Nutritive values of wheat bran-based broiler diet supplemented with different classes of enzymes

Previous studies have shown that inclusion of exogenous enzymes in broiler diets can improve metabolizable energy intakes, digestibility and performance parameters. However, there is limited information on the comparative effect of different enzymes in wheat bran-based broiler diet. This study investigated the effect of different enzyme classes on metabolizable energy (ME) values of wheat bran as well as the performance parameters and nutrient retention of broilers. A total of 216 mixed-sex one-day-old chicks were fed either the basal diet or test diet (20% basal diet replaced with wheat bran) without or with supplementation of carbohydrase-cocktail (CC), multi-enzyme (MEnz) and single-carbohydrase (SC). The enzymes increased (P<0.001) the ME values of wheat bran but SC had the highest increase for apparent ME, nitrogen-corrected apparent ME and true ME values of wheat bran. Neither performance parameters of feed intake (FI), body weight gain (BWG), feed conversion ratio (FCR) nor economic benefit (EB) was affected by the interaction between diets and enzymes. A significant dietary effect (P<0.05) was observed as higher FI, lower FCR, and better EB on the test diet compared to basal diet. The enzyme inclusions, however, had similar improvements on (P<0.05) on BWG, FCR and EB of broilers. The dietary enzymes increased fat and phosphorus (P) retentions on both test and basal diets (P<0.001), with birds fed CC added to test diet showing the highest phosphorus retention. In conclusion, enzyme inclusions in wheat-bran based diet improved the ME values of wheat bran and the nutrient retention of broilers, although broiler performance was unaffected. The inclusion of CC in 20% wheat bran-based diet can be economically useful in improving P retention of broilers, with potential benefit for reducing P losses to the environment.</p

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways