Dietary short-term supplementation of grape seed proanthocyanidin extract improves pork quality and promotes skeletal muscle fiber type conversion in finishing pigs.

Plant extracts are commonly used as feed additives to improve pork quality. However, due to their high cost, shortening the duration of supplement use can help reduce production costs. In this study, we aimed to investigate the effects of grape seed proanthocyanidin extract (GSPE) on meat quality and muscle fiber characteristics of finishing pigs during the late stage of fattening, which was 30 days in our experimental design. The results indicated that short-term dietary supplementation of GSPE significantly reduced backfat thickness, but increased loin eye area and improved meat color and tenderness. Moreover, GSPE increased slow myosin heavy chain (MyHC) expression and malate dehydrogenase (MDH) activity, while decreasing fast MyHC expression and lactate dehydrogenase (LDH) activity in the Longissimus thoracis (LT) muscle. Additionally, GSPE increased the expression of Sirt1 and PGC-1α proteins in the LT muscle of finishing pigs and upregulated AMP-activated protein kinase α 1 (AMPKα1), AMPKα2, nuclear respiratory factor 1 (NRF1), and calcium/calmodulin-dependent protein kinase kinase ß (CaMKKß) mRNA expression levels. These findings suggest that even during the late stage of fattening, GSPE treatment can regulate skeletal muscle fiber type transformation through the AMPK signaling pathway, thereby affecting the muscle quality of finishing pigs. Therefore, by incorporating GSPE into the diet of pigs during the late stage of fattening, producers can enhance pork quality while reducing production costs.

Dietary grape seed proanthocyanidin extract supplementation improves antioxidant capacity and lipid metabolism in finishing pigs.

Grape seed proanthocyanidin extract (GSPE) plays a significant role in body health, including improving antioxidant capacity and maintaining lipid metabolism stability. However, whether dietary GSPE supplementation can improve lipid metabolism in finishing pigs remains unclear. Here 18 castrated male Duroc × Landrace × Yorkshire finishing pigs were randomly divided into three groups with six replicates and one pig per replicate. Pigs were fed a basal diet (control), a basal diet supplemented with 100 mg/kg GSPE, or a basal diet supplemented with 200 mg/kg GSPE for 30 days. Antioxidant analysis showed that dietary 200 mg/kg GSPE supplementation increased glutathione, total antioxidant capacity and glutathione peroxidase levels, and reduced malondialdehyde levels in serum, muscle and liver. Dietary 200 mg/kg GSPE supplementation also upregulated the mRNA and protein levels of nuclear-related factor 2 (Nrf2). Lipid metabolism analysis showed that dietary GSPE supplementation increased serum high-density lipoprotein cholesterol levels and reduced serum triglyceride and total cholesterol levels. Besides, GPSE upregulated the mRNA expression of lipolysis- and fatty acid oxidation-related genes downregulated the mRNA expression of lipogenesis-related genes, and activated the AMPK signal in finishing pigs. Together, we provided evidence that dietary GSPE supplementation improved the antioxidant capacity and lipid metabolism in finishing pigs.

Delirium screening for patients in the intensive care unit: A prospective validation study of the iCAM-ICU by nurse researchers and bedside nurses in routine practice.

BACKGROUND: Daily delirium assessment using the Confusion Assessment Method for the Intensive Care Unit was recommended for patients in the intensive care unit, yet implementation may be difficult because of lack of simple and standardized data collection schemes which may result in low sensitivities when used by bedside nurses. OBJECTIVE: This study was to validate the diagnostic accuracy of the intelligent Confusion Assessment Method for the Intensive Care Unit (iCAM-ICU) used by both nurse investigators and bedside nurses in Chinese patients in the intensive care unit. DESIGN: Prospective cohort study. SETTING: A university affiliated tertiary hospital in China. PARTICIPANTS: A total of 373 hospitalized patients (181 in phase I and 192 in phase II) in the intensive care units met the inclusion criteria and participated in the study. There were two nursing researchers (phase I) and 24 bedside nurses (phase II) used the iCAM-ICU to assess delirium among patients. METHODS: Two prospective cohort studies were conducted to validate the diagnostic accuracy of iCAM-ICU on delirium screening when it was used by nurse investigators and bedside nurses in the intensive care unit. Using the Diagnostic and Statistical Manual of Mental Disorders as the gold standard, the sensitivity, specificity, predictive values along with the likelihood ratios were determined to estimate the performance of the iCAM-ICU in patients in the intensive care setting. The Kappa consistency test was examined to determine the inter-rater consistency. Subgroup analysis in terms of different age, level of education, severity of illness and cognitive status were also conducted to evaluate potential variations of the iCAM-ICU performance in different patient groups. RESULTS: A total of 373 patients were included in the validation studies. In comparing with the gold standard, the sensitivities of the iCAM-ICU demonstrated by the two nurse investigators were 95.2 % and 93.7%, while the specificities of the iCAM-ICU were 93.3% and 93.2%. The Kappa consistency between two nurse investigators was 0.96. The sensitivity and specificity of the iCAM-ICU demonstrated by bedside nurses in intensive care patients were 86.7% and 97.7%, respectively. Subgroup analysis also revealed that the sensitivities and specificities in those different subgroups were acceptable, with all statistics being above 80%. CONCLUSIONS: The iCAM-ICU, an information technology enabled delirium screening tool, showed highly acceptable accuracy in detecting delirium in the intensive care units. It can assist bedside nurses to detect delirium reliably and identify potential patients with delirium accurately. REGISTRATION NUMBER: ChiCTR-OCH-13003050.

Change in Serum Level of Interleukin 6 and Delirium After Coronary Artery Bypass Graft.

BACKGROUND: Serum level of interleukin 6 (IL-6) is known to be associated with postoperative delirium. However, no consensus has emerged on the postoperative time point at which IL-6 level may predict postoperative delirium after coronary artery bypass graft surgery. OBJECTIVES: To compare trends in IL-6 levels in patients with and without postoperative delirium and to examine the relationship between IL-6 levels at different times and postoperative delirium after coronary artery bypass graft. METHODS: A prospective cohort study of patients who underwent their first elective isolated coronary artery bypass graft between November 2013 and August 2015 at a cardiac intensive care unit in Beijing, China. Concentrations of IL-6 were measured before the operation and at the 6th, 12th, and 18th postoperative hours. Participants were assessed for postoperative delirium twice daily for 5 days. Univariate and multivariate logistic regression analyses were done to determine associations between IL-6 levels at different time points, postoperative changes in IL-6 levels, and the occurrence of postoperative delirium. RESULTS: Postoperative delirium was diagnosed in 85 of 266 patients (32%). Levels of IL-6 were significantly higher in patients with postoperative delirium than in patients without it at the 6th, 12th, and 18th postoperative hours (P = .03, .004, and .001, respectively). Change in IL-6 level (odds ratio, 2.97; 95% CI, 1.20-7.31; P = .02) and IL-6 level of 583 pg/mL or higher at the 18th postoperative hour (odds ratio, 5.20; 95% CI, 1.84-14.70; P = .002) were associated with higher incidence of postoperative delirium. CONCLUSION: Interleukin 6 level (≥ 583 pg/mL) at the 18th postoperative hour may serve as a potent predictor of postoperative delirium in coronary artery bypass graft patients.