Standard Nutrition Research Articles

Early goal-directed management after out-of-hospital cardiac arrest: lessons from a certified cardiac Arrest centre.

Despite continuous advances in post-resuscitation management, outcome after out-of-hospital cardiac arrest (OHCA) is limited. To improve the outcome, interdisciplinary Cardiac Arrest Centers (CACs) have been established in recent years, but survival remains low and treatment strategies vary considerably in clinical and geographical aspects. Here we analyzed a strategy of in-hospital post-resuscitation management while evaluating the outcome. A broad spectrum of pre- and in-hospital parameters of 545 resuscitated patients, admitted to the Cardiac Arrest Center of the University Hospital of Marburg (MCAC) between 01/2018 and 12/2022 were retrospectively analyzed. Inclusion criteria were≥18 years, resuscitation by emergency medical services, and non-traumatic cause of OHCA. In the overall patient cohort, the survival rate to hospital discharge was 39.8% (n=217/545), which is 50.7% higher than in the EuReCa-TWO registry. 77.2% of the survivors had CPC status 1 or 2 (favorable neurological outcome) before and after therapy. A standardized 'therapy bundle' for in-hospital post-resuscitation management was applied to 445 patients who survived the initial treatment in the emergency department. In addition to basic care (standardized antimicrobial therapy, adequate anticoagulation, targeted sedation, early enteral and parenteral nutrition), it includes early whole-body CT (n=391; 87.9%), invasive coronary diagnostics (n=322; 72.4%), targeted temperature management (n=293; 65.8%) and if indicated, mechanical circulatory support (n=145; 32.6%) and appropriate neurological diagnostics. Early goal-directed post-resuscitation management in a well-established and highly frequented CAC leads to significantly higher survival rates. However, our results underline the need for a broader standardization in post-resuscitation management to ultimately improve the outcome.

Association of Standardized Parenteral Nutrition with Early Neonatal Growth of Moderately Preterm Infants: A Population-Based Cohort Study.

In preterm infants, early nutrient intake during the first week of life often depends on parenteral nutrition. This study aimed to evaluate the influence of standardized parenteral nutrition using three-in-one double-chamber solutions (3-in-1 STD-PN) on early neonatal growth in a cohort of moderately preterm (MP) infants. This population-based, observational cohort study included preterm infants admitted to neonatal centers in the southeast regional perinatal network in France. During the study period, 315 MP infants with gestational ages between 320/7 and 346/7 weeks who required parenteral nutrition from birth until day-of-life 3 (DoL3) were included; 178 received 3-in-1 STD-PN solution (56.5%). Multivariate regression was used to assess the factors associated with the relative body-weight difference between days 1 and 7 (RBWD DoL1-7). Infants receiving 3-in-1 STD-PN lost 36% less body weight during the first week of life, with median RBWD DoL1-7 of -2.5% vs. -3.9% in infants receiving other PN solutions (p < 0.05). They also received higher parenteral energy and protein intakes during the overall first week, with 85% (p < 0.0001) and 27% (p < 0.0001) more energy and protein on DoL 3. After adjusting for confounding factors, RBWD DoL1-7 was significantly lower in the 3-in-1 STD-NP group than in their counterparts, with beta (standard deviation) = 2.08 (0.91), p = 0.02. The use of 3-in-1 STD-PN provided better energy and protein intake and limited early weight loss in MP infants.

Mapping the evidence of novel plant-based foods: a systematic review of nutritional, health, and environmental impacts in high-income countries.

Shifting from current dietary patterns to diets rich in plant-based (PB) foods and lower in animal-based foods (ABFs) is generally regarded as a suitable strategy to improve nutritional health and reduce environmental impacts. Despite the recent growth in supply of and demand for novel plant-based foods (NPBFs), a comprehensive overview is lacking. This review provides a synthesis of available evidence, highlights challenges, and informs public health and environmental strategiesfor purposeful political decision-making by systematically searching, analyzing, and summarizing the available literature. Five peer-reviewed databases and grey literature sources were rigorously searched for publications. Study characteristics meeting the inclusion criteria regarding NPBF nutrient composition and health and environmental outcomes in high-income countries were extracted. Fifty-seven peer-reviewed and 36 grey literature sources were identified; these were published in 2016-2022. NPBFs typically have substantially lower environmental impacts than ABFs, but the nutritional contents are complex and vary considerably across brands, product type, and main primary ingredient. In the limited evidence on the health impacts, shifts from ABFs to PB meats were associated with positive health outcomes. However, results were mixed for PB drinks, with links to micronutrient deficiencies. If carefully selected, certain NPBFs have the potential to be healthier and nutrient-rich alternatives to ABFs and typically have smaller environmental footprints. More disaggregated categorization of various types of NPBFs would be a helpful step in guiding consumers and key stakeholders to make informed decisions. To enable informed policymaking on the inclusion of NPBFs in dietary transitions as part of a wider net-zero and health strategy, future priorities should include nutritional food standards, labelling, and subdivisions or categorizations of NPBFs, as well as short- and long-term health studies evaluating dietary shifts from ABFs to NPBFs and standardized environmental impact assessments, ideally from independent funders.

Impact of Various Ration Energy Levels on the Slaughtering Performance, Carcass Characteristics, and Meat Qualities of Honghe Yellow Cattle.

Consumers are increasing their daily demand for beef and are becoming more discerning about its nutritional quality and flavor. The present objective was to evaluate how the ration energy content (combined net energy, Nemf) impacts the slaughter performance, carcass characteristics, and meat qualities of Honghe yellow cattle raised in confinement. Fifteen male Honghe yellow cattle were divided into three groups based on a one-way design: a low-energy group (LEG, 3.72 MJ/kg), a medium-energy group (MEG, 4.52 MJ/kg), and a high-energy group (HEG, 5.32 MJ/kg). After a period of 70 days on these treatments, the animals were slaughtered and their slaughter performance was determined, and the longissimus dorsi muscle (LD) and biceps femoris (BF) muscles were gathered to evaluate meat quality and composition. Increasing the dietary energy concentration led to marked improvements (p < 0.05) in the live weight before slaughter (LWBS), weight of carcass, backfat thickness, and loin muscle area. HEG also improved the yield of high-grade commercial cuts (13.47% vs. 10.39%) (p < 0.05). However, meat quality traits were not affected by treatment except for shear force, which was affected by dietary energy. A significant improvement (p < 0.05) in the intramuscular fat (IMF) content was observed in the HEG. Little effect on the amino acid profile was observed (p > 0.05), except for a tendency (p = 0.06) to increase the histidine concentration in the BF muscle. Increasing dietary energy also reduced C22:6n-3 and saturated fatty acids (SFAs) and enhanced C18:1 cis-9 and monounsaturated fatty acids (MUFAs, p < 0.05). Those results revealed that increasing energy levels of diets could enhance slaughter traits and affect the meat quality and fatty acid composition of different muscle tissues of Honghe yellow cattle. These results contribute to the theoretical foundation to formulate nutritional standards and design feed formulas for the Honghe yellow cattle.

Nutritional quality and level of processing of food items broadcasted on Italian television in advertisements targeted to children

This study evaluates the nutritional quality and level of processing of food and beverage products advertised on television channels most watched by children, in Italy. Data were collected over 20 non-consecutive days from the five top channels in Italy. A total of 209 food items were analysed using the Nutri-Score and the NOVA classification. Additionally, compliance with nutritional criteria established by the World Health Organisation (WHO) and the EU-PLEDGE was assessed. Results indicate a high proportion of energy-dense and low nutritional quality foods, with 68% falling into less favourable Nutri-Score categories (C, D, and E), and 61% classified as ultra-processed by NOVA classification. When applying WHO and PLEDGE criteria, 71% and 56% of products, respectively, did not meet nutritional standards. This study underscores the low prevalence of nutritionally adequate products in food advertisements targeting children on Italian television, despite differences found based on methodological variations.

Comparison of canine colostrum and milk using a multi-omics approach

BackgroundA mother’s milk is considered the gold standard of nutrition in neonates and is a source of cytokines, immunoglobulins, growth factors, and other important components, yet little is known about the components of canine milk, specifically colostrum, and the knowledge related to its microbial and metabolic profiles is particularly underwhelming. In this study, we characterized canine colostrum and milk microbiota and metabolome for several breeds of dogs and examined profile shifts as milk matures in the first 8 days post-whelping.ResultsThrough untargeted metabolomics, we identified 63 named metabolites that were significantly differentially abundant between days 1 and 8 of lactation. Surprisingly, the microbial compositions of the colostrum and milk, characterized using 16S rRNA gene sequencing, were largely similar, with only two differentiating genera. The shifts observed, mainly increases in several sugars and amino sugars over time and shifts in amino acid metabolites, align with shifts observed in human milk samples and track with puppy development.ConclusionLike human milk, canine milk composition is dynamic, and shifts are well correlated with developing puppies’ needs. Such a study of the metabolic profile of canine milk, and its relation to the microbial community, provides insights into the changing needs of the neonate, as well as the ideal nutrition profile for optimal functionality. This information will add to the existing knowledge base of canine milk composition with the prospect of creating a quality, tailored milk substitute or supplement for puppies.

Action on health screening and education to disseminate and improve the health status of the elderly

Indonesia has an alarming trend where from year to year the prevalence of degenerative diseases continues to increase, especially in the elderly. This condition is further exacerbated by the number of elderly people in Indonesia reaching 10.48% in proportion to 1 elderly person supported by the productive age population. In addition, there are still many elderly people who are vulnerable due to a lack of preparation both financially and non-financially. The implementation of this health screening action aims to stimulate the growth of disease prevention behavior in old age through education and disease screening activities. The methods used are counseling and health checks. As a result of this activity, 24 elderly people voluntarily participated in health screening. The health condition of the elderly in neighborhood V of Margodadi Village, South Metro District was identified. As many as 95.8% of the elderly are in an unhealthy condition. At least they have 1 problematic health indicator including BMI status, blood pressure, temporary blood glucose value, and uric acid. With details: hypertension 75% (18 elderly), high uric acid levels, 41.6% (10 elderly), and there is 1 elderly who has a malnutrition status based on BMI. It is important to provide assistance, especially for the elderly who are malnourished, to pay attention to food consumption that meets balanced nutritional standards. If possible, provide additional food such as mung bean porridge or other types and do physical activity to increase the metabolism of the elderly body which can support to improve the quality of life.

The Role of Maternal Secretor Status and Human Milk Oligosaccharides on Early Childhood Development: A Systematic Review and Meta-Analysis.

Background: Breast milk is the gold standard of infant nutrition, delivering nutrients and bioactive molecules as needed to support optimal infant growth and cognitive development. Increasing evidence links human milk oligosaccharides (HMOs) to these early childhood development milestones. Aims: To summarize and synthesize the evidence relating to HMOs and infant brain development, physical growth, and cognitive development. In addition, HMO concentrations in secretor and nonsecretor mothers were compared via a meta-analysis. Study Design: A systematic review and meta-analysis were carried out in accordance with the PRISMA statement. This review used three databases (PubMed, Scopus, and Web of Science) and was limited to English-language articles published between 2000 and June 30, 2023. Results: The initial searches yielded 245 articles, 27 of which were included in the systematic review and 12 in the meta-analysis. The meta-analysis revealed a substantial between-study heterogeneity, I2 = 97.3%. The pooled effect was 0.21 (95% CI: -0.41 to 0.83; p = 0.484), indicating that secretors had higher HMO concentrations, although this difference was not statistically significant. At one month of age, 2'FL, 3FL, and 3'SL play an important role in brain maturation and thus play a critical role in cognitive development. Secretors produce higher concentrations of 2'FL and 3'SL, explaining the benefits to infants of secretor mothers. Growth velocity was correlated to fucosylated and sialylated HMO concentrations, with lower concentrations linked to stunting. Conclusions: According to evidence from the systematically reviewed articles, HMOs are essential for a child's early development, but the extent to which they have an impact depends on maternal secretor status.

Impact of Immunonutrition on Nutritional Status in Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Clinical Trial

This study aimed to investigate the additional effects of perioperative immunonutrition (IMN) compared with preoperative immunonutrition (IMN) on anthropometric, nutritional, and biochemical parameters, hospital stay and postoperative complications in patients with colorectal cancer. Oral supplementation enriched with arginine, omega-3 fatty acids, and dietary nucleotides was given to 25 patients before and after the operation (Group 2); 25 patients received the same formula before surgery and standard isocaloric nutrition following the operation (Group 1). Postoperative body weight, body mass index (BMI), and middle upper arm circumference (MUAC) of Group 1 decreased more than Group 2 during follow-up (p < 0.05). The biochemical parameters, C-reactive protein (CRP), aspartate aminotransferase (AST) and fasting plasma glucose (FPG) were higher, and albumin was lower than the baseline in Group 1 compared to Group 2 (p < 0.05). There was a negative correlation between CRP and Nutrition Risk Screening (NRS) 2002 scores, and prealbumin and NRS 2002 scores had a positive correlation (p = 0.007, r = 0.384; p = 0.012, r = 0.352). There was no difference in hospital stay and postoperative complications between the groups (p > 0.05). Perioperative immunonutrition, compared to preoperative immunonutrition, can be used as a positive and effective approach in improving some anthropometric measurements and biochemical parameters in patients undergoing colorectal cancer surgery.

Quality evaluation of nutrition policies in early childhood education and care services in Nerang, QLD.

Food environments in early childhood, such as early childhood education and care services, influence the development of dietary patterns and behaviours that traverse into adulthood, where they affect health and longevity. Nutrition policies are mandatory in early childhood education and care services in Australia and can positively or negatively shape the food environment. However, the quality of such nutrition policies is unknown. This study aimed to evaluate the comprehensiveness and strength of nutrition policies of early childhood education and care services among services participating in a university-community alliance in South East Queensland. Early childhood education and care services (n = 12) in Nerang, Queensland, Australia, participated in a cross-sectional study evaluating the comprehensiveness and strength of nutrition policies across four domains (Nutrition Education, Nutrition Standards, Promoting Healthy Eating and Communication and Evaluation) of the Wellness in Child Care Assessment Tool. Nutrition policies evaluated in this study had median total comprehensiveness scores of 55 (out of 100) and median total strength scores of 19 (out of 100). 'Nutrition Education' had the highest median scores for comprehensiveness (67 out of 100) and strength (33 out of 100), while 'Nutrition Standards' had the lowest comprehensiveness score (41 out of 100), and 'Communication and Evaluation' had the lowest strength score (0 out of 100). All services have a nutrition policy, but there are opportunities to enhance both the content and linguistic strength of statements within policies related to nutrition domains. SO WHAT?: There is a clear need to improve the comprehensiveness and strength of written statements in nutrition policies across all four domains, particularly 'Nutrition Standards' and 'Communication and Evaluation'.

Impact of protein and carnitine consuption on outcomes of care development of full-term newborns with critical perinatal diseases

There were studied results of the impact of increased consumption of proteins and L-carnitine in the nutrition program of full-term newborns with perinatal diseases on the results of physical development and inpatient treatment features. The purpose of the work was to study the correlations between short-term higher consumption of protein and carnitine by full-term newborns and the results of their physical development, the duration of hospital care development. The vital signs of 59 full-term newborns were studied in a randomized controlled trial in the period 2017-2020. The main critical disease of the perinatal period in newborns of both groups was found to be hypoxic-ischemic encephalopathy of a moderate degree in 86.7% and 86.2%, without a statistically significant difference. One group (n=30) received nutrition with mother's milk or formula, the second group (n=29) received similar nutrition with fortification with a protein and L-carnitine supplement during the hospital stay. At the beginning and at the end of the treatment, physical development of the newborns was studied and correlations between the obtained data were investigated. Newborns of both groups did not differ in characteristics at the beginning of the study. The proportions of the newborns' weight corresponded to the limits of the 50% percentile. The group with increased consumption of protein and carnitine, fortification group (FG) demonstrated better indicators of physical development, they regained body mass faster. Body mass of the newborns of the fortification group goup was 3966.9±439.1 g, compared to the standard nutrition (SN) group, with indicators being 3554.6±452.3 g, at p=0.003. The rate of increase in body length in FG was twice that of the SN group. Consumption of a larger dose of protein was accompanied by a shorter stay in the intensive care unit – 10.0 (8.0; 12.0) days versus 12.0 (11.0; 16.0) days, with U=235.0; p=0.002; earlier discharge from the hospital – 21.0 (19.0; 27.0) days versus 26.5 (22.0; 31.0) days, with U=267.0, p=0.01. Carnitine supplementation in the FG group led to an increase in the level of free carnitine in the blood plasma samples taken before the discharge from the hospital. The study of correlations revealed a positive correlation between the consumption of a full dose of proteins and the total increase in height (R=0.3, p&lt;0.05), the increase in body weight (R=0.3, p&lt;0.05). A negative correlation was found between the protein level and the duration of treatment in the hospital (R= -0.3, p&lt;0.05). The level of free carnitine had a positive effect on the increase in body length (R=0.51, p&lt;0.05), daily weight gain (R=0.3, p&lt;0.05). A poor increase in body length was associated with a longer duration of respiratory support: the correlation had an inverse direction R= -0.4, p&lt;0.05. Improving nutritional strategies has significant prospects for improving care development of full-term babies with critical perinatal states.

What influence mothers’ mental health and health care seeking behaviors for their malnourished children in Nepal: building evidence for a broader perspective

IntroductionImplementing research projects on community-based health care interventions in low-ressource settings is feasible with specific methods and applications. In order to critically understand all ins and outs of influencing factors involved in health care pathways for children and their mothers, we must consider to implement more than one research in the same context.ObjectivesThe objective of this presentation is to showcase the continuum of research projects starting from the assessment of the effectiveness of a combined nutrition and psychosocial intervention and its economic evaluation, and how that led to exploring social representations of malnutrition in order to better understand the link with health care seeking behaviours.MethodsThe FUSAM cluster randomized control trial included 427 were severe acutely malnourished (SAM) children and their mothers. They were divided in two groups receiving the standard nutrition treatment while the intervention group benefited from five psychosocial sessions. A battery of tests for child development and maternal mental health was administered pre and post intervention. For the economic evaluation, a data collection was conducted with 98 community members and District Public Health Office personnel in Saptari and 17 Action contre la Faim and government personnel in Kathmandu. Finally, a mixed-method study comparing social representations of malnutrition included 376 adults in Saptari and Nuwakot district. Data analysis was performed according to the study design: a multivariate model analysis for the CRCT, a micro-costing methodology to cost data collection and analysis was favored. For the mixed-method analysis, descriptive and inductive analysis were performed.ResultsRegarding the child development, children in the intervention group showed higher scores than children in the control group at all time points. And the economic evaluation showed that the costs of adding psychosocial counselling to an existing CMAM program was approximately EUR 28,788 for 6 centers per year. However, referrals of children through the community-based screening were not optimal. The findings related to health seeking behaviors showed that different meaning categories were simultaneously resorted to by community members leading to different representations of SAM children and that relevant health advises were neither systematically nor uniquely associated to medical categories but are linked to different meaning categories depending on the cultural context.ConclusionsMultiplying research projects is crucial to mitigate the limitations of the studies often facing numerous contextual challenges and ultimately to leverage further opportunities.Disclosure of InterestNone Declared

Challenges of Inclusion of Almagirai in Nigerian School Feeding Scheme

Almagirci has recently become an ideological battlefield debate about the roles of government to support them, which sometimes often focuses on feeding. It is expected that all children should equally attain the highest standard of education and nutrition through a school feeding scheme, but in the context of Nigeria, the commitment is different, especially for Almajirai. This study aims to examine the likely challenges in including Almagirai in Nigerian school feeding schemes with an emphasis on people's perceptions. The use of a survey research method through a questionnaire was adopted by the researchers, administered in Mubi North and South local government area of Adamawa State, Nigeria. The survey area represents only two out of hundreds of local governments in the country where Almajirai are sited. The findings revealed that out of 220 respondents, 166 (75.45%) and 174 (79.09%) strongly disagree with the current situation of Almajirai in terms of their feeding and the government commitments toward Almagiranci respectively. It was also revealed that 188 (85.45%) of respondents strongly agreed and in support of governments to include Almajirai in the school feeding scheme, simultaneously, 198 (90.00%) respondents responded that the inclusion will have a positive impact on their learning. In response to these challenges, It is expected that governments should move urgently to bring Almagirai under their oversight and regulation to enable her to take care of nutrition and the standard of their education.

Infant formula ingredients: Updates for clinicians.

Take Away Points All infant formulas meet specific nutritional standards, but there are now numerous versions of formula with newer ingredients that more closely approximate breast milk. Select infant formulas include ingredients such as human milk oligosaccharides, lactoferrin, or milk fat globule membranes, which may have additional clinical benefits. These ingredients are considered safe in infants but there is not dosing standardization across formula companies, and they may increase cost.

The Right To Motherhood Behind Bars: Evaluating The Conditions And Policies For Women Prisoners With Children In India

This research paper delves into the complex issue of motherhood behind bars in India, focusing on the evaluation of the conditions and policies affecting women prisoners with children. Given the growing concern for human rights and gender-specific needs within the penal system, this study aims to shed light on the lived experiences of incarcerated mothers and the operational realities of the policies designed to support them. Employing a mixed-methods approach, including interviews, surveys, and document analysis, the research examines the living conditions, healthcare access, nutritional standards, and child-rearing facilities within Indian women's prisons. It juxtaposes these findings against existing policies and their implementation, identifying gaps between policy and practice, and evaluating compliance with international human rights standards. The voices of incarcerated mothers are central to this analysis, providing invaluable insights into the challenges and needs faced by this vulnerable population. The study culminates in actionable recommendations for policy reforms, emphasizing the need for a humane approach that prioritizes the welfare and rights of both mothers and their children. This research contributes to the broader discourse on prison reform and women's rights, advocating for significant changes to ensure dignity and support for motherhood behind bars in India.

School Meal Nutrition Standards Reduce Disparities Across Income and Race/Ethnicity

Children's diets in the U.S. typically fail to meet dietary recommendations, contributing to associated adverse health outcomes. The Healthy, Hunger-Free Kids Act (HHFKA) of 2010 required the U.S. government to update nutrition standards for school meals to align with the Dietary Guidelines for Americans (DGAs). This study estimates the evolving impact of substituting school-prepared food for home-prepared food on overall daily diet quality and by subcomponents of diet quality. Subgroup analyses are performed by race/ethnicity and income. Two, nonconsecutive days of dietary recall data from the National Health and Nutrition Examination Survey (2005-March 2020) are used to calculate schoolchildren's Healthy Eating Index (HEI)-2020 scores. The study includes children with complete two-day dietary intakes who attend kindergarten through twelfth grade in a school offering lunch. An individual-level fixed effects regression is employed to examine the relationship of school food consumption on HEI-2020 scores before and after HHFKA-mandated changes in nutrition standards. Analyses were conducted on September 23, 2023. Prior to changes in standards (2005-2008), school food did not impact diet quality within the overall group of children. In 2009-2012, positive associations between school food and diet quality emerged for low-income students and for non-Hispanic Black students. By 2013-2020, improvements were seen across all groups. The association between school food and diet quality was most attributable to more favorable consumption of dairy, fruit, whole grains, refined grains, added sugars and saturated fats. HHFKA-based nutrition standards were associated with beneficial dietary changes and reduced dietary disparities for children across diverse backgrounds.

Effects of in ovo vaccination time on broiler performance parameters under field conditions

Hatchery performance is often evaluated based on descriptors such as hatchability, 7-d mortality, and cost. In addition to these descriptors, it is useful to include in this analysis aspects of chick quality through post-hatch performance. Realizing the bird's complete genetic potential necessitates meeting various criteria, with effective support for the chick's immune system being among the pivotal factors. To be effective, in ovo vaccination systems must deliver the vaccines to specific sites in the egg, a circumstance that directly depends on when the injection is made. We examined production data to evaluate the impact of in ovo vaccination time on performance parameters of male Ross308AP chicks. A comprehensive survey was conducted examining records from 3,722 broiler flocks produced and raised by the same company under standard nutrition and management conditions. The selected data specifically pertained to flocks that underwent slaughter between 41 and 45 d. In our analysis, 4 different linear models were built, one for each response variable: mean weight (MW), body weight gain (BWG), corrected feeding conversion rate (cFCR), and total mortality (TM). The linear models used in the analyses included as main predictor the timing of in ovo vaccination (440, 444, 448, 452, 456, 458, and 460 h of incubation), and as additional predictors: age of the breeding flock (26-35, 36-55 and 56-66 wks old), slaughter age, identity of the hatchery, and the season at which the data was collected. Our results showed that the timing of in ovo vaccination significantly affected BWG and cFCR, with procedures performed at 460 h of incubation showing the best outcomes. Breeding flock age affected all response variables, with older breeding flocks delivering increased MW, BWG and TM, and middle-aged flocks increased cFCR. Increasing slaughter age reduced BWG while MW, cFCR and TM were all increased. These data emphasize the benefits of performing in ovo vaccination as close as possible to 460 h of incubation to extract the best BWG and cFCR from Ross308AP male broiler.

Association between protocol change to a higher-protein formula with lower energy targets and nutrient delivery in critically ill patients with COVID-19: A retrospective cohort study.

Guidelines recommend prioritizing protein provision while avoiding excessive energy delivery to critically ill patients with coronavirus disease 2019 (COVID-19), but there are no prospective studies evaluating such a targeted approach in this group. We aimed to evaluate the effect of a "higher-protein formula protocol" on protein, energy, and volume delivery when compared with standard nutrition protocol. This was a retrospective cohort study of adult patients with COVID-19 who received mechanical ventilation for >72 h and enteral nutrition. Before October 2021, the standard nutrition protocol for patients was 0.7 ml/kg/h ideal body weight (IBW) of a 63 g/L protein and 1250 kcal/L formula. From October 2021, we implemented a higher-protein formula protocol for patients with COVID-19. The initial prescription was 0.5 ml/kg/h IBW of a 100 g/L protein and 1260 kcal/L formula with greater emphasis on energy targets being directed by indirect calorimetry when possible. Measured outcomes included protein, energy, and volume delivered. There were 114 participants (standard protocol, 48; higher-protein protocol, 66) with 1324 days of nutrition support. The median (95% CI) differences in protein, energy, and volume delivery between targeted and standard protocol periods were 0.08 g/kg/day (-0.02 to 0.18 g/kg/day), -1.71 kcal/kg/day (-3.64 to 0.21 kcal/kg/day) and -1.5 ml/kg/day (-2.9 to -0.1 ml/kg/day). Thirty-three patients (standard protocol, 7; higher-protein protocol, 26) had 44 indirect calorimetry assessments. There was no difference in measured energy expenditure over time (increased by 0.49 kcal/kg/day [-0.89 to 1.88 kcal/kg/day]). Implementation of a higher-protein formula protocol to patients with COVID-19 modestly reduced volume administration without impacting protein and energy delivery.

Integrating Healthy Nutrition Standards and Practices Into Food Service Contracting in a Large US County Government.

Although considered a promising model of practice, integrating healthy nutrition standards and practices into a large county government's contracting process with food vendors has not been widely described in empirical literature. We conducted an implementation evaluation project to address this gap. County of Los Angeles food vendors provide food or meals annually to more than 100,000 employees and millions of clients and visitors. In 2011, the County of Los Angeles Board of Supervisors adopted a policy to integrate healthy nutrition standards and practices into its requests for proposals (RFPs) and contracting process with food vendors. The policy required all contracts awarded to adhere to these new standards. In 2011, the Los Angeles County Department of Public Health (DPH) began reviewing RFPs for food services for county departments that procured, served, or sold food. From 2011 through 2021, DPH applied a 4-pronged formative-evaluative approach to help county departments implement the Board of Supervisors policy and ensure that nutritional requirements were appropriately integrated into all RFPs for new and renewing contracts with food vendors. We focused our evaluation on understanding the process and tracking the progress of this policy intervention. Our evaluation included 13 key informant interviews, a 2-part survey, reviews of contract data, and synthesis of lessons learned. Based on reviews and subsequent actions taken on more than 20 RFPs, DPH successfully assisted 7 county departments to incorporate healthy nutrition standards and practices into their food vendor contracts. Implementation of the food policy encountered several challenges, including staffing and training constraints and a limited infrastructure. An iterative approach to program improvement facilitated the process. Although the model for integrating healthy nutrition standards and practices into a government contracting process is promising, more work is needed to make it less resource-intensive and to increase user buy-in.

Harmonising IV Oxycodone with Paediatric Perioperative Medications: A Compatibility Study Through Y-Type Connectors.

Co-administering multiple intravenous (IV) agents via Y-connectors is a common practice in hospitalised and fasting surgical patients. However, there is a lack of reliable data confirming the physical compatibility of some combinations including IV oxycodone, a drug that is gaining increasing popularity in the perioperative period. Concern regarding physical drug incompatibilities precludes concurrent coadministration with other common drugs through a single lumen. This can result in the cessation of infusions to allow the administration of other medications, resulting in exacerbation of acute pain. This study aims to evaluate the physical compatibility of IV oxycodone with some commonly co-administered drugs and IV fluids. Mixtures of oxycodone (1mg.mL-1) and the tested drugs and IV fluids were prepared in a ratio of 1:1. The mixtures were examined at 0 and 60 minutes from mixing and assessed using the European Conference Consensus Standards. This involved visual inspection (precipitation, turbidity, colour change, gas formation), spectrophotometry, and pH change. The tested drugs included ketamine, tramadol, clonidine, vancomycin, piperacillin/tazobactam, dexmedetomidine, cefotaxime, gentamicin, and paracetamol. In addition, the commonly used IV fluids tested included glucose 5% + sodium chloride 0.9% + 60 mmol potassium chloride, plasmalyte + dextrose 5%;plasmalyte + dextrose 5% + 55 mmol potassium chloride, plasmalyte + dextrose 5% + 55mmol potassium acetate, plasmalyte + dextrose 5% + 55mmol potassium dihydrogen phosphate, Hartmann's solution, Standard pediatric Total Parenteral Nutrition (TPN) 20/100 and TPN 25/150. IV oxycodone (1 mg.mL-1) showed no visual changes; no spectrophotometric absorption variability at 350, 410, or 550nm; and no pH changes of >0.5 at 0 or 60 minutes with any of the tested drugs or fluids in the concentrations tested. According to European Consensus Conference Standards, IV Oxycodone at 1 mg.mL-1 is physically compatible in a ratio of 1:1 v/v with all investigated drugs and fluids tested for at least 60 minutes.