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Strenuous physical activity, sleep deprivation, and psychological stress are common features of military field training. This study aimed to evaluate the effects of supplementation with a synbiotic ice cream on salivary IgA, gastrointestinal symptoms, well-being indicators, and gut microbiota in young military participants undergoing field training. Sixty-five military completed the study: one group was supplemented for 30 days with synbiotic ice cream containing: 2.1x108 CFU/g for L. acidophilus LA-5 and 2.7x109 CFU/g for B. animalis BB-12 and 2.3g of inulin in the 60g of ice cream at manufacture, and the other with a placebo ice cream. Volunteers were evaluated at pre-supplementation (baseline), post-supplementation, and after a five-day military training. Bifidobacterium and Lactobacillus genera were measured in stool samples and both showed a higher differential abundance post-supplementation and training. Salivary IgA and gastrointestinal symptoms decreased at post-training in both groups (p<0.05; main effect of time); however, supplementation with synbiotic did not mitigate this effect. Tenseness and sleepiness were decreased in the synbiotic-treated group, but not in the placebo group at post-military training (p=0.01 and p=0.009, respectively; group x time effect). The other well-being indicators were not affected by the synbiotic supplementation. In conclusion, 30 days of synbiotic ice cream supplementation containing inulin, L. acidophilus LA-5, and B. animalis BB-12 favourably modulated gut microbiota and improved tenseness and sleepiness in healthy young military undergoing a 5-day field training. These improvements may be relevant to this population as they may influence the decision-making process in an environment of high physical and psychological stress.
The objectives of this study were to evaluate the cross-cultural measurement equivalence of the Healthy Eating Index (HEI) for children aged 1–2 years and to analyse the quality of nutrition of preterm infants. This was a cross-sectional study with 106 premature infants attended in two specialised outpatient clinics of university hospitals. The quality of the diet was analysed through an adapted HEI to meet the dietary recommendations of Brazilian children aged 1–2 years. Food consumption was measured by 24-h recalls. The reliability of the instrument was evaluated by internal consistency analysis and inter-observer reliability using Cronbach’s α coefficient and κ with quadratic ponderation. The construct validity was evaluated by principal component analysis and by Spearman’s correlation coefficient with total energy and consumption of some groups’ food. The diet quality was considered adequate when the total HEI score was over 80 points. Cronbach’s α was 0·54. Regarding inter-observer reliability, ten items showed strong agreement (κ > 0·8). The item scores had low correlations with energy consumed (r ≤ 0·30), and positive and moderate correlation of fruit (r 0·67), meat (r 0·60) and variety of diet (r 0·57) with total scores. When analysing the overall quality of the diet, most patients need improvement (median 78·7 points), which can be attributed to low total vegetable intake and the presence of ultraprocessed foods in the diet. The instrument showed auspicious psychometric properties, being promising to evaluate the quality of the diet in children aged 1–2 years.
The fibrous scaffolds for bone tissue engineering that mimic the extracellular matrix with bioactive and bactericidal properties could provide adequate conditions for regeneration of damaged bone. Electrospun ultrathin fiber covered with nano-hydroxyapatite is a favorable fibrous scaffold design. We developed a fast and reproducible strategy to produce polyvinylidene fluoride (PVDF)/nano-hydroxyapatite (nHAp) nanofibrous scaffolds with bactericidal and bioactive properties. Fibrous PVDF scaffolds were obtained first by the electrospinning method. Then, their surfaces were modified using oxygen plasma treatment followed by electrodeposition of nHAp. This process formed nanofibrous and superhydrophilic PVDF fibers (133.6 nm, fiber average diameter) covered with homogeneous nHAp (202.6 nm, average particle diameter) crystals. Energy-dispersive X-ray spectrometry demonstrated the presence of calcium phosphate, indicating a Ca/P molar ratio of approximately 1.64. X-ray diffraction, Fourier transform infrared spectroscopy, and Raman spectroscopy spectra identified β-phase of nHAp. Thermal analysis indicated a slight reduction in stability after nHAp electrodeposition. Bactericidal assays showed that nHAp exhibited 99.8% efficiency against Pseudomonas aeruginosa bacteria. The PVDF/Plasma and PVDF/nHAp groups had the highest cell viability, total protein, and alkaline phosphatase activity by 7 days after exposure of the scaffolds to MG63 cell culture. Therefore, the developed scaffolds are an exciting alternative for application in bone regeneration.
To investigate the prevalence and socio-economic inequalities in breast milk, breast milk substitutes (BMS) and other non-human milk consumption, by children under 2 years in low- and middle-income countries (LMIC).
We analysed the prevalence of continued breast-feeding at 1 and 2 years and frequency of formula and other non-human milk consumption by age in months. Indicators were estimated through 24-h dietary recall. Absolute and relative wealth indicators were used to describe within- and between-country socio-economic inequalities.
Nationally representative surveys from 2010 onwards from eighty-six LMIC.
394 977 children aged under 2 years.
Breast-feeding declined sharply as children became older in all LMIC, especially in upper-middle-income countries. BMS consumption peaked at 6 months of age in low/lower-middle-income countries and at around 12 months in upper-middle-income countries. Irrespective of country, BMS consumption was higher in children from wealthier families, and breast-feeding in children from poorer families. Multilevel linear regression analysis showed that BMS consumption was positively associated with absolute income, and breast-feeding negatively associated. Findings for other non-human milk consumption were less straightforward. Unmeasured factors at country level explained a substantial proportion of overall variability in BMS consumption and breast-feeding.
Breast-feeding falls sharply as children become older, especially in wealthier families in upper-middle-income countries; this same group also consumes more BMS at any age. Country-level factors play an important role in explaining BMS consumption by all family wealth groups, suggesting that BMS marketing at national level might be partly responsible for the observed differences.
The objective of this study was to evaluate the fermentative characteristics and chemical composition of cochineal nopal cactus silage additives with urea or Lactobacillus buchneri (LB), as well as the association of both additives in four storage times (7, 15, 60 and 120 days) and during aerobic stability, with evaluations at 0, 48 and 96 h. Four silages were used: no additive, addition of 2% urea, addition of LB and addition of 2% urea and LB. The study was divided into two experiments: the first experiment evaluated the silages at different storage times, and the second experiment evaluated the silages during the aerobic stability test. In both experiments, the experimental design was completely randomized in a factorial scheme (4 × 4 and 4 × 3) with three replicates per treatment. After the ensiling process, lactic acid bacteria predominated in all treatments. The concentration of lactic acid increased significantly from 60 days of ensiling. The concentration of acetic acid varied significantly between the storage times only for the silages treated with urea and LB alone. The silage treated with urea maintained a constant pH value up to 120 days of storage. During the 96 h aerobic stability test, no breaking in the stability of silages was observed. The exclusive or associated use of urea and LB promotes improvement in the fermentative characteristics of cochineal nopal cactus silage, without major alterations in the chemical composition or interfering with the aerobic stability of the silages.
This study aimed to analyse the trend and spatial–temporal clusters of risk of transmission of COVID-19 in northeastern Brazil. We conducted an ecological study using spatial and temporal trend analysis. All confirmed cases of COVID-19 in the Northeast region of Brazil were included, from 7 March to 22 May 2020. We used the segmented log-linear regression model to assess time trends, and the local empirical Bayesian estimator, the global and local Moran indexes for spatial analysis. The prospective space–time scan statistic was performed using the Poisson probability distribution model. There were 113 951 confirmed cases of COVID-19. The average incidence rate was 199.73 cases/100 000 inhabitants. We observed an increasing trend in the incidence rate in all states. Spatial autocorrelation was reported in metropolitan areas, and 178 municipalities were considered a priority, especially in the states of Ceará and Maranhão. We identified 11 spatiotemporal clusters of COVID-19 cases; the primary cluster included 70 municipalities from Ceará state. COVID-19 epidemic is increasing rapidly throughout the Northeast region of Brazil, with dispersion towards countryside. It was identified high risk clusters for COVID-19, especially in the coastal side.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Accurate estimates of methane (CH4) production by cattle in different contexts are essential to developing mitigation strategies in different regions. We aimed to: (i) compile a database of CH4 emissions from Brazilian cattle studies, (ii) evaluate prediction precision and accuracy of extant proposed equations for cattle and (iii) develop specialized equations for predicting CH4 emissions from cattle in tropical conditions. Data of nutrient intake, diet composition and CH4 emissions were compiled from in vivo studies using open-circuit respiratory chambers, SF6 technique or the GreenFeed® system. A final dataset containing intake, diet composition, digestibility and CH4 emissions (677 individual animal observations, 40 treatment means) obtained from 38 studies conducted in Brazil was used. The dataset was divided into three groups: all animals (GEN), lactating dairy cows (LAC) and growing cattle and non-lactating dairy cows (GCNL). A total of 54 prediction equations available in the literature were evaluated. A total of 96 multiple linear models were developed for predicting CH4 production (MJ/day). The predictor variables were DM intake (DMI), gross energy (GE) intake, BW, DMI as proportion of BW, NDF concentration, ether extract (EE) concentration, dietary proportion of concentrate and GE digestibility. Model selection criteria were significance (P < 0.05) and variance inflation factor lower than three for all predictors. Each model performance was evaluated by leave-one-out cross-validation. The Intergovernmental Panel on Climate Change (2006) Tier 2 method performed better for GEN and GCNL than LAC and overpredicted CH4 production for all datasets. Increasing complexity of the newly developed models resulted in greater performance. The GCNL had a greater number of equations with expanded possibilities to correct for diet characteristics such as EE and NDF concentrations and dietary proportion of concentrate. For the LAC dataset, equations based on intake and animal characteristics were developed. The equations developed in the present study can be useful for accurate and precise estimation of CH4 emissions from cattle in tropical conditions. These equations could improve accuracy of greenhouse gas inventories for tropical countries. The results provide a better understanding of the dietary and animal characteristics that influence the production of enteric CH4 in tropical production systems.
This study aimed to examine the effects of re-ensiling time and Lactobacillus buchneri on the fermentation profile, chemical composition and aerobic stability of sugarcane silages. The experiment was set up as a repeated measure design consisting of four air-exposure periods (EP)(0, 6, 12, and 24 h) microbial additive (A) (L. buchneri; or lack of there), with five replicates. Sugarcane was ground through a stationary forage chopper and ensiled in four plastic drums of 200-L capacity. After 210 days of storage, the drums were opened and half of the silage mass was treated with L. buchneri at the concentration of 105 cfu/g of forage. Subsequently, the silages were divided into stacks. The re-ensiling process was started immediately, at 0, 6, 12 and 24-hour intervals, by transferring the material to PVC mini-silos. Silos were opened after 120 days of re-ensiling. The use of L. buchneri reduced butyrate concentration but did not change ethanol or acetic acid concentrations and aerobic stability. An interaction effect between L. buchneri and re-ensiling time was observed for dry matter (DM) losses and composition. Lactobacillus buchneri is not effective in improving aerobic stability in re-ensiled sugarcane silages. However, less DM is lost in silages treated with L. buchneri and exposed to air for 24 h. Re-ensiling sugar cane in up to 24 h of exposure to air does not change final product quality.
The aim of this study was to investigate the effects of Cactus (Opuntia spp) levels in total mixed ration silages based on Cactus and Gliricidia (Gliricidia sepium (Jacq.) Steud) on the fermentation profile, microbial populations, aerobic stability and taxonomic diversity. The completely randomized design was used in a 4 × 4 factorial design with four replications, being four rations with different levels of Cactus (15, 30, 45, 60% based on the dry matter) and four opening periods (0, 15, 30 and 60 days of fermentation). An interaction effect (P < 0.050) was observed among the diets and opening times for mould and yeast populations. An interaction effect for the levels of acetic acid was observed, where the diets 15, 30, 45 and 60% showed higher values at 60 days (0.44, 0.41, 0.35 and 0.40 g/kg DM, respectively). A significant difference was observed for the richness and diversity index (Chao1 and Shannon). The most abundant bacterial phyla were Proteobacteria and Firmicutes and the genera Lactobacillus and Weissella. Cactus can be added in total mixed ration silages up to the level of 60% in a way that it positively affects the qualitative indicators of the silages, modulating the taxonomic communities and allowing the predominance of important groups for preservation of the ensiled mass.
The farrowing process is one of the most energy-demanding activities for the modern hyperprolific sow. This study evaluated the effects of supply of energy on the expected date of farrowing on the farrowing kinetics and piglets’ performance during the first 24 h after birth. A total of 80 sows were used. The sows and their respective litters were considered as the experimental unit. On the expected day of farrowing, the sows were allocated to one of the following groups: sows that did not have access to feed from farrowing induction until the end of the farrowing process (CON, n = 40); sows fed 500 g of energetic supplement, which consisted of 250 g of the basal lactation diet plus 250 g of cane sugar, 18 h after farrowing induction (SUP, n = 40). The farrowing duration, farrowing assistance, birth interval, number of total born, stillborn and mummified piglets were recorded for each sow. Piglets were weighed individually at birth and 24 h later. The interval from birth to first suckle was evaluated individually for each piglet in 16 randomly selected litters (eight litters per treatment group). Blood glucose concentrations of six sows were measured shortly after expulsion of the first piglet. Farrowing duration, farrowing assistance and stillborn rate tended to be greater (P = 0.06, P = 0.09 and P = 0.07, respectively) in sows from the CON group compared to sows from the SUP group. However, there was no difference (P > 0.05) between the groups for birth interval. Colostrum intake was greater (P < 0.05) for piglets from the SUP group compared to piglets from the CON group. Additionally, BW gain of the piglets suckling the SUP group was greater (P < 0.05) than those suckling the CON group at 24 h after birth. The blood glucose concentrations during the expulsive stage of farrowing were greater (P < 0.05) in the SUP group than for sows from the CON group. In conclusion, supplying modern hyperprolific sows energy on the expected day of farrowing is a valuable nutritional intervention to improve the farrowing kinetics and piglets’ performance in early life.
Spontaneous abortion is considered a public health problem having several causes, including infections. Among the infectious agents, bacteria of the vaginal microbiota and Ureaplasma parvum have been associated with abortion, but their participation needs to be further elucidated. This study aims to evaluate the influence of Mollicutes on the development of spontaneous abortion. Women who underwent spontaneous abortion and those with normal birth (control) were studied. Samples of cervical mucus (CM) and placental tissue were collected to identify Mollicutes using the quantitative polymerase chain reaction methodology. Eighty-nine women who had a miscarriage and 20 women with normal pregnancies were studied. The presence of Mollicutes in placental tissue increased the chance of developing miscarriage sevenfold. The prevalence of U. parvum in women who experienced spontaneous abortion was 66.3% in placental tissue. A positive association was observed between the detection of U. parvum in samples of placental tissue and abortion. There was a significant increase in microbial load in placental tissue for M. hominis, U. urealyticum and U. parvum compared to the control group. Detection of U. parvum in CM in pregnant women can ascend to the region of the placental tissue and trigger a spontaneous abortion.
Failure to adjust doses may contribute to adverse events. We evaluated the effectiveness of providing the estimated glomerular filtration rate on appropriateness of dosing for antimicrobials. The approach increased appropriateness of dosing from 33.9% to 41.4% (P < .001). Nudging prescription behavior can boost strategies for adequate antimicrobial prescription.
This article assesses the nutritional status of Indigenous women from 14 to 49 years of age in Brazil.
Sample size was calculated for each region considering a prevalence of 50 % for all disease outcomes, a relative error of 5 % and a CI of 95 %. In the initial data analysis, the prevalence of excess weight and obesity was calculated according to independent variables. Multivariate multilevel hierarchical analyses were conducted based on a theoretical model of two ranked blocks.
The 2010 Indigenous population in Brazil was 896 000, with approximately 300 Indigenous ethnic groups, making Brazil one of the most ethnically diverse countries in the Americas and the world.
Of the total target sample of 6722 women evaluated by the National Survey, thirty did not participate, 939 were not eligible for analyses due to pregnancy or unknown pregnancy status, and thirty-nine were excluded due to missing anthropometric data.
The evaluation of nutritional status was completed for 5714 non-pregnant women (99·3 % of eligible participants for this outcome). High prevalence rates were encountered for both excess weight (46·2 %) and obesity (15·8 %) among the sampled women. In the multivariate analyses, higher socioeconomic indicators, market-integrated living conditions and less reliance on local food production, as well as increased age and parity were associated with excess weight and obesity.
Results point to distinct patterns of associations between socioeconomic indicators and the occurrence of excess weight and obesity among Indigenous women, which have potentially significant implications from a public policy perspective for Indigenous peoples in Brazil.
This research communication describes the influence of diet, mammary quarter position and milking process on the temperature of teats and udder of cows fed diets containing different lipid sources. Five primiparous cows were fed diets containing cottonseed, sunflower seed, soybeans or soybean oil as a source of lipids and a reference diet without the inclusion of lipid sources in a 5 × 5 Latin Square design. Milk yield was determined in the last five days of each period. Milk samples were collected for SCC analysis on the last two days of each experimental period. The images of the mammary gland were obtained using an infrared camera and were analyzed with appropriate computer software. Milk yield was 14.8% higher for cows fed soybeans as a source of lipids. Diets and somatic cell counts did not influence the temperature of teats and udder. The milking process reduced the temperature of teats and udder by 0.79°C. Rear teats and rear quarters had higher surface temperatures than front teats and fore quarters. Changes in temperature of teats and mammary quarters occurred as a function of the milking process and quarter position. However, the diet and the SCC did not influence the temperature of teats and mammary quarters in this experiment.
The use of antibiotics as performance enhancers in animal feeding is declining, so Lippia gracilis Schauer essential oil (LGSEO) could be used as a potential substitute for the conventionally used growth promoters. The LGSEO contains components such as carvacrol and thymol, which kill and/or control pathogenic bacteria, increase population of beneficial organisms, act against oxidative processes and onto nutrient digestibility and absorption. The aim of this study was to investigate the action and the effects of LGSEO as a growth promoter in the diet of Japanese quail by examining their productive performance, intestinal microbiology, blood biochemical parameters, hepatic thiobarbituric acid reactive substances (TBARS) content and intestinal gene expression. A total of 252 two-day-old quail (Coturnix coturnix japonica) were assigned to 3 treatments in 7 replicates, using 12 birds per experimental unit. The treatments consisted of a basal diet, basal diet + LGSEO at 400 mg/kg of diet and basal diet + chemical antimicrobial (bacitracin methylene disalicylate) at 500 mg/kg of diet. The experimental period was 34 days. The highest feed intake (P < 0.01) was found in the group receiving the conventional antimicrobial, whereas the best feed conversion (P < 0.01) was shown by the animals receiving LGSEO. Escherichia coli growth was restricted in the quail receiving the growth promoters. Salmonella spp. growth was controlled by the treatment containing the conventional antimicrobial. There was no difference between the treatments (P > 0.05) for the concentration of aspartate aminotransferase and alanine aminotransferase enzymes in the blood or hepatic TBARS content. Birds receiving negative-control treatment exhibited a higher expression of sodium-glucose cotransporter (SGLT1), while those receiving the treatment with essential oil showed lower catalase (CAT) and glutathione peroxidase (GPX7) expressions compared to the conventional antimicrobial and control groups, respectively. Lippia gracilis Schauer essential oil is a powerful performance enhancer for Japanese quail by virtue of its abilities to improve their intestinal environment, balance the microbial population and reduce energy expenditure for oxidative processes.
Chronic diabetics at some point gives up their vigilance in the sugar control. Many of them end up with intractable diabetic feet with limb losses incurring health budget, enormous morbidity and mortality.
300 patients who presented with diabetic feet been interviewed and noticed that ‘few weeks or months prior to their start of symptoms a major change in the treatment mechanism happens which lead to catastrophic complications of Diabetes’. They do not qualify according to DSM IV classification to be called MDE. But can be called Dysthymia. Surgical, Medical, Vascular and Psychiatric units in an Australian Hospital have been involved in these interviews (a simple questionnaire). Personal audit in two countries (Fiji Islands & Bangladesh) where Diabetes is pretty alarming in number have been included in the data.
Diabetic patients over time develop Dysthymia when they feel hopeless about control of their illness. Often they are overwhelmed by thoughts of long-term complications like retinopathy, neuropathy that they give up hope that they could combat its complications. Diabetic educators should be involved during their early stage of their illness before complications set in and should be trained to pick up dysthymic signs and symptoms for prompt referral for early psychological and psychiatric intervention.
• Diabetic feet are preventable.
• Early psychiatric assessment is helpful.
• Preventive steps are cost effective.
• Should Psychiatry Department have a role in the multidisciplinary management team of Diabetes?
The aim of this study was to asses the impact of different psychological and/or biological effects in the recovery from surgery.
The sample was composed of 42 patients waiting for a surgical intervention. Patients with cognitive impairment were removed from the sample. Prior to surgical intervention (48 to 72 hours), patients were administered the Millon Clinical Multiaxial Inventory-II (Millon, 1986) and salivary cortisol were measured 24 hours before surgery. Following surgical intervention, recovery was coded as good or poor accordingly to Moix et als criteria (1995). Dietary intake, resting and sleeping hours, as well as the existence of fever, perceived pain and related surgery complications were daily registered and controlled for.
The cortisol values were increased in patients with high score in Histrionic Scale (t = 2.10, p = 0.043). There was a significant relation between personality, cortisol and recovery. the patients with low score in Dependent Scale (t = 2.33, p = 0.029), Histrionic Scale ( t = 2.51, p = 0.020), Alcohol Dependence Scale (t = 2.01, p = 0.049), Drug Dependence Scale (t = 2.08, p = 0.050) and cortisol show better recovery from surgery.
The results of this study indicate that psychological factors and levels of cortisol may have a critical rol in post-operatory recovery. Taking these data into account, it seems necessary to assess psychopathology on a regular basis in all the patients waiting for surgically interventions.