The effects of cereal type and α-tocopherol level on milk production, milk composition, rumen fermentation, and nitrogen excretion of spring-calving dairy cows in late lactation.

Grass-based production systems use concentrate supplementation primarily when pasture quality and availability have declined. Barley is a common concentrate ingredient; however, oat grain grows well in Ireland, is a source of lipids and fiber, and may provide an alternative to barley. The antioxidant α-tocopherol (α-TOC) plays a role in cell membrane structure, and it has the potential to improve tight junction structures of the mammary gland that deteriorate in late lactation. The objective of this research was to investigate the effect of cereal type and α-TOC level on milk yield, milk composition, rumen fermentation, and N excretion in late-lactation dairy cows at pasture and when housed indoors on grass silage. Forty-eight Holstein Friesian dairy cows were blocked on days in milk (+185 d in milk) and balanced for parity, pre-experimental milk yield, milk composition, and body condition score and assigned to 1 of 4 dietary treatments in a randomized complete block design (n = 12). The dietary treatments were control (C) base diet; base diet + barley-based concentrate + low α-TOC (350 IU/kg) (B); base diet + oat-based concentrate + low α-TOC (350 IU/kg) (O); and base diet + oat-based concentrate + high α-TOC (1,050 IU/kg) (O+T). Following a 14-d acclimation period, diets were offered for a 49-d experimental period at pasture (P1) and a 21-d experimental period indoors (P2). The base diet was grazed grass in P1 and grass silage in P2. In P2, cows on C also received 2.65 kg (dry matter) of a standard concentrate. In P1, supplementation increased milk and milk solids yield (B: 20.7 kg/d, 1.74 kg/d; O: 20.6 kg/d, 1.81 kg/d; O+T: 20.5 kg/d, 1.77 kg/d, respectively) compared with C (17.8 kg/d, 1.60 kg/d). Cows offered B had a lower milk fat (4.60%) concentration than C (5.00%) and O (4.90%). In P2, cereal type and α-TOC level did not alter milk production. In conclusion, concentrate supplementation increased milk and milk solids yield and cows offered O had a higher milk fat concentration than cows offered B. Increasing the level of α-TOC had no major effect on production parameters measured in P1 or in P2.

The effect of concentrate supplementation type on milk production, dry matter intake, rumen fermentation, and nitrogen excretion in late-lactation, spring-calving grazing dairy cows.

In Ireland, milk is primarily produced using a spring-calving grass-based system, with the use of concentrate supplementation mainly when pasture availability and quality are reduced. In the autumn, when cows are in late lactation, reduced pasture productivity results in reduced milk yield and altered milk composition. Nitrogen utilization efficiency also reduces as lactation progresses. Concentrate supplementation has been found to increase milk production and reduce nitrogen (N) excretion, as high-N grass is usually replaced by a lower-N supplement; however, there is a paucity of information with regard to the optimum type of supplementation in late lactation. Therefore, the objective of this research is to investigate the effect of different concentrate supplementation types, based on barley or maize, on milk production, dry matter intake (DMI), rumen fermentation, and N excretion in late-lactation, spring-calving, grazing dairy cows. Thirty-six Holstein Friesian dairy cows were blocked on days in milk (185 DIM) and balanced for parity, pre-experimental milk yield, milk composition, and body condition score. Cows were randomly assigned to 1 of 3 dietary treatments in a randomized complete block design (n = 12). The 3 treatments consisted of a perennial ryegrass-based pasture-only (PO) treatment and pasture plus either of 2 supplementary concentrates, based on barley (PB) or maize (PM). The diets were fed for a 14-d acclimatization period and then for a further 63-d experimental period. Cows offered PO had a lower daily milk yield (15.1 kg) than PB (18.2 kg) or PM (16.8 kg). Similarly, PO had lower daily milk solids yield (1.46 kg) than PB or PM (1.68 and 1.53 kg, respectively). Cows offered PB had a greater milk yield and higher fat and protein yields than those offered PM. Offering PB increased total DMI (19.5 kg) compared with PO (17.7 kg), and milk response to concentrates was also greater for PB compared with PM (1.21 vs. 0.71 kg of milk per kg of concentrate). Cows offered PB had increased N in milk compared with PO. In conclusion, concentrate supplementation based on barley or maize resulted in increased milk and milk solids yield compared with offering PO. Cows offered barley had a greater response to concentrates and increased milk and milk solids yield in comparison to maize and showed increased N partitioning in milk compared with PO. A barley-based concentrate increased total DMI compared with PO.

Production responses and cost-benefit of long-acting pre-lambing anthelmintic treatment of yearling ewes in two commercial flocks in New Zealand.

AIMS: To investigate the production responses and cost-benefit of administering a controlled-release anthelmintic capsule (CRC) to pregnant yearling ewes prior to lambing. METHODS: Yearling ewes from two commercial sheep flocks (A, n=489; B, n=248) in the North Island of New Zealand were enrolled in the study. Prior to lambing, CRC containing albendazole and abamectin were administered to half the ewes while the other half remained untreated. Ewe liveweights and body condition scores were measured prior to lambing, at weaning and, for Flock B, prior to subsequent mating. Lambs were matched to dams shortly after birth and the weight and number of lamb weaned per ewe were determined. A cost-benefit analysis was undertaken for Flock B considering the increased weight of lamb weaned per ewe, and the weight of ewes at the next mating and the benefit in terms of lambs born. RESULTS: The mean weight at weaning of treated ewes was greater for treated than untreated ewes by 2.76 (95% CI 0.64-4.88) kg in Flock A (p<0.001) and 2.35 (95% CI -0.41-5.12) kg in Flock B (p=0.003); the weight of lamb weaned per ewe was greater for treated than untreated ewes by 1.43 (95% CI -0.71 to -3.49) kg in Flock A (p=0.041) and 3.97 (95% CI 1.59-6.37) kg in Flock B (p<0.001), and ewe liveweight prior to subsequent mating was greater for treated than untreated ewes in Flock B by 4.60 (95% CI 3.6-5.6) kg (p<0.001). There was no difference in the percentage of lambs reared to weaning between treated and untreated ewes in either flock (p>0.8). The overall cost-benefit of treatment for Flock B was NZ$9.44 per treated ewe. CONCLUSIONS AND CLINICAL RELEVANCE: Pre-lambing CRC administration to yearling ewes resulted in increased ewe weaning weights and weight of lamb weaned in both the flocks studied. There was an economic benefit in the one flock where this was assessed.

Concordance and acceptability of electric stimulation therapy: a randomised controlled trial.

OBJECTIVE: A pilot single-blinded randomised controlled trial (RCT) was conducted to examine concordance with and acceptability of electric stimulation therapy (EST) in patients with venous leg ulcers (VLUs) who had not tolerated moderate to high compression. METHOD: Participants were randomised to the intervention group (n=15) or a placebo control group (n=8) in which EST was used four times daily for 20 minutes per session. Participants were monitored for eight weeks during which time concordance with the treatment and perceptions of the treatment were assessed. RESULTS: Concordance with the total recommended treatment time was 71.4% for the intervention group and 82.9% for the control group; a difference that was not statistically significant. Participants rated EST as acceptable (84.6% intervention; 83.3% control), only two participants, both from the placebo control group, would not be willing to use EST again. The majority considered EST easier to use than compression (68.4%). CONCLUSION: EST was a practical and acceptable treatment among people who have been unable to tolerate moderate to high compression therapy.

Venous leg ulcer healing with electric stimulation therapy: a pilot randomised controlled trial.

OBJECTIVE: Compression therapy is a gold standard treatment to promote venous leg ulcer (VLU) healing. Concordance with compression therapy is, however, often sub-optimal. The aim of this study was to evaluate the effectiveness of electric stimulation therapy (EST) to facilitate healing of VLUs among people who do not use moderate-to-high levels of compression (>25 mmHg). METHOD: A pilot multicentre, single-blinded randomised controlled trial was conducted. Participants were randomised (2:1) to the intervention group or a control group where EST or a sham device was used 4 times daily for 20 minutes per session. Participants were monitored fortnightly for eight weeks. The primary outcome measure was percentage of area (wound size) change. RESULTS: In the 23 patients recruited, an average redution in wound size of 23.15% (standard deviation [SD]: 61.23) was observed for the control group compared with 32.67 % (SD: 42.54) for the intervention. A moderate effect size favouring the intervention group was detected from univariate [F(1,18)=1.588, p=0.224, partial eta squared=0.081] and multivariate repeated measures [F(1,18)=2.053, p=0.169, partial eta squared=0.102] analyses. CONCLUSION: The pilot study was not powered to detect statistical significance, however, the difference in healing outcomes are encouraging. EST may be an effective adjunct treatment among patients who have experienced difficulty adhering to moderate-to-high levels of compression therapy.

Antibacterial effects of blackberry extract target periodontopathogens.

BACKGROUND AND OBJECTIVE: Antimicrobial agents provide valuable adjunctive therapy for the prevention and the control of oral diseases. Limitations in their prolonged use have stimulated the search for new, naturally occurring agents with more specific activity and fewer adverse effects. Here we sought to determine the antibacterial properties of blackberry extract (BBE) in vitro against oral bacterial commensals and periodontopathogens. MATERIAL AND METHODS: The effects of whole and fractionated BBE on the metabolism of 10 different oral bacteria were evaluated using the colorimetric water-soluble tetrazolium-1 assay. The bactericidal effects of whole BBE against Fusobacterium nucleatum were determined by quantitating the numbers of colony-forming units (CFUs). Cytotoxicity was determined in oral epithelial (OKF6) cells. RESULTS: BBE at 350-1400 µg/mL reduced the metabolic activity of Porphyromonas gingivalis, F. nucleatum and Streptococcus mutans. The reduced metabolic activity observed for F. nucleatum corresponded to a reduction in the numbers of CFUs following exposure to BBE for as little as 1 h, indicative of its bactericidal properties. An anthocyanin-enriched fraction of BBE reduced the metabolic activity of F. nucleatum, but not of P. gingivalis or S. mutans, suggesting the contribution of species-specific agents in the whole BBE. Oral epithelial cell viability was not reduced following exposure to whole BBE (2.24-1400 µg/mL) for ≤ 6 h. CONCLUSION: BBE alters the metabolic activity of oral periodontopathogens while demonstrating a minimal effect on commensals. The specific antibacterial properties of BBE shown in this study, along with its previously demonstrated anti-inflammatory and antiviral properties, make this natural extract a promising target as an adjunct for prevention and/or complementary therapy of periodontal infections.

Cosolvent flushing for the remediation of PAHs from former manufactured gas plants.

Cosolvent flushing is a technique that has been proposed for the removal of hydrophobic organic contaminants in the subsurface. Cosolvents have been shown to dramatically increase the solubility of such compounds compared to the aqueous solubility; however, limited data are available on the effectiveness of cosolvents for field-contaminated media. In this work, we examine cosolvent flushing for the removal of polycyclic aromatic hydrocarbons (PAHs) in soil from a former manufactured gas plant (FMGP). Batch studies confirmed that the relationship between the soil-cosolvent partitioning coefficient (K(i)) and the volume fraction of cosolvent (f(c)) followed a standard log-linear equation. Using methanol at an fc of 0.95, column studies were conducted at varying length scales, ranging from 11.9 to 110 cm. Removal of PAH compounds was determined as a function of pore volumes (PVs) of cosolvent flushed. Despite using a high f(c), rate and chromatographic effects were observed in all the columns. PAH effluent concentrations were modeled using a common two-site sorption model. Model fits were improved by using MeOH breakthrough curves to determine fitted dispersion coefficients. Fitted mass-transfer rates were two to three orders of magnitude lower than predicted values based on published data using artificially contaminated sands.

Marizomib, a proteasome inhibitor for all seasons: preclinical profile and a framework for clinical trials.

The proteasome has emerged as an important clinically relevant target for the treatment of hematologic malignancies. Since the Food and Drug Administration approved the first-in-class proteasome inhibitor bortezomib (Velcade) for the treatment of relapsed/refractory multiple myeloma (MM) and mantle cell lymphoma, it has become clear that new inhibitors are needed that have a better therapeutic ratio, can overcome inherent and acquired bortezomib resistance and exhibit broader anti-cancer activities. Marizomib (NPI-0052; salinosporamide A) is a structurally and pharmacologically unique ß-lactone-γ-lactam proteasome inhibitor that may fulfill these unmet needs. The potent and sustained inhibition of all three proteolytic activities of the proteasome by marizomib has inspired extensive preclinical evaluation in a variety of hematologic and solid tumor models, where it is efficacious as a single agent and in combination with biologics, chemotherapeutics and targeted therapeutic agents. Specifically, marizomib has been evaluated in models for multiple myeloma, mantle cell lymphoma, Waldenstrom's macroglobulinemia, chronic and acute lymphocytic leukemia, as well as glioma, colorectal and pancreatic cancer models, and has exhibited synergistic activities in tumor models in combination with bortezomib, the immunomodulatory agent lenalidomide (Revlimid), and various histone deacetylase inhibitors. These and other studies provided the framework for ongoing clinical trials in patients with MM, lymphomas, leukemias and solid tumors, including those who have failed bortezomib treatment, as well as in patients with diagnoses where other proteasome inhibitors have not demonstrated significant efficacy. This review captures the remarkable translational studies and contributions from many collaborators that have advanced marizomib from seabed to bench to bedside.

DLK1: increased expression in gliomas and associated with oncogenic activities.

DLK1 (delta-like) is a transmembrane and secreted protein in the epidermal growth factor-like homeotic family. Although expressed widely during embryonic development, only a few tissues retain the expression in adults. Neuroendocrine tumors often highly express this protein; therefore, we hypothesized that brain tumors might also express it. This study found that the expression of DLK1 in gliomas was higher than that in normal brain (P < 0.05). After stable transfection of a DLK1 cDNA expression vector into GBM cell lines, their proliferation was increased. Furthermore, they lost contact inhibition, had enhanced anchorage-independent growth in soft agar, and had significantly greater capacity to migrate. Western blot studies showed that expression of cyclin D1, CDK2, and E2F4 were increased, and Rb levels were decreased in these cells. DLK1 was found on the cell surface and secreted in the medium from the transfected GBM cells. DLK1-enriched condition medium stimulated the growth of glioblastoma multiforme cell lines and explants. DLK1 antibody blocked cell growth stimulated by DLK1. In summary, these results suggest that DLK1 may play a role in the formation or progression of gliomas.

Hydrazinonaphthalene and azonaphthalene thrombopoietin mimics are nonpeptidyl promoters of megakaryocytopoiesis.

High-throughput screening for the induction of a luciferase reporter gene in a thrombopoietin (TPO)-responsive cell line resulted in the identification of 4-diazo-3-hydroxy-1-naphthalenesulfonic acids as TPO mimics. Modification of the core structure and adjustment of unwanted functionality resulted in the development of (5-oxo-1,5-dihydropyrazol-4-ylidene)hydrazines which exhibited efficacies equivalent to those of TPO in several cell-based assays designed to measure thrombopoietic activity. Furthermore, these compounds elicited biochemical responses in TPO-receptor-expressing cells similar to those in TPO itself, including kinase activation and protein phosphorylation. Potencies for the best compounds were high for such low molecular weight compounds (MW < 500) with EC(50) values in the region of 1-20 nM.

Amodal completion of acoustic signals by a nonhuman primate.

Evidence of amodal completion exists for both visual and auditory stimuli in humans. The importance of this mechanism in forming stable representations of sensory information suggests that it may be common among multiple modalities and species. Here we show that a species of nonhuman primate amodally completes biologically meaningful acoustic stimuli, which provides evidence that the neural mechanism mediating this aspect of auditory perception is shared among primates, and perhaps other taxonomic groups as well.

Toxicant-induced loss of tolerance.

Drug addiction and multiple chemical intolerance (abdiction) appear to be polar opposites--the former characterized by craving and dependency, the latter by aversion. However, when the two are viewed in juxtaposition similarities emerge, revealing a common underlying dynamic, one which appears to be a new paradigm of disease. TILT, or toxicant-induced loss of tolerance, bridges the gap between addiction and abduction and has the potential to explain a variety of illnesses, including certain cases of asthma, migraine headaches and depression, as well as chronic fatigue syndrome, fibromyalgia and "Gulf War syndrome". This paper argues that both addiction and chemical intolerance involve a fundamental breakdown in innate tolerance, resulting in an amplification of various biological effects, particularly withdrawal symptoms. While addicts seek further exposures so as to avoid unpleasant withdrawal symptoms, chemically intolerant individuals shun their problem exposures, but for the same reason--to avoid unpleasant withdrawal symptoms. These observations raise critical questions: do addictive drugs and environmental pollutants initiate an identical disease process? Once this process begins, can both addictants and pollutants trigger symptoms and cravings? TILT opens a new window between the fields of addiction and environmental medicine, one that has the potential to transform neighboring realms of medicine, psychology, psychiatry and toxicology.

Effect of avocado and soybean unsaponifiables on gelatinase A (MMP-2), stromelysin 1 (MMP-3), and tissue inhibitors of matrix metalloproteinase (TIMP- 1 and TIMP-2) secretion by human fibroblasts in culture.

BACKGROUND: In inflamed periodontal tissues, gingival fibroblasts are able to express matrix metalloproteinases (MMPs) and their natural inhibitors, tissue inhibitors of matrix metalloproteinases (TIMPs). They can also respond to growth factors and cytokines. In this study, the in vitro effects of avocado and soybean unsaponifiable residues (ASU), their fractions (avocado unsaponifiable [ASF] or soy unsaponifiable [SSF]) on MMP-2 and MMP-3, and the activity and secretion of their inhibitors TIMP-1 and TIMP-2 were investigated using cultured human gingival fibroblasts. METHODS: Gingival fibroblasts were cultured for 72 hours with ASU, ASF, and SSF at concentrations of 0. 1, 0.5, 2.5, 5, and 10 microgram/ml of culture medium, after pretreatment or no pretreatment for 1 hour with interleukin-1beta (IL-1beta). MMP-2 and MMP-3 were detected and quantified in the culture media after zymography and image analysis. TIMP-1, TIMP-2, MMP-2, and MMP-3 were also evidenced by dot blotting and quantified by image analysis. RESULTS: In the absence of IL-1beta, a slight decrease in the secretion of MMP-2 was observed with lower doses of ASU, ASF, and SSF. The decrease of MMP-3 secretion was clearly marked with all fractions especially at low concentrations (0.1 and 2.5 microgram/ml). A slight decrease in TIMP-2 secretion was seen for low doses of ASU, ASF, and SSF, while a small increase was seen at higher concentrations. Concerning TIMP-1, no significant variation was observed in culture medium for low concentrations, and a decrease was noted for 5 and 10 microgram/ml of ASU, ASF, and SSF. As anticipated, IL-1beta induced a marked release of MMP-2, MMP-3, and TIMP-1, but no variation for TIMP-2 was seen. ASU, ASF, and SSF reversed the IL-1beta effect on gingival fibroblasts for MMP-2 and MMP-3, particularly with doses varying from 0.1 to 2.5 microgram/ml and for TIMP-1, particularly with doses varying from 2.5 to 10 microgram/ml. CONCLUSIONS: These findings suggest a potential role for avocado and soy unsaponifiable extracts to prevent the deleterious effects of IL-1beta that occur during periodontal diseases.

Supplementing pasture to lactating Holsteins fed a total mixed ration diet.

Beginning in September 1997, a 6-week study was conducted to compare performance and income-over-feed cost of lactating Holsteins cows fed either a total mixed ration diet (TMR) only, compared to TMR in the afternoon and pasture in the morning, or TMR in the morning and pasture in the afternoon. Fifty-four Holstein cows in midlactation, averaging 28.1 kg/d of milk, were used in the study. Cows were on pasture for 8 h/d after either the p.m. or the a.m. milking. Predominantly orchardgrass with lesser amounts of white clover and Kentucky bluegrass were grazed. Pasture was sampled once per week, and weekly composites were analyzed. Compressed sward height and herbage dry matter (DM) yield were estimated once per week. Milk yield was electronically recorded and was sampled biweekly. Body condition score and body weight (BW) was recorded at the beginning and end of the study. Income-over-feed cost was calculated for each treatment. Compressed sward height and DM yield averaged 12.7 cm and 1397 kg/ha, respectively. Pasture crude protein, neutral detergent fiber, and acid detergent fiber averaged 27.0, 55.7, and 26.9%, respectively, and net energy-lactation was 1.65 Mcal/kg of dry matter. Milk production was greater for cows on the TMR treatment (29.1 vs. 28.2 and 27.6). No significant difference occurred in percentage of milk fat (3.54, 3.42, and 3.46%), or protein (3.28, 3.20, and 3.22%) for the above respective treatments. The SNF content (8.77 vs. 8.67 and 8.63%) was higher in TMR cows. While BW change did not differ among treatments (23, 32, and 22 kg), body condition score change was greater in cows fed TMR only (0.14 vs. -0.06 and 0.01). As expected, TMR intake was greatest for cows fed TMR only and lowest for cows grazing after the p.m. milking (26.6 vs. 20.3 vs. 17.5 kg/d dry matter). Income-over-feed cost differed between treatments and was approximately 18.6 and 7.5% higher for cows grazing high quality pasture during the afternoon and the morning, respectively, compared with cows on the TMR treatment.

Improving psychosocial assessment in oncology.

A project that encouraged nurses to give greater emphasis to cancer patients' psychological, social and spiritual concerns, and not only to the condition's physical effects, reflects one target outlined in The NHS Cancer Plan.

Milk production and composition, rumen fermentation parameters, and grazing behavior of dairy cows supplemented with different forms and amounts of corn grain.

The objectives were to compare milk production and composition, change in body weight and body condition score, rumen fermentation parameters and grazing patterns by cows when supplemented with different forms and amounts of corn grain. In experiment 1, 36 Holstein cows were supplemented with either 6, 6, 6, or 4 kg/d of dry matter of high moisture corn, coarsely ground corn, finely ground corn, or high moisture corn in two equal daily feedings, respectively. Milk yield (30.3 kg/d), milk protein (2.97%), and milk urea N (14.7 mg/dl) were not different among treatments. Body weight change and body condition score change were similar (23.1 kg and -0.24) for the 10-wk study. During experiment 2, four rumen cannulated cows in midlactation were supplemented with 6 kg/d of dry matter from either coarsely ground corn or high moisture corn in two equal feedings after milking. After the p.m. milking, ruminal pH was measured and rumen fluid samples, were collected from cows to determine ammonia N and volatile fatty acids at 0.5, 1, 2, 3, ...8 h post-corn feeding during grazing. Ruminal pH values were similar for corn supplements, and, with one exception, were 6.0 or below between 5 and 8 h. Ruminal ammonia-N concentrations reached a maximum at 7 h also. In experiment 3, 40 cows were observed for grazing behavior every 30 min for two consecutive days. Cows grazed an average of 6.4 h/d, 4.1 h in the afternoon and 2.3 h in the morning. Milk yield, milk composition, change in body weight, and body condition were similar regardless of the type or amount of corn supplemented.

Characterization and expression of the pseudomonas putida bacterioferritin alpha subunit gene.

The root-colonizing pseudomonad Pseudomonas putida (Pp) appears to produce two subunits, alpha and beta, of the iron-binding protein, bacterioferritin. A gene encoding the alpha-bacterioferritin subunit was located adjacent to the major catalase in Pp. The deduced protein sequence of the Pp bfralpha gene had a very high identity with other alpha-subunits, possessing conserved amino acids responsible for ferroxidase activity. The gene also lacked a deduced methionine at residue 52, associated with heme binding in beta-subunits. An antibody generated toward the Escherichia coli (E. coli) multifunctional single subunit bacterioferritin recognized two proteins in the Pp extract, a 22 kDa protein likely to be a beta-subunit and, to a lesser extent, a 23 kDa band. The 23 kDa band was absent in a Pp mutant in which the bfralpha gene was disrupted. Loss of alpha-bacterioferritin stimulated production of fluorescent siderophore. Growth on media and on root surfaces was not impaired by deletion of the alpha-bacterioferritin. Transcription of bfralpha was independent of the catalase gene and was dependent on iron. The transcript levels from bfralpha decreased in iron deficiency experienced during stationary-phase or upon treatment during growth with an iron chelator.

Relationship between serum inositol concentration and development of retinopathy of prematurity: a prospective study.

PURPOSE: To examine the relationship between the intake of sugar inositol, serum inositol levels, and ROP in three groups of low birthweight infants receiving feedings containing various concentrations of inositol. METHODS: Infants with a birthweight <1500 g, with severe lung disease, were eligible for the study when they began enteral feedings. Infant formulas contained three different inositol concentrations: 2500, 710, and 242 micromol/L. Serum inositol concentrations were averaged over specific time intervals. A logistic regression model was used to investigate the confounding effect of duration of mechanical ventilation and oxygen therapy, birthweight, Apgar score, and serum inositol concentration on development of ROP. RESULTS: Infants receiving high inositol formula and with higher serum inositol concentrations at birth and after 30 days had a statistically significant lower incidence of severe ROP than those receiving the lower inositol formula and with lower serum concentrations (P<.05). The effective serum inositol concentration (EC90) associated with lesser disease was >215 micromol/L. By logistic regression, the odds of developing severe ROP were greater among infants with low serum inositol concentration (odds ratio=4.7, 95% confidence interval 0.90-24.8, P=.017). CONCLUSION: Inositol supplementation may help prevent the most severe form of ROP.