Protein and carbohydrate fractionation of Piata palisadegrass ensiled with energetic meals

This study determined the fractionation of protein and carbohydrate of Piata palisadegrass ensiled with energetic meals. The experiment was developed at the Federal Institute of Goiás State, Rio Verde Campus, using a completely randomized design with four replications, in a 4 x 5 factorial arrangement, being four energetic meals (millet, corn, sorghum and wheat) and five levels of addition (0, 8, 16, 24 and 32%). The meals were obtained by grinding the grains, where the levels of addition were calculated based on natural material. The results indicated that the energetic meals represented good sources of additives for ensiling Piata palisadegrass, for considerably improving protein and carbohydrate fractions. However, among the meals used, the sorghum was less efficient by presenting a lower protein fraction (A) and higher fraction C, compared with other additives. The meals of wheat and sorghum showed higher contents of carbohydrate fractions (A+B1 and C). It is recommended the level of addition of 24% of meals, for providing better nutritional value to silage

Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries

Background: Pancreatic surgery remains associated with high morbidity rates. Although postoperative mortality appears to have improved with specialization, the outcomes reported in the literature reflect the activity of highly specialized centres. The aim of this study was to evaluate the outcomes following pancreatic surgery worldwide.Methods: This was an international, prospective, multicentre, cross-sectional snapshot study of consecutive patients undergoing pancreatic operations worldwide in a 3-month interval in 2021. The primary outcome was postoperative mortality within 90 days of surgery. Multivariable logistic regression was used to explore relationships with Human Development Index (HDI) and other parameters.Results: A total of 4223 patients from 67 countries were analysed. A complication of any severity was detected in 68.7 percent of patients (2901 of 4223). Major complication rates (Clavien-Dindo grade at least IIIa) were 24, 18, and 27 percent, and mortality rates were 10, 5, and 5 per cent in low-to-middle-, high-, and very high-HDI countries respectively. The 90-day postoperative mortality rate was 5.4 per cent (229 of 4223) overall, but was significantly higher in the low-to-middle-HDI group (adjusted OR 2.88, 95 per cent c.i. 1.80 to 4.48). The overall failure-to-rescue rate was 21 percent; however, it was 41 per cent in low-to-middle-compared with 19 per cent in very high-HDI countries.Conclusion: Excess mortality in low-to-middle-HDI countries could be attributable to failure to rescue of patients from severe complications. The authors call for a collaborative response from international and regional associations of pancreatic surgeons to address management related to death from postoperative complications to tackle the global disparities in the outcomes of pancreatic surgery (NCT04652271; ISRCTN95140761)