Benefits of Leucaena diversifolia in grazing steer’s diet: performance, methane and fatty acids

Leucaena diversifolia (Ld) is a legume species that has received little attention in terms of its nutritive value, methane (CH4) emissions, and impact on meat quality. To address this gap, a study was conducted to compare the performance, CH4 emissions, and fatty acid content of steers grazing on a monoculture of tropical grass Urochloa hybrid cv. Cayman versus a combination of Cayman and Ld. Over a period of 15 months, 14 Angus crossbred steers weighing an average of 374±7.5 kg were used in the study, with half of them grazing only Cayman grass and the other half grazing on a combination of Cayman and Ld at a ratio of 74:26. Live weight gain was recorded and CH4 emissions were measured after the animal productivity test. Meat quality and fatty acid profiles were measured after the steers were slaughtered. The results showed that steers grazing on a combination of Cayman and Ld consumed more dry matter, crude protein, and energy per day than those grazing on grass alone, and this difference was still evident when digestibility was considered (P≤0.05). Moreover, animals grazing on a combination of Cayman and Ld weighed an average of 63 kg more at the end of the experiment compared to those grazing only Cayman (466 vs. 403 kg; P≤0.05). Interestingly, animals that consumed only Cayman grass emitted more CH4 than those that included Ld in their diet (168 vs. 144 g/d; P≥0.05). The total polyunsaturated, monounsaturated, and saturated fatty acid concentrations in the meat did not differ between the two groups (P≥0.05). In conclusion, incorporating Ld in the diet of grazing steers can increase nutrient intake (protein and energy) and animal productivity without affecting daily net CH4 emissions or fatty acid concentrations in the meat. This study sheds light on the potential benefits of legume inclusion in animal diets and highlights the need for further research in this area

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

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

Improving the accuracy of beef cattle methane inventories in Latin America and Caribbean countries

On-farm methane (CH4) emissions need to be estimated accurately so that the mitigation effect of recommended practices can be accounted for. In the present study prediction equations for enteric CH4 have been developed in lieu of expensive animal measurement approaches. Our objectives were to: (1) compile a dataset from individual beef cattle data for the Latin America and Caribbean (LAC) region; (2) determine main predictors of CH4 emission variables; (3) develop and cross-validate prediction models according to dietary forage content (DFC); and (4) compare the predictive ability of these newly-developed models with extant equations reported in literature, including those currently used for CH4 inventories in LAC countries. After outlier's screening, 1100 beef cattle observations from 55 studies were kept in the final dataset (∼ 50 % of the original dataset). Mixed-effects models were fitted with a random effect of study. The whole dataset was split according to DFC into a subset for all-forage (DFC = 100 %), high-forage (94 % ≥ DFC ≥ 54 %), and low-forage (50 % ≥ DFC) diets. Feed intake and average daily gain (ADG) were the main predictors of CH4 emission (g d−1), whereas this was feeding level [dry matter intake (DMI) as % of body weight] for CH4 yield (g kg−1 DMI). The newly-developed models were more accurate than IPCC Tier 2 equations for all subsets. Simple and multiple regression models including ADG were accurate and a feasible option to predict CH4 emission when data on feed intake are not available. Methane yield was not well predicted by any extant equation in contrast to the newly-developed models. The present study delivered new models that may be alternatives for the IPCC Tier 2 equations to improve CH4 prediction for beef cattle in inventories of LAC countries based either on more or less readily available data

Improving the accuracy of beef cattle methane inventories in Latin America and Caribbean countries

On-farm methane (CH4) emissions need to be estimated accurately so that the mitigation effect of recommended practices can be accounted for. In the present study prediction equations for enteric CH4 have been developed in lieu of expensive animal measurement approaches. Our objectives were to: (1) compile a dataset from individual beef cattle data for the Latin America and Caribbean (LAC) region; (2) determine main predictors of CH4 emission variables; (3) develop and cross-validate prediction models according to dietary forage content (DFC); and (4) compare the predictive ability of these newly-developed models with extant equations reported in literature, including those currently used for CH4 inventories in LAC countries. After outlier's screening, 1100 beef cattle observations from 55 studies were kept in the final dataset (~ 50 % of the original dataset). Mixed-effects models were fitted with a random effect of study. The whole dataset was split according to DFC into a subset for all-forage (DFC = 100 %), high-forage (94 % ≥ DFC ≥ 54 %), and low-forage (50 % ≥ DFC) diets. Feed intake and average daily gain (ADG) were the main predictors of CH4 emission (g d−1), whereas this was feeding level [dry matter intake (DMI) as % of body weight] for CH4 yield (g kg−1 DMI). The newly-developed models were more accurate than IPCC Tier 2 equations for all subsets. Simple and multiple regression models including ADG were accurate and a feasible option to predict CH4 emission when data on feed intake are not available. Methane yield was not well predicted by any extant equation in contrast to the newly-developed models. The present study delivered new models that may be alternatives for the IPCC Tier 2 equations to improve CH4 prediction for beef cattle in inventories of LAC countries based either on more or less readily available data

Naturaleza urbana. Plataforma de experiencias

Naturaleza Urbana presenta experiencias autogestionadas que, con el tiempo, se han posicionado como ejercicios alternativos de identificación, monitoreo y recuperación de la biodiversidad urbana. En otros casos, el modelo comunidad-gobierno ha permitido desarrollar diagnósticos y propuestas de gestión corresponsables y sistémicas, entendiendo por esto último iniciativas que nacen desde los valores mismos que cada comunidad le atribuye a su biodiversidad. Del mismo modo, se presentan esfuerzos gubernamentales que han enriquecido la visión ambiental de los principales instrumentos de planificación urbana, por ejemplo, integrando la condición propiamente urbana como oportunidad para aumentar la oferta ambiental de la ciudad, fortaleciendo las funciones y procesos de la biodiversidad y revitalizando, con ello, la calidad de vida del entorno urbano. Por su parte, las universidades y los centros de investigación se han sumado a la ola emergente de generación de conocimiento en biodiversidad urbana (fenómeno nacional e internacional), han brindado evidencia científica de su valor para el bienestar humano y han propuesto reflexiones y lineamientos cualitativos de biodiversidad, con miras a hacer del ordenamiento un ejercicio más coherente con cada contexto territorial en particular.Bogotá, D. C., ColombiaInstituto de Investigación de Recursos Biológicos Alexander von Humbold

Urban Nature

Preservation, restoration, monitoring of biodiversity and promotion of native species, in their strict and classical sense, could be unviable strategies in the cities. Management systems such as the protected areas acquire profoundly different connotations and objectives from the traditional ones when thought of in the context of a city. Similarly, although ecological restoration seeks to return to a baseline ecosystem, there is little that we know about the vegetation present on the urban borders of the main Colombian cities prior to the 20th century. Finally, the models for potential distribution of species could produce unreliable results, because their methodological bases were not conceived based on urban dynamics. In this context, to de ne urban biodiversity and what strategy must be applied for its conservation implies a challenge that, beyond being scienti c, is necessarily social and cultural and involves planning and design. Innovation is inevitable.Bogotá, D. C

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk

Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes

BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo