We have used the Leiden anaesthesia simulator, which makes use of a standard anaesthesia machine and monitors, and realistically simulates the anaesthesia work place. After obtaining informed consent, 28 anaesthetists and anaesthesia trainees in one hospital took part in the study. All participants were exposed to a pre-scripted simulated "control" scenario of anaphylactic shock (phase 1). The sessions were videotaped and the performances of individual participants were evaluated using a standardized scoring scheme. During phase 2, the participants were allocated randomly to undergo training in the management of either anaphylactic shock (group A, n = 13) or malignant hyperthermia (group B, n = 15) on the simulator. After 4 months, each participant underwent a blinded evaluation session with a pre-scripted "test" scenario of malignant hyperthermia (phase 3). These sessions were also videotaped and evaluated as for phase 1. The participants in group B responded more quickly, treated better and deviated less from the accepted procedure during phase 3 than those in group A. The total performance of participants in group B during phase 3 was significantly better than those in group A. We conclude that training on an anaesthesia simulator does improve the performance of anaesthetists in dealing with emergencies during anaesthesia.

We propose a new definition for erosions visualized with HR-pQCT imaging. Interreader reliability for erosion detection is good, but further refinement of selection of landmarks for erosion size measurement, or automated volumetric methods, will be pursued.

Imaging is essential to the evaluation of bone and joint diseases, and the digital era has contributed to an exponential increase in the number of publications on noninvasive analytical techniques for the quantification of changes to bone and joints that occur in health and in disease. One such technique is high-resolution peripheral quantitative CT (HR-pQCT), which has introduced a new dimension in the imaging of bone and joints by providing images that are both 3D and at high resolution (82 μm isotropic voxel size), with a low level of radiation exposure (3-5 μSv). HR-pQCT enables the analysis of cortical and trabecular properties separately and to apply micro-finite element analysis for calculating bone biomechanical competence in vivo at the distal sites of the skeleton (distal radius and distal tibia). Moreover, HR-pQCT makes possible the in vivo assessment of the spatial distribution, dimensions and delineation of cortical bone erosions, osteophytes, periarticular cortical and trabecular microarchitecture, and 3D joint-space volume of the finger joints and wrists. HR-pQCT is, therefore, a technique with a high potential for improving our understanding of bone and joint diseases at the microarchitectural level.

This study aimed to obtain insights into the presence of cadmium, lead, mercury and arsenic in feed materials and feed over time for the purpose of guiding national monitoring. Data from the Dutch feed monitoring programme and from representatives of the feed industry during the period 2007-13 were used. Data covered a variety of feed materials and compound feeds in the Netherlands. Trends in the percentage of samples that exceeded the maximum limit (ML) set by the European Commission, and trends in average, median and 90th percentile concentrations of each of these elements were investigated. Based on the results, monitoring should focus on feed material of mineral origin, feed material of marine origin, especially fish meal, seaweed and algae, as well as feed additives belonging to the functional groups of (1) trace elements (notably cupric sulphate, zinc oxide and manganese oxide for arsenic) and (2) binders and anti-caking agents. Mycotoxin binders are a new group of feed additives that also need attention. For complementary feed it is important to make a proper distinction between mineral and non-mineral feed (lower ML). Forage crops in general do not need high priority in monitoring programmes, although for arsenic grass meal still needs attention.

No abstract

Chloramphenicol (CAP), a broad-spectrum antibiotic, was detected in several herb and grass samples from different geographic origins. Due to its suspected carcinogenicity and linkages with the development of aplastic anemia in humans, CAP is banned for use in food-producing animals in the European Union (EU) and many other countries. However, products of animal origin originating from Asian countries entering the European market are still found noncompliant (containing CAP) on a regular basis, even when there is no history of chloramphenicol use in these countries. A possible explanation for the continued detection of these residues is the natural occurrence of CAP in plant material which is used as animal feed, with the consequent transfer of the substance to the animal tissues. Approximately 110 samples were analyzed using liquid chromatography coupled with mass spectrometric detection. In 26 samples, the presence of CAP was confirmed using the criteria for banned substances defined by the EU. Among other plant materials, samples of the Artemisia family retrieved from Mongolia and from Utah, USA, and a therapeutic herb mixture obtained from local stores in the Netherlands proved to contain CAP at levels ranging from 0.1 to 450 µg/kg. These findings may have a major impact in relation to international trade and safety to the consumer. The results of this study demonstrate that noncompliant findings in animal-derived food products may in part be due to the natural occurrence of chloramphenicol in plant material. This has implications for the application of current EU, USA, and other legislation and the interpretation of analytical results with respect to the consideration of CAP as a xenobiotic veterinary drug residue and the regulatory actions taken upon its detection in food.

In the framework of sustainability and a circular economy, new ingredients for feed are desired and, to this end, initiatives for implementing such novel ingredients have been started. The initiatives include a range of different sources, of which insects are of particular interest. Within the European Union, generally, a new feed ingredient should comply with legal constraints in terms of 'yes, provided that' its safety commits to a range of legal limits for heavy metals, mycotoxins, pesticides, contaminants, pathogens etc. In the case of animal proteins, however, a second legal framework applies which is based on the principle 'no, unless'. This legislation for eradicating transmissible spongiform encephalopathy consists of prohibitions with a set of derogations applying to specific situations. Insects are currently considered animal proteins. The use of insect proteins is a good case to illustrate this difference between a positive, although restricted, modus and a negative modus for allowing animal proteins. This overview presents aspects in the areas of legislation, feed safety, environmental issues, efficiency and detection of the identity of insects. Use of insects as an extra step in the feed production chain costs extra energy and this results in a higher footprint. A measure for energy conversion should be used to facilitate the comparison between production systems based on cold-versus warm-blooded animals. Added value can be found by applying new commodities for rearing, including but not limited to category 2 animal by-products, catering and household waste including meat, and manure. Furthermore, monitoring of a correct use of insects is one possible approach for label control, traceability and prevention of fraud. The link between legislation and enforcement is strong. A principle called WISE (Witful, Indicative, Societal demands, Enforceable) is launched for governing the relationship between the above-mentioned aspects.

A study was conducted with conventional and germ-free broiler chicks to obtain more information on the role of the intestinal microflora in the anti-nutritive effects of NSP in broiler chicks. As the NSP source, highly methylated citrus pectin (HMC) was used at a dose level of 30 g/kg in a maize-based diet. The diets fed to the germ-free chicks were γ-irradiated, whereas those fed to the conventional chicks were not. Feeding the HMC diet to conventional birds depressed weight gain and food utilization (P < 0·05), whereas in germ-free birds only weight gain was reduced (P < 0·05). Feeding the HMC diet to conventional birds reduced digestibilities of energy and starch at the end of the jejunum. Ileal digestibilities of starch and energy were not strongly affected when birds were fed on the HMC-containing diet. Faecal digestibilities of organic matter, crude fat, starch and amino acids, N retention and metabolizable energy were reduced when conventional chicks were fed on the HMC diet. Feeding the HMC diet to germ-free birds hardly affected faecal digestibility of nutrients and N retention, whereas metabolizable energy was increased. Feeding the HMC diet to conventional or germ-free birds increased the viscosity of the digesta in the small intestine. This increase in digesta viscosity was more pronounced in conventional than in germ-free birds. The pH of ileal digesta was reduced when HMC was added to the diet of conventional chicks, but not in germ-free chicks. Feeding the HMC diet to conventional birds markedly affected morphology of the gut wall, whereas in germ-free chicks very little effect was found on gut morphology. Based on the results of the present study, it is concluded that the gastrointestinal microflora mediates the magnitude of the anti-nutritive effects of HMC in broiler chicks. However, the exact role of the microflora in chicks in the magnitude of the anti-nutritional effects of HMC could not be derived from the present study, since the results might have been influenced by γ-irradiation of the diets fed to the germ-free chicks.