Effects of Saccharomyces cerevisiae at direct addition or pre-incubation on in vitro gas production kinetics and degradability of four fibrous feeds

The aim of this study was to determine effects of increasing doses of the yeast (Saccharomyces cerevisiae) in two methods of applications (direct or 72 h of pre-incubation) on in vitro GP, degradability and some ruminal fermentation parameters of the fibrous feedstuffs of corn stover, oat straw, sugarcane bagasse, and sorghum straw.The objective of this study was to evaluate the effects of Saccharomyces cerevisiae on in vitro gas production (GP) kinetics and degradability of corn stover, oat straw, sugarcane bagasse and sorghum straw. Feedstuffs were incubated with different doses of yeast [0, 4, 8 and 12 mg/g dry matter (DM)] at direct addition or 72 h pre-incubation. Rumen GP was recorded at 2, 4, 6, 8, 10, 12, 14, 24, 30, 48, 54 and 72 h of incubation. After 72 h, rumen pH and methane were determined and contents were filtrated for DM, neutral (NDF) and acid detergent fibre (ADF) degradability. Fibrous species×method of application×yeast interactions occurred (P<0.001) for all measured ruminal GP parameters and degradability. The direct addition or 72 h pre-incubation of S. cerevisiae with corn stover improved (P<0.05) GP and methane and decreased (P<0.05) the lag time (L) and NDF degradability (NDFD). The direct addition of S. cerevisiae to oat straw increased (P<0.05) rate of GP (c) and decreased (P<0.05) asymptotic GP (b). However, 72 h pre-incubation increased (P<0.05) c with linearly decreased b, DM degradability (DMD) and NDFD. Applying S

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. Trial registration number NCT0432364