Postoperative Ultrasound in Kidney Transplant Recipients: Association Between Intrarenal Resistance Index and Cardiovascular Events

Background. Doppler ultrasound, including intrarenal resistance index (RI) measurement, is a widely used modality to assess kidney transplantation (KTx) vascularization. The aim of this study is to gain insight in the associations between early postoperative RI measurements and cardiovascular events (CVEs), all-cause mortality, and death-censored graft survival. Methods. From 2015 to 2017, a prospective cohort study was

Fasting before living-kidney donation:effect on donor well-being and postoperative recovery: study protocol of a multicenter randomized controlled trial

BACKGROUND: One of the main effectors on the quality of life of living-kidney donors is postoperative fatigue. Caloric restriction (CR) and short-term fasting (STF) are associated with improved fitness and increased resistance to acute stress. CR/STF increases the expression of cytoprotective genes, increases immunomodulation via increased anti-inflammatory cytokine production, and decreases the expression of pro-inflammatory markers. As such, nutritional preconditioning by CR or STF represents a non-invasive and cost-effective method that could mitigate the effects of acute surgery-induced stress and postoperative fatigue. To investigate whether preoperative STF contributes to a reduction in fatigue after living-kidney donation, a randomized clinical trial is indicated. METHODS: We aim to determine whether 2.5 days of fasting reduces postoperative fatigue score in subjects undergoing living-kidney donation. In this randomized study, the intervention group will follow a preoperative fasting regime for 2.5 days with a low-dose laxative, while the control group will receive standard care. The main study endpoint is postoperative fatigue, 4 weeks after living-kidney donation. Secondary endpoints include the effect of preoperative fasting on postoperative hospital admission time, the feasibility of STF, and the postoperative recovery of donor and recipient kidney function. This study will provide us with knowledge of the feasibility of STF and confirm its effect on postoperative recovery. DISCUSSION: Our study will provide clinically relevant information on the merits of caloric restriction for living-kidney donors and recipients. We expect to reduce the postoperative fatigue in living-kidney donors and improve the postoperative recovery of living-kidney recipients. It will provide evidence on the clinical merits and potential caveats of preoperative dietary interventions. TRIAL REGISTRATION: Netherlands Trial Register NL9262. EudraCT 2020-005445-16. MEC Erasmus MC MEC-2020-0778. CCMO NL74623.078.21 SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-021-05950-x

Aorto-Iliac Artery Calcification Prior to Kidney Transplantation

As vascular calcification is common in kidney transplant candidates, aorto-iliac vessel imaging is performed for surgical planning. The aim of the present study was to investigate whether a novel non-contrast enhanced computed tomography-based quantification technique for aorto-iliac calcification can be used for cardiovascular risk stratification prior to kidney transplantation. In this dual-center cohort study, we measured the aorto-iliac calcium score (CaScore) of 547 patients within three years prior to transplantation (2005–2018). During a median (interquartile range) follow-up of 3.1 (1.4, 5.2) years after transplantation, 80 (14.7%) patients died, of which 32 (40.0%) died due to cardiovascular causes, and 84 (15.5%) patients had a cardiovascular event. Kaplan-Meier survival curves showed significant differences between the CaScore tertiles for cumulative overall-survival (Log-r

Prediction of nitrogen excretion from data on dairy cows fed a wide range of diets compiled in an intercontinental database: A meta-analysis

Manure nitrogen (N) from cattle contributes to nitrous oxide and ammonia emissions and nitrate leaching. Measurement of manure N outputs on dairy farms is laborious, expensive, and impractical at large scales; therefore, models are needed to predict N excreted in urine and feces. Building robust prediction models requires extensive data from animals under different management systems worldwide. Thus, the study objectives were (1) to collate an international database of N excretion in feces and urine based on individual lactating dairy cow data from different continents; (2) to determine the suitability of key variables for predicting fecal, urinary, and total manure N excretion; and (3) to develop robust and reliable N excretion prediction models based on individual data from lactating dairy cows consuming various diets. A raw data set was created based on 5,483 individual cow observations, with 5,420 fecal N excretion and 3,621 urine N excretion measurements collected from 162 in vivo experiments conducted by 22 research institutes mostly located in Europe (n = 14) and North America (n = 5). A sequential approach was taken in developing models with increasing complexity by incrementally adding variables that had a significant individual effect on fecal, urinary, or total 2manure N excretion. Nitrogen excretion was predicted by fitting linear mixed models including experiment as a random effect. Simple models requiring dry matter intake (DMI) or N intake performed better for predicting fecal N excretion than simple models using diet nutrient composition or milk performance parameters. Simple models based on N intake performed better for urinary and total manure N excretion than those based on DMI, but simple models using milk urea N (MUN) and N intake performed even better for urinary N excretion. The full model predicting fecal N excretion had similar performance to simple models based on DMI but included several independent variables (DMI, diet crude protein content, diet neutral detergent fiber content, milk protein), depending on the location, and had root mean square prediction errors as a fraction of the observed mean values of 19.1% for intercontinental, 19.8% for European, and 17.7% for North American data sets. Complex total manure N excretion models based on N intake and MUN led to prediction errors of about 13.0% to 14.0%, which were comparable to models based on N intake alone. Intercepts and slopes of variables in optimal prediction equations developed on intercontinental, European, and North American bases differed from each other, and therefore region-specific models are preferred to predict N excretion. In conclusion, region-specific models that include information on DMI or N intake and MUN are required for good prediction of fecal, urinary, and total manure N excretion. In absence of intake data, region-specific complex equations using easily and routinely measured variables to predict fecal, urinary, or total manure N excretion may be used, but these equations have lower performance than equations based on intake

Peptide-Mediated Liposome Fusion: The Effect of Anchor Positioning

Supramolecular & Biomaterials Chemistr

Simulating the intake and nitrogen excretion from cows grazing forages fertilised with increasing rates of nitrogen

The dry matter intake (DMI), production, and urinary nitrogen (N) excretion of dairy cows grazing forage grown under increasing N fertiliser rates were explored using a mechanistic model of a grazing ruminant. The MINDY cow model was initialised to represent a multiparous Holstein-Friesian dairy cow in late lactation (age 3.5 years, 212 days in milk). Simulated cows were offered a common allowance (30 kg DM/cow/d) of chicory, plantain, lucerne, or perennial ryegrass, fertilised at rates of 0, 100, 200, 350 and 500 kg N/ha/y (0N, 100N etc.) for 20 days in March. Forage physical and chemical composition data were obtained from a Waikato experimental field site. When N rate increased from 0–500N, predicted DMI of cows grazing plantain and ryegrass increased by 5.2 and 2.7 kg DM/cow/day (43 and 20% increase), respectively, facilitated by increased sward height and mass, and reduced herbage strength. Predicted DMI of cows grazing chicory peaked at 200N and, for cows grazing lucerne, declined with N fertilisation. Intake of highly fertilised (>200N) chicory and lucerne diets were potentially affected by high herbage soluble N content resulting in high predicted rumen ammonia concentrations (>18 mmol/L), reducing incentive for grazing. While predicted milk production from cows grazing chicory, plantain and ryegrass increased, the efficiency of dietary N used for milk production declined, with increasing N applied. Increasing N rate also increased predicted urine N concentration, and urinary N excretion from simulated cows fed chicory, plantain, and ryegrass. This study suggests that N fertiliser rates of 200N for chicory, plantain and ryegrass provides a balance between cow production and N excretion

Solid‐Phase Synthesis and Biological Evaluation of Peptides ADP‐ribosylated at Histidine

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordThe transfer of an adenosine diphosphate (ADP) ribose moiety to a nucleophilic side chain by consumption of nicotinamide adenine dinucleotide is referred to as ADP-ribosylation, which allows for the spatiotemporal regulation of vital processes such as apoptosis and DNA repair. Recent mass-spectrometry based analyses of the ‘ADP-ribosylome’ have identified histidine as ADP-ribose acceptor site. In order to study this modification, a fully synthetic strategy towards α-configured N(τ)- and N(π)-ADP-ribosylated histidine-containing peptides has been developed. Ribofuranosylated histidine building blocks were obtained via Mukaiyama-type glycosylation and the building blocks were integrated into an ADP-ribosylome derived peptide sequence using fluorenylmethyloxycarbonyl (Fmoc)-based solid-phase peptide synthesis. On-resin installation of the ADP moiety was achieved using phosphoramidite chemistry, and global deprotection provided the desired ADP-ribosylated oligopeptides. The stability under various chemical conditions and resistance against (ADP-ribosyl) hydrolase-mediated degradation has been investigated to reveal that the constructs are stable under various chemical conditions and non-degradable by any of the known ADP-ribosylhydrolases.Medical Research Council (MRC)National Institute for Health and Care Research (NIHR)Wellcome TrustBiotechnology and Biological Sciences Research Council (BBSRC)Cancer Research UKOvarian Cancer Research Allianc