linearly and quadratically with increasing BP inclusion levels (P<0.001) up to 100 g/kg of BP. A significant effect of the antioxidant status was found in the kidneys and liver (P<0.05) where the glutathione peroxidase activity increased as the BP increased. As far as gut microbiota is concerned, BP increased the relative abundance of the Clostridium, Oscillospira, Ruminococcus and Ruminococcaceae species which were clearly associated with the BP inclusion level. In conclusion, BP showed a potential use as an alternative protein and fibre sources for growing rabbits.
The objective of the present study was to evaluate the effects of partial or total replacement of finisher diet soybean oil with black soldier fly (Hermethia illucens L.; HI) larva fat on the growth performance, carcass traits, blood parameters, intestinal morphology and histological features of broiler chickens. At 21 days of age, a total of 120 male broiler chickens (Ross 308) were randomly allocated to three experimental groups (five replicates and eight birds/pen). To a basal control diet (C; 68.7 g/kg as fed of soybean oil), either 50% or 100% of the soybean oil was replaced with HI larva fat (HI50 and HI100 group, respectively). Growth performance was evaluated throughout the trial. At day 48, 15 birds (three birds/pen) per group were slaughtered at a commercial abattoir. Carcass yield and proportions of carcass elements were recorded. Blood samples were taken from each slaughtered chicken for haematochemical index determination. Morphometric analyses were performed on the duodenum, jejunum and ileum. Samples of liver, spleen, thymus, bursa of fabricius, kidney and heart were submitted to histological investigations. Growth performance, carcass traits, haematochemical parameters and gut morphometric indexes were not influenced by the dietary inclusion of HI larva fat. Histopathological alterations developed in the spleen, thymus, bursa of fabricius and liver and were identified in all of the experimental groups, but HI larva fat inclusion did not significantly affect (P>0.05) the severity of the histopathological findings. The present study suggests that 50% or 100% replacement of soybean oil with HI larva fat in broiler chickens diets has no adverse effects on growth performance or blood parameters and had no beneficial effect on gut health.
The present research studied the effect of a dietary inclusion with Hermetia illucens larvae meal (Hi) on rainbow trout’s fillets chemical composition. The effect of Hi inclusion in diets on rainbow trout chemical characteristics was evaluated. Trout were fed three different diets: control (C, no Hi inclusion), 25% and 50% of substitution of fish meal with Hi (Hi25 and Hi50, respectively). Fillets were analysed to quantify proximate composition, carbohydrates percentage, colour parameters, nucleotides concentration, fatty acids profile, volatile organic compounds (VOCs) and myofibrillar and sarcoplasmic concentrations. Diets did not affect proximate composition. Contrariwise, Hi50 diet decreased fillet yellowness and both substitution percentages affected negatively adenosine monophosphate concentration. Saturated fatty acids, mostly C12 : 0, increased their contents in relation with Hi inclusion at the expense of monounsaturated and polyunsaturated (both n-3 and n-6) fatty acids. Less modifications were reported in VOCs as only heptanal and octanal concentrations were affected, no new compounds appeared in relation with Hi inclusion. No modifications in proteins patterns were shown even if myofibrillar content decreased in trout fed Hi50. The results highlighted that chemical modifications occurred in fillets were related to the chemical composition of the H. illucens meal and to the percentage of inclusion in the diet. Substitution of fish meal with a precisely percentage of H. illucens meal could be a potential future solution in order to decrease the quantity of fish meal used in aquafeeds.
Across the globe, the implementation of quality improvement science and collaborative learning has positively affected the care and outcomes for children born with CHD. These efforts have advanced the collective expertise and performance of inter-professional healthcare teams. In this review, we highlight selected quality improvement initiatives and strategies impacting the field of cardiovascular care and describe implications for future practice and research. The continued leveraging of technology, commitment to data transparency, focus on team-based practice, and recognition of cultural norms and preferences ensure the success of sustainable models of global collaboration.
Different metabolic pathways of supplemental and fortification Fe, or inhibition of Zn absorption by Fe, may explain adverse effects of supplemental Fe in Fe-sufficient infants. We determined whether the mode of oral Fe administration or the amount habitually consumed affects Fe absorption and systemic Fe utilisation in infants, and assessed the effects of these interventions on Zn absorption, Fe and Zn status, and growth. Fe-sufficient 6-month-old infants (n 72) were randomly assigned to receive 6·6 mg Fe/d from a high-Fe formula, 1·3 mg Fe/d from a low-Fe formula or 6·6 mg Fe/d from Fe drops and a formula with no added Fe for 45 d. Fractional Fe absorption, Fe utilisation and fractional Zn absorption were measured with oral (57Fe and 67Zn) and intravenous (58Fe and 70Zn) isotopes. Fe and Zn status, infection and growth were measured. At 45 d, Hb was 6·3 g/l higher in the high-Fe formula group compared with the Fe drops group, whereas serum ferritin was 34 and 35 % higher, respectively, and serum transferrin 0·1 g/l lower in the high-Fe formula and Fe drops groups compared with the low-Fe formula group (all P<0·05). No intervention effects were observed on Fe absorption, Fe utilisation, Zn absorption, other Fe status indices, plasma Zn or growth. We concluded that neither supplemental or fortification Fe nor the amount of Fe habitually consumed altered Fe absorption, Fe utilisation, Zn absorption, Zn status or growth in Fe-sufficient infants. Consumption of low-Fe formula as the only source of Fe was insufficient to maintain Fe stores.
Echinacea pallida (EPAL), a herbaceous flowering plant with immunomodulatory properties, has been chosen to determine the pre- and post-supplementary effects on the growth performances, bacterial community, blood parameters and immunity of growing rabbits. The same Grimaud does (14-week-old) from the studied in the first part of this study were randomly divided into two groups (n=50/group). The first group was fed a basal diet without supplementation (Control group, C) while the another group was fed a basal diet supplemented with 3 g EPAL/kg diet (Echinacea group, E). From the second parturition, 80 weaned kits (40 from the C does and 40 from the E does) were randomly assigned to four groups of 20 animals each and were fed a growing commercial diet supplemented with or without a 3 g EPAL/kg diet: the CC group (rabbits from the C does fed the control diet), CE group (rabbits from the C does fed the supplemented diet), EC (rabbits from the E does fed the control diet) and EE group (rabbits from the E does fed the supplemented diet). The dietary EPAL treatment did not affect the growth performance. Ten fattening rabbits from each group were selected to evaluate the bacterial community and blood parameters, while the remaining rabbits (n=10/group) were used to study phagocytosis and the humoral immune response. The variability was evaluated from hard faeces at 35, 49 and 89 days, and the caecal content at 89 days. The variability of the bacterial community of the EE group was higher than that of the other groups. The phagocytic activity was higher in the CE and EE groups than in the CC and EC ones (30.9 and 29.7 v. 21.2 and 21.8%; P<0.05), whereas no statistically significant difference was observed for the blood parameters or humoral immune response against vaccination (rabbit haemorrhagic disease virus) at 95 days old which the serum was collected at 88, 102, 109, 116 and 123 days old. In conclusion, no impact of EPAL dietary supplementation has been observed on the growth performances, bacterial community, blood parameters or humoral immune responses in growing rabbits, except for an increase in phagocytic activities.
In this study, 160 Hycole weaned rabbits (35 days old) were randomly divided into four groups of 40. The rabbits were studied throughout a 54-day experimentation period in order to determine the impact of dietary supplementation from herbs composed of 0.2%, 0.4% dry ground Lythrum salicaria leaves (LS) and 0.3% Cunirel® (CR; a commercial herb mixture containing LS as the main ingredient) on performance, digestibility, health and meat quality. The basal diet was given to the control group. No significant differences were found in performance, 10 rabbits from each group were selected for evaluation regarding apparent digestibility. The rabbits fed the control diet and the diet with the low level of LS had a higher level of CP digestibility than did the animals that were supplemented with the high LS levels and CR (85.7% and 84.9% v. 84.0% and 84.0%, respectively; P<0.05). The ether extract digestibility was lower in the treatment group with 0.4%LS addition and CR as compared with the control group (52.2% and 54.5% v. 62.6%, respectively; P<0.05). The slaughter process was performed on 89-day-old rabbits to study the carcass characteristics, meat quality, blood parameters, caecal contents and gut histology. The total leukocyte counts in the control animals were lower than they were in the rabbits fed 0.2%, 0.4%LS and CR (4.06 v. 8.25, 8.63 and 8.21×109/l, respectively; P<0.05). For caecal fermentation, the caecal contents of the rabbits fed 0.4% of LS, showed higher concentrations of total volatile fatty acid (VFA; 24.1 v. 18.9 mg/kg dry matter (DM); P<0.05) and acetic acid (18.3 v. 14.4 mg/kg DM; P<0.05), but lower ammonia levels (594 v. 892 mg/kg DM; P<0.05) as compared with the control group. PCR-denaturing gradient gel electrophoresis analyses were performed to evaluate the microbial community in hard faeces, collected at days 35, 42, 49, 56, 70 and 89, whereas the caecal contents were taken after slaughtering. The results demonstrated that between the treatment groups, the similarity of the microbial communities was higher as compared with the control group. Moreover, only age was shown to influence microbiota diversity. In conclusion, the results of this study indicated that supplementation of LS in rabbit diets leads to an increase in the total white blood cells, total VFA and acetic acid concentration, and a decrease in the ammonia levels, as well as the digestibility when CR and high level of LS were supplemented, without causing any adverse effects on other parameters.
The objective of this study was to assess the performance of several algorithms for outbreak detection based on weekly proportions of whole carcass condemnations. Data from one French slaughterhouse over the 2005–2009 period were used (177 098 slaughtered cattle, 0.97% of whole carcass condemnations). The method involved three steps: (i) preparation of an outbreak-free historical baseline over 5 years, (ii) simulation of over 100 years of baseline time series with injection of artificial outbreak signals with several shapes, durations and magnitudes, and (iii) assessment of the performance (sensitivity, specificity, outbreak detection precocity) of several algorithms to detect these artificial outbreak signals. The algorithms tested included the Shewart p chart, confidence interval of the negative binomial model, the exponentially weighted moving average (EWMA); and cumulative sum (CUSUM). The highest sensitivity was obtained using a negative binomial algorithm and the highest specificity with CUSUM or EWMA. EWMA sensitivity was too low to select this algorithm for efficient outbreak detection. CUSUM's performance was complementary to the negative binomial algorithm. The use of both algorithms on real data for a prospective investigation of the whole carcass condemnation rate as a syndromic surveillance indicator could be relevant. Shewart could also be a good option considering its high sensitivity and simplicity of implementation.
We report here on the chemical methodologies that are being settled in our labs for the insertion in diamond of foreign atoms and consequent creation of fluorescent defects. The inclusion of Si, Cr, Ge, able to produce color centers, is directly obtained during the process of diamond synthesis by means of a CVD technique. The deposition of the diamond films takes place on substrates of different nature, treated following procedures specifically settled to control the insertion of the different species. The photoluminescence emission from a series of diamond samples grown on different substrates (Si, Ge and Ti) has been investigated and is discussed with reference to the morphological/structural features of the diamond phase and to the experimental procedures adopted for substrate preparation.
In this study, the effects of the inclusion of artichoke bracts (AB) in rabbit diets on the carcass characteristics and rabbit meat quality were studied. A total of 120 rabbits aged 38 days were used and divided into three groups that were fed with different isonitrogenous and isocaloric diets supplemented with AB at 0%, 5% and 10%. The animals were single housed in wire cages at a temperature of 22±2°C and had free access to clean drinking water. At 96 days of age, 12 rabbits/group were slaughtered in an experimental slaughterhouse without fasting. The carcass was weighed and the weights of the skin and full gastrointestinal tract were recorded. Carcasses were chilled at +4°C for 24 h in a refrigerated room. The chilled carcass weight (CCW), dressing out percentage (CCW as percentage of slaughter weight), and the ratio of the head and liver were determined as a percentage of CCW. The reference carcass weight was also calculated. Carcasses were halved and the two longissimus dorsi (LD) muscles were excised. The left LD muscle was divided into two parts. The fore part was used to measure pH, colour and cooking losses. The hind part of the left LD was vacuum-packed, frozen at –20°C and then freeze-dried. Proximate composition, fatty-acid profile and thiobarbituric acid-reactive substances values were determined on freeze-dried samples. Results showed that carcass characteristics, LD muscle traits and its oxidative status were not affected by the AB supplementation, except for the meat ether extract content that increased from 0.68% to 0.94% on fresh matter basis with the increase of the AB supplementation (P<0.01). The α-linolenic acid proportion decreased with the increase of the AB supplementation from 3.58% to 2.59% in the LD muscle and from 4.74% to 3.62% in the perirenal fat, whereas the n-6/n-3 ratio increased significantly with increasing AB inclusion from 7.15 to 10.20 in the LD muscle and from 6.68 to 9.35 in the perirenal fat (P<0.01). Furthermore, no significant difference was found in preference among meat samples from each group. The enrichment of the rabbit’s diet with AB allows the production of rabbit meat with a good degree of unsaturation and low saturation, even if the n-6/n-3 ratio was slightly worse.
A laser-welded blank (LWB) offers several notable benefits including decreased part weight, reduced manufacturing costs, increased environmental friendliness and improved dimensional consistency. However, in order to take advantage of these benefits, designers need to overcome the formability of LWBs and be able to accurately predict the LWB forming characteristics early in the design process. We present a new approach to predict the maximum elongation of the laser seam; for example, for Advanced High-Strength Steel (AHSS)-based LWBs. This approach is based on a coupling model taking into account the thermal, metallurgical and mechanical phenomena. A comparison of numerical and experimental results shows very good agreement. These approaches offer a considerable advantage in obtaining the formability limits for all configurations.
The purpose of this study was to develop a standardized tool for the assessment of surveillance systems on zoonoses and animal diseases. We reviewed three existing methods and combined them to develop a semi-quantitative assessment tool associating their strengths and providing a standardized way to display multilevel results. We developed a set of 78 assessment criteria divided into ten sections, representing the functional parts of a surveillance system. Each criterion was given a score according to the prescription of a scoring guide. Three graphical assessment outputs were generated using a specific combination of the scores. Output 1 is a general overview through a series of pie charts synthesizing the scores of each section. Output 2 is a histogram representing the quality of eight critical control points. Output 3 is a radar chart representing the level reached by ten system attributes. This tool was applied on five surveillance networks.
To better understand the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization or infection in different patient populations, to perform quantitative analysis of MRSA in nasal cultures, and to characterize strains using molecular fingerprinting.
Prospective, multicenter study.
Eleven different inpatient and outpatient healthcare facilities.
MRSA-positive inpatients identified in an active surveillance program; inpatients and outpatients receiving hemodialysis; inpatients and outpatients with human immunodeficiency virus (HIV) infection; patients requiring cardiac surgery; and elderly patients requiring long-term care.
Nasal swab samples were obtained from January 23, 2006, through July 27, 2007; MRSA strains were quantified and characterized by molecular fingerprinting.
A total of 444 nares swab specimens yielded MRSA (geometric mean quantity, 794 CFU per swab; range, 3-15,000,000 CFU per swab). MRSA prevalence was 20% for elderly residents of long-term care facilities (25 of 125 residents), 16% for HIV-infected outpatients (78 of 494 outpatients), 15% for outpatients receiving hemodialysis (31 of 208 outpatients), 14% for inpatients receiving hemodialysis (86 of 623 inpatients), 3% for HIV-infected inpatients (5 of 161 inpatients), and 3% for inpatients requiring cardiac surgery (6 of 199 inpatients). The highest geometric mean quantity of MRSA was for inpatients requiring cardiac surgery (11,500 CFU per swab). An association was found between HIV infection and colonization with the USA300 or USA500 strain of MRSA (P ≤ .001). The Brazilian clone was found for the first time in the United States. Pulsed-field gel electrophoresis patterns for 11 isolates were not compatible with known USA types or clones.
Nasal swab specimens positive for MRSA had a geometric mean quantity of 794 CFU per swab, with great diversity in the quantity of MRSA at this anatomic site. Outpatient populations at high risk for MRSA carriage were elderly residents of long-term care facilities, HIV-infected outpatients, and outpatients receiving hemodialysis.
Interferometry in the near IR aims at providing imaging resolution on the mas scale, and astrometry at the few μas level, from ground based infrastructures using current telescope technology. To take advantage of simultaneous combination of four to eight telescopes, an international consortium is proposing to ESO the development of the VLTI Spectro-Imager. One of the key sub-systems, to measure and correct the atmospheric perturbations relative to the beam phase, is the fringe tracker, aimed at providing the science combiner with long, stable observing conditions. The fringe tracker function in interferometer is equivalent to adaptive optics for conventional telescopes. The fringe tracker concept under study, using minimum redundancy combination and bulk optics, is described.