Kernel processing and theoretical length of cut (TLOC) of whole-plant corn silage (WPCS) can affect feed intake, digestibility, and performance of dairy cows. The objective of this study was to ...evaluate for lactating dairy cows the effects of kernel processing and TLOC of WPCS with vitreous endosperm. The treatments were a pull-type forage harvester without kernel processor set for a 6-mm TLOC (PT6) and a self-propelled forage harvester with kernel processor set for a 6-mm TLOC (SP6), 12-mm TLOC (SP12), and 18-mm TLOC (SP18). Processing scores of the WPCS were 32.1% (PT6), 53.9% (SP6), 49.0% (SP12), and 40.1% (SP18). Twenty-four Holstein cows (139 ± 63 d in milk) were blocked and assigned to six 4 × 4 Latin squares with 24-d periods (18 d of adaptation). Diets were formulated to contain 48.5% WPCS, 15.5% citrus pulp, 15.0% dry ground corn, 9.5% soybean meal, 6.8% low rumen degradability soybean meal, 1.8% calcium soap of palm fatty acids (FA), 1.7% mineral and vitamin mix, and 1% urea (dry matter basis). Nutrient composition of the diets (% of dry matter) was 16.5% crude protein, 28.9% neutral detergent fiber, and 25.4% starch. Three orthogonal contrasts were used to compare treatments: effect of kernel processing (PT6 vs. SP6) and effect of TLOC (particle size; SP6 vs. SP12 and SP12 vs. SP18). Cows fed SP6 produced 1.2 kg/d greater milk yield with no changes in dry matter intake, resulting in greater feed efficiency compared with PT6. Cows fed SP6 also produced more milk protein (+36 g/d), lactose (+61 g/d), and total solids (+94 g/d) than cows fed PT6. The mechanism for increased yield of milk and milk components involved greater kernel fragmentation, starch digestibility, and glucose availability for lactose synthesis by the mammary gland. However, cows fed SP6 had lower chewing time and tended to have greater levels of serum amyloid A compared with PT6. Milk yield was similar for SP6 and SP12, but SP12 cows tended to have less serum amyloid A with greater chewing time. Cows fed SP18 had lower total-tract starch digestibility and tended to have lower plasma glucose and produce less milk compared with cows fed SP12. Compared with PT6, feeding SP6 raised linear odd-chain FA concentration in milk. Similarly, a reduction of these same FA occurred for SP12 compared with SP6. Cows fed SP6 had greater proportion of milk C14:1 and C16:1 compared with PT6 and SP12. Lesser trans C18:1 followed by greater C18:0 concentrations were observed for SP12 and PT6 compared with SP6, which is an indication of more complete biohydrogenation in the rumen. Under the conditions of this study, the use of a self-propelled forage harvester with kernel processing set for a 12-mm TLOC is recommended for WPCS from hybrids with vitreous endosperm.
Twenty Holstein cows at 168 ± 87 d in milk (mean ± SD) were assigned to a 4 × 4 Latin square design with a 2 × 2 factorial arrangement to evaluate the effects of 2 storage lengths (30 or 90 d) and ...the presence of sodium benzoate (control or 0.2% as fed) on the nutritive value of reconstituted sorghum grain silages (RSGS). For each treatment, dry ground sorghum grain was rehydrated to 35% moisture and ensiled in 200-L plastic drums. The treatments were RSGS stored for 30 d without sodium benzoate (30 CON), RSGS stored for 30 d with sodium benzoate (30 BEN), RSGS stored for 90 d without sodium benzoate (90 CON) and RSGS stored for 90 d with sodium benzoate (90 BEN). Diets contained 16.3% RSGS. Silages stored for 90 d had higher concentrations of 1,2-propanediol, soluble protein, and ammonia nitrogen than did those stored for 30 d. Sodium benzoate reduced ethanol and ethyl-ester formation. Silages stored for 90 d had higher starch (89.3 vs. 86.9%) and protein (57.1 vs. 54.0%) digestibility compared with silages stored for 30 d. The ruminal acetate-to-propionate ratio tended to be lower in RSGS stored for 90 d than in RSGS stored for 30 d (3.75 vs. 3.34). Milk yield increased from 30.0 kg/d in cows fed RSGS stored for 30 d to 31.2 kg/d in cows fed RSGS stored for 90 d, without a change in dry matter intake (23.5 kg/d on average). Hence, feed efficiency and milk N efficiency also had tendencies to increase in cows fed RSGS stored for 90 d. Sodium benzoate did not alter cow performance but slightly increased plasma glucose (65.2 vs. 63.6 mg/dL). In conclusion, increasing the storage period of RSGS from 30 to 90 d improved starch and protein digestibility, milk yield, and feed efficiency.
Abstract
Background and purpose
Post-angiography renal replacement therapy (RRT) has shown protective effects from Ci-AKI (contrast induced acute kidney injury) in patients with pre-existing advanced ...renal disfunction. We analysed a series of 1095 continuative patients who undergone coronary or peripheral angiography in our center. In non-haemodialyzed patients with eGFR <20ml/min/1.73m2 or with poor renal reserve we performed an “early” RRT, starting during angiography procedure and applied for at least 6 h after procedure, thus diverging from previous literature data based only on post-procedure hours delayed RRT application. The RRT modality chosen was CVVHDF (continous veno-venous hemodiafiltration).
Methods
We considered following subjects variability: age, sex, weight, presence of hypertension, dyslipidaemia, diabetes, smoking habitude, left ventricular ejection fraction, amount of contrast media given and shock or infection occurrence during hospital stay. We evaluate statistic significative of serum creatine (SCr) variation in patients receiving RRT from pre-procedure time (T0), at 24h (T1), 48h (T2), 72h (T3) after procedure and at 3–8 weeks follow-up (T4). Quantitative data were compared with Student T test, qualitative data with Chi Square test, considering statistically significant p value <0.05 with two tails. Ci-AKI was defined as serum creatinine rise ≥0.3 mg/dL at 48h from contrast media administration, following KDIGO (kidney disease improving global outcomes) guidelines definition.
Results
26 patients received RRT. Medium SCr at T0 was 3.37 mg/dl and showed a significative reduction (see figure) at T1 (−0.88mg/dl = −20.6%, p=0.003) and T2 (−0.96mg/dl = −18.33%, p=0.029) and a trend towards reduction at T3 (−0.78mg/dl, p=0.174) and at T4 (−0.28mg/dl, p=0.568).
Between 26 pts, 6 pts (23%) developed Ci-AKI. Only contrast media amount significatively diverge between two groups (183 ml in the group with Ci-AKI vs 162 ml in pts with no Ci-AKI, p=0.03), showing also a trend towards significance for infection occurrence (83.3% pts Ci-AKI vs 40% pts no Ci-AKI, p=0.06) and shock onset (33.3%pts Ci-AKI vs 5% pts no Ci-AKI, p=0.06).
Average SCr diverge at T2 (3.18mg/dl Ci-AKI vs 2.04mg/dl no Ci-AKI, p=0.01) and at T3 (3.33mg/dl CI-AKI vs 2.31mg/dl no CI-AKI, p=0.06); we also found a trend towards progressive increase of SCr for Ci-AKI pts (T0-T1: +0.17mg/dl, p=ns; T0-T2: +0.41mg/dl, p=ns; T0-T3: +0.57mg/dl, p=ns; T0-T4: +1.35mg/dl, p=ns) and a significative reduction in SCr for no Ci-AKI pts (T0-T1: −1.23mg/dl = −29.32% p=0.001; T0-T2: −1.46mg/dl = −30.78%, p=0.01; T0-T4: −0.41mg/dl = −15.5%, p=0.05).
Conclusions
Early RRT with CVVHDF modality results effective in 77% of patients in avoiding Ci-AKI, with a significative SCr reduction at 24 and 48h. An increased amount of contrast media is significatively related to Ci-AKI incidence. Ci-AKI development could also possibly be related to shock and infection occurrence.
Figure 1
Funding Acknowledgement
Type of funding source: None
Abstract
Background
Coronary bifurcation disease (CBD) accounts for approximately 20% of all and is associated with worse short- and long- term clinical outcomes. Provisional stenting (PS) is the ...preferred choice, however, this approach may not be suitable in all CBD anatomies, therefore several elective two-stents techniques have been described, however there is lack of randomized evidence to guide interventionalist across different stent techniques. Objectives. To identify the best percutaneous coronary interventions (PCI) technique for CBD.
Methods
We systematically review randomized clinical (RCTs) of patients receiving CBD PCI with either PS or six type of elective two-stent techniques (DK-crush, TAP, culotte, dedicated bifurcation stents, crushing, T-stenting) and compare device oriented clinical events (DOCE) in a network meta-analysis. DOCE was defined as composite of cardiac death, target-vessel myocardial infarction, stent thrombosis, target lesion revascularization OR target vessel revascularisation.
Results
We included 26 RCTs leading to a pooled population of 10339 patients-years with 1229 DOCE. Compared to PS, the DK-crush technique had a lower DOCE with RR=0.62, 0.42–0.92. Figure. DK-crush had the highest likelihood (model likelihood=90.2%, SUCRA=98.0%) of being the best treatment to reduce DOCE.
Figure 1
Conclusions
In the management CBD, when a two-stent technique is required as upfront strategy, the DK- Crush technique should be privileged as it showed to reduce stent-related clinical outcomes (DOCE) when compared to other bifurcation techniques.
Globoid cell leukodystrophy (GLD) is a lysosomal storage disease caused by deficient activity of β-galactocerebrosidase (GALC). The infantile forms manifest with rapid and progressive central and ...peripheral demyelination, which represent a major hurdle for any treatment approach. We demonstrate here that neonatal lentiviral vector-mediated intracerebral gene therapy (IC GT) or transplantation of GALC-overexpressing neural stem cells (NSC) synergize with bone marrow transplant (BMT) providing dramatic extension of lifespan and global clinical-pathological rescue in a relevant GLD murine model. We show that timely and long-lasting delivery of functional GALC in affected tissues ensured by the exclusive complementary mode of action of the treatments underlies the outstanding benefit. In particular, the contribution of neural stem cell transplantation and IC GT during the early asymptomatic stage of the disease is instrumental to enhance long-term advantage upon BMT. We clarify the input of central nervous system, peripheral nervous system and periphery to the disease, and the relative contribution of treatments to the final therapeutic outcome, with important implications for treatment strategies to be tried in human patients. This study gives proof-of-concept of efficacy, tolerability and clinical relevance of the combined gene/cell therapies proposed here, which may constitute a feasible and effective therapeutic opportunity for children affected by GLD.
The pathological cascade leading from primary storage to neural cell dysfunction and death in metachromatic leukodystrophy (MLD) has been poorly elucidated in human-derived neural cell systems. In ...the present study, we have modeled the progression of pathological events during the differentiation of patient-specific iPSCs to neuroepithelial progenitor cells (iPSC-NPCs) and mature neurons, astrocytes, and oligodendrocytes at the morphological, molecular, and biochemical level. We showed significant sulfatide accumulation and altered sulfatide composition during the differentiation of MLD iPSC-NPCs into neuronal and glial cells. Changes in sulfatide levels and composition were accompanied by the expansion of the lysosomal compartment, oxidative stress, and apoptosis. The neuronal and glial differentiation capacity of MLD iPSC-NPCs was significantly impaired. We showed delayed appearance and/or reduced levels of oligodendroglial and astroglial markers as well as reduced number of neurons and disorganized neuronal network. Restoration of a functional Arylsulfatase A (ARSA) enzyme in MLD cells using lentiviral-mediated gene transfer normalized sulfatide levels and composition, globally rescuing the pathological phenotype. Our study points to MLD iPSC-derived neural progeny as a useful in vitro model to assess the impact of ARSA deficiency along NPC differentiation into neurons and glial cells. In addition, iPSC-derived neural cultures allowed testing the impact of ARSA reconstitution/overexpression on disease correction and, importantly, on the biology and functional features of human NPCs, with important therapeutic implications.
Summary URBAN is a multicentric, ambispective study evaluating the effectiveness and safety of obinutuzumab‐based immuno‐chemotherapy and maintenance in patients with untreated advanced follicular ...lymphoma (FL). The study began before the COVID‐19 emergency declaration in Italy. It is currently ongoing for follow‐up, and the enrolment timeline encompassed different stages of the pandemic, various vaccination roll‐out phases and prevalence of SARS‐CoV‐2 variants. Outcomes of interest of the present sub‐analysis included SARS‐CoV‐2 infection rates and COVID‐19‐related hospitalizations/deaths. At data cut‐off, 86 (28.8%) and 213 patients (71.2%) were treated before and during/after the COVID‐19 outbreak respectively; 294 (98.3%) completed the induction, 31 (10.4%) completed maintenance and 170 (56.9%) were still on maintenance. Overall, 245 patients (81.9%) received at least one SARS‐CoV‐2 vaccine dose: 13.5%, 31.4% and 55.1% received one, two and three doses respectively. We observed a substantial decrease in COVID‐19‐related mortality rates in pre‐ versus post‐vaccination phases, along with a reduction in COVID‐19‐related outcomes due to the shift from alpha/delta to omicron variant predominance. No differences emerged between patients given maintenance or not, although the schedule was modified in 65% of cases. To our knowledge, URBAN represents the largest dataset of COVID‐19‐related outcomes in FL patients extensively exposed to obinutuzumab. ClinicalTrials.gov identifier: NCT04034056.
In stage IIIA non-small cell lung cancer (NSCLC), surgery plays a role in terms of multimodal treatment. Surgery rates have increased in recent years, mainly due to the combination of more accurate ...imaging tools, electromagnetic navigation bronchoscopy, robotic bronchoscopy, robotic surgery, and a wide range of challenging clinical scenarios to lead surgeons and oncologists to include surgery as an option in therapeutic management.
To assess the prognostic factors, the 5-year overall survival (OS) and cancer-specific survival (CSS) of patients with resectable stage III-NSCLC.
Patients' information was extracted from 76 Hospitals' Cancer Registry. OS and CSS were constructed using the Kaplan-Meier method, and the log-rank test was used to assess differences between curves. In addition, Cox regression was conducted to evaluate the patients' characteristics leading to better OS and CSS.
Overall, 433 stage III NSCLC surgical patients followed over 19 years were included. The median age was 61.29 ± 9.62 years, 58.4% male, 50.1% with adenocarcinoma, 29.3% with squamous cell carcinoma, 3.7% with large-cell lung carcinoma, and 16,9% with other lung cancer types. The 5-year OS was 30.6% (95% confidence interval CI: 27.4-36.1), and the CSS was 35.0% (95% CI: 29.4-41.0). In the Cox multivariate regression, squamous cell carcinoma was associated with reduced OS (hazard ratio HR: 1.40; 95% CI: 1.07-1.83; p=0.014) and CSS (HR: 1.56; 95% CI: 1.17-2.08; p = 0.002), in comparison with adenocarcinoma. The 2015-2019 quinquennial had a 50% reduction in HR (0.49; 95% CI: 0.29-0.81; p = 0.006), and the 2010-2014 group had a 40% reduction (0.59; 95% CI: 0.42-0.83; p = 0.006) in comparison with the 2000-2004 patients' group.
The OS and CSS of patients with resectable stage III NSCLC have improved over the past 19 years in our region. Squamous cell carcinoma was associated with increased mortality risk from any cause or specific cancer.
The excess adsorption isotherms of methanol, ethanol, 2-propanol, acetonitrile, and tetrahydrofuran from water were measured on five different silica-based packing materials by the minor disturbance ...method. These materials were prepared with the same lot of 5-
μ
m particles (average pore size 90
Å), all endcapped with trimethylchlorosilane (TMS), and bonded to octadecyl chains with different surface coverages (0, 0.42, 1.01, 2.03, and 3.15
μ
mol/m
2). The relative adsorption of one eluent by respect to a second one informs on the heterogeneity of the material (alkyl-bonded and bare silica regions) and on the accessibility of the unreacted silanol groups to the mobile phase. It is shown that the total surface area of the adsorbent decreases with increasing degree of surface coverage with octadecyl chains and that the relative surface area of the regions occupied by accessible silanol groups to the regions occupied by alkyl-bonded groups decreases. For the five columns, an average of 10% of the adsorbent surface area is covered of bare silica accessible to the liquid phase, with a minimum of 5% with tetrahydrofuran and a maximum of 12% with ethanol or 2-propanol. Increasing the surface coverage by the C
18 chains causes a significant increase of the attraction potential of the hydrophobic surface toward the organic solvent. This result is confirmed by the increase of the number of adsorbate monolayers with increasing bonding density of the octadecyl chains. This number is twice larger for the 315C
18 column than for the C
1 column.
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