The effect of ad libitum and regulated feeding on the growth, body composition and reproductive performance of broiler breeders

Two experiments were conducted to investigate the effect of two feeding systems, ad libitum (A) and regulated (R) feeding on the growth and reproductive performance of broiler breeders in floor pens and in cages from day old to 55 weeks of age. The degree of restriction used was more severe than some years ago and regulation started at an earlier age. The opening literature review deals with the management of broiler breeders, experiments to control breeding weight, the effect of nutrition on the growth, the control of feed intake in the fowl and energy requirements. In addition the factors affecting reproductive fitness of broiler breeders and responses to artificial insemination and natural mating are also reviewed. In the first experiment the objective was to compare the growth, feed intake and body composition of females and males on A and, R feeding. The starter and grower feeds contained 12.2 and 12.5 MJ ME/kg. At 10 weeks the body weight of A birds was twice that of the R birds. This difference was maintained to about 20 weeks. Regulated females did not catch up the growth of ad libitum females while regulated males reached similar body weight to ad libitum males. At 55 weeks the body weight of the A males and females was 5.29 and 4.79 kg and for the R males and females was 4.84 and 3.51 kg. To achieve target weight with both sexes the highest level of feed restriction was 65 per cent during the growing period. The highest fat content of the carcass weight in A females was 9 times that of females on R feeding and twice more protein than thos on R, by 20 weeks of age. From 30 weeks the carcass protein of females was relatively constant, whereas in the males growth of protein continued until 40 weeks, after which it was relatively constant. Second experiment was conducted to investigate the effects of dietary energy levels on feed intake, energy intake of females and to study the reproduction by artificial insemination of caged hens. Three breeder feeds (L, M and H) containing 10.1, 12.2 and 13.3 MJ ME/kg respectively, were used. Experiment 2 was conducted in two phases which were 22 to 35 weeks (phase 1) and 36 to 54 weeks (phase 2). The feeds were offered to the ad libitum fed birds and only feed M was given to those hens fed regulated amounts of feed. At 36 weeks of age, the number of treatments was increased from 4 to 10. The 6 treatments comprised ad libitum hens changed from L to H, from M to R or from H to L (treatments LH, MR and HL) and hens on R changed from R to L, from R to M or from R to H (treatments RL, RM and RH). Daily feed intake values directly decreased as dietary energy level increased. The highest daily feed intakes were 194 and 184 g/b for hens on L and M respectively at 30-31 weeks of age while for those on H it was 165-g/b at 28-29 weeks, and, for those on R it was 181 g/b at 34-35 weeks of age. Ad libitum hens adjusted their feed intake to dietary energy levels better than was expected on the basis of previous research by other workers. Throughout the first phase, the highest daily weight gain occurred with hens on R feeding while during the second phase it occurred with hens on RH. After 35 weeks of age hen-day production of hens on regulated feeding and those hens previously on R (RL, RM and RH) was about 19 per cent greater than ad libitum groups. The body fat content of hens previously on R did not affect their egg production. As with experiment 1, the egg weights of ad libitum fed birds was heavier than those produced from the regulated birds. The fertility and hatchability for all hens mated with ad libitum males in cages were higher than those on the floor except those on feed H which was lower. For hens mated with regulated males the levels of fertility and hatchability were lower than those on the floor except hens on H which had a higher hatchability. The main effect of ad libitum feeding of males was to depress the reproductive performance of all females. There was a higher mortality associated with ad libitum feeding and a high energy layers feed (H or LH groups). (Abstract shortened by ProQuest.

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Evaluation of Serum Testosterone, Progesterone, Seminal Antisperm Antibody, and Fructose Levels among Jordanian Males with a History of Infertility

Due to the biochemical complexity of seminal fluid, we attempt to study the possible correlation between fructose, which is secreted under the effect of androgen hormone, and autoimmunity, which might play a role in varicocele associated infertility, in reducing sperm motility. Seminal fructose, antisperm antibodies (ASAs) and blood steroids hormones (testosterone and progesterone) levels were measured in 66 infertile males with varicocele and 84 without varicocele referred for fertility treatment. Seminal analysis was performed with biochemical measurements of seminal fructose and mixed agglutination reaction (MAR) for ASA. Serum levels of progesterone and testosterone were estimated using a competitive chemoluminescent enzyme immunoassay. The mean values for serum testosterone were 380.74±24.331, 365.9±16.55, and 367.5±21.8 ng/dl, progesterone 0.325±0.243, 0.341±0.022, and 0.357  ±  0.0306 ng/ml, and seminal plasma fructose 359.6  ±  26.75, 315.6  ±  13.08, and 332.08  ±  24.38 mg/dl in males with varicocele, without varicocele, and fertile males, respectively. A significant high level of testosterone was observed within varicocele group (P=.001). This result showed that testosterone may play a role as an infertility determinant in subjects with varicocele. ASA was detected in 18 (26.47%) of cases with varicocele, 20 (38.46%) without varicocele, and in 16 (32.0%) fertile men. Cases with ASAs associated with low sperm motility morphology. An inverse correlation between sperm-bound antibodies and viscosity has been shown (P=.017). ASA showed some significant inverse relations with ages, durations of infertility, and viscosity (P<.05). In addition, a significant correlation was observed between ASA positive seminal plasma and testosterone concentration among infertile cases (with or without varicocele) and fertile (P<.05). Our results suggest a relationship between testicular steroid hormone levels with autoimmunity and sperm antibodies which influence the motility of ejaculated spermatozoa among Jordanian infertile males

Evaluation of Serum Testosterone, Progesterone, Seminal Antisperm Antibody, and Fructose Levels among Jordanian Males with a History of Infertility

Due to the biochemical complexity of seminal fluid, we attempt to study the possible correlation between fructose, which is secreted under the effect of androgen hormone, and autoimmunity, which might play a role in varicocele associated infertility, in reducing sperm motility. Seminal fructose, antisperm antibodies (ASAs) and blood steroids hormones (testosterone and progesterone) levels were measured in 66 infertile males with varicocele and 84 without varicocele referred for fertility treatment. Seminal analysis was performed with biochemical measurements of seminal fructose and mixed agglutination reaction (MAR) for ASA. Serum levels of progesterone and testosterone were estimated using a competitive chemoluminescent enzyme immunoassay. The mean values for serum testosterone were 380.74 ± 24.331, 365.9 ± 16.55, and 367.5 ± 21.8 ng/dl, progesterone 0.325 ± 0.243, 0.341 ± 0.022, and 0.357 ± 0.0306 ng/ml, and seminal plasma fructose 359.6 ± 26.75, 315.6 ± 13.08, and 332.08 ± 24.38 mg/dl in males with varicocele, without varicocele, and fertile males, respectively. A significant high level of testosterone was observed within varicocele group (P = .001). This result showed that testosterone may play a role as an infertility determinant in subjects with varicocele. ASA was detected in 18 (26.47%) of cases with varicocele, 20 (38.46%) without varicocele, and in 16 (32.0%) fertile men. Cases with ASAs associated with low sperm motility morphology. An inverse correlation between sperm-bound antibodies and viscosity has been shown (P = .017). ASA showed some significant inverse relations with ages, durations of infertility, and viscosity (P &lt; .05). In addition, a significant correlation was observed between ASA positive seminal plasma and testosterone concentration among infertile cases (with or without varicocele) and fertile (P &lt; .05). Our results suggest a relationship between testicular steroid hormone levels with autoimmunity and sperm antibodies which influence the motility of ejaculated spermatozoa among Jordanian infertile males