Effect of wearing an N95 respirator on the internal nasal valve and the association with external nasal anatomy - a cohort study.

OBJECTIVES: To determine whether: the N95 respirator affects nasal valve patency; placement on the bony vault improves patency; and external nasal anatomy affects the outcome. METHODS: A prospective study with 50 participants was conducted. Nasal patency was measured by the minimal cross-sectional area via acoustic rhinometry, and using the Nasal Obstruction Symptom Evaluation survey, before and after wearing the N95 respirator and after adjustment. RESULTS: The minimal cross-sectional area was narrowed by 27 per cent when wearing the N95 respirator (p < 0.001), and improved by 9.2 per cent after adjustment (p = 0.003). The total Nasal Obstruction Symptom Evaluation score increased from 10.2 to 25.4 after donning the N95 respirator (p < 0.001), and decreased from 25.4 to 15.6 after adjustment (p < 0.001). There was no correlation with external nasal anatomy parameters. CONCLUSION: Wearing the N95 respirator causes narrowing of the nasal valve, and adjustment onto the bony vault improves symptoms. The findings were not affected by external nasal anatomy.

Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ).

BACKGROUND: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. METHODS: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. RESULTS: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. CONCLUSIONS: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.

Reducing inhomogeneity in the dynamic properties of quantum dots via self-aligned plasmonic cavities.

A plasmonic cavity is shown to greatly reduce the inhomogeneity of dynamic optical properties such as quantum efficiency and radiative lifetime of InGaN quantum dots. By using an open-top plasmonic cavity structure, which exhibits a large Purcell factor and antenna quantum efficiency, the resulting quantum efficiency distribution for the quantum dots narrows and is no longer limited by the quantum dot inhomogeneity. The standard deviation of the quantum efficiency can be reduced to 2% while maintaining the overall quantum efficiency at 70%, making InGaN quantum dots a viable candidate for high-speed quantum cryptography and random number generation applications.

Association between obesity and risk of chronic kidney disease: A nationwide Cohort study in Taiwan.

BACKGROUND AND AIMS: Increased body fat relates to enhanced inflammatory cytokine production, which, in turn, activates the renin-angiotensin-aldosterone system and increases the risk of chronic kidney disease (CKD). Herein, we aimed to examine the association between obesity and the risk of CKD in a population-representative cohort in Taiwan. METHODS AND RESULTS: A multistage systematic sampling process was applied in the National Health Interview Survey (NHIS) 2000, 2005, and 2009. Participants were interviewed by a standardized face-to-face questionnaire to obtain information on their demographics, socioeconomic status, lifestyle factors, and body mass index (BMI). The BMI values were classified as follows: underweight (<18.5 kg/m2), normal (18.5-23.9 kg/m2), overweight (24-26.9 kg/m2), and obesity (≥27 kg/m2). The NHIS dataset was linked to National Health Insurance claims data to identify the incidence of CKD. Univariate and multivariate Cox proportional hazard models with competing risks were used to investigate the association between BMI and CKD incidence. We analyzed 45,012 subjects (mean age, 42.03 years; 50.09% males). During 374,254 person-years of follow-up, a total of 1913 new-onset CKD cases were identified. Kaplan-Meier curves comparing the four BMI groups revealed a significant difference (p < 0.01, log-rank test). After controlling for confounding factors, the relative risk of incident CKD was significantly higher in the obese group compared to the normal-weight group (adjusted hazard ratio = 1.32; 95% confidence interval: 1.17-1.49), with a significant linear trend (p < 0.01). CONCLUSION: Obesity was suggested as an independent risk factor for CKD. Further studies focusing on the effect of losing weight on CKD prevention are warranted.

Obesity/overweight reduces the risk of active tuberculosis: a nationwide population-based cohort study in Taiwan.

BACKGROUND: Obesity affects immune function by increasing the number of T helper lymphocytes, which may reduce the risk of tuberculosis (TB) infection. However, the effect of obesity on TB development has not been extensively studied. This nationwide population-based cohort study investigated the effect of obesity on TB development in Taiwanese adults. METHODS: We included 46 028 adult participants (age ⩾18 years) from three rounds (2001, 2005 and 2009) of the Taiwan National Health Interview Survey. Obesity and overweight were defined as a body mass index (BMI) ⩾27 and 24-26.9 (kg/m2), respectively. Data on BMI and other covariates at baseline were collected by in-person interviews. Incident cases of active TB were identified from the National Health Insurance database. Multivariable logistic regression was used to estimate the associations of obesity and overweight with active TB, with adjustment for age, sex, smoking, alcohol consumption, socioeconomic status and other covariates. RESULTS: In total, 241 new cases of active TB occurred during the study period. Obesity (adjusted odds ratio [AOR], 0.43; 95% confident interval [CI], 0.28-0.67) and overweight (AOR, 0.67; 95% CI, 0.49-0.91) were associated with lower risk of incident TB, after adjusting for demographic characteristics and comorbidities. There was a linear dose-response relation of BMI with active TB incidence (AOR per unit change in BMI, 0.92; 95% CI, 0.88-0.95; P <0.001). CONCLUSION: Obesity and overweight are associated with lower risk of active TB. Future studies should investigate the underlying mechanisms and clinical and epidemiological consequences of these findings.

The limits of stability and muscle activity in middle-aged adults during static and dynamic stance.

Balance control plays an important role in maintaining daily activity. However, studies on postural control among middle-aged adults are scarce. This study aims (i) to examine directional control (DCL) and electromyography activity (EMG) for different stability levels, and (ii) to determine left-right asymmetry for DCL and muscle activity among sedentary middle-aged adults. Twenty healthy, middle-aged adults (10 males, 10 females; age=50.0±7.5yrs; body height: 1.61±0.10m; body mass: 70.0±14.5kg) participated in the study. EMG for left and right side of rectus femoris (RF), biceps femoris (BF), and medial gastrocnemius (MG) were recorded. Two-way repeated measures analysis of variance was used to assess the effect of dynamic level on DCL and EMG, whereas independent sample t-test was conducted to analyse the asymmetries of DCL and EMG for the left and right leg. When the dynamic tilt surface increased, DCL scores significantly decreased (except forward, forward-rightward, and backward-leftward direction) and only RF muscle indicated significant differences. Left-right asymmetry was found in BF and MG muscles. No significant gender difference was observed in DCL and EMG. These data demonstrated that increased dynamic tilt surface may increase the displacement of center of pressure of certain directions, and stimulate RF activity in dynamic stance among sedentary middle-aged adults. Further studies should be conducted to examine the dynamic stance and muscle activity of the lower limb in age-matched patient groups with balance abnormalities.

Association between actigraphy-derived physical activity and cognitive performance in patients with schizophrenia.

BACKGROUND: An association between low levels of physical activity and impaired cognitive performance in schizophrenia has been proposed, but most studies have relied on self-report measures of activity. This study examined the association between actigraphy-derived physical activity and cognitive performance adjusting for multiple covariates in patients with schizophrenia. METHOD: Patients with schizophrenia (n = 199) were recruited from chronic psychiatric wards, and 60 age-, sex- and body mass index-matched comparison participants were recruited from the staff of two hospitals and universities. Physical activity was assessed objectively for 7 days using an ActiGraph. Cognitive performance was assessed with the Cognitrone test from the Vienna Test System and the Grooved Pegboard Test. Demographic variables, metabolic parameters, positive and negative symptoms, duration of illness and hospitalization, and medication use were included as covariates. Pearson correlations and multivariable linear regressions were conducted to examine the associations between physical activity levels and cognitive performance. RESULTS: Patients with schizophrenia were less physically active and had poorer performance on attention/concentration and speed of processing than the comparison group. Patients with schizophrenia who spent more time in light physical activity showed better performance on attention/concentration (ß = 0.198, p = 0.020) and speed of processing (ß= -0.169, p = 0.048) tasks than those who were less active. Cognitive performance was also associated with moderate-vigorous physical activity, but the effect was no longer significant once light physical activity had been taken into account. CONCLUSIONS: This study provides evidence for a positive association between objectively measured light physical activity and cognitive performance in people with schizophrenia, after adjustment for multiple confounders.

Modelling the vicious circle between obesity and physical activity in children and adolescents using a bivariate probit model with endogenous regressors.

The increasing prevalence of obesity in children and adolescents has become one of the most important public health issues around the world. Lack of physical activity is a risk factor for obesity, while being obese could reduce the likelihood of participating in physical activity. Failing to account for the endogeneity between obesity and physical activity would result in biased estimation. This study investigates the relationship between overweight and physical activity by taking endogeneity into consideration. It develops an endogenous bivariate probit model estimated by the maximum likelihood method. The data included 4008 boys and 4197 girls in the 5th-9th grades in Taiwan in 2007-2008. The relationship between overweight and physical activity is significantly negative in the endogenous model, but insignificant in the comparative exogenous model. This endogenous relationship presents a vicious circle in which lower levels of physical activity lead to overweight, while those who are already overweight engage in less physical activity. The results not only reveal the importance of endogenous treatment, but also demonstrate the robust negative relationship between these two factors. An emphasis should be put on overweight and obese children and adolescents in order to break the vicious circle. Promotion of physical activity by appropriate counselling programmes and peer support could be effective in reducing the prevalence of obesity in children and adolescents.

Cerebral klotho protein as a humoral factor for maintenance of baroreflex.

The klotho protein produced by the choroid plexus is known as a humoral factor in central nervous system. Many hormones affecting the baroreflex sensitivity have been introduced in the brain. However, role of klotho in the baroreflex sensitivity is still unknown. Recently, mutations in the klotho gene have been linked to cardiovascular diseases in both animals and human subjects. Also, silencing of brain klotho has been reported to enhance cold-induced elevation of blood pressure. Thus, we investigated the role of klotho in maintenance of central cardiovascular reflex sensitivity. Male Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs) were used. Either klotho shRNA or scramble shRNA was also ICV-infused into the brains of WKY rats to investigate the role of klotho in brain. Recombinant klotho or rat IgG was infused into the cerebral paraventricle (ICV) of SHRs for further understanding the role of klotho in hypertension. The baroreflex sensitivity was detected using the challenge with a depressor dose of sodium nitroprusside (SNP, 50 µg/kg) or with a pressor dose of phenylephrine (PE, 8 µg/kg). We found that silencing of klotho expression in the brain decreased the baroreflex sensitivity in WKY rats. Also, modulation of the blood pressure for one week altered the cardiovascular homeostasis and resulted in an increased expression of klotho in medulla oblongata. Moreover, the baroreflex sensitivity was restored in SHRs that received recombinant klotho through ICV brain. Thus, klotho is involved in the maintenance of baroreflex sensitivity in the brain.

Insulin resistance induced by zymosan as a new animal model in mice.

Insulin resistance (IR) is known as a main problem in diabetic disorders. Some animal models for research in IR have been mentioned. Each model shows merit with some disadvantages. Thus, a new animal model for IR is required. The present study used zymosan, a mixture of cell-wall particles from the yeast named Saccharomyces cerevisiae, to establish a new model of IR in mice. Also, we compared the difference of this model with fructose-rich chow-induced model and found some merits of this model. Moreover, we identified that this model induced by zymosan is reversible and IR can be reversed gradually after termination of treatment. Taken together, we suggest zymosan as a useful agent to induce IR through inflammatory pathway in mice.

Activation of receptors δ (PPARδ) by agonist (GW0742) may enhance lipid metabolism in heart both in vivo and in vitro.

It has been documented that cardiac agents may regulate the lipid metabolism through increased expression of PPARδ in cardiac cells. However, the effect on lipid metabolism by direct activation of PPARδ is still unknown. The present study applied specific PPARδ agonist (GW0742) to investigate this point in the heart of Wistar rats and in the primary cultured cardiomyocytes from neonatal rat. Expressions of PPARδ in the heart and cardiomyocytes after treatment with GW0742 were detected using Western blots. The fatty acid (FA) oxidation and the citric acid (TCA) cycle related genes in cardiomyocytes were also examined. In addition, PPARδ antagonist (GSK0660) and siRNA-PPARδ were employed to characterize the potential mechanisms. After a 7-day treatment with GW0742, expressions of PPARδ in the heart were markedly increased. Increased expressions of FA oxidation and TCA cycle related genes were also observed both in vivo and in vitro. This action of GW0742 was blocked by GSK0660 or by siRNA-PPARδ. The obtained results show that activation of PPARδ by GW0742 is responsible for the increase of FA oxidation and TCA cycle related genes in hearts. Role of PPARδ in the regulation of lipid metabolism in heart is then established.

Characterization of the specificity of imidazoline I-1 receptor antibody for subtype of imidazoline receptors in vitro.

Specific antibodies are essential in the study of receptor protein. Gene matching shows that Nischarin (NISCH) is a mouse homologue of human imidazoline receptor antisera-selective (IRAS) protein, a viable candidate for imidazoline I-1 receptor. However, selectivity of this antibody against imidazoline I-2 or imidazoline I-3 receptors remained obscure. At first, an intracerebroventricular (ICV) injection of anti-NISCH antibody blocked the blood pressure lowering action of rilmenidine (I-1 receptor agonist) in spontaneous hypertensive rat (SHR). However, the same injection of anti-NISCH antibody showed no effect in SHR treated with clonidine (α2 agonist). In order to clarify the selectivity of anti-NISCH antibody for each subtype of imidazoline receptors, this anti-NISCH antibody was subjected to the lysate of organs isolated from Wistar rats including cortex, hippocampus, cerebellum, and brain stem as central nervous tissues, and heart, liver, pancreas, skeletal muscle, kidney, prostate, and bladder as peripheral tissues. The results show that anti-NISCH antibody positively reacted with all tissues including heart, pancreas, skeletal muscle, kidney and bladder by Western blot analysis. Also, the blotting spots for anti-NISCH antibody show a concentration-dependent manner. Moreover, anti-NISCH antibody blocked the action of glucose uptake induced by 2-BFI (I-2 receptor agonist) in L6 cells. Taken together, the obtained data suggest that anti-NISCH antibody can be used not only for imidazoline I-1 receptor but also for I-2 and I-3 subtypes in immunoassays.

Mediation of AMP kinase in the increase of glucose uptake in L6 cells induced by activation of imidazoline I-2 receptors.

Recent work using radioactive tracer indicates that activation of imidazoline I2 receptor (I2R) by guanidinium derivatives may increase the glucose uptake in the skeletal muscle. However, the effect of I2R activation on nonradioactive glucose uptake is still unknown. The ability of glucose uptake in cultured L6 cells is then determined using 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino]-2-deoxyglucose (2-NBDG) as a fluorescence indicator. The changes in 5'-AMP-activated protein kinase (AMPK) expression were also identified by Western blot analysis. In the present study, 2-(2-benzofuranyl)-2-imidazoline (2-BFI) is used to stimulate I2R while 5-aminoimidazole-4-carboxamide-1-ß-D-ribofuranoside (AICAR) is applied to activate AMPK directly. Both compounds can increase 2-NBDG in L6 cells in a concentration-dependent manner. Meanwhile, compound C at concentrations sufficient to inhibit AMPK blocked this increase of glucose uptake by 2-BFI or AICAR. However, only 2-BFI-induced glucose uptake action was dose-dependently blocked by BU224, a specific I2R antagonist, in L6 cells. Moreover, AMPK phosphorylation was markedly increased by 2-BFI or AICAR in L6 cells. Similarly, only the effect of 2-BFI was attenuated by BU224 in L6 cells. Thus, we suggest that AMPK is mediated in I2R activation for increase of glucose uptake in the skeletal muscle cell and I2R will be a new target for diabetic therapy.

The pre-emptive analgesic effect of a cyclooxygenase-2 inhibitor in a rat model of acute postoperative pain.

We examined the pre-emptive analgesic effect of a cyclooxygenase (COX)-2 inhibitor in a rat surgical pain model and characterised the changes in cutaneous COX-2 around a surgical site. Thermal hyperalgesia and mechanical allodynia were tested in the rats for three days after incision and skin tissues were collected for analysis of COX-2. There was decreased expression of cutaneous COX-2 one day after surgical incision. Pre-incision injection of the COX-2 inhibitor significantly inhibited expression of COX-2 and also reduced thermal hyperalgesia (but not mechanical allodynia) compared with the post-incision COX-2-inhibitor injection group, one day after incision.

Biomechanical evaluation of the relationship between postural control and body mass index.

Postural stability is crucial in maintaining body balance during quiet standing, locomotion, and any activities that require a high degree of balance performance, such as participating in sports and dancing. Research has shown that there is a relationship between stability and body mass. The aims of this study were to examine the impact that two variables had on static postural control: body mass index (BMI) and gender. Eighty healthy young adults (age=21.7±1.8 yr; height=1.65±0.09 m; mass=67.5±19.0 kg) participated in the study and the static postural control was assessed using the Biodex Balance System, with a 20 Hz sampling rate in the bipedic stance (BLS) and unipedic stance (ULS) for 30s. Five test evaluations were performed for each balance test. Postural control was found to be negatively correlated with increased adiposity, as the obese BMI group performed significantly poorer than the underweight, normal weight and overweight groups during BLS and ULS tests. The underweight, normal weight and overweight groups exhibited greater anterior-posterior stability in postural control during quiet stance. In addition, female displayed a trend of having a greater postural sway than male young adults, although it was evidenced in only some BMI groups. This study revealed that BMI do have an impact on postural control during both BLS and ULS. As such, BMI and gender-specific effects should be taken into consideration when selecting individuals for different types of sporting activities, especially those that require quiet standing.

Angular selective semi-transparent photovoltaics.

Conventional semi-transparent photovoltaics suffer from an inherent tradeoff between the amount of visible light transmitted versus absorbed, reducing energy conversion efficiency when higher transparency is desired. As a solution to lift this tradeoff, we propose a wavelength and angular selective reflector and demonstrate a potential implementation utilizing high aspect ratio metal nanoparticles. Using the anisotropy in the localized surface plasmon resonance wavelength, the proposed device can selectively harness sunlight incident at an elevated angle, increasing the power conversion efficiency by a factor of 1.44, while maintaining 70 percent optical transparency at normal incidence.

'Steam-boat' supraglottic laryngoplasty for treatment of chronic refractory aspiration: a modification of Biller's technique.

OBJECTIVE: The surgical treatment of intractable aspiration usually requires sacrifice of the patient's natural voice to prevent food entering the airway. Biller described a tubed supraglottic laryngoplasty to control aspiration while allowing patients to phonate with their larynx. Our preliminary experience with this technique in Chinese patients has been disappointing, as tension in the mucosa on wound closure led to wound dehiscence. Our objective was to modify Biller's technique in order to achieve a better outcome. METHOD: We modified Biller's technique by trimming the epiglottic cartilage and by inserting a tibial periosteal graft to reinforce closure of the mucosa, creating an arrangement resembling a Chinese steam boat. RESULTS: Three Chinese patients underwent the modified Biller's technique. No wound dehiscence occurred, the surgery controlled aspiration, and the patients were able to phonate with their own larynx. All patients resumed oral feeding, and previously placed gastrostomy tubes were removed. CONCLUSION: The 'steam-boat' supraglottic laryngoplasty is a viable surgical alternative to total laryngectomy or tracheal diversion for controlling intractable aspiration, and preserves a phonating larynx.

Emergency department organ-donation card pilot study.

OBJECTIVE: To determine public attitudes about an emergency department (ED)-based organ-donor enrollment program. METHOD: A total of 211 non-acutely ill patients treated in the ED of a 300-bed urban university hospital between November 1, 2004, and January 2, 2005, were asked to complete a survey. Surveys were obtained over six 4-hour daytime intervals. RESULTS: Of the 211 patients, 199 completed the survey and 12 refused. One hundred sixty-four patients (82%; 95% confidence interval [CI], 77%-88%) were interested in organ-donation information via the ED; 173 (87%; 95% CI, 82%-92%) approved of the ED providing organ-donation cards; and 82 (41%; 95% CI, 34%-48%) were current organ-donor cardholders. Of 117 patients who were not current organ-donor cardholders, 65 (56%; 95% CI, 46%-66%) stated that they would be willing to enroll in an ED-based organ-donor card program. Fifty-seven patients (49%, 95% CI, 39%-58%) were African American, and 35 of these (61%; 95% CI, 48%-74%) said they would obtain an organ-donor card via the ED. Overall, 137 of 199 patients (69%; 95% CI, 62%-75%) preferred ED organ donation information in written form, and the remainder preferred a personal interview or lecture. CONCLUSIONS: An ED organ-donation enrollment program would be acceptable to patients and effective in capturing groups who currently do not have organ-donor cards.

Population-specific anthropometric cutoff standards improve the functionality of the Mini Nutritional Assessment without BMI in institutionalized elderly in Taiwan.

OBJECTIVE: To assess the nutritional status of institutionalized Taiwanese elderly with the Mini Nutritional Assessment (MNA) without BMI and to determine whether the application of population-specific MAC and CC cutoff standards would improve the functionality of the tool. DESIGN: Purposive sampling. SETTING: A long-term care facility in central Taiwan. PARTICIPANTS: Two hundred and eight > 65 y residents who were free of acute infection/diseases and were able to communicate. MEASUREMENTS: A questionnaire survey to elicit personal data and administer the MNA and measurements of anthropometric and blood biochemical indicators. RESULTS: The MNA, without BMI, predicted 22.1% of participants malnourished and 61.1% at risk of malnutrition among residents of a long-term care facility in Taiwan. Replacing the population-specific cutoff standards of MAC and CC for the original cutoff standards in the MNA and increasing the weighted score of MAC and CC to replace for the weighted score of BMI preserved and improved the predicting ability of the MNA. The improvement was evidenced by the increase in the correlationships between the MNA scores and the anthropometric, biochemical or health status indicators. CONCLUSION: The MNA predicted nutritional risk status of the institutionalized elderly Taiwanese. The study suggests that whenever possible population-specific anthropometric cutoff standards should be applied to improve the functionality of the MNA. It also appears possible to preserve or even improve the functionality of the MNA without BMI. The modifications indicate an improvement in the application of the MNA in long-term care patients.

Dietary protein concentration affects plasma arteriovenous difference of amino acids across the porcine mammary gland.

The objective of this study was to determine whether the porcine mammary gland responds to increasing dietary CP concentration through changes in AA arteriovenous difference (a-v). Sixteen Landrace x Yorkshire lactating sows were provided ad libitum access to one of four isocaloric diets varying in CP concentration (7.8, 13.0, 18.2, and 23.5 %; as-fed basis). Litters were adjusted to 11 pigs within 48 h of birth. Sows were fitted with catheters in the carotid artery and main mammary vein on d 4. On d 10, 14, 18, and 22 of lactation, arterial and venous blood samples were obtained every 30 min over 6 h. Milk yield was estimated on d 11 and 21 using the D2O dilution technique. Final litter sizes on d 21 were 10.3, 11, 9.5, and 11 piglets for sows fed the 7.8, 13.0, 18.2, and 23.5% CP diets, respectively. Piglet ADG tended (P = 0.088) to increase with increasing dietary CP concentration and were 186, 221, 220, and 202 g for sows fed the 7.8, 13.0, 18.2, and 23.5% CP diet, respectively. Daily total milk yield on d 21 (kg milk/d) tended (P = 0.099) to increase, and average milk yield per nursed piglet (kg of milk-pig(-1)d(-1)) increased (P < 0.05) with increasing CP concentration and were, on a per-piglet basis, 0.95, 1.19, 1.14 and 1.13 kg of milk/d for the 7.8, 13.0, 18.2, and 23.5% CP diets, respectively. As dietary CP increased from 7.8 to 23.5%, isoleucine and leucine a-v increased linearly only (linear, P < 0.01); all other AA a-v increased, reached a maximum in sows fed 18.2% CP, and decreased thereafter in sows fed 23.5% CP (quadratic, from P = 0.10 to P < 0.05). Amino acid uptake by the entire udder and by each gland increased (linear, P < 0.05) with increasing dietary CP. Arteriovenous differences response to increasing day of lactation varied among AA, from no change for histidine, isoleucine, lysine, methionine, tryptophan, and valine, to a linear trend increase for arginine (P = 0.055), leucine (P = 0.064), phenylalanine (P = 0.101), and threonine (P = 0.057). In summary, for the majority of AA, a-v increased with increasing dietary CP concentration from 7.8 to 18.2%, but decreased when CP concentration exceeded 18.2%. In contrast, mammary AA uptake, piglet ADG and milk yield per pig increased linearly with increasing dietary CP, suggesting a coordinated regulation between AA delivery and transport to meet the demand for milk yield.