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There is a wide range of feed additives deliberately designed to be used in sheep diets that can improve production performance. Whereas herbal supplementation is gaining popularity not only for improving sheep productivity and mutton quality but also for safe application without any harmful residual effects. The present study was designed to investigate the effect of plantain (Plantago lanceolata L.) and/or garlic leaf (Allium sativum) dietary supplementation on growth performance, immunity, rumen histology, serum antioxidants and meat quality of sheep. The experiment consisted of a completely randomized design with 32 one-year-old sheep (initial mean live weight 9 ± 0.2 kg) allocated to four groups (8 sheep per group). Rice straw and concentrates-based total mixed ration pellets (2390 kcal/kg DM, CP = 15.1%) were offered as a control diet (CL diet). Herbal treatment diets included (i) CL diet + 10 g DM of plantain herb (PL diet), (ii) CL diet + 10 g DM of garlic leaf (GL diet) and (iii) CL diet + 5 g DM of PL and 5 g DM of GL (PG diet). Compared with the CL diet group, the live weight gain and feed conversion ratio were 18% to 26% and 13% to 20% higher in herbal-supplemented groups, respectively. Moreover, the herbal-supplemented groups, especially the PL diet group had higher serum immunoglobulin concentration, antioxidant capacity and rumen papillae size compared to the control. Besides, the lowest caul fat and pelvic fat levels were observed in the PL diet group followed by PG, GL and CL diet groups. In addition, lower mutton ether extract and saturated fatty acid along with higher polyunsaturated fatty acid levels were found in all herbal-supplemented groups. In conclusion, dietary supplementation with PL and/or GL might be used as an alternative in sheep to promote growth, health status and lean mutton production.Objective To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects. Design All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter. Results Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Cediranib purchase Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p less then 0.01), incomplete right bundle branch block (p less then 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts. Conclusions Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.Idiopathic dilatation of the right atrium is an isolated enlargement of the right atrium in the absence of other cardiac lesions. This rare anomaly has a clinical spectrum ranging from asymptomatic to heart failure or even sudden death. It can be associated with atrial arrhythmias and thrombus formation. Antiplatelet therapy is prescribed in most cases reported in the literature, and reduction plasty is indicated when there is rapid growth of the right atrium, compression of adjacent structures, or refractory arrhythmias. We report four cases of idiopathic dilatation of the right atrium diagnosed during prenatal screening. We describe the intrauterine course and management in postnatal life until early childhood.Background Dementia guidelines propose the use of nonpharmacological interventions for sleep disturbances for older people. Based on available reviews, it seems most likely that multicomponent interventions have the strongest potential to be effective in improving sleep. However, a detailed description of multicomponent interventions is missing. This systematic review aims to identify, describe, and summarize multicomponent, nonpharmacological interventions to reduce or avoid sleep disturbances in nursing home residents. Methods This review followed established methodological frameworks for systematic evidence syntheses. A computerized search was conducted in December 2018, using the databases PubMed, CINAHL, Scopus, and Cochrane Library. Two independent reviewers assessed all search results to identify eligible studies and assessed studies' methodological quality following the Cochrane Risk of Bias methodology for randomized controlled trials and the CASP Appraisal Checklist for controlled trials.Evaluation s. Conclusions The analysis of included interventions demonstrates somehow promising results, although findings are difficult to interpret as interventions were not well described, and the challenges of developing and evaluating complex interventions were not sufficiently acknowledged.The Diamond Princess cruise ship, carrying 3711 passengers and crew members, docked at Yokohama Port in Japan on February 3, 2020. A quarantine was immediately instituted because 1 passenger who had disembarked in Hong Kong was confirmed to have tested positive for coronavirus disease 2019 (COVID-19). After the quarantine began, all passengers and crew were tested using the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction assay on the ship, 696 of whom tested positive. In total, 769 patients, including 696 with COVID-19, required transport to a hospital. The Japan Disaster Medical Assistance Team (DMAT) successfully picked up and safely transported the COVID-19 patients using a novel classification system to prioritize patients. The Japan DMAT transported 203 patients to hospitals in Kanagawa and another 566 patients to hospitals in 15 different prefectures.

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