A study was conducted with Hy-Line Brown laying hens to examine the effects of reduced protein diet, deficiency of arginine (Arg), and addition of crystalline Arg, citrulline (Cit) and guanidinoacetic acid (GAA) as substitutes for Arg. Hen performance, egg quality, serum uric acid, liver and reproductive organ weights, and energy and protein digestibility were measured using a completely randomized design with 5 treatments. Treatments were a standard diet (17% protein diet; SP), a reduced diet (13% protein diet deficient in Arg; RP) and RP with added Arg (0.35%, RP-Arg), GAA (0.46% equivalent to 0.35% Arg, RP-GAA) or Cit (0.35%, RP-Cit) to the level of SP. It was hypothesized that performance would decrease with Arg deficient RP diet and the addition of GAA or Cit in RP would allow birds to perform similar or greater than Arg-added RP treatment. The experiment was conducted from 20 to 39 wk of age but the treatment effect was seen only after 29 wk of age. The birds offered RP had reduced egg and albumin weights ( P < 0.01), lower yolk color score ( P < 0.01), lower protein intake and excretion ( P < 0.01) than those offered SP. When Arg or Cit were added to RP to make them equivalent to SP, feed intake (FI) and egg production were not different than those of RP ( P > 0.05). The birds offered RP-GAA decreased FI and egg production ( P < 0.01) compared to those offered RP. The addition of Arg, Cit or GAA to the RP had no effect on egg quality parameters, protein and energy digestibilities ( P > 0.05). However, birds offered the RP-Cit diet tended to have higher Haugh unit ( P = 0.095) and lower shell breaking strength ( P = 0.088) compared to all other treatments while those offered RP-GAA had higher energy digestibility ( P < 0.05) than all other groups but RP. The limited performance response of hens fed RP with added Arg, GAA, or Cit may be due to deficiency of some other nutrients in RP such as phenylalanine, potassium or non-essential amino acids and other components of soybean meal in the diet.

BackgroundEvidence-based practice (EBP) enhances healthcare services and keeps providers current with best practices. EBP has been adopted and spread worldwide. However, people will not apply it if they do not know, understand, or believe it. Few studies have considered EBP application in Viet Nam. This study explores whether Vietnamese physical therapists’ attitude, knowledge, skills toward EBP and barriers to its use make them ready to implement its practice.MethodsA survey questionnaire was sent directly to physical therapists in governmental healthcare organizations in Ho Chi Minh City, Viet Nam, from July to October, 2017. It consisted of 41 closed- and open-ended questions related to knowledge, attitude, behaviors, frequency of use, and barriers of EBP and the demographic characteristics of participants. Descriptive statistics and significant correlations were determined from Chi-Square statistics or odds ratios between the variables.ResultsThe return rate was 93% (421 out of 453). Eliminated were 40 responses inconsistent with inclusion criteria. The 381 eligible participants were more female (62%) than male, about 53% had vocational degrees, less than 1% had M.S. degrees. Participants reported a positive attitude toward EBP. An incongruity existed between knowledge/ skills of EBP and the frequency of using its 5 steps. English competence was the most critical barrier to applying EBP. The significant associations between attitude and knowledge, and demographical attributes indicated that younger therapists with lower educational degrees had less knowledge of EBP and they rarely employed the application and analytical steps 4 and 5.ConclusionsThe incongruity between knowledge and use of EBP may result from the lack of EBP in academic education. The skills of reading professional articles in the English language and understanding and applying the steps of EBP should be emphasized in academic physical therapy programs. Additionally, policy makers should consider the number of patients a day per physical therapist which impacts EBP use and the quality of healthcare service.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1428-3) contains supplementary material, which is available to authorized users.

Arginine activity in broiler diets can be supplied by L‐arginine (Arg), guanidinoacetic acid (GAA) and L‐citrulline (Cit), all of which are commercially available. This study was conducted to assess the effects of Arg source and level on broiler performance, nutrient digestibility and carcass parameters. Day‐old Ross 308 cockerels (n = 768) were assigned to one of eight dietary treatments using a completely randomized design: normal protein (NP), low protein deficient in Arg (LP) and LP with two levels of either Arg (0.238% and 0.476%), GAA (0.309% and 0.618%) or Cit (0.238 and 0.476%). The LP was 5 percentage points lower in protein level than the NP. Wheat, sorghum, soya bean meal, canola meal, and meat and bone meal‐based diets were fed over three feeding phases to 6 replicate floor pens with 16 birds each. Compared to NP, birds fed LP had reduced feed intake (FI, p < 0.001), reduced body weight gain (BWG, p < 0.001) and increased feed conversion ratio (FCR, p < 0.001) from day 0 to day 35. Additions of Arg or Cit to the LP at both levels resulted in increased BWG and reduced FCR (p < 0.05). Birds fed LP with GAA added had lower FCR (p < 0.05) but not higher BWG (p > 0.05) compared with the LP observed from day 0 to day 35. Supplementation of Arg, Cit and the low level of GAA to LP resulted in increased carcass yield, bone length, diameter and ash (p < 0.05) but did not increase ileal energy or nitrogen digestibility (p > 0.05). The findings indicate that Cit is an efficacious source of Arg activity in Arg‐deficient diets.

Context. Improving immune status through nutritional adjustments may be part of an effective strategy to reduce reliance on antibiotic growth promoters for controlling necrotic enteritis (NE) in broiler chickens. Aims. This study examined the effect of dietary protein level and the replacement of crystalline L-arginine (Arg) with L-citrulline (Cit) in the reduced-protein diet on the performance of broilers challenged with subclinical NE. Methods. Ross 308 cockerels (n = 720) were randomly allocated to six dietary treatments, with eight replicates of 15 birds per pen, during a 35-day feeding experiment. The treatments were as follows: standard protein without NE challenge (SP−); standard protein with NE challenge (SP+); reduced protein (two percentage points lower crude protein) without NE challenge (RP−); reduced protein with NE challenge (RP+); RP+ plus added Arg (103% of RP, RPA+) and RPC+ where supplemental Arg in RPA+ was replaced with Cit. The first four treatments were considered as a 2 × 2 factorial arrangement, with factors being NE (− or +) and protein level (SP or RP). Treatments SP+, RP +, RPA+, and RPC+ were analysed by one-way ANOVA. Key results. Subclinical NE challenge reduced feed intake (FI), reduced body weight gain (BWG) and increased feed to gain ratio (FCR) from Day 0 to Day 35, increased intestinal lesion scores on Day 16, and reduced relative breast yield on Day 35 (P < 0.05). Feeding RP diets increased FI (P < 0.001), increased BWG (P < 0.01) and reduced FCR (P < 0.01) during the grower phase compared with SP diets when birds were challenged with NE. Birds in the RPC+ treatment had a lower overall FCR than did those in the SP+ treatment (P < 0.001). Birds in the RPA+ treatment had similar FI, BWG and FCR to those in the RP+ treatment (P > 0.05). Conclusions. Collectively, the results showed protective effects of replacing the supplemental Arg with Cit against NE in RP diets, as indicated by higher performance during and after the challenge. Implications. Feeding the RP diets supplemented with Cit may be part of an effective strategy to reduce reliance on antibiotic growth promoters for controlling NE in broiler chickens.