Intake by Lactating Goats Browsing on Mediterranean Shrubland

In Mediterranean regions goat feeding systems are mainly based on shrubland that contain a wide variety of species. There are only a few equations for predicting feed intake of stall-fed goats (Luo et al., 2004). The objective of this study was to develop a model for predicting the intake of lactating goats browsing on Mediterranean shrubland

Prescribing Hemodialysis or Hemodiafiltration: When One Size Does Not Fit All the Proposal of a Personalized Approach Based on Comorbidity and Nutritional Status

There is no simple way to prescribe hemodialysis. Changes in the dialysis population, improvements in dialysis techniques, and different attitudes towards the initiation of dialysis have influenced treatment goals and, consequently, dialysis prescription. However, in clinical practice prescription of dialysis still often follows a “one size fits all” rule, and there is no agreed distinction between treatment goals for the younger, lower-risk population, and for older, high comorbidity patients. In the younger dialysis population, efficiency is our main goal, as assessed by the demonstrated close relationship between depuration (tested by kinetic adequacy) and survival. In the ageing dialysis population, tolerance is probably a better objective: “good dialysis” should allow the patient to attain a stable metabolic balance with minimal dialysis-related morbidity. We would like therefore to open the discussion on a personalized approach to dialysis prescription, focused on efficiency in younger patients and on tolerance in older ones, based on life expectancy, comorbidity, residual kidney function, and nutritional status, with particular attention placed on elderly, high-comorbidity populations, such as the ones presently treated in most European centers. Prescription of dialysis includes reaching decisions on the following elements: dialysis modality (hemodialysis (HD) or hemodiafiltration (HDF)); type of membrane (permeability, surface); and the frequency and duration of sessions. Blood and dialysate flow, anticoagulation, and reinfusion (in HDF) are also briefly discussed. The approach described in this concept paper was developed considering the following items: nutritional markers and integrated scores (albumin, pre-albumin, cholesterol; body size, Body Mass Index (BMI), Malnutrition Inflammation Score (MIS), and Subjective Global Assessment (SGA)); life expectancy (age, comorbidity (Charlson Index), and dialysis vintage); kinetic goals (Kt/V, normalized protein catabolic rate (n-PCR), calcium phosphate, parathyroid hormone (PTH), beta-2 microglobulin); technical aspects including vascular access (fistula versus catheter, degree of functionality); residual kidney function and weight gain; and dialysis tolerance (intradialytic hypotension, post-dialysis fatigue, and subjective evaluation of the effect of dialysis on quality of life). In the era of personalized medicine, we hope the approach described in this concept paper, which requires validation but has the merit of providing innovation, may be a first step towards raising attention on this issue and will be of help in guiding dialysis choices that exploit the extraordinary potential of the present dialysis “menu”

Where Are You Going, Nephrology? Considerations on Models of Care in an Evolving Discipline

Nephrology is a complex discipline, including care of kidney disease, dialysis, and transplantation. While in Europe, about 1:10 individuals is affected by chronic kidney disease (CKD), 1:1000 lives thanks to dialysis or transplantation, whose costs are as high as 2% of all the health care budget. Nephrology has important links with surgery, bioethics, cardiovascular and internal medicine, and is, not surprisingly, in a delicate balance between specialization and comprehensiveness, development and consolidation, cost constraints, and competition with internal medicine and other specialties. This paper proposes an interpretation of the different systems of nephrology care summarising the present choices into three not mutually exclusive main models (“scientific”, “pragmatic”, “holistic”, or “comprehensive”), and hypothesizing an “ideal-utopic” prevention-based fourth one. The so-called scientific model is built around kidney transplantation and care of glomerulonephritis and immunologic diseases, which probably pose the most important challenges in our discipline, but do not mirror the most common clinical problems. Conversely, the pragmatic one is built around dialysis (the most expensive and frequent mode of renal replacement therapy) and pre-dialysis treatment, focusing attention on the most common diseases, the holistic, or comprehensive, model comprehends both, and is integrated by several subspecialties, such as interventional nephrology, obstetric nephrology, and the ideal-utopic one is based upon prevention, and early care of common diseases. Each model has strength and weakness, which are commented to enhance discussion on the crucial issue of the philosophy of care behind its practical organization. Increased reflection and research on models of nephrology care is urgently needed if we wish to rise to the challenge of providing earlier and better care for older and more complex kidney patients with acute and chronic kidney diseases, with reduced budgets

The Diet and Haemodialysis Dyad: Three Eras, Four Open Questions and Four Paradoxes. A Narrative Review, Towards a Personalized, Patient-Centered Approach

The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients’ lives. In the early years of dialysis, potassium was identified as “the killer”, and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the “third era” finds us combating protein-energy wasting. This review discusses four questions and four paradoxes, regarding the diet-dialysis dyad: are the “magic numbers” of nutritional requirements (calories: 30–35 kcal/kg; proteins > 1.2 g/kg) still valid? Are the guidelines based on the metabolic needs of patients on “conventional” thrice-weekly bicarbonate dialysis applicable to different dialysis schedules, including daily dialysis or haemodiafiltration? The quantity of phosphate and potassium contained in processed and preserved foods may be significantly different from those in untreated foods: what are we eating? Is malnutrition one condition or a combination of conditions? The paradoxes: obesity is associated with higher survival in dialysis, losing weight is associated with mortality, but high BMI is a contraindication for kidney transplantation; it is difficult to limit phosphate intake when a patient is on a high-protein diet, such as the ones usually prescribed on dialysis; low serum albumin is associated with low dialysis efficiency and reduced survival, but on haemodiafiltration, high efficiency is coupled with albumin losses; banning plant derived food may limit consumption of “vascular healthy” food in a vulnerable population. Tailored approaches and agreed practices are needed so that we can identify attainable goals and pursue them in our fragile haemodialysis populations

DISTRIBUTION OF SPAWNING AND NURSERY GROUNDS FOR DEEP–WATER RED SHRIMPS IN THE CENTRAL WESTERN MEDITERRANEAN SEA

The presence of spawning and nursery grounds of Aristeids in the central western Mediterranean Sea were investigated using fishery-independent data (trawl surveys, 1994–2012). Spatial distributions were generated for mature animals and recruits, for both spring/summer and autumn data, using an inverse distance weighted deterministic interpolation. The persistence index was used to identify stable spawning and nursery grounds in the Sardinian slope region for Aristaeomorpha foliacea and Aristeus antennatus. Areas of aggregation for recruits and mature females appear connected with important physical habitat features. The analysis also suggests a seasonal bathymetric distribution for nursery areas. The recruits of A. foliacea are located in the upper part of the continental slope (377-450 m) in spring-summer and reach greater depths (468-628 m) in autumn. For A. antennatus, for which nursery areas only emerge in autumn, there is presumably an opposite ontogenic migration, from deep sea to upper slope, during the summer (575-681 m). Results indicate also a partial overlap between the nursery and spawning grounds of both species. In this particular areas, local environmental conditions such as upwelling events or the presence of canyons and seamounts seem to play an important role in their distribution. This study generated also relevant information on the spatial and temporal distribution of seasonal or persistent aggregations of spawners and recruits, providing scientific elements to suggest the feasibility of protecting these important resources

Distribution of spawning and nursery grounds for deep–water red shrimps in the central western Mediterranean Sea

The presence of spawning and nursery grounds of Aristeids in the central western Mediterranean Sea were investigated using fishery-independent data (trawl surveys, 1994–2012). Spatial distributions were generated for mature animals and recruits, for both spring/summer and autumn data, using an inverse distance-weighted deterministic interpolation. The persistence index was used to identify stable spawning and nursery grounds in the Sardinian slope region for Aristaeomorpha foliacea and Aristeus antennatus. Areas of aggregation for recruits and mature females appear to be connected with important physical habitat features. The analysis also suggests a seasonal bathymetric distribution for nursery areas. The recruits of A. foliacea are located in the upper part of the continental slope (377-450 m) in spring/summer and reach greater depths (468-628 m) in autumn. For A. antennatus, for which nursery areas only emerge in autumn, there is presumably an opposite ontogenic migration, from deep sea to upper slope, during the summer (575-681 m). The results also indicate a partial overlap between the nursery and spawning grounds of both species. In this particular area, local environmental conditions such as upwelling events or the presence of canyons and seamounts seem to play an important role in their distribution. This study also generated relevant information on the spatial and temporal distribution of seasonal or persistent aggregations of spawners and recruits, providing scientific elements to suggest the protection of these important resources

Effects of different fat-enriched concentrates on fatty acid profile of cheese from grazing dairy sheep

A trial on different fatty acid supplementation was run in grazing dairy sheep. Forty-eight lactating Sarda ewes were randomly allocated to four homogeneous groups: PAS, control group grazing for 22h/d without supplementation; NOF, group supplemented with a cereal based non-fat enriched concentrate; C182, group supplemented with a concentrate rich in sunflower seeds; and C183, group supplemented with a concentrate rich in linseeds. The results showed that the concentrates, based on oilseeds from both sunflower and linseed sources determined high C18:1 t11 and CLA c9 t11 cheese fat content. Moreover linseeds supplementation improved the concentration in the cheese of other beneficial fatty acids such as LN and PUFAω3

How the characteristics of words in child-directed speech differ from adult-directed speech to influence children's productive vocabularies

Child-directed speech has long been known to influence children's vocabulary learning. However, while we know that caregiver utterances differ from those directed at adults in various ways, little is known about any differences in the lexical properties of child-directed and adult-directed utterances. We compare over half a million word tokens from adult speech directed at children (from caregiver-child transcriptions) to the same quantity directed at adults. We show that child-directed speech contains greater numbers of words that are lower in phonemic length, higher in frequency, lower in phonotactic probability, and higher in neighborhood density than adult-directed speech; furthermore, child-directed speech explains over twice the variability of children's productive noun vocabularies than adult-directed speech. These findings indicate that children's word production is clearly influenced by the characteristics of the words spoken directly to them and that researchers need to be wary of using adult-directed language corpora when calculating lexical measures