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Background: Multidrug-resistant organisms (MDROs) have emerged as an important cause of poor prognoses of patients in the intensive care unit (ICU). This study aimed to establish an easy-to-use nomogram for predicting the occurrence of MDRO colonization or infection in ICU patients. Methods: In this study, we developed a nomogram based on predictors in patients admitted to the ICU in the First Affiliated Hospital of Xiamen University from 2016 to 2018 using univariate and multivariate logistic regression analysis. We externally validated this nomogram in patients from another hospital over a similar period, and assessed its performance by calculating the area under the receiver operating characteristic (ROC) curve (AUC) and performing a decision curve analysis. Results: 331 patients in the primary cohort and 181 patients in the validation cohort were included in the statistical analysis. Independent factors derived from the primary cohort to predict MDRO colonization or infection were male sex, higher C-reactive protein (CRP) levels and higher Pitt bacteremia scores (Pitt scores), which were all assembled in the nomogram. The nomogram yielded good discrimination with an AUC of 0.77 (95% CI 0.70–0.84), and the range of threshold probabilities of decision curves was approximately 30–95%. Conclusion: This easy-to-use nomogram is potentially useful for predicting the occurrence of MDRO colonization or infection in ICU patients. [ABSTRACT FROM AUTHOR]

Background: Postoperative radiation (PORT) is an option for non-small cell lung cancer (NSCLC) patients with resectable stage IIIA pathological N2 status (pN2). For patients with PORT, this study aims to investigate the impact of the exact number of positive lymph nodes (LNs) on overall survival (OS) and lung cancer-specific survival (LCSS).Methods: Within the Surveillance, Epidemiology, and End Results database, we identified 3373 patients with stage IIIA pathological N2 status (pN2) NSCLC who underwent a lobectomy or pneumonectomy from 2004 to 2013. OS and LCSS were compared among patients coded as receiving PORT or observation. The proportional hazards model was applied for investigation.Results: OS and LCSS favored PORT for patients with stage IIIA (pN2) NSCLC. Multivariable analyses showed that PORT and the exact number of positive LNs (n ≤ 3) were independently associated with better OS and LCSS. Both better OS and LCSS emerged for positive LNs (n > 3) after the use of PORT in survival analyses, whereas the benefits of OS and LCSS were not observed anymore for positive LNs (n ≤ 3) group. More importantly, multivariable analyses showed that the use of PORT is an independent risk factor of survival for positive LNs (n > 3) but not for positive LNs (n ≤ 3).Conclusions: In Stage IIIA (pN2) NSCLC, the use of PORT demonstrated better survival results than no PORT for patients with positive LNs (n > 3), but not for patients with positive LNs (n ≤ 3). [ABSTRACT FROM AUTHOR]

Background: Postoperative radiation (PORT) is an option for non-small cell lung cancer (NSCLC) patients with resectable stage IIIA pathological N2 status (pN2). For patients with PORT, this study aims to investigate the impact of the exact number of positive lymph nodes (LNs) on overall survival (OS) and lung cancer-specific survival (LCSS)., Methods: Within the Surveillance, Epidemiology, and End Results database, we identified 3373 patients with stage IIIA pathological N2 status (pN2) NSCLC who underwent a lobectomy or pneumonectomy from 2004 to 2013. OS and LCSS were compared among patients coded as receiving PORT or observation. The proportional hazards model was applied for investigation., Results: OS and LCSS favored PORT for patients with stage IIIA (pN2) NSCLC. Multivariable analyses showed that PORT and the exact number of positive LNs (n ≤ 3) were independently associated with better OS and LCSS. Both better OS and LCSS emerged for positive LNs (n > 3) after the use of PORT in survival analyses, whereas the benefits of OS and LCSS were not observed anymore for positive LNs (n ≤ 3) group. More importantly, multivariable analyses showed that the use of PORT is an independent risk factor of survival for positive LNs (n > 3) but not for positive LNs (n ≤ 3)., Conclusions: In Stage IIIA (pN2) NSCLC, the use of PORT demonstrated better survival results than no PORT for patients with positive LNs (n > 3), but not for patients with positive LNs (n ≤ 3).

Background: The present experiment was performed to assess the effects of different sources of milk on the growth performance, serum metabolism, immunity, and intestinal development of calves. Eighty-four Holstein male neonatal calves were assigned to one of the following four treatment groups: those that received bunk tank milk (BTM), untreated waste milk (UWM), pasteurized waste milk (PWM), and acidified waste milk (AWM) for 21 d., Results: Calves in the BTM and AWM groups consumed more starter ( P  < 0.05) than those in the UWM group. Average daily gain in the UWM group was the highest ( P  < 0.05). Calves exhibited the highest ( P  < 0.05) serum total protein, albumin, total cholesterol, high density lipoprotein, triglycerides, growth hormone, immunoglobulin (Ig) A and IgM concentrations in the UWM group, highest malondialdehyde and tumor necrosis factor-α in the PWM group ( P  < 0.05), and highest glutathione peroxidase and IgG in the BTM group ( P  < 0.05). The jejunum and ileum of the calves in all treatments presented a slight inflammatory response. The jejunal inflammation scores were higher ( P  < 0.05) in the UWM and AWM groups than the BTM group; the ileal inflammation scores increased more ( P  < 0.05) in the AWM group than the BTM group. Jejunal immunohistochemical scores (IHS) were higher ( P  < 0.05) in the PWM and AWM groups than the BTM group. Compared to the other three groups, calves feeding on BTM had lower ( P  < 0.05) ileal IHS. Jejunal interleukin(IL)-1β , IL-8 , and IL-10 mRNA expression in the UWM group was the highest ( P  < 0.05). Calves fed AWM increased ( P  < 0.05) mRNA expression of IL-8 and toll like receptor 4 (TLR-4) in the jejunum and IL-8 , IL-1β , IL-6 , IL-8 , and IL-10 in the mesenteric lymph nodes., Conclusions: Overall, bunk tank milk is the best choice for calf raising compared to waste milk. The efficiency of feeding pasteurized and acidified waste milk are comparable, and the acidification of waste milk is an acceptable labor-saving and diarrhea-preventing feed for young calves.

Yeast of Saccharomyces cerevisiae (SCY) origin has over long time been incorporated into domestic animal diets. In calves, several products have offered improved performance and health. Although several types of research have been completed, the mode of action of SCY is not clear in calves. Under this review, we have highlighted the works available in the literature on the use of SCY in calves performance, health, immunity, and the gut environment. Both active live yeast and yeast culture have positive effects on growth, rumen, small intestines, immunity and general health of the calf. Specifically, SCY can improve DMI, growth, feed efficiency and reduce diarrhea in calves. Furthermore, subtle improvements are seen in rumen fermentation (increased butyrate production) and rumen papillae growth. These positive results are, however, more pronounced in calves that are under stress or exposed to significant levels of disease-causing agents. There is a need for further research in areas such as gut morphology, gut microbiology and immunity using latest molecular methods to fully understand how SCY helps the growth and development of calves.

Background: Original rumen digesta, rumen liquid and solid fractions have been frequently used to assess the rumen bacterial community. However, bacterial profiles in rumen original digesta, liquid and solid fractions vary from each other and need to be better established., Methods: To compare bacterial profiles in each fraction, samples of rumen digesta from six cows fed either a high fiber diet (HFD) or a high energy diet (HED) were collected via rumen fistulas. Rumen digesta was then squeezed through four layers of cheesecloth to separate liquid and solid fractions. The bacterial profiles of rumen original digesta, liquid and solid fractions were analyzed with High-throughput sequencing technique., Results: Rumen bacterial diversity was mainly affected by diet and individual cow ( P  > 0.05) rather than rumen fraction. Bias distributed bacteria were observed in solid and liquid fractions of rumen content using Venn diagram and LEfSe analysis. Fifteen out of 16 detected biomarkers (using LEfSe analysis) were found in liquid fraction, and these 15 biomarkers contributed the most to the bacterial differences among rumen content fractions., Conclusions: Similar results were found when using samples of original rumen digesta, rumen liquid or solid fractions to assess diversity of rumen bacteria; however, more attention should be draw onto bias distributed bacteria in different ruminal fractions, especially when liquid fraction has been used as a representative sample for rumen bacterial study.

Background: Endothelial dysfunction plays a critical role in the development of type 2 diabetes (T2DM). T-cadherin (T-cad) has gained recognition as a regulator of endothelial cell (EC) function. The present study examined whether T-cad deficiency increases vascular vulnerability in T2DM., Methods: Vascular segments were isolated from WT or T-cad knockout mice. Endothelial function, total NO accumulation, and the expression of T-cad related proteins were determined., Results: Ach and acidified NaNO2 induced similar vasorelaxation in WT groups. T-cad KO mice exhibited normal response to acidified NaNO2, but manifested markedly reduced response to Ach. NO accumulation was also decreased in T-cad KO group. T-cad expression was reduced in WT mice fed 8 weeks of high fat diet (HFD). Furthermore, exacerbated reduction of vasorelaxation was observed in T-cad KO mice fed 8 weeks of HFD., Conclusions: In the current study, we provide the first in vivo evidence that T-cadherin deficiency causes endothelial dysfunction in T2DM vascular segments, suggesting the involvement of T-cad deficiency in T2DM pathogenesis.

Platelet hyper-reactivity is a crucial cause of accelerated atherosclerosis increasing risk of thrombotic vascular events in diabetic patients. The mechanisms leading to abnormal platelet activity during diabetes are complex and not fully defined. The current study attempted to clarify the role of CTRP9, a novel adiponectin paralog, in enhanced platelet activity and determined whether CTRP9 may inhibit platelet activity. Adult male C57BL/6 J mice were randomized to receive high-fat diet (HFD) or normal diet (ND). 8 weeks after HFD, animals were sacrificed, and both plasma CTRP9 and platelet aggregation were determined. HFD-fed animals increased weight gain significantly, and became hyperglycemic and hyperinsulinemic 8 weeks post-HFD. Compared to ND animals, HFD animals exhibited significantly decreased plasma CTRP9 concentration and increased platelet response to ADP, evidenced by augmented aggregation amplitude, steeper aggregation slope, larger area under the curve, and shorter lag time (P < 0.01). A significant negative correlation between plasma CTRP9 concentration and platelet aggregation amplitude was observed. More importantly, in vitro pre-treatment with CTRP9 significantly inhibited ADP-stimulated platelet activation in platelet samples from both ND and HFD animals. Taken together, our results suggest reduced plasma CTRP9 concentration during diabetes plays a causative role in platelet hyper-activity, contributing to platelet-induced cardiovascular damage during this pathologic condition. Enhancing CTRP9 production and/or exogenous supplementation of CTRP9 may protect against diabetic cardiovascular injury via inhibition of abnormal platelet activity.

Energy intake prepartum is critically important to health, milk performance, and profitability of dairy cows. The objective of this study was to determine the effect of reduced energy density of close-up diets on dry matter intake (DMI), lactation performance and energy balance (EB) in multiparous Holstein cows which were housed in a free-stall barn and fed for ad libitum intake. Thirty-nine dry cows were blocked and assigned randomly to three groups fed a high energy density diet [HD, n = 13; 6.8 MJ of net energy for lactation (NEL)/kg; 14.0% crude protein (CP) ], or a middle energy density diet (MD, n = 13; 6.2 MJ NEL/kg; 14.0% CP), or a low energy density diet (LD, n = 13; 5.4 MJ NEL/kg; 14.0% CP) from d 21 before expected day of calving. After parturition, all cows were fed the same lactation diet to d 70 in milk (DIM). The DMI and NEL intake prepartum were decreased by the reduced energy density diets (P < 0.05). The LD group consumed 1.3 kg/d (DM) more diet compared with HD group in the last 24 h before calving. The milk yield and the postpartum DMI were increased by the reduced energy density diet prepartum (P < 0.05). The changes in BCS and BW prepartum and postpartum were not affected by prepartum diets. HD group had higher milk fat content and lower lactose content compared with LD group during the first 3 wk of lactation (P < 0.05). The energy consumption for HD, MD and LD groups were 149.8%, 126.2% and 101.1% of their calculated energy requirements prepartum (P < 0.05), and 72.7%, 73.1% and 75.2% during the first 4 wk postpartum, respectively. In conclusion, the low energy density prepartum diet was effective in controlling NEL intake prepartum, and was beneficial in increasing DMI and milk yield, and alleviating negative EB postpartum.