Total Urine Research Articles

168 Evaluate the digestibility effects of alfalfa-bermudagrass mixtures on beef cattle in the Deep South

Abstract In the Deep South, one of the hardest times of year for cattle producers is the summer due to extreme temperatures and low-quality perennial forages. Incorporating a high-quality crop like alfalfa (Medicago sativa) into forage mixtures could be economically advantageous; however, there is not much alfalfa produced in the Deep South. Therefore, our objective was to evaluate the effects of forage type on in vivo digestibility and nutrient balance in beef cattle systems. There was also an interest in differing conserved forage types, so we analyzed digestion dynamics influenced by various conserved forage types. Three treatments including bermudagrass (Cynodon dactylon) hay, alfalfa baleage, and alfalfa-bermudagrass baleage were supplied to four fistulated steers (average 412.34 kg +/- 41.25 kg) with a calculated daily forage allowance based on intake, body weight, and feed refusals. Each diet was allocated to one of three periods in which all four animals received the same diet due to potential feed spoilage. Each period had a 21-d adaptation period followed by a 5-d collection period to analyze total fecal excretion, feed intake, feed refusal, total urine output, and rumen fluid dynamics. Data were analyzed using R Core Team (2023) and the GLIMMIX procedure of SAS version 9.4 (SAS Inst., Cary, NC). There were significant differences in dry matter digestibility (DMD) between diets (P < 0.0015). We found that alfalfa-bermudagrass baleage had a 9% (+/- 0.058, 95% C.I.) less DMD than bermudagrass hay (P < 0.0088) and alfalfa baleage had a 7% (+/- 0.058, 95% C.I.) greater DMD than bermudagrass hay (P < 0.025). Results indicate that alfalfa baleage provides the most nutrient use efficiency when comparing alfalfa-bermudagrass mixtures. There was no significant conserved forage effect potentially due to baleage quality and inadequate fermentation of the alfalfa-bermudagrass baleage. That said, there is still potential for beef cattle producers in the Deep South to diversify feeding strategies by using nutrient-rich forage additives like alfalfa and different conserved forage methods to increase digestibility, thus increasing returns in their operations.

Relationships between gastrointestinal permeability, heat stress, and milk production in lactating dairy cows

Heat stress (HS) is a global issue that decreases farm profits and compromises animal welfare. To distinguish between the direct and indirect effects of HS, 16 multiparous Holstein cows approximately 100 d in milk were assigned to one of 2 treatments: pair fed to match HS cow intake, housed in thermoneutral conditions (PFTN, n = 8) or cyclical HS (n = 8). All cows were subjected to 2 experimental periods. P1 consisted of a 4 d thermoneutral period with ad libitum intake. During P2, the HS cows were housed in cyclical HS conditions with a temperature humidity index (THI) ranging from 76 to 80 and the PFTN cows were exposed to a constant THI of 64 for 4 d. DMI of the PFTN cow was intake matched to the HS cows. Milk yield, milk composition, rectal temperature, and respiration rate were recorded twice daily, blood was collected daily via a jugular catheter, and cows were fed twice daily. On d 3 of each period, Cr-EDTA and sucralose were orally administered and recovered via 24 h total urine collection to assess gastrointestinal permeability (GIP). All data were analyzed using the GLIMMIX procedure in SAS. The daily data collected in P1 was averaged and used as a covariate if deemed significant in the model. HS decreased voluntary intake by 35% and increased rectal temperature and respiration rate (38.4 vs 39.4°C and 40 vs 71 respirations/min, respectively). HS reduced dry matter intake (DMI) by 35% which accounted for 66% of the decrease in milk yield. The yield, and not concentration, of milk protein, fat, and other solids were lower in the HS cows on d 4 of P2. Milk urea nitrogen (MUN) was higher and plasma urea nitrogen (PUN) tended to be higher on d 3 and d 4 of HS. Glucose was 7% lower in the HS cows and insulin was 71% higher in the HS cows than the PFTN cows on d 4 of P2. No difference in lipopolysaccharide binding protein (LBP) was observed. HS cows produced 7 L/d more urine than PFTN cows. No differences were detected in the urine concentration or percentage of the oral dose recovered for Cr-EDTA or sucralose. In conclusion, HS was responsible for 34% of the reduction of milk yield. The elevated MUN and the tendency for elevated PUN indicate a whole-body shift in nitrogen metabolism. No differences in GIP or LBP were observed. These results indicate that, under conditions of this experiment, activation of the immune system by gut derived lipopolysaccharide was not responsible for the decreased milk yield observed during HS.

Prediction of successful weaning from renal replacement therapy in critically ill patients based on machine learning

Background Predicting the successful weaning of acute kidney injury (AKI) patients from renal replacement therapy (RRT) has emerged as a research focus, and we successfully built predictive models for RRT withdrawal in patients with severe AKI by machine learning. Methods This retrospective single-center study utilized data from our general intensive care unit (ICU) Database, focusing on patients diagnosed with severe AKI who underwent RRT. We evaluated RRT weaning success based on patients being free of RRT in the subsequent week and their overall survival. Multiple logistic regression (MLR) and machine learning algorithms were adopted to construct the prediction models. Results A total of 976 patients were included, with 349 patients successfully weaned off RRT. Longer RRT duration (7.0 vs. 9.6 d, p = 0.002, OR = 0.94), higher serum cystatin C levels (1.2 vs. 3.2 mg/L, p < 0.001, OR = 0.46), and the presence of septic shock (28.1% vs. 41.5%, p < 0.001, OR = 0.63) were associated with reduced likelihood of RRT weaning. Conversely, a positive furosemide stress test (FST) (60.2% vs. 40.7%, p < 0.001, OR = 2.75) and higher total urine volume 3 d before RRT withdrawal (755 vs. 125 mL/d, p < 0.001, OR = 2.12) were associated with an increased likelihood of successful weaning from RRT. Next, we demonstrated that machine learning models, especially Random Forest and XGBoost, achieving an AUROC of 0.95. The XGBoost model exhibited superior accuracy, yielding an AUROC of 0.849. Conclusion High-risk factors for unsuccessful RRT weaning in severe AKI patients include prolonged RRT duration. Machine learning prediction models, when compared to models based on multivariate logistic regression using these indicators, offer distinct advantages in predictive accuracy.

Effects of ingesting beverages containing glycerol and sodium with isomaltulose or sucrose on fluid retention in young adults: a single-blind, randomized crossover trial.

We evaluated changes in hyperhydration and beverage hydration index (BHI, a composite measure of fluid balance after consuming a test beverage relative to water) during resting, induced by the consumption of beverages containing glycerol and sodium supplemented with fast-absorbing sucrose or slow-absorbing isomaltulose. In a randomized crossover, single-blinded protocol (clinical trials registry: UMIN000042644), 14 young physically active adults (three women) consumed 1L of beverage containing either 7% glycerol+0.5% sodium (Gly+Na), Gly+Na plus 7% sucrose (Gly+Na+Suc), Gly+Na plus 7% isomaltulose (Gly+Na+Iso), or water (CON) over a 40min period. We assessed the change in plasma volume (ΔPV), BHI (calculated from cumulative urine output following consumption of water relative to that of the beverage), and blood glucose and sodiumfor 180min after initiating ingestion. Total urine volume was reduced in all beverages containing glycerol and sodium compared to CON (all P≤0.002). The addition of isomaltulose increased BHI by ∼45% (3.43±1.0vs. 2.50±0.7 for Gly+Na, P=0.011) whereas sucrose did not (2.6±0.6, P=0.826). The PV expansion was earliest for Gly+Na (30min), slower for Gly+Na+Suc (90min), and slowest for Gly+Na+Iso (120min) with a concomitant lag in the increase of blood glucose and sodium concentrations. Supplementation of beverages containing glycerol and sodium with isomaltulose but not sucrose enhances BHI from those of glycerol and sodium only under a resting state, likely due to the slow absorption of isomaltulose-derived monosaccharides (i.e., glucose and fructose).

Does Acidification Affect Urinary Creatinine in Dairy Cattle?

Nitrogen content in urine plays a crucial role in assessing the environmental impact of dairy farming. Urine acidifications avoid urine nitrogen volatilization, but potentially lead to a degradation of creatinine, the most dependable marker for quantifying total urine excretion volume, affecting its measurement. This study aimed to assess how acidifying urine samples affects the concentration and detection of creatinine in dairy cattle. In this trial, individual urine samples from 20 Holstein lactating dairy cows were divided into three subsamples, allocated to 1 of 3 groups consisting of 20 samples each. Samples were immediately treated as follows: acidification with H2SO4 (1 mL of acid in 30 mL of sample) to achieve a pH < 2 (Group 1)); addition of an equal volume of distilled water (1 mL of distilled water in 30 mL of sample) to investigate dilution effects (Group 2); or storage without any acid or water treatment (Group 3). An analysis of creatinine levels was carried out using the Jaffe method. The Friedman test was employed to compare urine groups across treatments, and the Bland-Altman test was used to assess the agreement between measurements in Group 1 and Group 3. Urinary creatinine values were statistically different (p < 0.001) between Group 1 (median 48.5 mg/dL; range 36.9-83 mg/dL), Group 2 (median 47.5 mg/dL; range 36.5-80.7 mg/dL), and Group 3 (median 48.9 mg/dL, range 37.2-84). Bland-Altman analysis demonstrates agreement between Group 3 and Group 1. The measurement of urinary creatinine using the Jaffe method is affected by sample acidification, but the use of creatinine as a marker for total urine output could remain a viable tool when urine samples are acidified.

Impact of low pneumoperitoneum on renal function and acute kidney injury biomarkers during robot-assisted radical prostatectomy (RARP): a randomised clinical trial

The objective of this study was to evaluate the effect of low pneumoperitoneum pressure (Pnp) on renal function and renal injury biomarkers during robot-assisted radical prostatectomy (RARP). A single-centre, triple-blinded, randomised clinical trial was conducted with 98 patients undergoing RARP, who were assigned to either standard Pnp of 12 mmHg or low Pnp of 7 mmHg. The primary outcome was urinary neutrophil gelatinase-associated lipocalin (u-NGAL), and several other kidney injury biomarkers were assessed as secondary outcomes. Acute kidney injury (AKI) was evaluated using the Kidney Disease Improving Global Outcomes (KDIGO) criteria, the gold standard method for defining AKI. The trial was registered on ClinicalTrials.gov (NCT04755452). Patients in the low Pnp group had significantly lower levels of u-NGAL (mean difference − 39.9, 95% CI − 73.7 to − 6.1, p = 0.02) compared to the standard Pnp group. No significant differences were observed for other urinary biomarkers. Interestingly, there was a significant difference in intraoperative urine production between the groups (low Pnp median: 200 mL, IQR: 100–325 vs. standard Pnp median: 100 mL, IQR: 50–200, p = 0.01). Similarly, total postoperative urine production also varied significantly (low Pnp median: 1325 mL, IQR: 1025–1800 vs. standard Pnp median: 1000 mL, IQR: 850–1287, p = 0.001). The occurrence of AKI, as defined by the KDIGO criteria, did not differ significantly between the groups. Low Pnp during RARP resulted in lower u-NGAL levels, suggesting a potential benefit in terms of reduced renal injury. However, the lack of a notable difference in AKI as defined by the KDIGO criteria indicates that the clinical significance of this finding may be limited. Further research is needed to validate and expand on these results, ultimately defining the optimal Pnp strategy for RARP and improving patient outcomes.

Inguinal hernia leads to worse immediate urinary continence after robot-assisted radical prostatectomy.

Patients with inguinal hernia (IH) may have voiding dysfunction and weak urethra-stabilizing periurethral fascial tissues, contributing to urinary incontinence. This study aimed to review the association between IH and urinary continence after robotic-assisted radical prostatectomy (RARP). This single-institution retrospective study included 251 consecutive cases of RARP between April 2019 and June 2022. Patients with concurrent IH or a history of adult IH repair were examined. The urine loss rate (ULR), defined as 24-h urine loss volume divided by the total urine volume immediately after urinary catheter removal (i.e., 6 or 7 postoperative days), was compared between the groups with (n = 33) and without IH (n = 214). Possible contributing factors for ULR were assessed, including age, body mass index (BMI), after benign prostatic hyperplasia surgery, prostate weight, and nerve-sparing. ULR was compared intergroup after propensity score matching countering selection biases. Patients with IH were older (71.3 versus. 66.8years, p < 0.01), had lower BMI (22.8 versus. 24.3, p < 0.01), and had higher ULR (14.5% versus. 5.1%, p < 0.01). In a multiple linear regression analysis (adjusted R2 = 0.084), IH (p < 0.01) was an independent contributing factor for ULR besides advancing age (p < 0.03). After propensity score matching adjusted for patient's age and nerve-sparing, patients with IH had higher ULR (14.1% versus. 5.7%, p < 0.03) as well. This study first reported that IH may be one of the risk factors of urinary incontinence after RARP.

Ex vivo normothermic preservation of a kidney graft from uncontrolled donation after circulatory death over 73 hours.

The transplant community is focused on prolonging the ex vivo preservation time of kidney grafts to allow for long-distance kidney graft transportation, assess the viability of marginal grafts, and optimize a platform for the translation of innovative therapeutics to clinical practice, especially those focused on cell and vector delivery to organ conditioning and reprogramming. We describe the first case of feasible preservation of a kidney from a donor after uncontrolled circulatory death over a 73-h period using normothermic perfusion and analyze hemodynamic, biochemical, histological, and transcriptomic parameters for inflammation and kidney injury. The mean pressure and flow values were 71.24 ± 9.62mmHg and 99.65 ± 18.54mL/min, respectively. The temperature range was 36.7°C-37.2°C. The renal resistance index was 0.75 ± 0.15mmHg/mL/min. The mean pH was 7.29 ± 0.15. The lactate concentration peak increased until 213mg/dL at 6h, reaching normal values after 34h of perfusion (8.92mg/dL). The total urine output at the end of perfusion was 1.185mL. Histological analysis revealed no significant increase in acute tubular necrosis (ATN) severity as perfusion progressed. The expression of KIM-1, VEGF, and TGFβ decreased after 6-18h of perfusion until 60h in which the expression of these genes increased again together with the expression of β-catenin, Ki67, and TIMP1. We show that normothermic perfusion can maintain a kidney graft viable ex vivo for 3days, thus allowing a rapid translation of pre-clinical therapeutics to clinical practice.

Reducing dietary protein and supplementation with starch or rumen-protected methionine and its effect on performance and nitrogen efficiency in dairy cows fed a red clover and grass silage–based diet

The increasing cost of milk production, in association with tighter manure N application regulations and challenges associated with ammonia emissions in many countries, has increased interest in feeding lower crude protein (CP) diets based on legume silages. Most studies have focused on alfalfa silage, and little information is available on low-CP diets based on red clover silage. Our objectives were to examine the effects of dietary CP content and supplementing a low-CP diet with dietary starch or rumen-protected Met (RPMet) on the performance, metabolism, and nitrogen use efficiency (NUE; milk N output/N intake) in dairy cows fed a red clover and grass silage-based diet. A total of 56 Holstein-Friesian dairy cows were blocked and randomly allocated to 1 of 4 diets over a 14-wk feeding period. Diets were based on red clover and grass silages at a ratio of 50:50 on a dry matter (DM) basis and were fed as a total mixed ration, with a 53:47 ratio of forage to concentrate (DM basis). The diets were formulated to supply a similar metabolizable protein (MP) content, and had a CP concentration of either 175 g/kg DM (control [CON]) or 150 g/kg DM (low-protein [LP]), or LP supplemented with either additional barley as a source of starch (LPSt; +64 g/kg DM) or RPMet (LPM; +0.3 g/100 g MP). At the end of the 14-wk feeding period, 20 cows (5 per treatment) continued to be fed the same diets for a further 6 d, and total urine output and fecal samples were collected. We observed that dietary treatment did not affect DM intake, with a mean of 21.5 kg/d; however, we also observed an interaction between diet and week with intake being highest in cows fed LPSt in wk 4 and CON in wk 9 and 14. Mean milk yield, 4% fat-corrected milk, and energy-corrected milk were not altered by treatment. Similarly, we found no effect of dietary treatment on milk fat, protein, or lactose content. In contrast, milk and plasma urea concentrations were highest in cows fed CON. The concentration of blood plasma β-hydroxybutyrate was highest in cows receiving LPM and lowest in LPSt. Apparent NUE was 28.6% in cows fed CON and was higher in cows fed any of the low-protein diets (LP, LPSt, or LPM), with a mean value of 34.2%. The sum of milk fatty acids with a chain length below C16:0 was also highest in cows fed CON. We observed that dietary treatment did not affect the apparent whole-tract nutrient digestibility of organic matter, N, neutral detergent fiber, and acid detergent fiber, with mean values of 0.785, 0.659, 0.660, and 0.651 kg/kg respectively, but urinary N excretion was approximately 60 g/d lower in cows fed the low-CP diets compared with CON. We conclude that reducing the CP content of red clover and grass silage-based diets from 175 to 150 g/kg DM while maintaining MP supply did not affect performance, but reduced the urinary N excretion and improved NUE, and that supplementing additional starch or RPMet had little further effect.

Modeling energy partition patterns of growing pigs fed diets with different net energy levels based on machine learning.

The objectives of this study were to evaluate the energy partition patterns of growing pigs fed diets with different net energy (NE) levels based on machine learning methods, and to develop prediction models for the NE requirement of growing pigs. Twenty-four Duroc × Landrace × Yorkshire crossbred barrows with an initial body weight of 24.90 ± 0.46kg were randomly assigned to 3 dietary treatments, including the low NE group (2,325 kcal/kg), the medium NE group (2,475 kcal/kg), and the high NE group (2,625 kcal/kg). The total feces and urine produced from each pig during each period were collected, to calculate the NE intake, NE retained as protein (NEp), and NE retained as lipid (NEl). A total of 240 sets of data on the energy partition patterns of each pig were collected, 75% of the data in the dataset was randomly selected as the training dataset, and the remaining 25% was set as the testing dataset. Prediction models for the NE requirement of growing pigs were developed using algorithms including multiple linear regression (MR), artificial neural networks (ANN), k-nearest neighbor (KNN), and random forest (RF), and the prediction performance of these models was compared on the testing dataset. The results showed pigs in the low NE group showed a lower average daily gain, lower average daily feed intake, lower NE intake, but greater feed conversion ratio compared to pigs in the high NE group in most growth stages. In addition, pigs in the 3 treatment groups did not show a significant difference in NEp in all growth stages, while pigs in the medium and high NE groups showed greater NEl compared to pig in the low NE group in growth stages from 25 to 55kg (P < 0.05). Among the developed prediction models for NE intake, NEp, and NEl, the ANN models demonstrated the most optimal prediction performance with the smallest root mean square error (RMSE) and the largest R2, while the RF models had the worst prediction performance with the largest RMSE and the smallest R2. In conclusion, diets with varied NE concentrations within a certain range did not affect the NEp of growing pigs, and the models developed with the ANN algorithm could accurately achieve the NE requirement prediction in growing pigs.

Calcium trafficking and gastrointestinal physiology following an acute lipopolysaccharide challenge in pigs.

The influence of systemic immune activation on whole-body calcium (Ca) trafficking and gastrointestinal tract (GIT) physiology is not clear. Thus, the study objectives were to characterize the effects of lipopolysaccharide (LPS) on Ca pools and GIT dynamics to increase understanding of immune-induced hypocalcemia, ileus, and stomach hemorrhaging. Twelve crossbred pigs [44 ± 3kg body weight (BW)] were randomly assigned to 1 of 2 intramuscular treatments: (1) control (CON; 2mL saline; n = 6) or (2) LPS (40 µg LPS/kg BW; n = 6). Pigs were housed in metabolism stalls to collect total urine and feces for 6h after treatment administration, at which point they were euthanized, and various tissues, organs, fluids, and digesta were weighed, and analyzed for Ca content. Data were analyzed with the MIXED procedure in SAS 9.4. Rectal temperature and respiration rate increased in LPS relative to CON pigs (1.4 °C and 32%, respectively; P ≤ 0.05). Inflammatory biomarkers such as circulating alkaline phosphatase, aspartate aminotransferase, and total bilirubin increased in LPS compared with CON pigs whereas albumin decreased (P ≤ 0.02). Plasma glucose and urea nitrogen decreased and increased, respectively, after LPS (43% and 80%, respectively; P < 0.01). Pigs administered LPS had reduced circulating ionized calcium (iCa) compared to CON (15%; P < 0.01). Considering estimations of total blood volume, LPS caused an iCa deficit of 23mg relative to CON (P < 0.01). Adipose tissue and urine from LPS pigs had reduced Ca compared to CON (39% and 77%, respectively; P ≤ 0.05). There did not appear to be increased Ca efflux into GIT contents and no detectable increases in other organ or tissue Ca concentrations were identified. Thus, while LPS caused hypocalcemia, we were unable to determine where circulating Ca was trafficked. LPS administration markedly altered GIT dynamics including stomach hemorrhaging, diarrhea (increased fecal output and moisture), and reduced small intestine and fecal pH (P ≤ 0.06). Taken together, changes in GIT physiology suggested dyshomeostasis and alimentary pathology. Future research is required to fully elucidate the etiology of immune activation-induced hypocalcemia and GIT pathophysiology.

Solução intravenosa poliiônica com concentração elevada de lactato (84 mEq/L) é eficaz para o tratamento de bezerros com diarreia

ABSTRACT This study aimed to evaluate the effectiveness of an electrolyte solution with a high lactate concentration (84mEq/L; L84) in correcting imbalances in diarrheal calves. Another solution with similar electrolyte composition, containing 84mEq/L of bicarbonate (B84) was used for comparison. Diarrhea was induced in neonatal calves by rotavirus infection, sucrose ingestion and furosemide administration. When a moderate degree of metabolic acidosis was reached, the calves were treated with intravenous infusion of L84 (n=10) or B84 (n=10) solutions. Venous blood and urine samples were collected before starting the infusion (0 h), in the middle (2.5 h), at the end (5.0 h) and 2.5 hours later. Total plasma protein concentration, blood and urine pH, blood pCO2, HCO3 -, and BE, plasma and urine concentration of L-lactate, and serum and urine concentrations of Na+, K+, and Cl- were measured. Strong ion difference, total concentration of non-volatile weak acids, anion gap, strong ion gap, percentage change in plasma volume, and urinary fractional clearances of Na+, K+, Cl-, and L-lactate were calculated. The calves demonstrated moderate dehydration, hypernatremia, hyperchloremia, metabolic acidosis, and unmeasured anion accumulation. These changes were completely corrected with the L84 solution, and the effects did not differ from those observed with B84 solution. The calves recovered without further therapeutic procedures, demonstrating that the L84 solution was effective for treating diarrheal calves.

Intraoperative goal-directed fluid therapy in neurosurgical patients: A systematic review.

Perioperative fluid management is critical in neurosurgery as over perfusion can lead to brain edema whereas under perfusion may lead to brain hypoperfusion or ischemia. We aimed to determine the effectiveness of intraoperative goal-directed fluid therapy (GDFT) in patients undergoing intracranial surgeries. We searched MEDLINE, Cochrane, and PubMed databases and forward-backward citations for studies published between database inception and February 22, 2024. Randomized controlled trials where intraoperative GDFT was performed in neurosurgery and compared to the conventional regime were included in the study. GDFT was compared with the conventional regime as per primary outcomes - total intraoperative fluid requirement, serum lactate, hemodynamics, brain relaxation, urine output, serum biochemistry, and secondary outcomes - intensive care unit and hospital length of stay. The quality of evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42024518816). Of 75 records identified, eight were eligible, the majority of which had a low to moderate risk of overall bias. In four studies, more fluid was given in the control group. No difference in postoperative lactate values was noted in 50% of studies. In the remaining 50%, lactate was more in the control group. Three out of four studies did not find any significant difference in the incidence of intraoperative hypotension, and four out of six studies did not find a significant difference in vasopressor requirement. The majority of studies did not show significant differences in urine output, brain relaxation, and length of stay between both groups. None found any difference in acid base status or electrolyte levels. GDFT, when compared to the conventional regime in neurosurgery, showed that the total volume of fluids administered was lesser in the GDFT group with no increase in serum lactate. There was no difference in the hemodynamics, urine output, brain relaxation, urine output, length of stay, and biochemical parameters.

Combination of β-mannanase plus multi-carbohydrase complex in simple or complex post-weaned pig diets on nutrient metabolism and gut health.

This study was conducted to evaluate whether adding β-mannanase alone or in combination with a multi-carbohydrase complex to simple and complex diets could improve diet digestibility, nutrient and energy metabolism, and gut health in weaned pigs. Thirty pigs (7.9 kg ± 0.851 kg) weaned at 28 days were randomly split into a 2 × 3 factorial arrangement, considering a simple (corn and soybean meal-based diet) or complex diet (13% point reduction in inclusion of soybean meal, 5% of whey power, and 2.5% of spray-dried plasma compared to the simple diet) and diet without any addition (control) or the addition of β-mannanase (BM; 0.300 g/kg of the diet) or β-mannanase plus a multi-carbohydrase complex blend such as xylanase, β-glucanase, and arabinofuranosidases (BM + MCC; 0.300 + 0.050 g/kg of the diet) for 17 days post-weaned. Total fecal and urine samples were collected on days 11-17. Fecal samples were collected from all pigs to identify fecal biomarkers using commercial ELISA tests. Blood samples were collected from all pigs at the end of the experimental period to assess serum concentrations of acute-phase proteins. All pigs were euthanized on day 18 for intestinal tissue collection. The simple diet had greater (p < 0.05) protein digestibility and metabolizability coefficients than the complex diet. Greater (p < 0.05) energy digestibility and energy metabolizability coefficients were observed in the BM and BM+ MCC compared to the control diet. On average, BM improved by 64 kcal/kg and BM + MCC improved by 100 kcal/kg of metabolizable energy. Furthermore, the addition of BM and BM + MCC to the diets led to lower fecal moisture and fecal output. Moreover, the BM and BM + MCC diets also reduced fecal calprotectin concentrations by 29 and 46%, respectively, compared to control pigs (p < 0.001). We conclude that simple diets are a suitable alternative to complex diets, without compromising the nutrient digestibility and gut health of post-weaned pigs. The addition of exogenous enzymes improves nutrient and energy utilization, as well as the absorption area, and decreases calprotectin concentrations.

The effects of endurance physical exercise with fat-free milk intake as a therapy for metabolic syndrome and/or sarcopenia

Background: Nutrition and exercise are important factors for addressing metabolic syndrome and sarcopenia as they are related to insulin secretion. Proteins, particularly branched-chain amino acids (BCAAs), have insulinotropic effects, while exercise reduces insulin secretion. It is thus important to investigate the effects of protein intake and exercise alone and in combination to determine suitable dietary and exercise therapies for treating metabolic syndrome and sarcopenia. Methods: Eight healthy young adult female volunteers participated in a crossover trial consisting of two 5-day experiments. Days 1 and 2 comprised a body-weight-maintained adjustment period during which the participants consumed control diets (energy, 2,010 kcal; protein, 51.9 g). Days 3 to 5 comprised the treatment period during which the participants consumed experimental diets (energy, 2,010 kcal; protein 82.3 g) containing 402 kcal of fat-free milk, and either performed only normal daily activities (non-Ex) or performed normal daily activities and exercised on a bicycle with an ergometer at a target intensity of about 50% of the maximal oxygen intake, expending 402 kcal of additional energy (Ex). Total urine samples were collected during the daytime (6:45 to 18:45) and nighttime (18:45 to 6:45 the next morning). Fasting blood samples were collected early in the morning before and after the treatment period. Results: Plasma valine, leucine, and BCAA levels were significantly elevated after both the non-Ex and Ex periods. Serum insulin levels were significantly elevated only after the non-Ex period. Urinary C-peptide immunoreactivity excretion levels increased significantly during the non-Ex period, but they decreased significantly during the Ex period. After the Ex period, the serum triglyceride and remnant lipoprotein-cholesterol (RLP-C) levels were significantly decreased. Homeostatic model assessment for insulin resistance (HOMA-IR) and atherosclerosis index (AI) values were slightly, yet significantly, increased after the non-Ex period, but were unchanged after the Ex period. The degree of change (Δ) in the RLP-C level significantly and positively correlated with the Δ HOMA-IR and Δ AI.

Immune-metabolic marker of albumin-to-fibrinogen ratio based prognostic nomogram for patients following peritoneal dialysis.

The nutritional status and coagulation function of peritoneal dialysis (PD) patients are closely associated with their prognosis. This study aims to investigate the prognostic value of the albumin-to-fibrinogen ratio (AFR) on mortality in PD patients and to establish a prognostic prediction model based on AFR. We retrospectively collected data from 148 PD patients treated at our hospital between Oct. 2011 and Dec. 2021. Using the "survminer" package in R, we determined the optimal cutoff value for AFR and divided the patients into low-AFR and high-AFR groups. The primary endpoint of this study was overall survival (OS). Univariate and multivariate Cox analyses were used to assess the impact of AFR and other factors on prognosis, and a corresponding prognostic prediction model was constructed using a nomogram, which was evaluated through ROC curves, the c-index, and calibration plots. The optimal cutoff value for AFR was 9.06. In the entire cohort, 30 patients (20.2%) were classified into the low-AFR group. Compared to the high-AFR group, patients in the low-AFR group were older, had lower total urine output over 24 h, higher blood urea nitrogen, higher total protein and urinary microalbumin levels, and longer remission times (p < 0.05). They also had a poorer OS (HR: 1.824, 95%CI: 1.282-2.594, p < 0.05). Multivariate Cox analysis indicated that AFR was an independent prognostic factor for OS (HR: 1.824, 95% CI: 1.282-2.594, p < 0.05). A prognostic prediction model based on AFR, age, and cause of ESRD was successfully validated for predicting OS in PD patients. AFR represents a potential prognostic biomarker for PD patients. The prognostic prediction model based on AFR can provide accurate OS predictions for PD patients, aiding clinicians in making better-informed decisions.

Bacterial Uropathogens causing Urinary Tract Infection at Hetauda Hospital

Introduction: Urinary tract infection is the infection of the uroepithelium that mainly affects kidney, ureter, urinary bladder and urethra. The causative agents of urinary tract infections are bacteria and fungi. Among these, bacteria are the most causative uropathogens of urinary tract infections. Objectives: The objective of this study is to isolate, identify, characterized and perform antibiotic sensitivity test from the bacterial isolates. Methods: A descriptive cross-sectional study was conducted from March 2023 to May 2023. Ethical approval was obtained from Institutional Review Committee (IRC), Madan Bhandari Academy of Health Sciences, IRC-32-079. Total of 1120 urine samples were collected during this study. Convenient sampling technique was used for this study. Clean catch or mid-stream urine was collected in a sterile container. All urine samples were submitted to Department of Microbiology for culture. A set of biochemical tests were done for bacterial identification. Antibiotic sensitivity test was performed by Kirby-Bauer disk diffusion method. Results: Total of 1120 urine samples were collected from patients suspected to Urinary Tract Infections. Total urine culture positive was 340 (30.36%). Of these bacterial isolates, Escherichia coli (248, 73%) was the most common species, followed by Klebsiella species (26, 7.6%), Staphylococcus saprophyticus (23, 6.76%) and Enterococcus fecalis (18, 5.3%). Conclusion: As prevalence of bacteria causing urinary tract infections is increasing day by day; so its proper isolation, identification, characterization with their antibiotic profile is necessary as it forms the base line for the clinicians to choose appropriate antimicrobial agents for empirical as well as rational treatment for UTIs.

Reliability of the urine spot test in predicting urinary tract infections during pregnancy: a cross-sectional study

Background: The aim of this study was to investigate whether there is a significant difference in positive uronalysis (Total UA) results and fertility in urine cultures during pregnancy.&#x0D; Material and Methods: Our retrospective observational study included 177 patients who were admitted to our hospital between September 1, 2023 and November 1, 2023 and had a complete urinalysis performed. As a result of the total UA, patients with leukocytes/bacteria&gt; 5, leukocyte esterase positive and nitrite positive were identified. Among the patients whose urine culture was detected according to the results of urinalysis, those whose urine culture was evaluated and those who were not were divided into two groups. The results of total UA and urine culture were compared. In addition, the weeks of gestation of patients with positive urinalysis results were recorded and it was investigated whether there was a correlation between the frequency of urinary tract infections (UTI) and pregnancy.&#x0D; Results: A total of 177 patients who were followed up for pregnancy were included in the study. All patients had total UA results. When the total UA abnormalities were examined, it was found that the rate of those with a high leukocyte/bacteria ratio was 80.2%, the rate of those with positive leukocyte esterase was 61%, and the rate of those who were nitrite positive was 25.4%. According to the urine culture results, 54.8% of participants had no urine culture and 45.2% of participants had one. The rate of urine cultures was 77.5% without reproduction and 22.5% with reproduction. In addition, the mean gestational weeks of the patients was 25.96±11.57 weeks, the mean week of gestation according to ultrasound measurements was 26.02±11.64. and no significant association was found between weeks of gestation and the incidence of UTI.&#x0D; Conclusion: In our study, no significant association was found between positive total UA results during pregnancy and urine culture reproduction. There is a need for comprehensive multicenter studies with a larger number of patients regarding the incidence of UTIs in relation to gestational age and other tests that can be used in the diagnosis of UTIs.

Intake, digestibility, rumen fermentation and nitrogen balance in sheep offered alfalfa silage with different proportions of the tannin-rich legume sericea lespedeza

Dietary manipulations to include tannins can change the proportion and amounts of nitrogen (N) excreted in the urine and feces as well as improve nitrogen use efficiency by ruminants. This study was conducted to investigate the effects of adding different proportions of sericea lespedeza (Lespedeza cuneate) hay (SL) containing tannins (16.8% total condensed tannins; CT) to alfalfa (Medicago sativa) silage. Alfalfa silage was either offered alone (0 g/kg; CONT) or mixed with chopped SL to provide 90 (LOW), 180 (MED), or 270 g/kg SL (HIGH) or 15, 30, or 45 g CT/kg on a dry matter (DM) basis. These diets were offered randomly for ad libitum consumption to 16 Dorper ewe lambs (42.1 ± 1.15 kg BW; Period 1; 41.7 ± 1.12 kg BW; Period 2) in a randomized complete block design experiment where each treatment was offered to four lambs during each of two periods. The same 16 lambs were used in both periods, resulting in eight total observations/treatment. Each period consisted of a 14-d dietary adaptation period followed by 5 d of total fecal and urine collection. Data were analyzed using PROC MIXED of SAS. Dry matter (DM), organic matter (OM), neutral detergent fiber (aNDF) and acid detergent fiber (ADF) digestibility as well as digestible DM and OM intake (g/day or g/kg BW) decreased linearly (P < 0.05) with increasing SL in the diet. Ruminal acetate and butyrate molar proportions increased quadratically (P = 0.01), whereas ruminal isobutyrate and isovalerate decreased linearly (P = 0.02) with increasing SL in the diet. Apparent N absorption (g/kg N intake) decreased linearly (P < 0.05) with increasing SL in the diet. Urinary N excretions (g/kg N intake) tended (P = 0.10) to respond quadratically while fecal N (g/kg N intake) increased linearly (P < 0.01) with increasing SL proportion in the diet. In this study, supplementation with sericea lespedeza as a tannin source to alfalfa silage decreased forage digestibility without affecting feed intake, and significantly increased N excreted in feces and tended to decrease urine N excretion without affecting N balance. Therefore, feeding tannins in diet can alter N excretion route from urine to feces but may not improve N-use efficiency by the animal.

Could Cratylia argentea replace Tifton 85 hay on growing and finishing lamb diets in tropical areas?

Legumes shrubs such as Cratylia argentea have an ability to thrive in environments with low water availability and poor soil. On the other hand, forage grasses such as Tifton 85 have a greater demand for inputs to be productive. The objective of this study was to evaluate the performance of growing and finishing Lacaune lambs fed Cratylia argentea hay as an alternative to Tifton 85 (Cynodon spp). Twenty-four Lacaune lambs aged between five and six months (average body weight [BW] 21.50 ± 3.38 kg) were arranged in a split-plot randomized block design. The plots consisted of different Cratylia to Tifton 85 hay proportions (0, 20%, 40%, or 100%, dry matter [DM] basis) as a roughage replacement in the total diet. The subplots represented two evaluation times, entitled "initial period" and "final period", which consisted of the early seven days of total feces and urine collection, and the last seven days of the experiment, respectively. The lambs were blocked by weight with six replicates per treatment. The results show that the level of Tifton 85 replacement for Cratylia hay in the roughage portion of the lamb diet did not influence (P > 0.05) weight gain (WG), dry matter intake or dry matter digestibility; feed conversion, feed efficiency; and the evaluated nitrogen balance variables. The digestibility coefficient of neutral detergent fiber decreased linearly as Tifton 85 replacement for Cratylia level was increased, which probably happened due to the presence of highly lignified material within the Cratylia hay. However, the alternative legume maintained animal performance of Tifton 85. In conclusion, Cratylia hay can be recommended as a potential substitute for Tifton 85 hay, which requires greater inputs for the production. Cratylia may be considered a feeding strategy for livestock production, especially for smallholder livestock systems and regions with unfavorable soil and climate.