Optimization of process parameters for production of volatile fatty acid, biohydrogen and methane from anaerobic digestion

The anaerobic digestion process has been primarily utilized for methane containing biogas production over the past few years. However, the digestion process could also be optimized for producing volatile fatty acids (VFAs) and biohydrogen. This is the first review article that combines the optimization approaches for all three possible products from the anaerobic digestion. In this review study, the types and configurations of the bioreactor are discussed for each type of product. This is followed by a review on optimization of common process parameters (e.g. temperature, pH, retention time and organic loading rate) separately for the production of VFA, biohydrogen and methane. This review also includes additional parameters, treatment methods or special additives that wield a significant and positive effect on production rate and these products' yield.

Population-based cohort study of variation in the use of emergency cholecystectomy for benign gallbladder diseases

Background

The aims of this prospective population-based cohort study were to identify the patient and hospital characteristics associated with emergency cholecystectomy, and the influences of these in determining variations between hospitals.

Methods

Data were collected for consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing the performance of emergency cholecystectomy were analysed by means of multilevel, multivariable logistic regression modelling using a two-level hierarchical structure with patients (level 1) nested within hospitals (level 2).

Results

Data were collected on 4744 cholecystectomies from 165 hospitals. Increasing age, lower ASA fitness grade, biliary colic, the need for further imaging (magnetic retrograde cholangiopancreatography), endoscopic interventions (endoscopic retrograde cholangiopancreatography) and admission to a non-biliary centre significantly reduced the likelihood of an emergency cholecystectomy being performed. The multilevel model was used to calculate the probability of receiving an emergency cholecystectomy for a woman aged 40 years or over with an ASA grade of I or II and a BMI of at least 25·0 kg/m2, who presented with acute cholecystitis with an ultrasound scan showing a thick-walled gallbladder and a normal common bile duct. The mean predicted probability of receiving an emergency cholecystectomy was 0·52 (95 per cent c.i. 0·45 to 0·57). The predicted probabilities ranged from 0·02 to 0·95 across the 165 hospitals, demonstrating significant variation between hospitals.

Conclusion

Patients with similar characteristics presenting to different hospitals with acute gallbladder pathology do not receive comparable care.

Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages

Introduction

The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages.

Methods

Translation and cross-cultural adaptation has been carried out following the forward–backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included.

Results

The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option ‘not applicable’ was added to two items of the ASAS HI to improve appropriateness.

Discussion

This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.

Structural Variations of Nose and Paranasal Sinuses in Various Sinonasal Pathologies: Tomographic Study of 50 Cases in Bangladeshi People

The aim of this study was to determine the frequency of structural variations in nose & paranasal sinuses in computed tomography in Bangladeshi people. This retrospective study was done at the Sir Salimullah Medical College Mitford Hospital and Apollo Hospitals, Dhaka, Bangladesh. Fifty (50) CT scan of Nose and Para nasal sinuses were collected from the patients presented with different sinonasal pathologies in OPD, IPD of both hospitals from July 2013 to June 2014. The scans were reviewed for the presence of different structural variations of nose and paranasal sinuses. The age range of the patients was 25 to 65 years. The most common anatomical variation in this study was hypertrophied inferior turbinate (82%) followed by ethmoidal bulla (70%), deviated nasal septum (64%), agar nasi cell (40%), concha bullosa (38%). In most of the patients we found more than one variation. There is wide range of anatomical variations in nose and paranasal sinuses which might be regarded as the aetiological factors of different sinonasal pathologies. To maximize patients' benefit and to avoid unexpected situations during surgeries as well as dreadful complications, individualized pre-planning through tomographic study should be considered.

An improved DNA marker technique for genetic characterization using RAMP-PCR with high-GC primers

Random amplified polymorphic DNA (RAPD) is a widely used molecular marker technique. As traditional RAPD has poor reproducibility and productivity, we previously developed an improved RAPD method (termed RAMP-PCR), which increased the reproducibility, number of bands, and efficiency of studies on polymorphism. To further develop the efficiency of this method, we used high-GC content primers for improved RAMP-PCR with DNA samples from Lonicera japonica. Comparison of amplification profiles obtained by standard RAPD primers with those obtained by regular PCR and RAMP-PCR, and high-GC primers with regular PCR and RAMP-PCR showed that the average number of bands and polymorphisms per primer gradually and significantly increased (from 6.4 to 15.0 and from 4.6 to 10.2, respectively). Cluster dendrograms showed similar results, indicating that this new method is consistent and reproducible. A total of 22 samples from different species, including plants, animals, and humans, were used for RAMP-PCR with high-GC primers. Multiple bands were successfully amplified from all samples, demonstrating that this method is a reliable technique with consistent results and may be of general interest in studies on different genera and species. We developed highly effective DNA markers, which can provide a more effective and potentially valuable approach than traditional RAPD for the genetic identification of various organisms, particularly of medicinal plants.

Development of two novel specific SCAR markers by cloning improved RAPD fragments from the medicinal mushroom Ganoderma lucidium (Leysser: Fr) Karst

Development of sequence-characterized amplified region (SCAR) markers from random-amplified polymorphic DNA (RAPD) fragments is a valuable molecular approach for the genetic identification of different species. By using SCAR markers, molecular analysis is reduced to a simple polymerase chain reaction (PCR) analysis using primers designed from the amplicon sequence of RAPD. In this study, the DNA fragments from an improved RAPD amplification of Ganoderma species were cloned into a pGM-T vector; positive clones were identified by PCR amplification and enzymatic digestion, and finally, DNA fragments were sequenced using the Sanger sequencing method for developing the SCAR markers. Two SCAR markers, named LZ4-1 with 534 nucleotides, and LZ5-2 with 337 nucleotides were identified, which are specific to Ganoderma lucidium (Leysser: Fr) Karst species. BLAST of these two nucleotide sequences in the GenBank database showed no identity to other species. We deposited these sequences into the GenBank database (LZ4-1 accession No. KM391933, LZ5-2 accession No. KM391934). PCR assays confirmed them as novel molecular markers for G. lucidium (Leysser: Fr) Karst, which might be used for genetic authentication of adulterant samples. Thus, our study developed two specific SCAR markers for identifying and distinguishing the medicinal mushroom G. lucidium (Leysser: Fr) Karst from other Ganoderma species.

Clinical outcomes of the very elderly undergoing enhanced recovery programmes in elective colorectal surgery

Introduction Enhanced recovery programmes (ERPs) have been shown to improve short-term outcomes after major colorectal surgery. Benefits of the ERP in patients who are very elderly (VE) are less well understood. We aimed to evaluate the role of the ERP in the VE population, which for the purpose of this study was defined as any patient aged 75 years or over. Methods A prospectively compiled database was used to identify all patients aged ≥75 years who underwent elective colorectal resection in our unit between January 2011 and September 2012. These data were analysed to study the short-term outcomes in these patients and compared with those of patients aged <75 years. Results Overall, 352 patients underwent elective surgery during this period; 106 were identified as VE. The median length of stay (LOS) in the VE group was 7 days (5 days in non-VE group; p=0.002). Two-thirds (62%) underwent laparoscopic surgery. The median LOS of VE patients undergoing laparoscopic surgery was 6 days (11 days for open surgery; p=0.003). A third (33%) of the VE cohort was discharged by day 5. Of these patients, 85% underwent laparoscopic surgery. There was no statistical difference in overall complication rates (VE vs non-VE). Conclusions Accepting that some VE patients may stay in hospital for longer, this study supports our current policy of including everyone in the ERP regardless of age. Patients undergoing laparoscopic surgery appear to benefit, with a shorter LOS. Further large scale trials are required to support the results of this study and to identify long-term outcomes.

Comparing the value of bioproducts from different stages of anaerobic membrane bioreactors

The anaerobic digestion process in anaerobic membrane bioreactors is an effective way for waste management, energy sustainability and pollution control in the environment. This digestion process basically involves the production of volatile fatty acids and biohydrogen as intermediate products and methane as a final product. This paper compares the value of bioproducts from different stages of anaerobic membrane bioreactors through a thorough assessment. The value was assessed in terms of technical feasibility, economic assessment, environmental impact and impact on society. Even though the current research objective is more inclined to optimize the production of methane, the intermediate products could also be considered as economically attractive and environment friendly options. Hence, this is the first review study to correlate the idea into an anaerobic membrane bioreactor which is expected to guide future research pathways regarding anaerobic process and its bioproducts.

Human factors in contingency operations

The UK Defence Medical Services are currently supporting contingency operations following a period of intensive activity in relatively mature trauma systems in Iraq and Afghanistan. Among the key lessons identified, human factors or non-technical skills played an important role in the improvement of patient care. This article describes the importance of human factors on Role 2 Afloat, one of the Royal Navy's maritime contingency capabilities, and illustrates how they are vital to ensuring that correct decisions are made for patient care in a timely manner. Teamwork and communication are particularly important to ensure that limited resources such as blood products and other consumables are best used and that patients are evacuated promptly, allowing the facility to accept further casualties and therefore maintain operational capability. These ideas may be transferred to any small specialist team given a particular role to perform.

Molecular characterization of Staphylococcus aureus isolates causing skin and soft tissue infections in patients from Malakand, Pakistan

Comparatively few studies have been published describing Staphylococcus aureus/MRSA epidemiology in Central Asia including Pakistan. Here, we report the genotyping of Staphylococcus aureus strains (that include both methicillin-susceptible and methicillin-resistant Staphylococcus aureus) from community- and hospital-acquired skin and soft-tissue infections in a tertiary care hospital in the Malakand district of the Khyber Pakhtunkhwa Province of Pakistan. Forty-five isolates of Staphylococcus aureus were characterized by microarray hybridization. Twenty isolates (44 %) were MRSA, whereas 22 (49 %) were PVL-positive. Fourteen isolates (31 %) harboured both mecA and PVL genes. The dominant clones were CC121-MSSA (n = 15, 33 %) and the PVL-positive "Bengal Bay Clone" (ST772-MRSA-V; n = 13, 29 %). The PVL-positive CC8-MRSA-IV strain "USA300" was found once. The pandemic ST239-MRSA-III strain was absent, although it has previously been observed in Pakistan. These observations require a re-assessment of schemes for initial antibiotic therapy to cover MRSA and they emphasise the need for a rapid and non-molecular test for PVL.

Management and treatment outcomes of MDR-TB: results from a setting with high rates of drug resistance

SETTINGS

Although Pakistan has a high burden of multidrug-resistant tuberculosis (MDR-TB), little is known about the management and treatment outcomes of MDR-TB patients in Pakistan.

OBJECTIVE

To evaluate management and predictors of unsuccessful treatment outcomes among MDR-TB patients.

METHODS

In this observational cohort study, 196 MDR-TB patients enrolled at the Programmatic Management Unit for drug-resistant TB of Lady Reading Hospital, Peshawar, Pakistan, between 1 January 2012 and 28 February 2013 were included. Patients were followed until an outcome was recorded or 31 January 2015.

RESULTS

Extensive concurrent resistance to ofloxacin (OFX) and pyrazinamide (54.6%) was observed. Among 181 patients for whom treatment outcome was available, 135 (74.6%) were cured, 1 (0.6%) completed treatment, 35 (19.3%) died, 8 (4.4%) failed treatment and 2 (1.1%) defaulted. In multivariate analysis, predictors of unsuccessful treatment outcome (death, failure and default) were age >40 years (OR 3.412, P = 0.009), baseline body weight <40 kg (OR 2.966, P = 0.020), concurrent comorbidity (OR 3.785, P = 0.023), resistance to OFX (OR 2.777, P = 0.023), lung cavitations at baseline chest X-ray (OR 5.253, P < 0.001) and regimen modification due to adverse events (OR 3.492, P = 0.037).

CONCLUSION

The treatment outcome results were encouraging. Patients with identifiable predictors of poor treatment outcome should receive enhanced clinical management. Early detection and management of mild adverse effects can help prevent regimen modification and may improve treatment outcomes.

A prospective interventional study of effect of accelerated orthokeratology on the corneal curvature and refraction among young adults with myopia

BACKGROUND

Orthokeratology with reverse geometry contact lens is a non-surgical alternative to conventional contact lenses for correction of myopia. However, the strength of evidence for its efficacy and safety is limited to retrospective studies and only a few prospective studies. This prospective study, the first on Indian subjects, evaluated the outcome of orthokeratology among young myopes.

METHODS

Fifty eyes of 25 young myopes (age 19-29 years) with myopia of -1 to 5.0 diopter underwent accelerated orthokeratology using the reverse geometry ortho K - LK lenses for correction of myopia. They were followed up prospectively with weekly vision, refraction, corneal topography, and pachymetry to assess the correction of myopia.

RESULTS

The mean Log MAR vision corrected from 0.748 ± 0.225 at base line to 0.025 ± 0.0630 at 12 weeks with 86% achieving 6/6 unaided day time vision. This was associated with significant central corneal flattening and thinning. The lenses were well tolerated with no significant complications.

CONCLUSION

Overnight accelerated orthokeratology effectively corrects moderate degree of myopia and provide excellent spectacle free day time vision without any significant adverse effects in the short term.

Reducing crude protein and rumen degradable protein with a constant concentration of rumen undegradable protein in the diet of dairy cows: Production performance, nutrient digestibility, nitrogen efficiency, and blood metabolites

The goals of ruminant protein nutrition are to provide adequate amounts of RDP for optimal ruminal efficiency and to obtain the desired animal productivity with a minimum amount of dietary CP. The aim of the present study was to examine effects of decreasing dietary protein by decreasing RDP with the optimum concentration of RUP on production performance, nutrient digestibility, N retention, rumen fermentation parameters, and blood metabolites in high-producing Holstein cows in early lactation. Nine multiparous lactating cows (second parities, averaging 50 ± 12 d in milk and milk yield of 48 ± 5 kg/d) were used in a triplicate 3 × 3 Latin square design with 3 rations: 1) a total mixed ration (TMR) containing 16.4% CP (10.9% RDP based on DM), 2) a TMR containing 15.6% CP (10% RDP), and 3) a TMR containing 14.8% CP (9.3% RDP). The level of RUP was constant at 5.5% DM across the treatments. All diets were calculated to supply a postruminal lysine to methionine ratio of about 3:1. Dry matter intake, milk yield and composition, 4% fat-corrected milk, and energy-corrected milk were not significantly affected by decreasing dietary CP and RDP levels. Cows fed 16.4% CP diets had greater ( < 0.01) CP and RDP intakes, which resulted in a trend toward greater concentrations of plasma urea N compared with other treatments. Daily N intake linearly decreased ( < 0.01) with decreasing dietary CP and RDP levels, whereas the intake of RUP and fecal N excretion (g/d) did not change. Apparent digestibility of nutrients, ruminal pH, and NH-N concentration were not affected with decreasing dietary CP and RDP levels. Apparent N efficiency increased, and RDP N intake and predicted urine N output decreased with decreased concentration of dietary CP and RDP in the diets ( < 0.01). Blood metabolites were not affected by treatments. In conclusion, to improve the efficiency of N utilization by early-lactation dairy cows, 9.3% RDP in rations provides adequate protein to optimize milk production while minimizing N excretion in urine when the amounts of lysine and methionine and the lysine to methionine ratio are balanced with sufficient dietary RUP.

Plastic surgical operative workload in major trauma patients following establishment of the major trauma network in England: A retrospective cohort study

INTRODUCTION

The introduction of major trauma centres (MTCs) in England has led to 63% reduction in trauma mortality.(1) The role of plastic surgeons supporting these centres has not been quantified previously. This study aimed to quantify plastic surgical workload at an urban MTC to determine the contribution of plastic surgeons to major trauma care.

METHODS

All Trauma Audit and Research Network (TARN)-recorded major trauma patients who presented to an urban MTC in 2013 and underwent an operation were identified retrospectively. Patients who underwent plastic surgery were identified and the type and date of procedure(s) were recorded. The trauma operative workload data of another tertiary surgical specialty and local historical plastics workload data from pre-MTC go-live were collected for comparison.

RESULTS

Of the 416 major trauma patients who required surgical intervention, 29% (n = 122) underwent plastic surgery. Of these patients, 43% had open lower limb fractures, necessitating plastic surgical involvement according to British Orthopaedic Association Standards for Trauma (BOAST) 4 guidance. The overall plastic surgery operative workload increased sevenfold post-MTC go-live. A similar proportion of the same cohort required neurosurgery (n = 115; p = 0.589).

DISCUSSION

This study quantifies plastic surgery involvement in major trauma and demonstrates that plastic surgical operative workload is at least on par with other tertiary surgical specialties. It also reports one centre's experience of a significant change in plastic surgery activity following designation of MTC status. The quantity of plastic surgical operative workload in major trauma must be considered when planning major trauma service design and workforce provision, and for plastic surgical postgraduate training.

Dirac electrons in the presence of a matrix potential barrier: application to graphene and topological insulators

Scattering of 2D Dirac electrons on a rectangular matrix potential barrier is considered using the formalism of spinor transfer matrices. It is shown, in particular, that in the absence of the mass term, the Klein tunneling is not necessarily suppressed but occurs at oblique incidence. The formalism is applied to studying waveguiding modes of the barrier, which are supported by the edge and bulk states. The condition of the existence of the uni-directionality property is found. We show that the band of edge states is always finite with massless excitations, while the spectrum of the bulk states, depending on the parameters of the barrier, may consist of the infinite or finite band with both, massive and massless, low-energy excitations. The effect of the Zeeman term is considered and the condition of the appearance of two distinct energy-dependent directions corresponding to the Klein tunneling is found.

[On quality of life of children of senior school age in the Republic of Udmurtia]

The article presents results of population study of quality of life of children aged 2-17 years. The study of quality of life of children of senior school age using questionnaire PedsQL was carried out. The comparative characteristic of indices of quality of life of children ofjunior and senior school age in the Republic of Udmurtia is presented. The regional indices of quality of life of children of senior school age are determined. Among all aspects of quality of life the highest values had «physical functioning» and «social functioning». The scales «emotional functioning» and «social functioning» differed by their lesser level. The quality of life of girls of senior school age was lower than in boys in all aspects but more concerned emotional sphere. The residence in urban or rural territory effects indices of quality of life of children of senior school age in Udmurtia. The urban children had higher indices of quality of life on aspects «physical functioning» and «emotional functioning». The level of aspects of «social functioning» and «school functioning» is characterized by absence of disagreements between urban and rural children. The geographical area of residing of children of senior school age in Udmurtia has no effect on indices of quality of life. The aspects of «social functioning», «emotional functioning» and «school functioning» have particular characteristics depending on age (8-12 years and 13-17 years). The age characteristics consist in increasing of level of social functioning; age trend of aspects «emotional functioning» and «school functioning» has negative dynamics.

Bupropion Hydrochloride

Bupropion hydrochloride is a norepinephrine-dopamine disinhibitor (NDDI) approved for the treatment of depression and smoking cessation. Bupropion is a trimethylated monocyclic phenylaminoketone second-generation antidepressant, which differs structurally from most antidepressants, and resides in a novel mechanistic class that has no direct action on the serotonin system. Comprehensive chemical, physical, and spectroscopic profiles are presented. This analytical profile provides an extensive spectroscopic investigation utilizing mass spectrometry, one- and two-dimensional NMR, solid-state NMR, IR, NIR, Raman, UV, and X-ray diffraction. The profile also includes significant wet chemistry studies for pH, solubility, solution, and plasma stability. Both HPLC and UPLC methodology are presented for bupropion and its related impurities or major metabolites. The profile concludes with an overview of biological properties that includes toxicity, drug metabolism, and pharmacokinetics.

To study the adequacy of surgical muscle relaxation in paediatric patients scheduled for elective groin surgeries under general anesthesia using sevoflurane without using neuromuscular blocking agents

AbstractIntroduction:In Anesthesia practice neuromuscular blocking agents (muscle relaxants) are used for intubation and surgical muscle relaxation. The use of modern inhalational anesthetics like sevoflurane is commonly practiced in paediatric anesthesia for induction and endotracheal intubation. LMA is alternative to endotracheal intubation. It is commonly used supraglotic device for the elective surgical procedures in adults and paediatric population. We conducted this study to see whether sevoflurane produces enough surgical muscle relaxation so that the use of neuromuscular blocking agents can be avoided.Patients and Methods:84 paediatric patients of King Khalid Hospital (KSA) from April 2013 to February 2014 posted for elective surgical procedure were included in this observational study regarding the adequacy of surgical muscle relaxation. Induction of anesthesia was done with propofol 2mg/kg and Fentanyl 2 mcg/ kg. Airway was maintained with LMA. Anesthesia was maintained by sevoflurane in oxygen and air. Blood pressure and Heart rate was kept with 20% of baseline reading. Adequacy of surgical muscle relaxation was asked by the surgeon during surgery and was graded as good, fair or poor.Results:Mean age of the patients was 2.4 year. There were 76 male and 8 female patients. 47 patients were operated for inguinal herniotomy, 32 for orchedopexy and 5 for umbilical herniotomy. Surgical muscle relax-ation was good in all of the patients and none of them required use of muscle relaxants. Recovery of all patients was smooth.Discussion:Adequate surgical muscle relaxation is important to facilitate surgery. In paediatric population sevoflurane produces enough muscle relaxation for intubation and surgical muscle relaxation. Monitoring of muscle relaxation can be clinical as well as through muscle twitches.Conclusion:Our study showed that in paediatric population the elective surgical procedures of groin region can be done without using muscle relaxants.Keywords:Paediatric anesthesia, LMA, neuromuscular blocking agents, surgical muscle relaxation.

[The application of laser therapy for the medical rehabilitation of the children presenting with chronic osteomyelitis]

The objective of the present study was to develop a scientifically sound rationale for the application of infrared laser radiation (IRLR) either separately or in the combination with fluctuation magnetic therapy in the medical rehabilitation of the children presenting with chronic hematogenous osteomyelitis. Another objective was to evaluate the clinical effectiveness of this therapeutic modality. Two achieve these goals, the clinical observations and special research studies were conducted in two directions with the participation of 95 patients at the age varying from 1 to 15 years. The study has demonstrated the effectiveness of the inclusion of IRLR in the medical rehabilitation program for the children with chronic hematogenous osteomyelitis in different periods of the disease. It was shown that the transcutaneous infrared irradiation of the affected area during the exacerbation of chronic osteomyelitis had a well apparent immunostimulatory effect and reduced the activity of the inflammatory process. The application of IRLR in combination with fluctuation magnetic therapy during the period of partial remission, had a more pronounced influence on the microcirculation and stimulated the regenerative and trophic processes.

[The medical rehabilitation of the children presenting with the hyperactive urinary bladder]

The present article is focused on the modern technologies for the medical rehabilitation of the children presenting with the hyperactive urinary bladder (UB) designed to promote the act of urination in the children at all levels of bladder innervation.

Effects of physical form of starter and forage provision to young calves on blood metabolites, liver composition and intestinal morphology

This study evaluated the effects of physical form of starter feed and forage provision on the performance, blood metabolites, liver composition and intestinal morphology of dairy calves. Individually housed calves (n = 52; body weight = 41.5 ± 2.5 kg) were randomly allocated (n = 13 per treatment) to one of the following four treatments: (i) ground starter feed (GS; mean particle size = 0.72 mm in diameter), (ii) textured starter feed (TS; mean particle size = 3.61 mm in diameter, including steam-flaked corn and barley), (iii) pelleted starter feed (PS; mean particle size = 4.53 mm in diameter) and (iv) ground starter feed with chopped alfalfa hay (GS + AH; mean particle size = 1.02 mm in diameter). The calves fed GS + AH diets had greater (p < 0.01) starter intake, final body weight and average daily gain compared with the other groups, while GS and TS groups both had greater (p < 0.01) starter intake than the PS group. Feed efficiency was found to be better (p < 0.05) in the TS group than in the GS or PS group, but not different from the GS + AH one. Compared with the other groups, the GS + AH group had the highest (p < 0.01), while the PS one had the lowest (p < 0.01) concentrations of blood glucose and triglyceride. The calves fed GS + AH had the highest blood concentrations of total protein, globulin, triiodothyronine (T3), thyroxin (T4), T3 : T4 ratio (p < 0.05) and levels of fat and glycogen in the liver (p < 0.01) compared with the other groups. The highest (p < 0.05) liver glycogen contents were observed in the GS + AH and TS groups. The duodenum, ileum and jejunum in the calves fed GS + AH exhibited a greater muscle layer thickness (p < 0.05) compared with the other groups. Based on the results obtained, the addition of dietary forage to starter diets positively influenced performance, liver composition and intestinal morphology in developing calves.

[The topical problems of pediatric balneotherapy and the spa and health resort-based treatment of the children]

This article is devoted to the topical problems of pediatric balneotherapy with special reference to the organization of the spa and health resort-based treatment of the children in the Russian Federation. The main issues discussed by the authors include the current state of health resort care for the children, the problem of statutory regulation of the activities of the children's spa and health resort facilities, the approaches to increasing the availability of the spa and health resort-based treatment for the children at the enhanced risk of the development of chronic diseases, disabilities, and tuberculosis. Also considered are the problems of the development of the regulatory framework for the medical rehabilitation of the children based at the spa and health resort facilities. The principal goals to be sought in climatotherapy, physiotherapy, balneotherapy, and pelotherapy in the pediatric context are outlined along with the further prospects for the development of the main areas of pediatric balneology.

[The medical rehabilitation of the children presenting with atopic dermatitis (a literature review)]

Atopic dermatitis takes the predominant position in the structure of skin pathologies in the children of various age. Both the scientifically based forecasts and the data of numerous investigations give evidence not only of the significant increase in the number of patients presenting with this condition but also of the growing severity of this disease. Taken together, these facts account for the serious medico-social importance of the problems arising in connection with this pathology. The introduction of the eliminative actions, a hypoallergenic diet, local and systemic pharmacotherapeutic modalities do not always allow to prevent or arrest the inflammatory process and achieve the long-standing remission. The high frequency of undesirable reactions to the pharmacological products turns the attention of many clinicians to the application of the non-pharmacological factors and methods for the treatment of atopic dermatitis in the children. The main objectives of physical therapy in the case of atopic dermatitis include the normalization of the state of the central and vegetative nervous system, the achievement of hyposensitization, sedative, anti-toxic, and anti-inflammatory effects, as well as the application of the dissolving, trophic, and antipruritogenic agents, strengthening of the general health status of the children.

[The health promotion programs for the children based at health promotion institutions]

The research carried out in the framework of the health promotion programs for the children made it possible to obtain characteristics of the patients admitted to health promotion facilities, identify the risk factors for the development of acute respiratory diseases, and substantiate the principles of the differentiated approach to the rehabilitation of such patients based at the institutions of this type taking into consideration the health group to which a concrete patient is referred and the risk factors of acute respiratory diseases. The feasibility and effectiveness of the addition of aromatherapy and treatment with the use of polarized light into the health promotion programs for the children presenting with acute respiratory diseases that they develop during the period of adaptation based at health promotion institutions are discussed.