SUMMARYCarbon turnover differs between tissues within an animal, but the extent to which ecologically relevant increases in metabolism affect carbon turnover rates is largely unknown. We tested the energy expenditure and protein turnover hypotheses that predict increased carbon turnover, either in association with increased daily energy expenditure, or in concert with tissue-specific increased protein metabolism. We used stable-isotope-labeled diets to quantify the rate of carbon turnover in 12 different tissues for three groups of zebra finches (Taeniopygia guttata): cold-exposed birds kept at ambient temperatures below their thermoneutral zone, exercised birds that were flown for 2h per day in a flight arena, and control birds that were kept at ambient temperatures within their thermoneutral zone and that were not exercised. We found that increases in metabolism associated with cold-exposure but not exercise produced measurable increases in carbon turnover rate of, on average, 2.4±0.3days for pectoral muscle, gizzard, pancreas and heart, even though daily energy intake was similar for exercised and cold-exposed birds. This evidence does not support the energy expenditure hypothesis, and we invoke two physiological processes related to protein metabolism that can explain these treatment effects: organ mass increase and tissue-specific increase in activity. Such changes in carbon turnover rate associated with cold temperatures translate into substantial variation in the estimated time window for which resource use is estimated and this has important ecological relevance.
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The elective termination of ventilation requires differentiated pharmacologic palliative care. More controlled studies are required in order to establish evidence-based guidelines for the termination of ventilation.
Zusammenfassung
Die vorliegende Untersuchung zeigt die Kodierpr?valenz und die Erl?srelevanz der diagnostizierten und dokumentierten Diagnosen aus dem Bereich Mangelern?hrung in einem Krankenhaus der Maximalversorgung.
?ber den Zeitraum von 2010 bis einschlie?lich 2014 wurden insgesamt 194?154 Behandlungsf?lle analysiert. Die Kodierpr?valenz von Patienten mit dokumentierter Mangelern?hrung im Bezug zur Gesamtfallzahl stieg von 1,82?% im Jahre 2010 auf 3,2?% im Jahre 2014. Bei diesen F?llen erh?hte sich der prozentuale Anteil mit Erl?seffekt von 6?% zu Beginn der Untersuchung auf 10?% im Jahre 2014. Trotz erheblicher ?nderungen im DRG-System konnten Erl?seffekte von 50?T? in 2010 bis 274?T? in 2014 erzielt werden. Dies entspricht im bundesweiten Vergleich 18 Bewertungsrelationen im Jahr 2010 bis 88 Bewertungsrelationen in 2014.
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