ABSTRACT Our aim was to assess the mineral composition of corn silages produced in four states of Brazil: Goiás, Minas Gerais, Paraná, and Santa Catarina. In total, seventy-three samples were analyzed. Total element content was extracted by HNO3 and H2O2 microwave-assisted digestion, and inductively coupled plasma-mass spectrometry (ICP-MS) was used to determine concentration. Of the 31 elements analyzed (Ag, Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Rb, S, Se, Sr, Ti, Tl, U, V, and Zn), 21 had concentrations above equipment detection limits. No elements reached the maximum tolerable concentration, but concentrations of Ca (0.14-0.15%), Cu (3.4-5.6 mg kg−1), P (0.13-0.16%), S (0.06-0.08%), and Zn (13-19 mg kg−1) were below the adequate concentration for good nutritional balance. The strong and consistent correlation observed between Fe and Ti in silage samples indicated contamination by soil. Mean concentrations of Cu, Mn, Mo, P, S, and Zn were different among states, and canonic analyses successfully discriminate samples according to their state of origin. Minerals from corn silage should be considered when formulating balanced cattle diets. To ensure silage quality, farmers must adopt strategies that reduce contamination by soil during the ensiling process.

John de Gruchy's The Church Struggle in South Africa was a bold attempt to write the story of the kingdom of God in his native land. While it stood toward the beginning of his written work, the themes laid down in it have followed De Gruchy's writings up to the present. They have also sketched the story of South Africa from the climax of the struggle to end Apartheid to the present travails to realize its promise. This article takes up the final chapter in that work, comparing it to another great theological attempt to write the kingdom of God: H. Richard Niebuhr's The Kingdom of God in America. It follows that chapter through its disappearance in the third edition of The Church Struggle, to its re-emergence in The End is Not Yet. The article is especially interested in De Gruchy's eschatological retrieval of Bonhoeffer's tension between the ultimate and the penultimate, and in the question of God's trinitarian reality shaping the world - and us as community of anticipation.

摘要 目的 描述和分析口服霍乱疫苗接种活动的特点，包括位置、目标人群、物流、疫苗覆盖率和交付成本。 方法 我们搜索了PubMed、世界卫生组织（WHO）网站和Cochrane数据库，搜索中不附加任何日期或语言限制。联系该领域和卫生部的公...

Résumé Objectif Décrire et analyser les caractéristiques des campagnes de vaccination orale contre le choléra; y compris le site, la population cible, la logistique, la couverture vaccinale et les coûts de distribution. Méthodes Nous avons effectué des recherches dans PubMed, le site Internet de l'Organisation mondiale de la Santé (OMS) et la base de données Cochrane sans aucune restriction de date ou de langue. Nous avons contacté des membres du personnel de la santé publique, des experts travaillant dans le domaine et dans les ministè...

Резюме Цель Описать и проанализировать особенности кампаний по проведению пероральной вакцинации против холе...

Abstract Objective To describe and analyse the characteristics of oral cholera vaccination campaigns; including location, target population, logistics, vaccine coverage and delivery costs. Methods We searched PubMed, the World Health Organization (WHO) website and the Cochrane database with no date or language restrictions. We contacted public health personnel, experts in the field and in ministries of health and did targeted web searches. Findings A total of 33 documents were included in the analysis. One country, Viet Nam, incorporates oral cholera vaccination into its public health programme and has administered approximately 10.9 million vaccine doses between 1997 and 2012. In addition, over 3 million doses of the two WHO pre-qualified oral cholera vaccines have been administered in more than 16 campaigns around the world between 1997 and 2014. These campaigns have either been pre-emptive or reactive and have taken place under diverse conditions, such as in refugee camps or natural disasters. Estimated two-dose coverage ranged from 46 to 88% of the target population. Approximate delivery cost per fully immunized person ranged from 0.11–3.99 United States dollars. Conclusion Experience with oral cholera vaccination campaigns continues to increase. Public health officials may draw on this experience and conduct oral cholera vaccination campaigns more frequently.

ملخص الغرض وصف خصائص حملات التطعيم بلقاحات الكوليرا الفموية وتحليلها؛ بما في ذلك الموقع والسكان المستهدفين...

Resumen Objetivo Describir y analizar las características de las campañas de vacunación oral contra el cólera, incluyendo la ubicación, la población objetivo, la logística, los costes de cobertura y la entrega de vacunas. Métodos Realizamos búsquedas en PubMed, la página web de la Organización Mundial de la salud (OMS) y la base de datos Cochrane sin restricciones de fechas ni idioma. Nos pusimos en contacto con el personal de salud pública, expertos del sector y los ministerios de salud, y realizamos búsquedas específicas en la web. Resultados Se incluyó un total de 33 documentos en el análisis. Un país, Viet Nam, incorpora vacunas orales contra el cólera en su programa de salud pública y ha administrado aproximadamente 10,9 millones de dosis de vacunas entre 1997 y 2012. Además, se han administrado más 3 de millones de dosis de las dos vacunas orales contra el cólera orales que cumplen con los requisitos de la OMS en más de 16 campañas en todo el mundo realizadas entre 1997 y 2014. Estas campañas han sido preventivas o reactivas, y se han llevado a cabo en diversas condiciones, como en campamentos de refugiados o desastres naturales. La cobertura estimada de dos dosis osciló entre el 46 y 88 % de la población objetivo. El coste aproximado del suministro por persona completamente inmunizada osciló entre 0,11 y 3,99 dólares de los Estados Unidos. Conclusión La experiencia con las campañas de vacunación oral contra el cólera sigue aumentando. Los funcionarios de salud pública pueden aprovechar esta experiencia y realizar campañas de vacunación orales contra el cólera con mayor frecuencia.

The insulin-like growth factor system (insulin-like growth factor 1, insulin-like growth factor 2, insulin-like growth factor 1 receptor, insulin-like growth factor 2 receptor and six insulinlike growth factor-binding proteins) and insulin are essential to muscle metabolism and most aspects of male and female reproduction. Insulin-like growth factor and insulin play important roles in the regulation of cell growth, differentiation and the maintenance of cell differentiation in mammals. In order to better understand the local factors that regulate equine physiology, such as muscle metabolism and reproduction (e.g., germ cell development and fertilisation), real-time reverse transcription polymerase chain reaction assays for quantification of equine insulin-like growth factor 1 receptor and insulin receptor messenger ribonucleic acid were developed. The assays were sensitive: 192 copies/µL and 891 copies/µL for insulin-like growth factor 1 receptor, messenger ribonucleic acid and insulin receptor respectively (95% limit of detection), and efficient: 1.01 for the insulin-like growth factor 1 receptor assay and 0.95 for the insulin receptor assay. The assays had a broad linear range of detection (seven logs for insulinlike growth factor 1 receptor and six logs for insulin receptor). This allowed for analysis of very small amounts of messenger ribonucleic acid. Low concentrations of both insulin-like growth factor 1 receptor and insulin receptor messenger ribonucleic acid were detected in endometrium, lung and spleen samples, whilst high concentrations were detected in heart, muscle and kidney samples, this was most likely due to the high level of glucose metabolism and glucose utilisation by these tissues. The assays developed for insulin-like growth factor 1 receptor and insulin receptor messenger ribonucleic acid expression have been shown to work on equine tissue and will contribute to the understanding of insulin and insulin-like growth factor 1 receptor physiology in the horse.

The metric of "bed numbers" is commonly used in hospital planning, but it fails to capture key aspects of how hospital services are delivered. Drawing on a study of innovative hospital projects in Europe, we argue that hospital capacity planning should not be based on beds, but rather on the ability to deliver processes. We propose using approaches that are based on manufacturing theory such as "lean thinking" that focuses on the value that different processes add for the primary customer, i.e. the patient. We argue that it is beneficial to look at the hospital, not from the perspective of beds or specialties, but rather from the path taken by the patients who are treated in them, the respective processes delivered by health professionals and the facilities appropriate to those processes. Systematized care pathways seem to offer one avenue for achieving these goals. However, they need to be underpinned by a better understanding of the flows of patients, work and goods within a hospital, the bottlenecks that occur, and translation of this understanding into new capacity planning tools.

El parámetro del «número de camas» se suele utilizar en la planificación hospitalaria, si bien no logra captar los aspectos clave sobre cómo se ofrecen los servicios hospitalarios. En base a un estudio sobre proyectos hospitalarios innovadores llevado a cabo en Europa, argumentamos que la planificación de los recursos hospitalarios no se debe basar en el número de camas, sino en la capacidad de ofrecer procesos. Proponemos el uso de enfoques basados en un modelo de producción como el «pensamiento Lean» que se centra en el valor sumativo de los diferentes procesos para el principal cliente, es decir, el paciente. Sostenemos que es beneficioso considerar el hospital, no desde la perspectiva de las camas o de las especialidades, sino de la trayectoria que siguen los pacientes tratados en ellos, los correspondientes procesos ofrecidos por los profesionales sanitarios y la adecuación de las instalaciones a dichos procesos. Las trayectorias asistenciales sistematizadas parecen ofrecer una vía para la consecución de estos objetivos. Sin embargo, tienen que estar respaldadas por una mejor interpretación de los flujos de pacientes, el trabajo y los productos de un hospital, los obstáculos que se producen y la traducción de esta interpretación en nuevas herramientas de planificación de los recursos.

L'unité de mesure « nombre de lits » est habituellement utilisée dans la planification hospitalière, mais elle ne rend pas compte des principaux aspects caractéristiques de la façon dont les services hospitaliers sont fournis. Mettant à profit l'expérience de projets hospitaliers innovants en Europe, nous affirmons que la planification de la capacité hospitalière doit être basée non sur le nombre de lits, mais plutôt sur la capacité à fournir les services. Nous proposons d'utiliser des approches basées sur la théorie de construction, telle la « pensée LEAN » qui met en évidence les avantages que différents processus ajoutent pour le client primaire, c.-à-d. le patient. Nous soutenons qu'il est avantageux d'évaluer l'hôpital, non en fonction du nombre de lits ou de spécialités, mais plutôt au travers du parcours entrepris par les patients qui y sont traités, les services fournis respectivement par les professionnels de santé et les structures adaptées à ces services. Les parcours de soins systématisés semblent offrir une voie prioritaire pour parvenir à ces buts. Ils nécessitent toutefois d'être soutenus par une meilleure compréhension des flux de patients, de travail et de marchandises au sein de la structure hospitalière, des goulots d'étranglement qui surviennent et d'une traduction de ces connaissances en nouveaux outils de planification.

OBJECTIVE: To compare oxygen supply options for health facilities in the Gambia and develop a decision-making algorithm for choosing oxygen delivery systems in Africa and the rest of the developing world. METHODS: Oxygen cylinders and concentrators were compared in terms of functionality and cost. Interviews with key informants using locally developed and adapted WHO instruments, operational assessments, cost-modelling and cost measurements were undertaken to determine whether oxygen cylinders or concentrators were the better choice. An algorithm and a software tool to guide the choice of oxygen delivery system were constructed. FINDINGS: In the Gambia, oxygen concentrators have significant advantages compared to cylinders where power is reliable; in other settings, cylinders are preferable as long as transporting them is feasible. Cylinder costs are greatly influenced by leakage, which is common, whereas concentrator costs are affected by the cost of power far more than by capital costs. Only two of 12 facilities in the Gambia were found suitable for concentrators; at the remaining 10 facilities, cylinders were the better option. CONCLUSION: Neither concentrators nor cylinders are well suited to every situation, but a simple options assessment can determine which is better in each setting. Nationally this would result in improved supply and lower costs by comparison with conventional cylinders alone, although ensuring a reliable supply would remain a challenge. The decision algorithm and software tool designed for the Gambia could be applied in other developing countries.

OBJETIVO: Comparar las opciones de suministro de oxígeno para centros de salud en Gambia y desarrollar un algoritmo decisional para elegir los sistemas de suministro de oxígeno en África y en el resto del mundo en desarrollo. MÉTODOS: Se compararon la funcionalidad y el costo de las bombonas y los concentradores de oxígeno. Se llevaron a cabo entrevistas con informantes clave mediante instrumentos desarrollados localmente o adaptados a partir de otros de la OMS, evaluaciones operacionales, modelizaciones de costos y mediciones de costos a fin de determinar la mejor opción entre las bombonas y los concentradores de oxígeno. Se desarrolló así un algoritmo y un instrumento de software para fundamentar la elección del sistema de suministro de oxígeno. RESULTADOS: En Gambia, los concentradores de oxígeno presentan ventajas importantes en comparación con las bombonas allí donde el suministro eléctrico es fiable; en caso contrario, la opción preferible son las bombonas, siempre y cuando sea factible transportarlas. El costo de las bombonas depende considerablemente de las fugas, un problema frecuente, mientras que el de los concentradores depende mucho más del costo de la electricidad que de los gastos de infraestructura. Sólo dos de los 12 centros de Gambia analizados reunían las condiciones idóneas para usar concentradores; en los otros diez centros, la mejor opción eran las bombonas. CONCLUSIÓN: Ni los concentradores ni las bombonas son soluciones ideales para cualquier situación, pero una simple evaluación de esas dos opciones permite determinar cuál es preferible en cada entorno. A nivel nacional, esa diferenciación se traduciría en mejoras del suministro y menores costos en comparación con el uso exclusivo de las bombonas convencionales, pero seguiría habiendo problemas para garantizar un suministro fiable. El algoritmo decisional y el instrumento de software concebidos para Gambia podrían aplicarse en otros países en desarrollo.

OBJECTIF: Comparer les options d'approvisionnement en oxygène qui s'offrent aux établissements de soins de Gambie et développer un algorithme de prise de décisions pour guider le choix des systèmes d'approvisionnement en oxygène en Afrique et dans le reste du monde en développement. MÉTHODES: Les auteurs ont comparé en termes de fonctionnalité et de coût les bouteilles et les concentrateurs d'oxygène. Ils ont interrogé des informateurs clés en utilisant des instruments d'évaluation OMS mis au point et adaptés localement et réalisé des évaluations opérationnelles, ainsi qu'une modélisation et des mesures des coûts pour déterminer le meilleur choix entre les bouteilles et les concentrateurs d'oxygène. Ils ont élaboré un algorithme et un outil logiciel pour guider la sélection du système d'approvisionnement en oxygène. RÉSULTATS: En Gambie, les concentrateurs d'oxygène présentent des avantages notables par rapport aux bouteilles lorsque l'alimentation électrique est fiable ; dans d'autres contextes, il est préférable de faire appel aux bouteilles dans la mesure où leur transport est praticable. La présence de fuites, phénomène courant, influe fortement sur le coût des bouteilles, tandis que pour les concentrateurs, les coûts énergétiques sont de loin plus importants que les coûts en capital. Sur les 12 établissements gambiens, 2 seulement avaient intérêt d'après l'étude à utiliser des concentrateurs ; pour les 10 autres, les bouteilles constituaient une meilleure option. CONCLUSION: Ni les concentrateurs, ni les bouteilles ne conviennent à toutes les situations, mais une évaluation simple des options permet de déterminer pour chaque contexte la meilleure solution. A l'échelle nationale, cette évaluation devrait conduire à une amélioration de l'approvisionnement et à une baisse des coûts par rapport à la situation où l'on utilise uniquement des bouteilles d'oxygène classiques, mais assurer un approvisionnement fiable devrait rester un défi. L'algorithme décisionnel et l'outil logiciel conçus pour la Gambie devraient être applicables dans d'autres pays en développement.

OBJECTIVE: To examine the epidemiology of match injuries in southern hemisphere professional rugby union and assess the impact of the International Rugby Board (IRB) Experimental Law Variations. SETTING: One-season whole population prospective cohort. SUBJECTS: Twenty-seven teams (813 players) taking part in the 2008 Super 14 and Vodacom Cup competitions. OUTCOME MEASURES: Incidence, severity, location, type and cause of injury. RESULTS: The incidence in the Super 14 competition (96.3 injuries/1 000 player-match hours; 95% confidence interval (CI) 69.0 - 111.7) was significantly higher (p=0.003) than that in the Vodacom Cup (71.2; CI 60.0 - 84.5); injury severity was significantly lower (p<0.001) in the Super 14 (mean 13.4 days; median 5) than the Vodacom Cup (mean 21.2; median 12). There were no significant differences between the two competitions in type or location of injury: lower limb muscle/ tendon (Super 14: 27.8%; Vodacom Cup: 25.7%) and joint (non-bone)/ligament (Super 14: 18.8%; Vodacom Cup: 24.3%) were the most common injuries. Injury causation was similar for the two competitions but there were significantly fewer ruck/maul (p=0.001) and more tackled (p=0.010) injuries in Super 14 compared with English Premiership rugby and fewer collision (p=0.002) and more tackling (p<0.001) injuries compared with Rugby World Cup. In the Vodacom Cup, there were significantly more tackling (p<0.001) injuries compared with Rugby World Cup. CONCLUSION: The incidence, nature and causes of injuries in southern hemisphere professional club rugby played under IRB Experimental Law Variations were similar to those for professional club rugby in the northern hemisphere and Rugby World Cup played under the previous Laws of Rugby.

As estimativas atuais sugerem que mais de 1 bilhão de pessoas apresentam sobrepeso e 300 milhões são obesas. O ganho de peso representa um desequilíbrio entre o gasto energético e o consumo alimentar. Esta revisão discute o controle hipotalâmico do apetite e destaca os pontos-chave no desenvolvimento de pesquisas para ampliar o nosso entendimento dos complexos mecanismos envolvidos nesta regulação. Núcleos situados no hipotálamo integram uma série de sinais com o sistema nervoso central controlando a ingestão alimentar e o gasto energético. As vias mais estabelecidas envolvem os neurônios orexigênicos NPY/AgRP e os neurônios anorexigênicos POMC/CART no núcleo arqueado (ARC) do hipotálamo. Esses neurônios se projetam do ARC para outros importantes núcleos hipotalâmicos, tais quais: paraventricular, dorsomedial, ventromedial e lateral. Além disso, existem várias projeções que vão e vem do tronco cerebral, das áreas corticais e das vias de retroalimentação que modulam o consumo alimentar.

Current estimates suggest that over 1 billion people are overweight and over 300 million people are obese. Weight gain is due to an imbalance between energy expenditure and dietary intake. This review discusses the hypothalamic control of appetite and highlights key developments in research that have furthered our understanding of the complex pathways involved. Nuclei within the hypothalamus integrate peripheral signals such as adiposity and caloric intake to regulate important pathways within the central nervous system controlling food intake and energy expenditure. Firmly established pathways involve the orexigenic NPY/AgRP and the anorexigenic POMC/CART neurons in the arcuate nucleus (ARC) of the hypothalamus. These project from the ARC to other important hypothalamic nuclei, including the paraventricular, dorsomedial, ventromedial and lateral hypothalamic nuclei. In addition there are many projections to and from the brainstem, cortical areas and reward pathways, which modulate food intake.

Resumo Examinamos a afinidade pelo oxigênio do sangue total e intacto de representantes de 40 gêneros de peixes da Amazônia. Foram considerados todos os peixes de respiração aérea e branquial e nenhuma diferenciação na afinidade pelo oxigênio pode ser distinguível, embora nos dois casos de espécies próximas i, e. Osteoglossum de respiração branquial versus Arapaima de respiração aérea e Hoplias de respiração branquial versus Hoplerythrinus de respiração aérea; os de respiração aérea têm o sangue com mais afinidade pelo oxigênio do que os de respiração branquial. Significativas diferenças na afinidade pelo oxigênio foram encontradas quando foram considerados o habitat dos peixes: as afinidades pelo oxigênio foram em geral correlacionadas com o oxigênio disponível no meio ambiente e as demandas relativas de oxigênio dos peixes.

Summary We have examined the oxygen-affinity of the fresh, whole blood from representatives of 40 genera of Amazonian fishes. When all the air breathnig fishes and all the water breathing fishes were considered, no differentiation in oxygen affinity could be distinguished, although in two cases of closely related species i.e. Osteoglossum, a water breather, versus Arapaima, an air breather, and Hoplias, a water breather, versus Hoplerythrinus, an air breather; the air breathers have bloods with lower oxygen affinity than do the water breathers. Significant differences in the oxygen affinity were fround when fishes were considered by habitat: the oxygen affinities were in general correlated with available environmental oxygen and relative oxygen demand of the fishes.