Efficacy of life goals collaborative care for bipolar disorder: A systematic review

BACKGROUND

Bipolar disorder remains a disabling mental health condition despite the availability of effective treatments. Collaborative chronic care models (CCMs) represent an evidence-based way to structure care for conditions like bipolar disorder. Life Goals Collaborative Care (LGCC) was designed specifically for bipolar disorder, featuring psychoeducation alongside collaborative components (e.g. nurse care management or expert psychiatric consultation). Despite the use of Life Goals across health systems, a systematic review summarizing its effectiveness has never been conducted.

METHODS

We conducted a systematic review of randomized controlled trials (RCTs) of LGCC through December 2023 to help guide the field in treating bipolar disorder (PROSPERO: #404581). We evaluated study quality and outcomes in several symptom and quality of life domains.

RESULTS

Ten articles describing eight studies met inclusion criteria. All studies featured group-based LGCC; most were compared to treatment as usual (TAU). Three of eight studies found LGCC to be associated with statistically significant effects for the prevention of manic episodes. Most studies finding positive effects featured additional collaborative care components beyond psychoeducation and were conducted in capitated healthcare systems.

LIMITATIONS

Limitations include: several types of potential bias in included studies; exclusion of observational studies of LGCC; lack of generalizability to pediatric populations; insufficient studies to conduct subgroup analyses; and low confidence in the quality of the evidence.

CONCLUSIONS

In this systematic review, group-based LGCC demonstrated some positive effects for reducing mania recurrence; results for other outcome domains were equivocal. Future studies should investigate one-on-one LGCC, both in person and virtually, to enhance well-being for people with bipolar disorder.

Sustaining the collaborative chronic care model in outpatient mental health: a matrixed multiple case study

BACKGROUND

Sustaining evidence-based practices (EBPs) is crucial to ensuring care quality and addressing health disparities. Approaches to identifying factors related to sustainability are critically needed. One such approach is Matrixed Multiple Case Study (MMCS), which identifies factors and their combinations that influence implementation. We applied MMCS to identify factors related to the sustainability of the evidence-based Collaborative Chronic Care Model (CCM) at nine Department of Veterans Affairs (VA) outpatient mental health clinics, 3-4 years after implementation support had concluded.

METHODS

We conducted a directed content analysis of 30 provider interviews, using 6 CCM elements and 4 Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) domains as codes. Based on CCM code summaries, we designated each site as high/medium/low sustainability. We used i-PARIHS code summaries to identify relevant factors for each site, the extent of their presence, and the type of influence they had on sustainability (enabling/neutral/hindering/unclear). We organized these data into a sortable matrix and assessed sustainability-related cross-site trends.

RESULTS

CCM sustainability status was distributed among the sites, with three sites each being high, medium, and low. Twenty-five factors were identified from the i-PARIHS code summaries, of which 3 exhibited strong trends by sustainability status (relevant i-PARIHS domain in square brackets): "Collaborativeness/Teamwork [Recipients]," "Staff/Leadership turnover [Recipients]," and "Having a consistent/strong internal facilitator [Facilitation]" during and after active implementation. At most high-sustainability sites only, (i) "Having a knowledgeable/helpful external facilitator [Facilitation]" was variably present and enabled sustainability when present, while (ii) "Clarity about what CCM comprises [Innovation]," "Interdisciplinary coordination [Recipients]," and "Adequate clinic space for CCM team members [Context]" were somewhat or less present with mixed influences on sustainability.

CONCLUSIONS

MMCS revealed that CCM sustainability in VA outpatient mental health clinics may be related most strongly to provider collaboration, knowledge retention during staff/leadership transitions, and availability of skilled internal facilitators. These findings have informed a subsequent CCM implementation trial that prospectively examines whether enhancing the above-mentioned factors within implementation facilitation improves sustainability. MMCS is a systematic approach to multi-site examination that can be used to investigate sustainability-related factors applicable to other EBPs and across multiple contexts.

A Systematic Review of Lethal Means Safety Counseling Interventions: Impacts on Safety Behaviors and Self-Directed Violence

For lethal means safety counseling interventions (LMSC) to reduce population-level suicide rates, interventions must be deployed across many settings and populations. We conducted a systematic search in six databases to review the current state of LMSC interventions across study designs, settings, messengers, populations, and injury prevention levels (e.g., universal). Eligibility criteria were: any individual or group receiving a LMSC intervention involving a human-to-human component aiming to influence adult behaviors related to lethal suicide methods, and outcome assessment of storage behaviors and/or suicidal self-directed violence (SDV). Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool. A descriptive synthesis approach was used for analysis. Twenty-two studies were included that reported medication and/or firearm storage behaviors and/or SDV following LMSC. Fourteen of the 19 studies assessing behavioral change reported a significant improvement in safe storage behaviors, and all studies measuring acceptability reported that participants found the interventions favorable. Quality of evidence was limited. No studies were rated low risk of bias, and 77% were rated high risk of bias. There was substantial heterogeneity in the settings, populations, injury prevention levels, delivery methods, and intervention elements. Many included studies focused on caregivers of pediatric populations, and few studies assessed SDV outcomes. Higher quality trials conducted across a variety of settings, particularly those focusing on adults at risk of suicide, are needed. There was no funding for this review, and it was preregistered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42021230668).

Adaptation for sustainability in an implementation trial of team-based collaborative care

Background

Sustaining healthcare interventions once they have been implemented is a pivotal public health endeavor. Achieving sustainability requires context-sensitive adaptations to evidence-based practices (EBPs) or the implementation strategies used to ensure their adoption. For replicability of adaptations beyond the specific setting in question, the underlying logic needs to be clearly described, and adaptations themselves need to be plainly documented. The goal of this project was to describe the process by which implementation facilitation was adapted to improve the uptake of clinical care practices that are consistent with the collaborative chronic care model (CCM).

Method

Quantitative and qualitative data from a prior implementation trial found that CCM-consistent care practices were not fully sustained within outpatient general mental health teams that had received 1 year of implementation facilitation to support uptake. We undertook a multistep consensus process to identify adaptations to implementation facilitation based on these results, with the goal of enhancing the sustainability of CCM-based care in a subsequent trial. The logic for these adaptations, and the resulting adaptations themselves, were documented using two adaptation-oriented implementation frameworks (the iterative decision-making for evaluation of adaptations [IDEA] and the framework for reporting adaptations and modifications to evidence-based implementation strategies [FRAME-IS], respectively).

Results

Three adaptations emerged from this process and were documented using the FRAME-IS: (a) increasing the scope of implementation facilitation within the medical center, (b) having the internal facilitator take a greater role in the implementation process, and (c) shortening the implementation timeframe from 12 to 8 months, while increasing the intensity of facilitation support during that time.

Conclusions

EBP sustainability may require careful adaptation of EBPs or the implementation strategies used to get them into routine practice. Recently developed frameworks such as the IDEA and FRAME-IS may be used to guide decision-making and document resulting adaptations themselves. An ongoing funded study is investigating the utility of the resulting adaptations for improving healthcare.

Effect of heat treatment on protein quality of rapeseed protein isolate compared with non-heated rapeseed isolate, soy and whey protein isolates, and rice and pea protein concentrates

BACKGROUND

Rapeseed protein isolate is used in the food industry, and heating is often used during rapeseed processing. However, the digestible indispensable amino acid score (DIAAS) for heat-treated rapeseed protein isolate is unknown. The present study aimed to test the hypothesis that heating rapeseed protein isolate improves protein quality resulting in DIAAS that is greater than for pea and rice protein concentrates, and comparable to that of soy and whey protein isolates.

RESULTS

Standardized ileal digestibility (SID) of amino acids (AA), except leucine and methionine, was not different between heat-treated rapeseed protein isolate and soy protein isolate, but SID of most AA was greater (P < 0.001) for heat-treated rapeseed protein isolate than for brown rice protein concentrate, pea protein concentrate, rapeseed protein isolate and soy protein isolate, but not whey protein isolate. Non-heated rapeseed protein isolate had a reduced (P < 0.001) DIAAS for 6-month-old to 3-year-old children compared with soy protein isolate, but this was greater (P < 0.001) than for pea and brown rice protein concentrates. The DIAAS for heat-treated rapeseed protein isolate was greater (P < 0.001) than for non-heated rapeseed protein isolate for all age groups. Heat-treated rapeseed protein isolate and whey protein isolate had a DIAAS > 100 for individuals older than 3 years.

CONCLUSION

Rapeseed protein isolate had a DIAAS comparable to soy protein isolate, but heat-treated rapeseed protein isolate and whey protein isolate had DIAAS ≥ 100, qualifying these proteins as 'excellent'. Rice and pea protein concentrates had DIAAS < 75. © 2023 Society of Chemical Industry.

Myalgic Encephalomyelitis-Chronic Fatigue Syndrome Common Data Element item content analysis

INTRODUCTION

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a multisystem chronic disease estimated to affect 836,000-2.5 million individuals in the United States. Persons with ME/CFS have a substantial reduction in their ability to engage in pre-illness levels of activity. Multiple symptoms include profound fatigue, post-exertional malaise, unrefreshing sleep, cognitive impairment, orthostatic intolerance, pain, and other symptoms persisting for more than 6 months. Diagnosis is challenging due to fluctuating and complex symptoms. ME/CFS Common Data Elements (CDEs) were identified in the National Institutes of Health (NIH) National Institute of Neurological Disorders and Stroke (NINDS) Common Data Element Repository. This study reviewed ME/CFS CDEs item content.

METHODS

Inclusion criteria for CDEs (measures recommended for ME/CFS) analysis: 1) assesses symptoms; 2) developed for adults; 3) appropriate for patient reported outcome measure (PROM); 4) does not use visual or pictographic responses. Team members independently reviewed CDEs item content using the World Health Organization International Classification of Functioning, Disability and Health (ICF) framework to link meaningful concepts.

RESULTS

119 ME/CFS CDEs (measures) were reviewed and 38 met inclusion criteria, yielding 944 items linked to 1503 ICF meaningful concepts. Most concepts linked to ICF Body Functions component (b-codes; n = 1107, 73.65%) as follows: Fatiguability (n = 220, 14.64%), Energy Level (n = 166, 11.04%), Sleep Functions (n = 137, 9.12%), Emotional Functions (n = 131, 8.72%) and Pain (n = 120, 7.98%). Activities and Participation concepts (d codes) accounted for a smaller percentage of codes (n = 385, 25.62%). Most d codes were linked to the Mobility category (n = 69, 4.59%) and few items linked to Environmental Factors (e codes; n = 11, 0.73%).

DISCUSSION

Relatively few items assess the impact of ME/CFS symptoms on Activities and Participation. Findings support development of ME/CFS-specific PROMs, including items that assess activity limitations and participation restrictions. Development of psychometrically-sound, symptom-based item banks administered as computerized adaptive tests can provide robust assessments to assist primary care providers in the diagnosis and care of patients with ME/CFS.

Inclusion of spray dried plasma in diets based on different ingredient combinations increases the digestibility of energy, fiber, Ca, and P by young pigs

An experiment was conducted to test the hypothesis that inclusion of spray dried plasma (SDP) in diets increases apparent total tract digestibility (ATTD) and/or the standardized total tract digestibility (STTD) of gross energy (GE) and nutrients in diets for young pigs, and that ATTD of energy and nutrients or STTD of P in individual ingredients are additive in diets containing SDP. Eighty barrows (body weight: 9.30 ± 0.97 kg) were housed in individual metabolism crates and allotted to 1 of 10 diets in a randomized complete block design with 8 replicate pigs per diet. Four diets were prepared without SDP and contained ingredients commonly used in the U.S.A., Canada, the European Union, or Asia. Four additional diets were prepared by mixing 94% of the previous 4 diets and 6% SDP. A diet containing SDP as the sole source of P and a P-free diet were also formulated. The ATTD of GE and nutrients and the STTD of P were calculated in all diets except the P-free diet and for the four regional diets containing 6% SDP, values were also predicted from the digestibility obtained in SDP alone and the regional diets without SDP. Differences between measured and predicted values for digestibility of GE and nutrients were also calculated. An interaction was observed between SDP and region for the ATTD of soluble dietary fiber where the digestibility decreased (P &lt; 0.05) for pigs fed the U.S.A. diet with 6% SDP compared with 0% SDP, but that was not the case for the other regional diets. There was no interaction for the ATTD of GE, N, insoluble dietary fiber (IDF), total dietary fiber (TDF), Ca, and P or the STTD of P, but the ATTD and STTD values were greater (P &lt; 0.05) or tended to be greater (P &lt; 0.10%) when 6% SDP was included in the diet compared with diets with 0% SDP. The ATTD of GE, IDF, TDF, and P, and the STTD of P was greater (P &lt; 0.05) for the Asia diet compared with the other diets regardless of inclusion of SDP. The measured ATTD of IDF and TDF was greater (P &lt; 0.05) than the predicted values for the U.S.A. and European Union diets, and the measured ATTD of GE, N, Ca, and P and the STTD of P was greater (P &lt; 0.05) than the predicted values for the Asia diet. In conclusion, addition of 6% SDP to a diet will increase the ATTD of energy and nutrients and the STTD of P in diets for weanling pigs, and in some cases, the measured ATTD of energy and nutrients or the STTD of P by pigs fed diets containing SDP is greater than predicted from individual ingredients.

No carryover effect of feeding spray dried plasma to weanling pigs in phase 1 on energy and nutrient digestibility in phase 2 were observed

Spray dried plasma (SDP) is commonly used in phase 1 diets for weanling pigs, but it is unknown if SDP affects energy or nutrient digestibility of the subsequent diet. Therefore, two experiments were conducted to test the null-hypothesis that inclusion of SDP in a phase 1 diet fed to weanling pigs will not affect energy or nutrient digestibility of a phase 2 diet without SDP. In experiment 1, 16 newly weaned barrows with an initial body weight (BW) of 4.47 ± 0.35 kg were randomly allotted to a phase 1 diet without SDP or a diet including 6% SDP for 14 d. Both diets were fed on an ad libitum basis. All pigs (BW: 6.92 ± 0.42 kg) had a T-cannula surgically inserted in the distal ileum, moved to individual pens, and fed the common phase 2 diet for 10 d with ileal digesta collection on days 9 and 10. In experiments 2, 24 newly weaned barrows (initial BW: 6.60 ± 0.22 kg) were randomly allotted to phase 1 diets without SDP or a diet containing 6% SDP for 20 d. Both diets were provided on an ad libitum basis. All pigs (BW: 9.37 ± 1.40 kg) were then moved to individual metabolism crates and fed the common phase 2 diet for 14 d with the initial 5 d being the adaptation period to the diet followed by 7 d of fecal and urine collection according to the marker-to-marker procedure. The apparent ileal digestibility (AID) of starch, crude protein (CP), amino acids (AA), and acid hydrolyzed ether extract (AEE), was determined in experiment 1, and the apparent total tract digestibility (ATTD) of gross energy (GE), insoluble-, soluble-, and total-dietary fiber, Ca, and P, and the retention and biological value of N were determined in experiment 2. The statistical model included diet as fixed effect and block and pig within block as random effects. Results of experiment 1 indicated that the AID of starch, CP, AEE, and AA in phase 2 were not affected by phase 1 treatment. Results of experiment 2 indicated that the ATTD of GE, insoluble-, soluble-, and total-dietary fiber, Ca, and P and N retention and biological value in phase 2 were also not affected by phase 1 treatment. In conclusion, feeding weanling pigs a diet with 6% SDP in phase 1 did not affect the AID or ATTD of energy and nutrients in a phase 2 diet without SDP.

Sustainability of the Collaborative Chronic Care Model in Outpatient Mental Health Teams Three Years Post-Implementation: A Qualitative Analysis

Our goal was to investigate the sustainability of care practices that are consistent with the collaborative chronic care model (CCM) in nine outpatient mental health teams located within US Department of Veterans Affairs (VA) medical centers, three to four years after the completion of CCM implementation. We conducted qualitative interviews (N = 30) with outpatient mental health staff from each of the nine teams. We based our directed content analysis on the six elements of the CCM. We found variable sustainability of CCM-based care processes across sites. Some care processes, such as delivery of evidence-based psychotherapies (EBPs) and use of measurement-based care (MBC) to guide clinic decision-making, were robustly maintained or even expanded within participating teams. In contrast, other care processes-which had in some cases been developed with considerable effort-had not been sustained. For example, care manager roles were diminished in scope or eliminated completely in response to workload pressures, frontline care needs, or the COVID-19 pandemic. Similarly, processes for engaging Veterans more fully in decision-making had generally been scaled back. Leadership support in the form of adequate team staffing and time to conduct team meetings were seen as crucial for sustaining CCM-consistent care. Given the potential impact of leadership turnover on sustainability in mental health, future efforts to implement CCM-based mental health care should strive to involve multiple leaders in implementation and sustainment efforts, lest one key departure undo years of implementation work. Our results also suggest that implementing CCM processes may best be conceptualized as a partnership across multiple levels of medical center leadership.

Impact of the Early COVID-19 Pandemic on Burn Care: A Multi-National Study

This qualitative study documents and analyzes COVID-19’s impacts on burn care in twelve nations. Burn care saw valuable improvements in surgical techniques, skin grafting, and other acute treatments during the decades before the COVID-19 pandemic which increased severely burned patients’ survival rates and quality of life. Detailed interviews, conducted in the 12 nations reveal that the COVID-19 pandemic greatly affected the delivery of acute and rehabilitation services for burn patients. Resources have been suctioned away from non-COVID healthcare and burn care has not been spared. Acute, post-acute rehabilitation, and mental health services have all suffered. Weak preparation has deeply burdened health care services in most nations, resulting in lower access to care. Access problems have accelerated innovations like telehealth in many nations. The spread of misinformation through social and traditional media has contributed to the varied responses to COVID-19. This compounded problems in health care delivery. Burn care providers delivered services for survivors during extremely difficult circumstances by continuing to furnish acute and long-term services for patients with complex disease. Emphasis on future pandemic preparedness will be vital because they undermine all aspects of burn care and patient outcomes. As the COVID-19 pandemic continues to unfold around the world, it will be important to continue to monitor and analyze the adaptability of nations, health care systems, and burn care providers.

136 Optimum Concentration of Spray Dried Plasma for Maximized Growth Performance, Improved Intestinal Health, and Reduced Inflammation in Weaned Pigs Housed in a Challenged Environment

This study aimed at testing the hypothesis that greater inclusion of spray dried plasma (SDP) in diets improves growth performance, intestinal morphology, and reduces inflammation in weaned pigs. Four-hundred weaned pigs (body weight: 6.05 ± 0.80 kg) were allotted to a randomized complete block design with 5 diets and 2 blocks (16 pens/diet; 5 pigs/pen). Pens were not cleaned between groups to create a sanitation challenge. Phase-1 diets containing 0, 2, 4, 6, or 8% SDP were formulated. One pig per pen was sacrificed on d 14 and samples of intestinal tissue and mucosa were collected. Data were analyzed using PROC MIXED of SAS and linear, quadratic, and cubic contrast statements were used. During phase-1, ADG, ADFI, G:F, and body weight of pigs on d 14 increased (linear, P &lt; 0.05) with increasing levels of SDP in the diet (Table 1). Villus width in the jejunum of pigs on d 14 tended to increase (linear, P &lt; 0.10) with increasing inclusion of SDP (Table 2), and villus height:crypt depth tended to increase (quadratic, P &lt; 0.10) with the greatest value observed for pigs fed a diet with 8% SDP. Secretory immunoglobulin A in the jejunal mucosa was decreased when 4 or 8% SDP was included in the diet (cubic, P &lt; 0.05). Interleukin- (IL-) 2 (quadratic, P &lt; 0.10) and IL-18 (cubic, P &lt; 0.10) in the jejunal mucosa tended to decrease at 8% inclusion of SDP and IL-8 (linear, P &lt; 0.10) tended to increase as SDP inclusion increased in the diet. In conclusion, the optimal inclusion of SDP in diets for weanling pigs was 8% as indicated by improvements in growth performance, but the collective intestinal morphology and health data do not result in a clearly conclusive optimum concentration in SDP.

137 Inclusion of Spray Dried Plasma in Diets Based on Different Ingredient Combinations Increases the Digestibility of Energy, Fiber, Ca, and P by Young Pigs

An experiment was conducted to test the hypothesis that spray dried plasma (SDP) increases the apparent total tract digestibility (ATTD) of gross energy (GE), nitrogen (N), total dietary fiber (TDF), Ca, and P and the standardized total tract digestibility (STTD) of P from other ingredients in diets for young pigs. Eighty barrows (body weight: 9.30 ± 0.97 kg) housed in metabolism crates were allotted to a randomized complete block design with 10 diets and 2 blocks. Diets typically used in 4 regions using combinations of corn, soybean meal, wheat, barley, or rice were formulated: U.S.A., European Union, Canada, and Asia, and included 0 or 6% SDP. Differences between measured and predicted values for ATTD and STTD of energy and nutrients in diets with SDP were calculated. Data were analyzed using PROC MIXED of SAS as a 2 × 4 factorial with 2 SDP levels and 4 regions. When 6% SDP was included in the diet, ATTD and STTD values, except TDF, were increased (P &lt; 0.05) compared with diets without SDP (Table 1). The ATTD of GE, TDF, and P and the STTD of P was greater (P &lt; 0.05) for the Asia diet compared with the other diets. The measured ATTD of TDF was greater (P &lt; 0.05) than the predicted for the U.S.A. and European Union diets (Table 2), and the measured ATTD of GE, N, Ca, and P and STTD of P was greater (P &lt; 0.05) than the predicted for the Asia diet compared with the other diets. In conclusion, addition of 6% SDP to a diet increases the ATTD of energy and nutrients and the STTD of P regardless of diet composition, and therefore, the actual ATTD of energy and nutrients and the STTD of P in diets with SDP may be greater than predicted.

Physical Rehabilitation and Mental Health Care after Burn Injury: A Multi-Nation Study

While remarkable improvements have been made to acute hospital burn care in recent decades, it is not matched by improvements in post-acute care, including physical rehabilitation and mental health. Progress in acute hospital treatment of burn survivors now highlights the next important step-addressing care once a patient leaves intensive treatment and is discharged to the community. Long-term physical rehabilitation and mental health services are vital to improving quality of life for burn survivors. Using qualitative methods, we apply the adapted Reeve framework to assess and compare post-acute physical rehabilitation and mental health care across thirteen countries on six continents. Twenty semi-structured interviews were conducted with burn surgeons and rehabilitation specialists. One major theme that emerged was the importance of training and resources to the quality of post-acute care. This exploratory study suggests the value of investing scarce resources in a range of low-cost interventions to improve follow-up burn care. One intervention identified here is short-term training in post-acute rehabilitation and mental health to upgrade and standardize best clinical practices to address as-yet unmet post-discharge needs of burn survivors.

Digestible indispensable amino acid score (DIAAS) is greater in animal-based burgers than in plant-based burgers if determined in pigs

PURPOSE

Determine digestible indispensable amino acid score (DIAAS) for animal- and plant-based burgers and test the hypothesis that DIAAS calculated for a burger and a burger bun is additive in a combined meal.

METHODS

Ten ileal cannulated gilts were fed experimental diets for six 9-d periods with ileal digesta being collected on d 8 and 9 of each period. Six diets contained a burger (i.e., 80% lean beef, 93% lean beef, 80% lean pork, Impossible Burger, or Beyond Burger) or a burger bun as the sole source of crude protein and amino acids. Three additional diets were based on a combination of the bun and 80% beef, pork, or Impossible Burger. A nitrogen-free diet was also used. The DIAAS for all ingredients and mixed meals was calculated for children from 6 months to 3 years and for individuals older than 3 years, and DIAAS for combined meals was predicted from individual ingredient DIAAS.

RESULTS

The 93% lean beef and the pork burgers had greater (P < 0.05) DIAAS than the plant-based burgers for both age groups. The 80% lean beef burger had greater (P < 0.05) DIAAS than the plant burgers for children from 6 months to 3 years, and greater (P < 0.05) DIAAS than the Beyond Burger for individuals older than 3 years. There were no differences between the measured and predicted DIAAS.

CONCLUSIONS

The protein quality of animal-based burgers is greater than that of plant-based burgers. However, for individuals older than 3 years, the Impossible Burger has comparable protein quality to the 80% lean beef burger. The DIAAS obtained from individual foods is additive in mixed meals.

216 Effect of Spray Dried Plasma on the Standardized Ileal Digestibility of Crude Protein and Amino Acids in Diets Based on Different Ingredient Combinations Fed to Young Pigs

An experiment was conducted to test the hypothesis that spray dried plasma (SDP) increases the standardized ileal digestibility (SID) of CP and AA from other ingredients in diets for young pigs, which may result in a lack of additivity in such diets. Thirty ileal cannulated barrows (body weight: 9.30 ± 0.63 kg) were randomly allotted to a triplicated 10 × 3 Youden square design with 10 diets and three 7-d periods. Diets from four regions were formulated: the U.S.A. [corn-soybean meal (SBM)-based diet], the European Union (corn-wheat-barley-SBM-based diet), Canada (wheat-barley-SBM-fermented SBM-based diet), and Asia (corn-rice-SBM-fermented SBM-based diet). Diets from each region contained 0 or 6% SDP. Differences between measured and predicted SID of CP and AA in diets with SDP were calculated. Data were analyzed using PROC MIXED of SAS as a 2 × 4 factorial with 2 levels of SDP and 4 regions. There was an SDP by region interaction for the measured SID of CP and all AA, except Lys (Table 1). When SDP was added to the U.S.A, the European Union, and Asia diets, the SID of CP and AA was not increased. The SID of CP and AA, except Lys, was greater (P &lt; 0.05) in the Canada diet with SDP than without SDP. The measured SID of CP and AA was consistent with predicted values for the European Union and Asia diets (Table 2). The measured SID of Trp was less (P &lt; 0.05) than predicted for the U.S.A. diet, and the measured SID of CP and all indispensable AA was greater (P &lt; 0.05) than predicted in the Canada diet. In conclusion, addition of 6% SDP to wheat-barley-based diets may increase SID of CP and AA, and therefore, the SID of CP and AA in diets containing SDP may be greater than predicted.

Values for Digestible Indispensable Amino Acid Score (DIAAS) Determined in Pigs Are Greater for Milk Than for Breakfast Cereals, but DIAAS Values for Individual Ingredients Are Additive in Combined Meals

BACKGROUND

Breakfast cereals contain low-quality proteins and are often consumed with milk. The digestible indispensable amino acid score (DIAAS) has been used to evaluate protein quality, but it is not known if DIAAS obtained in individual foods is additive in combined meals.

OBJECTIVES

The following hypotheses were tested: amino acids (AAs) in milk complement AAs in breakfast cereals to provide a balanced meal, and DIAAS in individual foods is additive in combined meals.

METHODS

Six ileal cannulated gilts [body weight mean: 55.6 ± 3.7 (SD) kg] were allotted to a 6 × 6 Latin square with six 7-d periods. Ileal digesta were collected for 9 h on days 6 and 7 of each period. Three diets contained a breakfast cereal (i.e., cornflakes or quick oats) or dry milk as the sole source of AAs. Two additional diets contained a combination of dry milk and cornflakes or quick oats. A nitrogen-free diet was also used, and DIAAS was calculated for cornflakes, quick oats, dry milk, and the 2 combined meals for children aged 6 to 36 mo and individuals older than 36 mo through adulthood. For the combined meals, DIAAS was also predicted from the individual ingredient DIAAS.

RESULTS

Dry milk had greater (P < 0.05) DIAAS (123 and 144) than quick oats (57 and 67), but cornflakes had less (P < 0.05) DIAAS (16 and 19) than the other ingredients. Both breakfast cereal-dry milk meals had DIAAS close to or greater than 100 for children aged 6 mo to 3 y and for older children, adolescents, and adults, but there were no differences between measured and predicted DIAAS.

CONCLUSIONS

The combination of milk and breakfast cereals results in a meal that is balanced in indispensable AAs for humans, and DIAAS obtained from individual ingredients is additive in mixed meals.

PSIX-2 Amino acid digestibility and digestible indispensable amino acid scores of a few protein isolates and concentrates derived from cereal grains, plant proteins, or dairy proteins

The objective of this experiment was to determine standardized ileal digestibility (SID) of amino acid (AA) and digestible indispensable amino acid scores (DIAAS) for brown rice protein concentrate (BRPC), pea protein concentrate (PPC), two rapeseed protein isolates (RSP-1 and RSP-2), soy protein isolate (SPI), and whey protein isolate (WPI). Seven cannulated barrows (36.51 ± 1.61 kg) were randomly allotted to a 7 × 7 Latin square design and fed a diet containing each protein as the sole source of AA. A nitrogen-free diet was also used. The DIAAS was calculated for children from 6-mo to 3-yr and persons &gt;3-yr. Data were analyzed using PROC MIXED of SAS in a randomized complete block design with pigs as the experimental unit. Among proteins, WPI had the greatest (P &lt; 0.05) SID of all indispensable AA (IAA), except Lys and Thr, and RSP-1 had the least (P &lt; 0.05) SID of most IAA. The SID of all AA, except Leu and Met, did not differ between RSP-2 and SPI, and the SID of all IAA, except Arg and Lys, was greater (P &lt; 0.05) for RSP-2 than for PPC and BRPC. For DIAAS (Table 1), RSP-2 was the only protein with a DIAAS greater than 100 for children 6-mo to 3-yr, and both RSP-2 and WPI had a DIAAS greater than 100 for persons &gt;3-yr. For both reference patterns, the DIAAS for RSP-2 and WPI was greater (P &lt; 0.05) than for SPI. The DIAAS for RSP-1 was less (P &lt; 0.05) than for SPI and greater (P &lt; 0.05) than for PPC, which had a DIAAS greater (P &lt; 0.05) than BRPC. In conclusion, RSP-2 resulted in an excellent quality protein for persons &gt;6-mo, and WPI is an excellent quality protein for persons &gt;3-yr.

Raw and roasted pistachio nuts (Pistacia vera L.) are 'good' sources of protein based on their digestible indispensable amino acid score as determined in pigs

BACKGROUND

Pistachio nuts may be consumed as raw nuts or as roasted nuts. However, there is limited information about the protein quality of the nuts, and amino acid (AA) digestibility and protein quality have not been reported. Therefore, the objective of this research was to test the hypothesis that raw and roasted pistachio nuts have a digestible indispensable AA score (DIAAS) and a protein digestibility corrected AA score (PDCAAS) greater than 75, thereby qualifying them as a good source of protein.

RESULTS

The standardized ileal digestibility (SID) of all indispensable AAs, except arginine and phenylalanine, was less in roasted pistachio nuts than in raw pistachio nuts (P < 0.05). Raw pistachio nuts had a PDCAAS of 73, and roasted pistachio nuts had a PDCAAS of 81, calculated for children 2-5 years, and the limiting AA in the PDCAAS calculation was threonine. The DIAAS values calculated for children older than 3 years, adolescents, and adults was 86 and 83 for raw and roasted pistachio nuts respectively. The limiting AA in both raw and roasted pistachio nuts that determined the DIAAS for this age group was lysine.

CONCLUSION

The results of this research illustrate that raw and roasted pistachio nuts can be considered a good quality protein source with DIAAS greater than 75; however, processing conditions associated with roasting may decrease the digestibility of AAs in pistachio nuts. © 2020 Society of Chemical Industry.

Pork Products Have Digestible Indispensable Amino Acid Scores (DIAAS) That Are Greater Than 100 When Determined in Pigs, but Processing Does Not Always Increase DIAAS

BACKGROUND

Raw meat contains all indispensable amino acids (IAAs), but before human consumption, meat usually undergoes some degree of processing. Processing affects the 3-dimensional structure of proteins, which may affect amino acid (AA) digestibility and, therefore, overall protein quality.

OBJECTIVES

The experiment aimed at determining digestible indispensable amino acid scores (DIAAS) for pork products, and to test the hypothesis that processing increases DIAAS.

METHODS

Ten ileal cannulated gilts (body weight: 26.63 ± 1.62 kg) were randomly allotted to a 10 × 10 Latin square design with ten 7-d periods. Ileal digesta were collected for 9 h on days 6 and 7 of each period. Nine diets contained a single pork product (i.e., raw belly, smoked bacon, smoked-cooked bacon, non-cured ham, alternatively cured ham, conventionally cured ham, and loins heated to 63°C, 68°C, or 72°C) as the sole source of AAs. A nitrogen-free diet was formulated to determine basal endogenous losses of AAs, which enabled calculation of standardized ileal digestibility (SID) of AAs. DIAAS were subsequently calculated according to the FAO.

RESULTS

All pork products had DIAAS >100 (as-is basis). Loin heated to 63°C had the greatest (P < 0.05) DIAAS for children 6 mo to 3 y and smoked-cooked bacon had the greatest (P < 0.05) DIAAS for children older than 3 y, adolescents, and adults. Raw belly, smoked bacon, and loins heated to 68°C and 72°C had a reduced (P < 0.05) DIAAS for both reference patterns compared with other proteins. Alternatively cured ham had greater (P < 0.05) DIAAS when compared with non-cured ham and conventionally cured ham.

CONCLUSIONS

Bacon, ham, and loin are excellent proteins with DIAAS >100, and processing may sometimes, but not always, increase DIAAS.

Spire stimulates nucleation by Cappuccino and binds both ends of actin filaments

The actin nucleators Spire and Cappuccino synergize to promote actin assembly, but the mechanism of their synergy is controversial. Together these proteins promote the formation of actin meshes, which are conserved structures that regulate the establishment of oocyte polarity. Direct interaction between Spire and Cappuccino is required for oogenesis and for in vitro synergistic actin assembly. This synergy is proposed to be driven by elongation and the formation of a ternary complex at filament barbed ends, or by nucleation and interaction at filament pointed ends. To mimic the geometry of Spire and Cappuccino in vivo, we immobilized Spire on beads and added Cappuccino and actin. Barbed ends, protected by Cappuccino, grow away from the beads while pointed ends are retained, as expected for nucleation-driven synergy. We found that Spire is sufficient to bind barbed ends and retain pointed ends of actin filaments near beads and we identified Spire’s barbed-end binding domain. Loss of barbed-end binding increases nucleation by Spire and synergy with Cappuccino in bulk pyrene assays and on beads. Importantly, genetic rescue by the loss-of-function mutant indicates that barbed-end binding is not necessary for oogenesis. Thus, increased nucleation is a critical element of synergy both in vitro and in vivo.

PSIII-21 Processing of food proteins of animal origin sometimes, but not always, increases values for Digestible Indispensable Amino Acid Scores

Two experiments were conducted to test the hypothesis that processing of meat proteins increases the Digestible Indispensable Amino Acid Score (DIAAS). In Exp. 1, 10 pigs (26.62 ± 1.62 kg) with a T-cannula in the distal ileum were randomly allotted to a 10 x 10 Latin square with 10 diets and ten 7-d periods. In Exp. 2, 9 cannulated pigs (35.50 ± 3.77 kg) were randomly allotted to a 9 x 8 Youden square with 9 diets and eight 7-d periods. Meat proteins (Table 1) were included in the diet as the only source of AA. The DIAAS for each meat protein was calculated using the Food and Agriculture Organization of the United Nations (FAO) established reference patterns for children 6 mo to 3 yr and older children, adolescents, and adults. Data were analyzed using PROC MIXED of SAS in a randomized complete block design with the pig as the experimental unit. In Exp. 1, all meat proteins had a DIAAS greater than 100% regardless of the reference pattern. For both reference patterns, the DIAAS for smoked-cooked bacon was greater (P < 0.05) than for raw belly and smoked bacon, the 2 cured hams had a numerically greater DIAAS than the uncured ham, and the medium loin had a greater (P < 0.05) DIAAS compared with the medium-well and well-done loins. In Exp. 2, most proteins had a DIAAS value greater than 100%. For both reference patterns, raw ground beef had a greater (P < 0.05) DIAAS than cooked ground beef, and medium ribeye roast had a greater (P < 0.05) DIAAS than medium-rare and well-done ribeye roasts. In conclusion, curing and moderate cooking may increase DIAAS, whereas grinding meat prior to some, but not all, cooking methods or overcooking may reduce the DIAAS of meat proteins.

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Aminohexyl-sepharose affinity chromatography : purification of an auxin receptor

Affinity chromatography is a widely used technique that is based on specific binding, usually between proteins and low-molecular weight ligands. It is often found that the presence of a spacer arm between the supporting matrix and the affinity ligand is beneficial to binding capacity. A convenient starting material for affinity chromatography involving carboxyl-containing ligands is aminohexyl-Sepharose, which is commercially available and contains a spacer arm; any carboxyl-containing ligand can easily be coupled to the amino group of the resin. As an example of the use of aminohexyl-Sepharose, this chapter describes the purification of a soluble auxin receptor using an affinity resin produced by derivatization of aminohexyl-Sepharose.