Replacement of soya bean meal with peas and faba beans in growing/finishing pig diets: effect on performance, carcass composition and nutrient excretion

There is now an increasing debate about the viability of using temperate-grown legumes in pig diets as a potential replacement for imported soya bean meal (SBM) and this is due to food security, sustainability and environmental concerns. Two trials were designed to examine nitrogen (N) retention, growth performance and carcass quality of grower and finisher pigs when fed nutritionally balanced SBM-free diets formulated to contain peas or faba beans at 300 g/kg, compared to an SBM-containing, pulse-free control diet. Trial 1 evaluated N digestibility/retention in four iso-energetic diets, comparing the SBM control with one diet formulated with peas and two with faba bean cultivars; a tannin-containing and a tannin-free variety. This trial employed a four by four Latin Square design with four male pigs housed in metabolism crates, fed twice daily at 0.9 of assumed ad libitum intake over four time periods during grower (30–55 kg) and finisher (55–95 kg) phases. Quantitative faecal and urine collection allowed determination of N coefficient of total tract apparent digestibility, coefficient of apparent metabolisability, and N balance. Results revealed that dietary treatment did not affect these N parameters (P > 0.05) during either the grower or finisher phase. Trial 2 evaluated growth performance (feed intake, daily live weight gain and feed conversion ratio) and carcass quality parameters. Five diets (based on SBM, peas and one of three faba bean cultivars) balanced for standard ileal digestible amino acids and net energy were each fed to eight replicates of individually housed entire male pigs over the same growth phases as Trial 1. The inclusion of three faba bean varieties allowed comparison of animal responses between tannin/tannin-free and spring vs. winter bean cultivars. At ∼95 kg, pigs were slaughtered and a comprehensive range of carcass measurements undertaken. Samples of shoulder backfat were also taken at slaughter to determine skatole and indole concentrations. As with N balance, feeding treatment did not affect performance data. Carcass parameters revealed pigs fed with the pea-based diet had a greater dressing percentage than those animals on faba bean-based diets. Pigs fed with the SBM or pea-based diets also had greater lean meat percentages than those on faba-bean diets. Mean skatole concentrations for all pigs were below the accepted maximum threshold level of 0.2 μg/g. In conclusion, it is suggested that peas and faba beans can be successfully fed in balanced pig diets throughout the grower/finisher periods as alternatives to SBM

Prevalence of headache in Europe: a review for the Eurolight project

The main aim of the present study was to do an update on studies on headache epidemiology as a preparation for the multinational European study on the prevalence and burden of headache and investigate the impact of different methodological issues on the results. The study was based on a previous study, and a systematic literature search was performed to identify the newest studies. More than 50% of adults indicate that they suffer from headache in general during the last year or less, but when asked specifically about tension-type headache, the prevalence was 60%. Migraine occurs in 15%, chronic headache in about 4% and possible medication overuse headache in 1–2%. Cluster headache has a lifetime prevalence of 0.2–0.3%. Most headaches are more prevalent in women, and somewhat less prevalent in children and youth. Some studies indicate that the headache prevalence is increasing during the last decades in Europe. As to methodological issues, lifetime prevalences are in general higher than 1-year prevalences, but the exact time frame of headache (1 year, 6 or 3 months, or no time frame stated) seems to be of less importance. Studies using personal interviews seem to give somewhat higher prevalences than those using questionnaires

Heterogeneous treatment effects of therapeutic-dose heparin in patients hospitalized for COVID-19

Importance Randomized clinical trials (RCTs) of therapeutic-dose heparin in patients hospitalized with COVID-19 produced conflicting results, possibly due to heterogeneity of treatment effect (HTE) across individuals. Better understanding of HTE could facilitate individualized clinical decision-making. Objective To evaluate HTE of therapeutic-dose heparin for patients hospitalized for COVID-19 and to compare approaches to assessing HTE. Design, Setting, and Participants Exploratory analysis of a multiplatform adaptive RCT of therapeutic-dose heparin vs usual care pharmacologic thromboprophylaxis in 3320 patients hospitalized for COVID-19 enrolled in North America, South America, Europe, Asia, and Australia between April 2020 and January 2021. Heterogeneity of treatment effect was assessed 3 ways: using (1) conventional subgroup analyses of baseline characteristics, (2) a multivariable outcome prediction model (risk-based approach), and (3) a multivariable causal forest model (effect-based approach). Analyses primarily used bayesian statistics, consistent with the original trial. Exposures Participants were randomized to therapeutic-dose heparin or usual care pharmacologic thromboprophylaxis. Main Outcomes and Measures Organ support–free days, assigning a value of −1 to those who died in the hospital and the number of days free of cardiovascular or respiratory organ support up to day 21 for those who survived to hospital discharge; and hospital survival. Results Baseline demographic characteristics were similar between patients randomized to therapeutic-dose heparin or usual care (median age, 60 years; 38% female; 32% known non-White race; 45% Hispanic). In the overall multiplatform RCT population, therapeutic-dose heparin was not associated with an increase in organ support–free days (median value for the posterior distribution of the OR, 1.05; 95% credible interval, 0.91-1.22). In conventional subgroup analyses, the effect of therapeutic-dose heparin on organ support–free days differed between patients requiring organ support at baseline or not (median OR, 0.85 vs 1.30; posterior probability of difference in OR, 99.8%), between females and males (median OR, 0.87 vs 1.16; posterior probability of difference in OR, 96.4%), and between patients with lower body mass index (BMI 90% for all comparisons). In risk-based analysis, patients at lowest risk of poor outcome had the highest propensity for benefit from heparin (lowest risk decile: posterior probability of OR >1, 92%) while those at highest risk were most likely to be harmed (highest risk decile: posterior probability of OR <1, 87%). In effect-based analysis, a subset of patients identified at high risk of harm (P = .05 for difference in treatment effect) tended to have high BMI and were more likely to require organ support at baseline. Conclusions and Relevance Among patients hospitalized for COVID-19, the effect of therapeutic-dose heparin was heterogeneous. In all 3 approaches to assessing HTE, heparin was more likely to be beneficial in those who were less severely ill at presentation or had lower BMI and more likely to be harmful in sicker patients and those with higher BMI. The findings illustrate the importance of considering HTE in the design and analysis of RCTs. Trial Registration ClinicalTrials.gov Identifiers: NCT02735707, NCT04505774, NCT04359277, NCT0437258

Growth performance of different breed crosses of chicks fed diets with different protein and energy sources

Six experiments (EXP) were conducted to evaluate growth performance of different breed crosses of broiler chicks fed diets containing soybean meal, soy protein isolate (SPI), soy protein concentrate (SPC), or rice and casein. Cornish x Plymouth Rock (CxPR; EXP 1, 3, 4, 5, and 6) or New Hampshire x Columbian (NHxC; EXP 2 and 4) cross chicks were used. The chicks were fed a corn-soybean meal (C-SBM) diet before allotment to treatment. The age of the chicks ranged from 5 to 9 d posthatching at the start of the EXP, and the assay periods ranged from 8 to 14 d. Initial weights were 194.9, 96.1, 102.1, 84.7 [84.1 (CxPR) or 85.3 (NHxC)], 101.8, and 145.1 g in EXP 1 to 6, respectively. A completely randomized design was used in all EXP, and treatments were replicated four to six times with four or five chicks each. All diets were formulated to meet the NRC nutrient requirements of chicks. In EXP 1 (CxPR male chicks) and EXP 2 (NHxC female chicks), gain and gain:feed (G:F) were greater (P \u3c 0.01) in chicks fed the C-SBM diet compared with chicks fed diets containing SPI. In EXP 3, CxPR chicks were fed a C-SBM diet, a SPI-dextrose-cornstarch diet (dextrose:cornstarch, 1:1) formulated by Louisiana State University Agricultural Center (LSU) or a similar SPI diet (dextrose:cornstarch, 0.53:1) formulated by the University of Illinois (UI). Daily gain, average daily feed intake (ADFI), and G:F were increased (P \u3c 0.01) in chicks fed the C-SBM diet relative to chicks fed the two SPI diets, and there were only minor differences between the two SPI diets. In EXP 4, the CxPR and NHxC male chicks were fed the same diets used in EXP 3. Daily gain and ADFI were greater in the CxPR and NHxC chicks fed the C-SBM diet relative to chicks fed the SPI diets (P \u3c 0.01), but the increased average daily gain (ADG) and ADFI in chicks fed the C-SBM diet were much greater in the CxPR chicks (chick x C-SBM vs. SPI, P \u3c 0.01). Daily gain, ADFI, and G:F were greater (P \u3c 0.01) in CxPR chicks than in NHxC chicks. In EXP 5, ADG, ADFI, and G:F were greater (P \u3c 0.04) in chicks fed the C-SBM diet compared with those fed a C-SPC diet. In EXP 6, CxPR chicks fed the C-SBM diet grew faster (P \u3c 0.09) than those fed a rice and casein diet. Variable effects of diet on growth of chicks were affected by breed crosses of chicks