Introductory Period Research Articles

EFFECT OF ENZYME SUPPLEMENTING AND SOAKING TO THE DIETS OF THE LAYING HENS CONTAINING CORN AND WHAET ON PRODUCTIVE PERFORMANCE

This study was conducted at Poultry Research Station Animal–State Board of Agricultural Research/ Ministry of Agricultural, which included two experiments to study the effect of enzyme supplementing and soaking to the diets of the laying hens containing corn and wheat on productive performance. Three hundred Brown-egg hens (ISA Brown) 40 weeks-old were used in this experiment after introductory period for two weeks. Layer hens distributed randomly to ten treatments with 2 replicates (15 hens per replicate); And fed on diets equal protein and metabolic energy according to the age periods in ISA guide. Treatments were as follows: Treatment 1: Control group (100 % corn).Treatment 2: 100% corn with soaking. Treatment 3 : 100% corn with enzymes. Treatment 4:100% corn with soaking and enzymes. Treatment 5: 33% corn replacement wheat with soaking. Treatment 6 : 33% corn replacement wheat and with enzymes. Treatment 7 : 33% corn replacement wheat with soaking and enzymes. Treatment 8: 66% corn replacement wheat with soaking. Treatment 9: 66% corn replacement wheat with enzymes. Treatment 10 :66% corn replacement wheat with soaking and enzymes. The results showed a significant differences between treatments in egg production (HD%), egg weight, egg mass and feed conversion ratio. Supplementary enzyme with soaking indicate a significant increase in productive performance.

Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.

Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.

한국 사회과교육과정의 시기별 특징 고찰: 초․중․고 교수요목기에서 2015개정교육과정기까지1)

This study inquires into the time-periodic characteristics of Korean elementary and secondary Social Studies curriculum from syllabus period to 2015 revised national curriculum. I took a chronological approach, dividing curricula of Social Studies into introductory period, setting period, growth period, transformational period. First, introductory period of Korean Social Studies curriculum emphasized the qualities of civic(公民) in a democratic society. Second, setting period of Korean Social Studies curriculum emphasized the qualities of people(國民) in a democracy. Third, growth period of Korean Social Studies curriculum emphasized the qualities of

Studies of International Political Economy in Korea

During the past 30 years, IPE studies in Korea have achieved outstanding developments in terms of the amount of research, academic issues, applied methodologies, and targeted regions. Even though we have been through introductory and expansion periods of Korean IPE studies, we have been trying to move into an indigenous period. This study compares the first 50 years’ IPE studies with recent 10 years’ IPE studies in Korea. There have been many changes in IPE studies in Korea. First, the number of articles related to International Trade has dropped dramatically during the last 10 years, while the number of articles in the categories of Money-Finance and Development Assistance has increased rapidly. Second, there have been decreasing academic interests in Korea and the United States, while there have been growing interests in other countries in Asia, especially China. Third, there have been methodological changes in IPE studies in Korea. We have seen more studies that have utilized comparative and statistical methods, while the number of review articles dropped rapidly. Finally, the number of articles featuring theory introduction and comparison has decreased, while the number of articles featuring theory verification has increased in the last decade. In the academic field of IPE in Korea, scholars need to prepare for new developments in the global economy such as exponentially growing cross-border economic transactions, growing importance of non-state actors, rapid technological developments and the new industrial revolution. In the process of preparation, we need to search for indigenous IPE studies in Korea as well as to develop generalized IPE theories. We always need to consider striking a balance between academic universality and academic distinctiveness.

Japanese historical challenge of social inclusion: from the digitally restored household survey data on receiving social security in 1952

This paper explores the historical challenge of social inclusion relying on the example of the Japanese social security system. The current public assistance system in Japan is grounded on the Public Assistance Act of 1951, which was originally constituted in 1946 and already declared equal treatment of all citizens. We will focus on a hidden aspect in this introductory period of the public assistance system, the actual situations of people who depend on it. We have digitally restored a survey data for households receiving public assistance. This data was collected in a Japanese prefecture in 1952. The results of this survey indicate that differences in poverty by gender are remarkable. For male householders, the total number of events that caused the onset of public assistance, principally injured or diseases, in 1950 or 1951 was more than that of 1944 or 1945. On the other hand, for female householders, the events of 1944 or 1945 were related to the Second World War, principally the death of male breadwinners, which induced poverty. Moreover, we broke down recipients by gender, age, and household types and revealed, in particular, two facts. First, many widows were receiving public assistance, but not all had lost their spouses in the war. Second, the largest age cluster of recipients was composed of children in the compulsory education age group. The increasing inclusion of the ‘standard’ type of household indicates the success of the Public Assistance Act’s universalism. This digitally restored sample has much potential to provide detailed descriptions of life courses and information on the jobs of household members.

Twelve-month outcomes in patients with retinal vein occlusion treated with low-frequency intravitreal ranibizumab.

PurposeThe purpose of this study was to determine the clinical efficacy of low-frequency intravitreal ranibizumab to treat macular edema due to retinal vein occlusion (RVO).Patients and methodsThis was a retrospective examination of cases that received intravitreal ranibizumab for untreated RVO over a period of 12 months. Instead of the conventional three monthly injections, injections were given once during the introductory period. If the recurrence of macular edema was diagnosed during the monthly visit, additional injections were given as needed. There were 21 eyes of 21 patients with branch RVO (BRVO) and ten eyes of ten patients with central RVO (CRVO). The parameters examined included the number of injections over the 12-month period, improvements in best-corrected visual acuity (BCVA), and the central macular thickness (CMT). For BRVO, preinjection parameters that had an effect on the prognosis of BCVA after the 12-month period were also examined.ResultsThe total mean number of injections over the 12-month period was 3.4 for CRVO and 2.1 for BRVO. For CRVO, the BCVA in log minimum angular resolution changed from a preinjection value of 0.80 to 0.55 at 12 months. For BRVO, the change was from 0.51 to 0.30. For all diseases, BCVA improved after 12 months compared with the preinjection values (P<0.05). There was improvement in the CMT, and the CRVO changed from 765.0 μm at preinjection to 253.5 μm 12 months later. BRVO changed from 524.1 to 250.1 μm, and pre-injection BCVA was associated with a prognosis of visual acuity after 12 months of the initial injection (P=0.0485).ConclusionEven with a low number of injections during the introductory period, there were still improvements in both visual acuity and CMT in RVO patients after 12 months, indicating that it was an effective treatment.

Socialization in pigtailed macaques (Macaca nemestrina).

In response to new emphasis by regulatory agencies regarding socialization, behavioral management programs are allocating greater resources to maximize socialization opportunities for laboratory primates. Information regarding predictors of compatibility and risk of injury for all laboratory-housed species of macaques are needed to make social introductions and pairings as efficient and safe as possible. This study presents data on 674 pairs of pigtailed macaques (Macaca nemestrina) at the Washington National Primate Research Center over a 7-year period. During pair introduction, behavior was monitored while the degree of tactile contact was gradually increased. Based on observed behavior, pairs were assigned a behavioral introduction score (BIS), rating the quality of their interactions for each day of introduction. Animals deemed compatible, based on the BIS and technologist judgment, were allowed to progress to continuous contact with no staff present. A small proportion of animals deemed compatible at introduction was later separated for subsequent incompatibility or aggression; these proportions were higher in full contact compared to protected contact pairings. Of 674 pairs, 75% were deemed compatible at introduction in protected contact; 86 of these pairs were later transitioned to full contact with 98% compatibility. Predictors of decreased compatibility assessed during protected contact introductions included age (adult pairs were less compatible), the BIS on the last day of introduction, and aggression or injury during the introductory period. Predictors of injuries during the protected contact introduction process included: aggression on the first day of introduction, a negative BIS on the first or last day of introduction, and, surprisingly, the presence of grooming on the first day of introduction. Injuries during both introduction and subsequent pairing in protected contact were rare; however, injury rates increased significantly during full-contact pairing. These findings underscore the necessity of species-specific data to guide decision-making during the social introduction process. Am. J. Primatol. 79:e22556, 2017. © 2016 Wiley Periodicals, Inc.

The Change in Value Relevance of Consolidated Financial Statements under K-IFRS

본 연구는 연결재무제표의 주재무제표화와 관련한 공시체계의 제도변화에 따른 가치관련성의 변화를 실증하였다. 구체적으로 본 연구는 2008년부터 2014년까지 유가증권시장 및 코스닥시장에서 연결재무제표를 공시한 5,966 기업-연도 표본을 대상으로 연결중심 공시체계의 도입단계를 도입기 (2008년 ~ 2010년), 과도기(2011년 ~ 2012년), 그리고 전면적용기(2013년 ~ 2014년)로 구분하였다. 그리고 연결중심 공시체계가 도입기에서 과도기로 진행된 경우와 과도기에서 전면적용기로 진행된 경우에 자산 2조원 이상인 기업과 자산 2조원 미만인 기업의 연결재무제표 가치관련성이 각각 어떠한 변화를 나타내는지 Ohlson(1995) 모형에 기초한 주가모형을 통해 분석하였다. 분석결과는 다음과 같다. 첫째, 도입기에서 과도기로 진행되면서 자산 2조원 미만인 기업은 연결 재무제표 중심의 공시체계 전환의 효과로 가치관련성이 증가했으나, 분·반기보고서에 대한 연결재 무제표 작성 유예의 영향 등으로 그 효과가 일부 혼재되어 나타났다. 그리고 자산 2조원 이상인 기업은 과거부터 연결중심의 공시체계를 적용해 온 영향으로 도입기에서 과도기로 진행되면서 가치 관련성에 있어 추가적인 변화는 나타나지 않았다. 둘째, 과도기에서 전면적용기로 진행되면서 자산 2조원 미만인 기업은 주당연결순자산과 주당연결순이익 모두 가치관련성이 증가함으로써 연결재무 제표가 주재무제표로서 안정적으로 정착한 효과가 나타났다. 그리고 자산 2조원 이상인 기업은 주당연결순자산의 가치관련성이 증가함으로써 과도기에서 전면적용기로 진행되면서 연결재무제표의 가치관련성이 제한적으로 더 증가하는 것으로 나타났다. 본 연구의 결과를 종합해 볼 때, 연결재무제표의 주재무제표화가 안정적으로 정착되고 있는 것으로 판단되며, K-IFRS의 도입과 그에 따른 연결중심 공시체계 도입이라는 정책은 성공적인 것으로 평가된다. 본 연구의 공헌점은 K-IFRS 도입 이후 연결재무제표 중심의 공시체계가 안정적으로 정착되었는지를 제도변화에 따른 각 단계별 가치관련성 변화를 통해 검증함으로써 정책적 효과를 실증하였다는 것이다.This study examines the change in value relevance according to the system change on disclosure relevant to the consolidated financial statements becoming the primary financial statements. Specifically, the study divides the process of change to the disclosure system into three stages&#8212;introductory period, transition period, and full adoption period. Afterwards, the paper analyzes the changes that took place in the company with asset over two trillion won and the company with asset under two trillion won in terms of value relevance of consolidated financial statements as the process of conversion progresses. The results are as follow. First, the company with asset of less than two trillion won has an conversion effect due to change in disclosure system; however, due to the impact of delay in making consolidated financial statements on the quarter and semi-annual report, the transition effect was partially mixed. Moreover, the company with asset over two trillion won does not have any additional change in value relevance as it moved from the introductory period to the transition period since it has applied the consolidation-oriented disclosure system from the past. Second, as it moved from the transition period to the full adoption period, the explanatory power of the stock price increases in both the consolidated net asset per share and consolidated net income per share for the company with asset of less than two trillion won, resulting in the consolidated financial statements as the primary financial statements with stability. Furthermore, as the ability to explain stock price of consolidated net asset per share increases in the company with asset over two trillion won, the value relevance of consolidated financial statements restrictively increase more as it progressed to full adoption period. The contribution of this study is that it investigates the policy effect by verifying, after the introduction of K-IFRS, whether the disclosure system on the consolidated financial statements is settled with stability through the value relevance for each stage of system change.

Research Note—Using Expectation Disconfirmation Theory and Polynomial Modeling to Understand Trust in Technology

Trust in technology is an emerging research domain that examines trust in the technology artifact instead of trust in people. Although previous research finds that trust in technology can predict important outcomes, little research has examined the effect of unmet trust in technology expectations on trusting intentions. Furthermore, both trust and expectation disconfirmation theories suggest that trust disconfirmation effects may be more complex than the linear expectation disconfirmation model depicts. However, this complexity may only exist under certain contextual conditions. The current study contributes to this literature by introducing a nonlinear expectation disconfirmation theory model that extends understanding of trust-in-technology expectations and disconfirmation. Not only does the model include both technology trust expectations and technology trusting intention, it also introduces the concept of expectation maturity as a contextual factor. We collected data from three technology usage contexts that differ in expectation maturity, which we operationalize as length of the introductory period. We find that the situation, in terms of expectation maturity, consistently matters. Using polynomial regression and response surface analyses, we find that in contexts with a longer introductory period (i.e., higher expectation maturity), disconfirmation has a nonlinear relationship with trusting intention. When the introductory period is shorter (i.e., expectation maturity is lower), disconfirmation has a linear relationship with trusting intention. This unique set of empirical findings shows when it is valuable to use nonlinear modeling for understanding technology trust disconfirmation. We conclude with implications for future research.

일본 학교도서관의 정보활용교육 변천

본 연구는 일본의 학교도서관에서 정보활용교육이 시대적 변화에 따라 어떻게 전개되어 왔는지를 밝히고, 역사적 변천을 통해 형성된 최근 동향에 대한 심층적인 분석을 목적으로 하였다. 이를 위해 관련연구, 전국학교도서관협의회의 간행물, 학습지도요령 등을 검토하였다. 연구 결과, 일본 학교도서관의 정보활용교육은 1940년대 후반 이후 도서관 이용지도의 도입기, 1950년대 후반 이후 지도방법의 모색기, 1980년대 이후 정보리터러시교육의 확립기, 2000년대 이후 탐구학습으로의 확대기를 거쳐 발전해 온 것으로 나타났다. The purpose of this paper is to investigate the historical changes of information literacy instruction in Japanese school libraries and in-depth research into recent educational situations. Related literature researches, the publication of School Library Association, The Courses of Study have been reviewed in this paper. As results of this research, information literacy education in Japanese school library has been developed from introductory period of the library use guidance after late 1940's, seek period of teaching method development after late 1950's, establishment period of information literacy instruction after 1980's, and enlargement period of inquiry based learning after 2000's.

Surfaces, Interfaces, and Rock and Roll

Dear Reader, Advanced Materials Interfaces is now in its third year. The positive response from our authors has resulted in the frequency of publication now increasing to 24 issues a year. Areas showing strong growth in submissions include photovoltaics, electrochemistry, biofilms, membranes, device junctions, 2D materials, strongly correlated systems, heterogeneous catalysis, and colloidal systems, always in conjunction with top-level research on interface technologies and effects. Advanced Materials Interfaces also has new members on its Advisory Board. We welcome Lifeng Chi (FUNSOM Institute, Soochow University), Hongjin Fan (Nanyang Technological University), and Taolei Sun (Wuhan University of Technology). The full listing of the Editorial Advisory Board be found here. The journal has quickly become truly interdisciplinary, as this selection of recent review articles demonstrates: Bio-Interface of Conducting Poly­mer-Based Materials for Neuroregeneration. Recent Advancements in All-Vanadium Redox Flow Batteries. Superamphiphobic Coatings with High Transmittance: Structure, Fabrication, and Perspective. Metal-Free Click Chemistry Reactions on Surfaces. Biomedical Applications of Functionalized ZnO Nanomaterials: from Biosensors to Bioimaging. Interfacial Friction Control. In 2016 we will also be publishing a regular section focusing on deposition methods such as Chemical Vapor Deposition (CVD), Atomic Layer Deposition (ALD), and related techniques. Francis Maury (CNRS, Toulouse) will coordinate input from the International Advisory Board for this section. In this context, Karen Gleason's Review on CVD polymerization, A Route Towards Sustainability Through Engineered Polymeric Interfaces, available here, is particularly worth a mention. 2016 will also see Advanced Materials Interfaces receive its first Impact Factor, and it is clear that this will reflect the outstanding work already published in the journal. Access was free to all in 2014 and 2015 but now, in January 2016, this introductory period comes to an end and all content is available through a paid subscription. While access to all manuscripts published until December 2015 is retained, if you wish to continue reading the excellent work published in Advanced Materials Interfaces going forward, please encourage your librarian to ensure a subscription is in place. You can do this by completing the recommendation form, here. We are indebted to our Advisory Board members, authors, reviewers, and readers, for entrusting the journal with exceptional papers, and for helping to improve them further. We wish you all the best for a healthy and productive year in 2016. Kind regards, P.S. The editorial team is happy to receive any input and comments at advmatinterfaces@wiley.com

Programmed intermittent epidural boluses for maintenance of labor analgesia: an impact study

IntroductionThe aim of this impact study was to compare the analgesic efficacy and side effect profile of programmed intermittent epidural boluses (PIEB)+patient-controlled epidural analgesia (PCEA) to continuous epidural infusion (CEI)+PCEA for maintenance labor analgesia after the introduction of PIEB at our institution. MethodsWe conducted a retrospective analysis after replacing the background CEI with PIEB for our labor PCEA. Pre-change pump settings were CEI 12mL/h with PCEA (12mL bolus, lockout 15min); PIEB settings were a 9mL bolus every 45min with PCEA (10mL bolus, lockout 10min). We compared medical records of all women receiving epidural or combined spinal-epidural labor analgesia for vaginal delivery for two months before PIEB implementation to a two-month period of PIEB utilization following a five-month introductory familiarization period. The primary outcome was the proportion of women requiring rescue clinician boluses. ResultsFewer patients in the PIEB group required rescue clinician boluses compared to the CEI group (12% vs. 19%, P=0.012). Time to first rescue bolus request and total bolus dose were not different. Peak (median [IQR]) pain scores were 2[0–5] with CEI and 0[0–4] with PIEB. There was no difference in instrumental delivery rates. ConclusionsUsing PIEB compared to CEI as the background maintenance epidural analgesia method in conjunction with PCEA reduced the number of women requiring clinician rescue boluses while providing comparable labor analgesia. The findings of this clinical care impact study confirm the results of randomized controlled studies and suggest PIEB may be a preferable technique to CEI for the maintenance of labor analgesia.

PWE-414 A designated eras nurse consistently achieves eras goals with significant cost reductions for the nhs

<h3>Introduction</h3> Enhanced recovery after surgery (ERAS) optimises patient outcomes after elective surgery. The role of designated ERAS nurse has rarely been assessed with limited information on any potential cost savings. <h3>Method</h3> 3 separate time periods were compared: n = 36, group 1 (ERAS established, no designated nurse, 3 months duration); n = 64, group 2 (5 month introductory period for ERAS Nurse) and group 3, n = 204 (12 months following introductory period) Total numbers of patients; length of hospital stay (LOS); re-admission rates were calculated with daily patient costs estimated using £541 / surgical ward. <h3>Results</h3> LOS reduced in group 2 and further reduced in group 3: 9 (3–36) vs. 8 (3–15) vs. 7 (3–68) [Groups 1, 2 and 3 respectively]. The re-admission rate reduced: 8% vs. 4.7% vs. 5.4%; length of re-admission stay shorter: 4.5 days vs. 1.7 vs. 1.7. The two day LOS reduction saved 408 bed days: potential cost reduction of £1082/patient/ hospital stay or alternatively, allowed extra 58 patients to have surgery. <h3>Conclusion</h3> A designated ERAS Nurse has substantially increased the number of patients undergoing surgery, with further reductions in hospital stay and re-admission rates; a designated ERAS Nurse has vital and cost-effective role in current surgical practice. <h3>Disclosure of interest</h3> None Declared.

OPTIMIZATION OF THE STRUCTURE OF MARKETING ACTIVITIES OF THE PROJECT "THE OPENING CAMPAIGN OF THE UNIVERSITY"

The model, which sets the optimal structure of marketing activities of the project University entrance campaign in view of the limited resources, the availability of synergies and the results of statistical analysis of past campaigns introductory periods is presented.The main types of marketing activities and the main categories of the target audience are determined. Model's optimality criterion is the forecast of enrollment of students. Optimality criterion is based on the effectiveness of marketing activities, taking into account the specificity of the reaction of various categories of the target audience.

Larry Cohen, indomitable pioneer.

Larry Cohen, indomitable pioneer.

National Identity in Citizenship Education Policy in England: Focusing on National Curriculum Introductory Period

National Identity in Citizenship Education Policy in England: Focusing on National Curriculum Introductory Period

Impact of malaria rapid diagnostic tests on prescription patterns of artemisinin-based combination therapy in Oyo State, Nigeria.

In the era of valuable and costly artemisinin-based combination therapy (ACT) for malaria it has been recommended that the use of ACTs is restricted to only those with confirmed positive malaria diagnosis. The potential benefits of rapid diagnostic tests (RDTs) on anti-malarial drug consumption have been demonstrated in a number of clinical trials. It is unknown if the introduction of RDTs in Nigeria has achieved the desired goal of reducing ACT consumption. This article assesses the impact of a state-wide roll-out of RDTs on ACT prescription in Oyo State, Nigeria. ACT prescribing patterns for febrile patients were compared pre- and post-RDT introduction in 106 primary health care facilities. Routine data from the national malaria control programme monthly facility summary forms were extracted for three months before and after the RDT intervention and compared using a 'before and after' design. RDT testing rates for patients with fever revealed no trend; mean testing rate in the post RDT period was 64.5%. The mean malaria positivity rate was 71.3%, which equalled a proportional morbidity rate of 45.9% of all fever cases. ACT treatment to confirmed case ratio was consistently above the expected value of one and the ratio of treatment to tested patient exceeded one (mean ratio of 1.1) for the three months post RDT. The absolute number of ACT doses prescribed increased remarkably after the introduction of RDTs and ACTs revealing an extra utilisation of 14,199 doses, 5,534 (±517) versus 10,267 (±2,452), p<0.001. Relative Risk of ACT prescription in the post RDT period was 1.71 (1.33-2.25). There is notable non-adherence to RDT results, with an increase in ACT prescriptions after the initial introductory period for RDTs. This over reliance on ACTs for the management of non-malaria illness could compromise gains from reducing malaria morbidity and mortality and needs to be addressed urgently.

Energy requirements for maintenance and growth of entire male Bali cattle in East Timor

The metabolisable energy (ME) requirements for maintenance and growth of entire male Bali cattle (Bos javanicus) were determined by regressing liveweight change on ME intake. Cattle were fed either a diet (DM basis) of 52.5% urea-treated rice straw plus 47.5% fresh leucaena forage (Expt 1), or fresh leucaena forage alone (Expt 2). In each experiment, liveweight change and feed intake were measured over 4 weeks, after a 1-week introductory period, and feed constituent digestibilities were measured during the final week. In Expt 1, 10 bulls between 1.5 and 3 years of age and weighing 123.7 ± 11.79 kg (mean ± s.d.) were allocated to DM intakes estimated to provide 0.75, 1.0, 1.25, 1.5, 1.75, or 2.0 times the estimated ME requirement for maintenance (based on calculations made from published CSIRO equations for tropical cattle species other than B. javanicus), with either one or two bulls per treatment. In Expt 2, the bulls were given treatments estimated to provide 0.85, 1.0, 1.4, 1.8, or 2.2 times the ME requirement for maintenance, with two bulls allocated to each treatment. The measured ME requirements for maintenance were 0.42 ± 0.369 and 0.40 ± 0.153 MJ/kg LW0.75.day (coefficient ± standard error, Expts 1 and 2, respectively). The ME requirement for ‘production’ (i.e. positive liveweight change of male Bali cattle under the specific conditions of the experiment) was calculated to be 39.2 MJ/kg liveweight gain in Expt 2. The calculated efficiency of use of dietary ME for production in Expt 2, was 0.34

Clinical Pharmacists in Outpatient Diabetes Care: Essential Members of the Multidisciplinary Team

T he American Diabetes Association (ADA), in its annual Standards of Medical Care in Diabetes, advocates a team-based approach to diabetes care, incorporating the involvement of health care professionals from various backgrounds who have expertise and interest in diabetes.1 It is widely accepted that this physician-led team may include nurses, certified diabetes educators, and advanced practice providers such as physician assistants and nurse practitioners. Since 2003,2 ADA has included pharmacists in the list of potential diabetes care team members. There is an increasing number of pharmacists involved in the direct care of patients with diabetes in the outpatient environment, as evidenced by the emerging body of literature on the subject.3–5 This article describes one such practice site. The University of North Carolina (UNC) Hospitals' endocrine clinic has long provided specialized care to patients with diabetes, including the clinical services of approximately nine attending physicians, four endocrine fellow physicians, one physician assistant, two diabetes educators (both of whom are also registered dietitians), two registered nurses, four certified medical/nursing assistants, and a large clinical trials group. In early 2009, the clinic created a position for a clinical pharmacist to be added to this extensive care team. Since then, the position has grown to include two clinical pharmacists (each of whom sees patients on a part-time basis), as well as pharmacy residents and students who rotate through the site. At the time the clinical pharmacist position was created, there was limited understanding on the part of the physicians, mid-level providers, clinic staff, and patients regarding the role of a clinical pharmacist. Much time was initially spent educating providers and staff about the educational background, postgraduate training, and certifications that allow pharmacists to operate in their unique role. This introductory period also included significant amounts of face time between …

Chronic Antibody-Mediated Rejection Is Reduced by Targeting B-Cell Immunity During an Introductory Period

Transplantation across blood group antigen and human leukocyte antigen (HLA) barriers are immunologically high risk. Both splenectomy and rituximab injection were developed to overcome those immunological barriers. The idea behind these treatments is to control B-cell immunity before and after renal transplantation and antibody production. Between January 2001 and December 2004, recipients underwent pretransplant double-filtration plasmapheresis (DFPP) and splenectomy at the time of transplantation in the ABO-incompatible group (ABO-I-SPX; n= 45). From January 2005 to June 2009, a low dose of rituximab was given as an alternative to splenectomy (ABO-I-RIT; n = 57). As a control group, we selected 83 cases of ABO-C living-donor kidney transplantation between January 2001 and December 2007 (ABO-C). We compared the graft survival rate and chronic antibody-mediated rejection (C-AMR) rate between ABO-C and ABO-I kidney transplantation with induction treatment. C-AMR rates 2 years after the operation were 8.8, 3.5 and 28.9%, and de novo donor-specific anti-HLA antibody (DSHA) positive rates were 2.2, 1.7 and 18.1% in the ABO-I-SPX, ABO-I-RIT and ABO-C groups, respectively. The ABO-C group showed the highest rate of C-AMR and de novo DSHA. B-cell depletion protocols, such as splenectomy or rituximab administration, reduced C-AMR after kidney transplantation.