Cardiometabolic health after first pregnancy: Associations with social determinants of health. A nuMoM2b-HHS study.

Study objective: This study sought to evaluate the associations between social determinants of health (SDOH) at the time of first pregnancy and subsequent cardiometabolic health, defined as the development of metabolic syndrome. Design: nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study- Monitoring Mothers-to-Be-Heart Health Study) is an ongoing prospective cohort study. Setting: Eight academic medical centers enrolled and continue to follow participants. Participants: 4484 participants followed a mean of 3.2 years from the time of their first pregnancy. Interventions: N/a. Main outcome measure: Unadjusted and adjusted Poisson regression models with robust standard errors were used to obtain relative risks and 95% confidence intervals estimating the risk of metabolic syndrome for each baseline SDOH. In secondary analyses we examined the associations between SDOH and incident hypertension, obesity, and diabetes mellitus. Results: Metabolic syndrome developed in 13.6% of participants. Higher socioeconomic position at the time of pregnancy was associated with lower rates of metabolic syndrome [income > 200% poverty level aRR 0.55 (95% CI, 0.42-0.71), attainment of a bachelor's degree aRR 0.62 (0.46-0.84) or higher aRR 0.50 (0.35-0.71)], while being single [aRR 1.45 (95% CI, 1.18-1.77)] and having low health literacy were associated with a greater risk of metabolic syndrome [aRR 1.98 (95% CI, 1.28-3.07)]. Conclusions: Over a short interval following first pregnancy, participants accumulated high proportions of cardiovascular risk factors and metabolic syndrome, with some risk associated with SDOH. The impact of interventions addressing SDOH in pregnant people on cardiometabolic health should be tested as a means of reducing health inequities at the population level.

Plasma Levels of a Product of Free Radical Injury and Antioxidant Status of Patients with Different Grades of Plasmodium Falciparum Infection.

BACKGROUND: Plasmodium falciparum infection, like any other clinical condition, is prone to generating free radicals. This can worsen patients' clinical presentations. Antioxidants do help in ameliorating these free radical effects. These antioxidants, especially vitamins, are sometimes given routinely to patients with Plasmodium falciparum infection of which it can be given according to the severity of this free radical injury. METHODOLOGY: A total number of qualified 245 patients that came for malaria parasite test between March and October, 2020 were recruited into the study. Patients on arrival at the laboratory had their samples collected for malaria parasite test and for the proposed biochemical parameters (MDA, GPx, SOD and TAS). Malaria parasite test was used to categorize the severity of Plasmodium falciparum infection. RESULTS: There were statistically significant differences (p<0.0001) in MDA, GPx, SOD and TAS among patients with negative MP, 1+ and >2+ on blood film for malaria parasite. Patients with >2+ MP had highest levels (2.21±0.40) while patients with negative blood film had lowest levels(0.8194±0.33) of MDA. Patients with >2+ had lowest levels of GPx (2406.41±1272.10), SOD (104.54±30.62) and TAS (1.18±.35) as against patients with negative MP that had highest levels (5229.85±.2957.95)( 206.41±36.70)( 2.40±.53), respectively. CONCLUSION: There was evidence of free radical generation as evidenced with raised plasma malondialdehyde in patients with Plasmodium falciparum infection. This was associated with severity of this infection. There was also corresponding decrease in measured antioxidants (GPx, SOD and TAS).

CONTEXTE: L'infection à Plasmodium falciparum, comme toute autre affection clinique, est susceptible de générer des radicaux libres. Cela peut aggraver les présentations cliniques des patients. Les antioxydants aident à améliorer ces effets des radicaux libres. Ces antioxydants, notamment des vitamines, sont parfois administrés en routine aux patients infectés par Plasmodium falciparum dont il peut être administré en fonction de la gravité de cette lésion radicalaire. MÉTHODOLOGIE: Un nombre total de 245 patients qualifiés qui sont venus pour un test de dépistage du paludisme entre mars et octobre 2020 ont été recrutés dans l'étude. Les patients à leur arrivée au laboratoire ont eu leurs échantillons collectés pour le test du parasite du paludisme et pour les paramètres biochimiques proposés (MDA, GPx, SOD et TAS). Le test du parasite du paludisme a été utilisé pour catégoriser la gravité de l'infection à Plasmodium falciparum. RÉSULTATS: Il y avait des différences statistiquement significatives (p<0,0001) dans le MDA, GPx, SOD et TAS parmi les patients avec MP négatif, 1+ et >2+ sur frottis sanguin pour le parasite du paludisme. Les patients avec >2+ MP avaient les niveaux les plus élevés (2,21 ± 0,40) tandis que les patients avec un frottis sanguin négatif avaient les niveaux les plus bas (0,8194 ± 0,33) de MDA. Les patients avec >2+ avaient les niveaux les plus bas de GPx (2406,41 ± 1272,10), SOD (104,54 ± 30,62) et TAS (1,18 ± 0,35) par rapport aux patients avec MP négatif qui avaient les niveaux les plus bas (5229,85 ± 0,2957,95) (206,41 ± 36,70 )( 2,40 ± 0,53), respectivement. CONCLUSION: Il y avait des preuves de génération de radicaux libres comme en témoigne l'augmentation du malondialdéhyde plasmatique chez les patients infectés par Plasmodium falciparum. Ceci était associé à la gravité de cette infection. Il y avait également une diminution correspondante des antioxydants mesurés (GPx, SOD et TAS). Mots-clés: Radicaux libres, stress oxydatif, antioxydants, Plasmodium falciparum, paludisme.

Reduced postprandial bone resorption and greater rise in GLP-1 in overweight and obese individuals after an α-glucosidase inhibitor: a double-blinded randomized crossover trial.

When taken with a meal, α-glucosidase inhibitors (α-GI) reduce the rise in postprandial glucose and increase glucagon-like peptide-1 (GLP-1), and this may lower bone turnover. In this study, a salacinol-type α-GI increased GLP-1 and markedly reduced postprandial bone resorption compared to placebo, suggesting it could have implications for bone health. INTRODUCTION: Animal and clinical trials indicate that α-glucosidase inhibitors attenuate postprandial glycemic indices and increase secretion of GLP-1. In addition, GLP-1 acts on bone by inhibiting resorption. The goal in this study was to determine if a salacinol α-GI alters postprandial bone turnover and can be explained by changes in serum GLP-1. METHODS: In this double-blind, placebo-controlled crossover study, healthy overweight/obese adults (body mass index 29.0 ± 3.8 kg/m2; 21-59 years; n = 21) received a fixed breakfast and, in random order, were administered Salacia chinensis (SC; 500 mg) or placebo. A fasting blood sample was taken before and at regular intervals for 3 h after the meal. Serum was measured for bone turnover markers, C-terminal telopeptide of type I collagen (CTX) and osteocalcin, and for glycemic indices and gut peptides. RESULTS: Compared to placebo, SC attenuated the bone resorption marker, CTX, at 60, 90, and 120 min (p < 0.05) after the meal, and decreased osteocalcin, at 180 min (p < 0.05). As expected, SC attenuated the postprandial rise in glucose compared with placebo, whereas GLP-1 was increased at 60 min (p < 0.05) with SC. Serum GLP-1 explained 41% of the variance for change in postprandial CTX (p < 0.05). CONCLUSION: This study indicates that attenuating postprandial glycemic indices, with an α-GI, markedly decreases postprandial bone resorption and can be explained by the rise in GLP-1. Future studies should determine whether longer term α-GI use benefits bone health.

[Epileptic status in paediatric patients: its developmental consequences and an epidemiological update]. / Estado epiléptico en pacientes pediátricos: consecuencias evolutivas y actualización epidemiológica.

INTRODUCTION: Epileptic status represents the most frequent neurological emergency in pediatrics. Prolonged febrile seizures represent the most common etiology. Our objective is to update its epidemiology and analyze its evolutionary consequences. PATIENTS AND METHODS: Observational analytical study of retrospective cohorts of children seen in the emergency department with epileptic status between January-2014 and December-2018. Demographic variables, personal history, clinical characteristics, complementary tests and the etiology of the epileptic status followed in our hospital were collected. The evolutionary consequences in terms of neurodevelopment and subsequent epilepsy were analyzed. RESULTS: Of a total of 525,000 emergencies attended during the study, epileptic status cases were 79 in 68 patients (16 cases/100,000 children/year). The symptomatic etiology was the most frequent (35.4%). 20.6% of the patients had a history of prematurity, 30.8% had a deficit of previous neurodevelopment, this being more frequent in case of symptomatic etiology, and 44% were diagnosed with epilepsy. The median duration of seizures was 50 minutes. An acute brain trigger was identified in seven patients. The subsequent neurodevelopmental deficit attributable to epileptic status was 9.1% of patients related to symptomatic etiology and/or a history of prematurity. The development of epilepsy occurred in 10.7%. CONCLUSIONS: The neurodevelopmental disorder attributable to epileptic status affects one in 11 cases. Prematurity was a risk factor per se. Post-epileptic status epilepsy developed in one in 10 cases.

TITLE: Estado epiléptico en pacientes pediátricos: consecuencias evolutivas y actualización epidemiológica.Introducción. El estado epiléptico representa la emergencia neurológica más frecuente en pediatría. Las convulsiones febriles prolongadas representan la etiología más frecuente. Nuestro objetivo es actualizar su epidemiología y analizar sus consecuencias evolutivas. Pacientes y métodos. Estudio observacional analítico de cohortes retrospectivas de niños atendidos en urgencias con estado epiléptico entre enero de 2014 y diciembre de 2018. Se recogieron las variables demográficas, los antecedentes personales, las características clínicas, las pruebas complementarias y la etiología de los estados epilépticos seguidos en nuestro hospital. Se analizaron las consecuencias evolutivas en cuanto a neurodesarrollo y epilepsia ulterior. Resultados. De un total de 525.000 urgencias atendidas durante el estudio, los casos de estado epiléptico fueron 79 en 68 pacientes (16 casos/100.000 niños/año). La etiología sintomática fue la más frecuente (35,4%). El 20,6% de los pacientes presentaba antecedente de prematuridad; el 30,8%, un déficit del neurodesarrollo previo, más frecuente en caso de etiología sintomática, y el 44% estaba diagnosticado de epilepsia. La duración mediana de las crisis fue de 50 minutos. En siete pacientes se identificó un desencadenante cerebral agudo. El déficit del neurodesarrollo ulterior achacable al estado epiléptico fue del 9,1%, y se relacionó con la etiología sintomática o antecedentes de prematuridad. El desarrollo de epilepsia ocurrió en el 10,7%. Conclusiones. La alteración del neurodesarrollo achacable al estado epiléptico afecta a uno de cada 11 casos. La prematuridad fue un factor de riesgo por sí misma. La epilepsia posterior a un estado epiléptico se desarrolló en uno de cada 10 casos.

Postpartum supplementation of fermented ammoniated condensed whey improved feed efficiency and plasma metabolite profile.

Postpartum dietary supplementation of gluconeogenic precursors may improve the plasma metabolite profile of dairy cows, reducing metabolic disorders and improving lactation performance. The objective of this trial was to examine the effects of supplementation with fermented ammoniated condensed whey (FACW) postpartum on lactation performance and on profile of plasma metabolites and hormones in transition dairy cows. Individually fed multiparous Holstein cows were blocked by calving date and randomly assigned to control (2.9% dry matter of diet as soybean meal; n = 20) or FACW (2.9% dry matter of diet as liquid GlucoBoost, Fermented Nutrition, Luxemburg, WI; n = 19) dietary treatments. Treatments were offered from 1 to 45 d in milk (DIM). Cows were milked twice a day. Dry matter intake and milk yield were recorded daily and averaged weekly. Individual milk samples from 2 consecutive milkings were obtained once a week for component analysis. Rumen fluid was collected (n = 3 cows/treatment) at 4 time points per day at 7 and 21 DIM. Blood samples were collected within 1 h before feeding time for metabolite analysis and hyperketonemia diagnosis. Supplementation of FACW improved feed efficiency relative to control; this effect may be partially explained by a marginally significant reduction in dry matter intake from wk 3 to 7 for FACW-supplemented cows with no detected FACW-driven changes in milk yield, milk protein yield, and milk energy output compared with control. Also, there was no evidence for differences in intake of net energy for lactation, efficiency of energy use, energy balance, or body weight or body condition score change from calving to 45 DIM between treatments. Supplementation of FACW shifted rumen measures toward greater molar proportions of propionate and butyrate, and lesser molar proportions of acetate and valerate. Cows supplemented with FACW had greater plasma glucose concentrations in the period from 3 to 7 DIM and greater plasma insulin concentrations compared with control. Plasma nonesterified fatty acid and ß-hydroxybutyrate concentrations were decreased in cows supplemented with FACW compared with control cows in the period from 3 to 7 DIM. These findings indicate that FACW may have improved the plasma metabolite profile immediately postpartum in dairy cows. Additionally, supplementation of FACW resulted in improved feed efficiency as accessed by measures of milk output relative to feed intake.

Dose-response evaluation of the standardized ileal digestible tryptophan : lysine ratio to maximize growth performance of growing-finishing gilts under commercial conditions.

Environmental regulations as well as economic incentives have resulted in greater use of synthetic amino acids in swine diets. Tryptophan is typically the second limiting amino acid in corn-soybean meal-based diets. However, using corn-based co-products emphasizes the need to evaluate the pig's response to increasing Trp concentrations. Therefore, the objective of these studies was to evaluate the dose-response to increasing standardized ileal digestible (SID) Trp : Lys on growth performance of growing-finishing gilts housed under large-scale commercial conditions. Dietary treatments consisted of SID Trp : Lys of 14.5%, 16.5%, 18.0%, 19.5%, 21.0%, 22.5% and 24.5%. The study was conducted in four experiments of 21 days of duration each, and used corn-soybean meal-based diets with 30% distillers dried grains with solubles. A total of 1166, 1099, 1132 and 975 gilts (PIC 337×1050, initially 29.9±2.0 kg, 55.5±4.8 kg, 71.2±3.4 kg and 106.2±3.1 kg BW, mean±SD) were used. Within each experiment, pens of gilts were blocked by BW and assigned to one of the seven dietary treatments and six pens per treatment with 20 to 28 gilts/pen. First, generalized linear mixed models were fit to data from each experiment to characterize performance. Next, data were modeled across experiments and fit competing dose-response linear and non-linear models and estimate SID Trp : Lys break points or maximums for performance. Competing models included broken-line linear (BLL), broken-line quadratic and quadratic polynomial (QP). For average daily gain (ADG), increasing the SID Trp : Lys increased growth rate in a quadratic manner (P<0.02) in all experiments except for Exp 2, for which the increase was linear (P<0.001). Increasing SID Trp : Lys increased (P<0.05) feed efficiency (G : F) quadratically in Exp 1, 3 and 4. For, ADG the QP was the best fitting dose-response model and the estimated maximum mean ADG was obtained at a 23.5% (95% confidence interval (CI): [22.7, 24.3%]) SID Trp : Lys. For maximum G : F, the BLL dose-response models had the best fit and estimated the SID Trp : Lys minimum to maximize G : F at 16.9 (95% CI: [16.0, 17.8%]). Thus, the estimated SID Trp : Lys for 30 to 125 kg gilts ranged from a minimum of 16.9% for maximum G : F to 23.5% for maximum ADG.

Modeling the effects of standardized ileal digestible isoleucine to lysine ratio on growth performance of nursery pigs.

Two experiments evaluated the effects of increasing standardized ileal digestible (SID) Ile:Lys ratio on growth performance of nursery pigs. In both experiments, dietary treatments consisted of 40, 44, 48, 52, 54, 58, or 63% SID Ile:Lys ratio. Diets were formulated using analyzed ingredient AA values and NRC (2012) SID coefficients. A combination of field peas and spray dried blood cells were used to ensure a low enough Ile diet concentration while minimizing the excess of Leu. The experiments consisted of 8 pens per dietary treatment with 5 pigs per pen for a total of 280 nursery pigs per experiment (Exp. 1: PIC 327 × 1,050, initially 6.7 ± 1.0 kg BW; Exp. 2: DNA 600 × 241, initially 6.0 ± 0.97 kg BW). Data were analyzed using mixed models with heterogeneous variance, where appropriate. The dose response was further characterized using quadratic polynomial (QP), broken-line linear (BLL), or broken-line quadratic (BLQ) functional forms. For Exp. 1, diets were initiated 6-d post-weaning and fed for 12-d followed by a common diet from d 12 to 28. From d 0 to 12, increasing dietary SID Ile:Lys ratio increased ADG (linear, P < 0.005) and ADFI (quadratic, P < 0.017) but G:F decreased (quadratic, P < 0.043). For ADG, the QP, BLL, and BLQ models resulted in maximum ADG at 64.7, 52.0, and 52.0 SID Ile:Lys ratios, respectively. For ADFI, the BLL breakpoint occurred at 50.6 and the QP predicted maximum ADFI at 56.2 SID Ile:Lys ratio. In Exp. 2, diets were initiated 6-d post-weaning for 7 pens and 3-d post-weaning for one heavier block and fed for 18-d followed by a common diet from d 18 to 32. From d 0 to 18, ADG and ADFI increased (quadratic, P < 0.016) with no evidence for difference in G:F as SID Ile:Lys ratio increased. For ADG, the QP and BLL had similar fit with breakpoints or maximums occurring at 58.3 and 51.8% SID Ile:Lys ratio, respectively. For ADFI, the BLQ breakpoint occurred at 52.0 SID Ile:Lys and the QP maximum ADFI at 57.2% SID Ile:Lys ratio. In conclusion, broken-line models reported maxima of 52.0% Ile:Lys ratio while quadratic models were as high as 64% of Lys to maximize ADG and ADFI of 6- to 11-kg nursery pigs. However, for the QP models 99% of the maximum response was achieved with a dose comparable to that from the broken line models. Therefore, these results are similar to the NRC (2012) requirement estimate of 51.1 Ile:Lys ratio.

Modeling the effects of standardized ileal digestible valine to lysine ratio on growth performance of nursery pigs.

Two experiments evaluated the effects of increasing Lys and Val on growth performance of nursery pigs. In Exp. 1,300 nursery pigs (PIC 327 × 1,050, initially 6.7 ± 1.4 kg BW) were randomly allotted to 1 of 6 diets containing 1.10, 1.20, 1.30, 1.40, 1.50, or 1.60% standardized ileal digestible (SID) Lys, with 10 pens per dietary treatment and 5 pigs per pen. Linear and nonlinear mixed models were fitted to estimate dose responses. From d 0 to 14, and for the overall 28 d period, ADG and G:F increased (linear, P < 0.001) as SID Lys increased, with no evidence of differences in ADFI. Dose response modeling indicated the SID Lys requirement for ADG and G:F was at 1.45% using a broken line linear (BLL) and greater than 1.60% using a quadratic polynomial (QP) model. In Exp. 2, 280 nursery pigs (PIC 327 × 1,050, initially 6.5 ± 1.3 kg BW) were allotted to 1 of 7 diets containing SID Val:Lys ratios of 50, 57, 63, 68, 73, 78, or 85%. The dietary SID Lys concentration 1.24% SID Lys which was below the estimated requirement from Exp. 1 and ensured the Val:Lys ratio was not underestimated. From d 0 to 14, ADG, ADFI, and G:F increased (quadratic, P < 0.039) with increasing SID Val:Lys. For ADG, the best fitting model was a BLL, with a breakpoint estimate of 62.9% SID Val:Lys [52.2, 73.7] ratio while for G:F the best fit model was a quadratic polynomial with a maximum G:F at 71.7% SID Val:Lys (95%CI:[58, > 85]). Average daily feed intake was also modeled with a quadratic polynomial and maximized at 73.7% Val:Lys (95% CI: [61, > 85]). In conclusion, the Val requirement ranged from approximately 63 to 74% of Lys depending on the response criteria modeled.

Cardiac Troponin T and creatine kinase MB fraction levels among patients with acute ischemic stroke in Nigeria.

BACKGROUND: Stroke has been a global burden, with increasing morbidity and mortality. Serum cardiac troponin t (cTnT) and creatine kinase (CK-MB) fraction are reported to be elevated in patients admitted with acute ischaemic stroke and high level of these biomarkers indicated more severe stroke and neurologic deficit in some of the patients. OBJECTIVE: To evaluate the serum levels cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in patients with acute ischaemic stroke and relate the analytes to severity of stroke. METHOD: Patients with clinical diagnosis of ischaemic stroke diagnosed, confirmed by brain Computerized Tomography scan and equal number of apparently healthy age and sex-matched were recruited. Serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) were analysed using ELISA method and Stroke severity was determined using National Institute of Health Stroke Score (NIHSS). RESULTS: Mean serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in stroke patients were found to be higher than age sex matched control (p<0.05). NIHS Score of 12.2 ± 5.43 and 9.78 ± 3.97 were observed in Patients with elevated and normal cTnT respectively (p=0.009) while NIHS Score were similar in patients with elevated and normal CK-MB (p = 0.772). CONCLUSION: The mean values of serum cTnT and CK-MB were higher in acute ischaemic stroke patients compared to controls. Serum cardiac Troponin t level may be a significant biomarker of the severity of stroke.

An update on modeling dose-response relationships: Accounting for correlated data structure and heterogeneous error variance in linear and nonlinear mixed models.

Advanced methods for dose-response assessments are used to estimate the minimum concentrations of a nutrient that maximizes a given outcome of interest, thereby determining nutritional requirements for optimal performance. Contrary to standard modeling assumptions, experimental data often present a design structure that includes correlations between observations (i.e., blocking, nesting, etc.) as well as heterogeneity of error variances; either can mislead inference if disregarded. Our objective is to demonstrate practical implementation of linear and nonlinear mixed models for dose-response relationships accounting for correlated data structure and heterogeneous error variances. To illustrate, we modeled data from a randomized complete block design study to evaluate the standardized ileal digestible (SID) Trp:Lys ratio dose-response on G:F of nursery pigs. A base linear mixed model was fitted to explore the functional form of G:F relative to Trp:Lys ratios and assess model assumptions. Next, we fitted 3 competing dose-response mixed models to G:F, namely a quadratic polynomial (QP) model, a broken-line linear (BLL) ascending model, and a broken-line quadratic (BLQ) ascending model, all of which included heteroskedastic specifications, as dictated by the base model. The GLIMMIX procedure of SAS (version 9.4) was used to fit the base and QP models and the NLMIXED procedure was used to fit the BLL and BLQ models. We further illustrated the use of a grid search of initial parameter values to facilitate convergence and parameter estimation in nonlinear mixed models. Fit between competing dose-response models was compared using a maximum likelihood-based Bayesian information criterion (BIC). The QP, BLL, and BLQ models fitted on G:F of nursery pigs yielded BIC values of 353.7, 343.4, and 345.2, respectively, thus indicating a better fit of the BLL model. The BLL breakpoint estimate of the SID Trp:Lys ratio was 16.5% (95% confidence interval [16.1, 17.0]). Problems with the estimation process rendered results from the BLQ model questionable. Importantly, accounting for heterogeneous variance enhanced inferential precision as the breadth of the confidence interval for the mean breakpoint decreased by approximately 44%. In summary, the article illustrates the use of linear and nonlinear mixed models for dose-response relationships accounting for heterogeneous residual variances, discusses important diagnostics and their implications for inference, and provides practical recommendations for computational troubleshooting.

Effects of amino acids and energy intake during late gestation of high-performing gilts and sows on litter and reproductive performance under commercial conditions.

The objective of this study was to determine the effects of AA and energy intake during late gestation on piglet birth weight and reproductive performance of high-performing (14.5 total born) gilts and sows housed under commercial conditions. At d 90 of gestation, a total of 1,102 females (PIC 1050) were housed in pens by parity group (gilts or sows) with approximately 63 gilts and 80 sows in each pen, blocked by BW within each pen, and each female was randomly assigned to dietary treatments within BW block. Dietary treatments consisted of combinations of 2 standardized ileal digestible (SID) AA intakes (10.7 or 20.0 g/d SID Lys and other AA met or exceeded the NRC [2012] recommendations) and 2 energy intakes (4.50 or 6.75 Mcal/d intake of NE) in a 2 × 2 factorial arrangement. Data were analyzed using generalized linear mixed models specified to recognize pen as the experimental unit for parity and the individual female as the experimental unit for dietary treatments. Results indicate an overall positive effect of high energy intake on BW gain during late gestation, although this effect was more manifest under conditions of high, as opposed to low, AA intake (interaction, < 0.001). Furthermore, the magnitude of BW gain response to increased energy intake was greater ( < 0.001) for sows compared with gilts. Sows fed high energy intake had a reduced probability of piglets born alive ( < 0.004) compared with those fed low energy, but no evidence for differences was found in gilts. This can be explained by an increased probability ( = 0.002) of stillborns in sows fed high energy intake vs. sows fed low energy intake. There were no evidences for differences among dietary treatments in litter birth weight and individual piglet birth weight of total piglets born. However, individual born alive birth weight was approximately 30 ± 8.2 g heavier ( = 0.011) for females fed high, as opposed to low, energy intake. Furthermore, piglets born alive were approximately 97 ± 9.5 g heavier ( < 0.001) for sows than for gilts. Preweaning mortality was decreased ( = 0.034) for females fed high AA intake compared with females fed low AA intake regardless of energy level. In conclusion, 1) BW gain of gilts and sows depended not only on energy but also on AA intake, 2) sows fed increased amount of energy had an increased stillborn rate, and 3) increased energy intake during late gestation had a positive effect on individual piglet birth weight with no evidence for such an effect for AA intake.

Juvenile, adult and late-onset systemic lupus erythematosus: a long term follow-up study from a geographic and ethnically homogeneous population.

OBJECTIVES: This paper aims to identify clinical and serological differences, damage accrual and mortality, in juvenile, adult and late-onset SLE. METHODS: We conducted our study with patients fulfilling SLE classification criteria taken from the Hospital Gregorio Marañon Autoimmune Systemic Rheumatic Diseases' Registry (1986 to 2012). Clinical characteristics, laboratory data and therapies used during the course of the disease were analysed with patients divided into 3 groups: juvenile-onset (≤ 18 years), adult-onset (19-50) and late onset (>50 years). RESULTS: Four hundred and forty-five patients were included. Renal disease and cutaneous manifestations were more frequent in the juvenile-onset group at disease onset. During follow-up, juvenile-onset group presented a higher incidence of renal disease, malar rash, Raynaud's phenomenon, cutaneous vasculitis, and neuropsychiatric manifestations than the other two groups. Arthritis and lymphopoenia were more frequent in the adult-onset group. Arterial hypertension and neoplasm were more frequent in the late-onset group. Low serum complement, anti-dsDNA, anti-U1RNP and anti-Sm antibodies were more common in the juvenile-onset group. Patients with late-onset SLE had more damage accrual. Thirty-seven patients (8.3%) died during the study. All-cause mortality was significantly higher in the late-onset group. Age at disease onset >50 years was an independent risk factor for damage accrual (OR, 2.2; 95%CI, 1.1-4.6; p=0.029) and mortality (OR, 2.6; 95%CI, 1.1-6.3; p=0.03). CONCLUSIONS: We found significant differences in clinical and serological profiles between juvenile, adult and late-onset SLE. The most significant of which was a higher prevalence of neuropsychiatric and renal complications as well as different autoantibody signatures for the juvenile-onset group.

Effects of standardized ileal digestible tryptophan: lysine ratio on growth performance of nursery pigs.

Two experiments were conducted to estimate the standardized ileal digestible (SID) Trp:Lys ratio requirement for growth performance of nursery pigs. Experimental diets were formulated to ensure that lysine was the second limiting AA throughout the experiments. In Exp. 1 (6 to 10 kg BW), 255 nursery pigs (PIC 327 × 1050, initially 6.3 ± 0.15 kg, mean ± SD) arranged in pens of 6 or 7 pigs were blocked by pen weight and assigned to experimental diets (7 pens/diet) consisting of SID Trp:Lys ratios of 14.7%, 16.5%, 18.4%, 20.3%, 22.1%, and 24.0% for 14 d with 1.30% SID Lys. In Exp. 2 (11 to 20 kg BW), 1,088 pigs (PIC 337 × 1050, initially 11.2 kg ± 1.35 BW, mean ± SD) arranged in pens of 24 to 27 pigs were blocked by average pig weight and assigned to experimental diets (6 pens/diet) consisting of SID Trp:Lys ratios of 14.5%, 16.5%, 18.0%, 19.5%, 21.0%, 22.5%, and 24.5% for 21 d with 30% dried distillers grains with solubles and 0.97% SID Lys. Each experiment was analyzed using general linear mixed models with heterogeneous residual variances. Competing heteroskedastic models included broken-line linear (BLL), broken-line quadratic (BLQ), and quadratic polynomial (QP). For each response, the best-fitting model was selected using Bayesian information criterion. In Exp. 1 (6 to 10 kg BW), increasing SID Trp:Lys ratio linearly increased ( 0.05) ADG and G:F. For ADG, the best-fitting model was a QP in which the maximum ADG was estimated at 23.9% (95% confidence interval [CI]: [<14.7%, >24.0%]) SID Trp:Lys ratio. For G:F, the best-fitting model was a BLL in which the maximum G:F was estimated at 20.4% (95% CI: [14.3%, 26.5%]) SID Trp:Lys. In Exp. 2 (11 to 20 kg BW), increasing SID Trp:Lys ratio increased ( 0.05) ADG and G:F in a quadratic manner. For ADG, the best-fitting model was a QP in which the maximum ADG was estimated at 21.2% (95% CI: [20.5%, 21.9%]) SID Trp:Lys. For G:F, BLL and BLQ models had comparable fit and estimated SID Trp:Lys requirements at 16.6% (95% CI: [16.0%, 17.3%]) and 17.1% (95% CI: [16.6%, 17.7%]), respectively. In conclusion, the estimated SID Trp:Lys requirement in Exp. 1 ranged from 20.4% for maximum G:F to 23.9% for maximum ADG, whereas in Exp. 2 it ranged from 16.6% for maximum G:F to 21.2% for maximum ADG. These results suggest that standard recommendations may underestimate the SID Trp:Lys requirement for nursery pigs from 11 to 20 kg BW.

An alternative approach to modeling genetic merit of feed efficiency in dairy cattle.

Genetic improvement of feed efficiency (FE) in dairy cattle requires greater attention given increasingly important resource constraint issues. A widely accepted yet occasionally contested measure of FE in dairy cattle is residual feed intake (RFI). The use of RFI is limiting for several reasons, including interpretation, differences in recording frequencies between the various component traits that define RFI, and potential differences in genetic versus nongenetic relationships between dry matter intake (DMI) and FE component traits. Hence, analyses focusing on DMI as the response are often preferred. We propose an alternative multiple-trait (MT) modeling strategy that exploits the Cholesky decomposition to provide a potentially more robust measure of FE. We demonstrate that our proposed FE measure is identical to RFI provided that genetic and nongenetic relationships between DMI and component traits of FE are identical. We assessed both approaches (MT and RFI) by simulation as well as by application to 26,383 weekly records from 50 to 200 d in milk on 2,470 cows from a dairy FE consortium study involving 7 institutions. Although the proposed MT model fared better than the RFI model when simulated genetic and nongenetic associations between DMI and FE component traits were substantially different from each other, no meaningful differences were found in predictive performance between the 2 models when applied to the consortium data.

Performance and carcass characteristics of commercial feedlot cattle from a study of vaccine and direct-fed microbial effects on Escherichia col O157:H7 fecal shedding.

The objective of this study was to quantify cattle performance and carcass characteristics associated with administration of a siderophore receptor and porin proteins-based vaccine (VAC) and a direct-fed microbial (DFM), which were originally evaluated for their impact on O157:H7 fecal shedding in a commercial feedlot population. Cattle (P = 17,148) were randomly allocated into 40 pens grouped by allocation dates into 10 complete blocks; pens within block were randomly allocated to control, VAC, DFM, or VAC + DFM treatment groups in a 2 × 2 factorial design. The DFM (Bovamine) was fed daily at the labeled dose of 10 cfu/animal of Lactobacillus acidophilus for the duration of the intervention period (mean = 86.6 d). The VAC cattle were vaccinated on Days 0 and 21 whereas unvaccinated cattle were not given a placebo or rehandled on Day 21. Data were analyzed using general and generalized linear mixed models that accounted for the study design. Main effects of DFM and VAC are reported as there were no significant treatment interactions for any of the outcomes evaluated. Vaccinated cattle had lower total weight gain (P < 0.01), ADG (P = 0.03), and cumulative DMI during the intervention period (P < 0.01) compared with unvaccinated cattle, whereas the DFM increased total weight gain (P = 0.03) and G:F (P = 0.05) during the intervention period. Daily DMI was decreased (P < 0.01) in vaccinated pens compared with unvaccinated pens during a 5-d period immediately following revaccination. After the intervention period was completed, cattle were sorted following the standard operating procedure for the feedlot and all cattle were fed the DFM from that point until harvest. Each steer was individually identified through harvest. At harvest, vaccinated cattle had more total days on feed (P < 0.01) with a larger HCW (P = 0.01) than nonvaccinated cattle, whereas cattle not fed the DFM during the intervention period had a significantly larger HCW (P < 0.01) than those fed the DFM during the intervention period. We conclude that the use of these DFM and vaccine products have differential and independent effects on cattle performance and carcass characteristics in a commercial feedlot setting. Although the magnitude of these effects may vary among production systems, a more comprehensive understanding of the potential production costs of preharvest food safety pathogen control programs is essential if such programs are to be fully adopted in the industry.

Characterisation of immune responses in healthy foals when a multivalent vaccine protocol was initiated at age 90 or 180 days.

REASONS FOR PERFORMING STUDY: Protection from infectious disease requires antigen-specific immunity. In foals, most vaccine protocols are delayed until 6 months to avoid maternal antibody interference. Susceptibility to disease may exist prior to administration of vaccination at age 4-6 months. OBJECTIVES: The aim of this investigation was to characterise immune activation among healthy foals in response to a multivalent vaccine protocol and compare immune responses when foals were vaccinated at age either 90 or 180 days. STUDY DESIGN: Randomised block design. METHODS: Twelve healthy foals with colostral transfer were blocked for age and randomly assigned to vaccination at age 90 days (treatment) or at age 180 days (control). Vaccination protocols included a 3-dose series and booster vaccine administered at age 11 months. RESULTS: Immune response following vaccination at age 90 or 180 days was comparable for several measures of cellular immunity. Antigen specific CD4+ and CD8+ expression of interleukin-4, interferon-γ and granzyme B to eastern equine encephalomyelitis, western equine encephalomyelitis, West Nile virus, tetanus toxoid, equine influenza and equine herpesvirus-1/4 antigens were evident for both groups 30 days after initial vaccine and at age 344 days. Both groups showed a significant increase in antigen-specific immunoglobulin G expression following booster vaccine at age 11 months, thereby indicating memory immune responses. CONCLUSIONS: The data presented in this report demonstrate that young foals are capable of immune activation following a 3-dose series with a multivalent vaccine, despite presence of maternal antibodies. Although immune activation does not automatically confer protection, several of the immune indicators measured showed comparable expression in foals vaccinated at 3 months relative to control foals vaccinated at age 6 months. In high-risk situations where immunity may be required earlier than following a conventional vaccine series, our data provide evidence that foals respond to immunisation initiated at 3 months in a comparable manner to foals initiated at an older age.

Discrepancies in identification of left atrial enlargement using left atrial volume versus left atrial-to-aortic root ratio in dogs.

BACKGROUND: Left atrial size is prognostically important in dogs with myxomatous mitral valve disease (MMVD). HYPOTHESIS/OBJECTIVES: To compare the level of agreement in identification of left atrial enlargement (LAE) between the left atrial-to-aortic root ratio (LA : Ao) and left atrial volume using the biplane area-length method indexed to body weight (LA Vol/BW). ANIMALS: Sixty dogs with MMVD and 22 normal dogs were prospectively studied with 2-dimensional echocardiography. METHODS: The upper limit of normal for LA Vol/BW was defined as 1.1 mL/kg. LA : Ao was deemed normal if ≤1.5. To define overall disease severity, each dog was assigned a mitral regurgitation severity score (MRSS) based on echocardiographic parameters that did not include left atrial size. ACVIM staging also was utilized. RESULTS: Of 60 affected dogs, 20 were ACVIM Stage B1, 25 were Stage B2, and 15 were Stage C. LA Vol/BW identified LAE in 12 cases in which LA : Ao was normal; 7 of these were Stage B1 and 5 were Stage B2. This diagnostic disagreement was significant (P = .00012). Of the 12 cases in which diagnostic discrepancies were identified, 5/5 of the B2 dogs and 3/7 B1 dogs had a moderate MRSS, whereas 4/7 B1 dogs had a mild MRSS. No diagnostic discrepancies between LA : Ao and LA Vol/BW were apparent in dogs with a severe MRSS. CONCLUSIONS AND CLINICAL IMPORTANCE: This study shows evidence of diagnostic disagreement between LA : Ao and LA Vol/BW for assessment of LAE. LA Vol/BW may be superior to LA : Ao for identification of mild LAE.

Effect of castration method on neurohormonal and electroencephalographic stress indicators in Holstein calves of different ages.

As public concern for food animal welfare increases, a need to validate objective pain assessment tools exists in order to formulate animal welfare policies and facilitate regulatory approval of compounds to alleviate pain in livestock in the United States. The aims of this study were (1) to compare the physiological response to pain induced by surgical and nonsurgical (band) castration in calves and (2) to elucidate age-related differences in pain response of calves subjected to different castration methods. Seventy-six Holstein bull calves were blocked by age (≤8-wk and ≥6-mo-old) and randomly assigned to 1 of 4 treatment groups: control (n=20), castration by banding (n=18), cut-and-clamp surgical castration (n=20), and cut-and-pull surgical castration (n=18). Measurements included electroencephalogram, heart rate variability, infrared thermography, electrodermal activity, and concentrations of serum cortisol and plasma substance P before, during, and within 20min following castration. Electroencephalogram recordings showed desynchronization for all treatments, consistent with increased arousal; yet the magnitude of desynchronization was greatest for 6-mo-old calves castrated by cut-and-clamp. Additionally, older calves in the cut-and-pull group showed greater desynchronization than younger calves in the same group. Based on the heart rate variability analysis, 6-mo-old calves in the control or cut-and-pull castration groups showed greater sympathetic tone than younger calves in the same treatment groups. Overall, younger calves showed lower electrodermal activity than older calves. Regardless of treatment, concentrations of cortisol and plasma substance P were greater in 6-mo-old calves relative to their younger counterparts, indicating a more robust response to all treatments in older calves. In summary, neurohormonal and electroencephalographic stress responses of calves to castration were age-specific. Castration by cut-and-clamp showed the most pronounced stress response in 6-mo-old calves. These findings provide evidence that support welfare policies recommending castration at an early age and the use of analgesic compounds at the time of surgical castration especially in older calves. However, the potential long-term negative consequences of early untreated pain must be considered and warrant further investigation.

Effects of urea formaldehyde condensation polymer treatment of flaxseed on ruminal digestion and lactation in dairy cows.

Flaxseed is a potent source of the n-3 fatty acid α-linolenic acid (ALA), yet most ALA is lost during ruminal biohydrogenation when ground flaxseed is fed to ruminants. Heat processing and urea formaldehyde condensation polymer (UFCP) treatment of flaxseed were investigated as possible means of protecting ALA from ruminal degradation. Ground flaxseed (GF), heated ground flaxseed (HGF), or UFCP-treated ground flaxseed (UFCPGF) were incubated for 0, 4, 8, and 12h in 4 ruminally cannulated multiparous lactating Holstein cows. Compared with GF, HGF and UFCPGF decreased ruminal disappearance of dry matter, crude protein, and ALA. Pepsin-digestible protein remaining after 12h of ruminal incubation was greater for UFCPGF and HGF than for GF. Twenty-four lactating Holstein cows (207 ± 37 d in milk, 668 ± 66 kg of body weight, and 1.33 ± 0.56 lactations) were then used in a randomized complete block design experiment with a basal feeding period to assess effects of flaxseed treatment on ALA enrichment of plasma and milk as well as lactational performance. No evidence existed that supplementation of HGF and UFCPGF affected dry matter intake, milk fat content, milk protein content, or energy-corrected milk yield, but UFCPGF marginally decreased milk yield compared with HGF. Plasma concentration of ALA was not affected by treatment. Concentrations of n-3 fatty acids and conjugated linoleic acids in milk fat were increased by UFCPGF relative to HGF, but ALA yield was not affected. Taken together, in situ results suggest that heat-treated flaxseed, with or without UFCP treatment, slowed ruminal disappearance of ALA. Feeding UFCP-treated flaxseed failed to alter ALA content of plasma or milk ALA yield relative to heating alone.

Cows and herds constitute distinct hierarchical levels of heterogeneity in the variability of and association between milk yield and pregnancy outcome in dairy cows.

The objectives of this study were to investigate heterogeneity in the variance of and the association between milk yield (MY) and pregnancy outcome (PO) in dairy cows, formally separating the within-herd (i.e., cow-level residual effects) from the between-herd (i.e., herd-level random effects) components. Based on a recently developed extension to bivariate generalized hierarchical linear mixed models, we specified functions of residual and random effect variances and covariances as linear combinations of fixed and random effects to infer upon heterogeneity in the variation of and the association between MY and PO at first postpartum insemination. As potential sources of heterogeneity, we evaluated various management practices and herd attributes of interest by assessing model fit using the deviance information criterion. Our data consisted of 89,105 Dairy Herd Improvement Association cow records from 379 dairy herds in Michigan. Within herds, no evidence of a cow-level (residual) association between MY and PO was observed, as the corresponding association parameter did not significantly depart from zero. However, the herd-level (random effects) relationship between MY and PO was antagonistic and depended on management practices that determine the baseline level of fertility for a herd. In other words, herds with greater average MY at the time of first postpartum insemination had lower pregnancy rates, but within such herds, cows with higher daily yields did not seem to be any more or less likely to become pregnant than lower-yielding herdmates. Nevertheless, Michigan counties differed in the magnitude of the herd-level association between MY and PO, thus indicating that regional environmental conditions or management practices may partially alleviate the herd-level antagonism between MY and PO. The heterogeneity in variability of MY was substantial and primarily explained at the cow level by management conditions and other herd-specific attributes. In summary, the nature of the variability of and the association between MY and PO in dairy cows is complex due to the heterogeneous contributions of both cow- and herd-level components. Further research should be pursued to investigate additional management scenarios that ameliorate or even enhance the association between MY and PO in commercial dairy cows during first postpartum insemination.