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Frontiers in Veterinary Science 2023Chromium (Cr) is an essential mineral that has been demonstrated to enhance milk production in dairy cows. This study aims to evaluate the effects of dietary Cr...
INTRODUCTION
Chromium (Cr) is an essential mineral that has been demonstrated to enhance milk production in dairy cows. This study aims to evaluate the effects of dietary Cr supplementation on dry matter intake (DMI), milk production and composition using a meta-analysis based on existing literature.
METHODS
A random effects meta-analysis was performed to investigate the effects of dietary Cr supplementation on DMI, milk production and composition. The heterogeneity was assessed using the statistic and Q test, while Egger's test was used to evaluate publication bias.
RESULTS
The meta-analysis discovered that Cr-supplemented cows had a significantly higher DMI compared to those not supplemented, with an increase of 0.72 kg/day [95% confidence interval (CI), 0.46-0.97]. The regression model indicated that DMI significantly increased by 0.9 g/kg of body weight (BW) and by 80.5 g for an increase of 1 mg of Cr supplement. The supplementation phase was associated with an increase in DMI, with an increase of 0.4582 kg/day for BFP (before parturition) and 0.853 kg/day for AFP (after parturition). The methionine and yeast forms of Cr increased DMI by 0.714 and 1.137 kg/day, respectively. The DMI was increased by 2.137 and 0.620 kg/day for multiparous (MP)+ primiparous (PP) cows and MP cows, respectively. Milk production was also increased by Cr supplementation, with an increase of 1.20 kg/day (95% CI, 0.65-1.76). The regression model indicated that milk production increased by 2.3 g/day for an increase of 1 kg of BW and by 122.4 g/day for an increase of 1 mg of Cr supplement. Milk production also increased with the duration of the experiment and days in milk. The amino acid and methionine forms of Cr complexes increased milk production by 1.645 and 1.448 kg/day, respectively. Milk production increased by 1.087 and 1.920 kg/day for MP and PP cows, respectively. Milk composition was not significantly affected by Cr supplementation. Egger's test for publication biases was not significant for all responses of interest.
DISCUSSION
The meta-analysis showed that Cr supplementation improves DMI and milk production in dairy cows. The results suggest that the supplementation phase, form of Cr, and parity should be considered when supplementing dairy cows with Cr. The results have important implications for the dairy industry and can contribute to the development of more effective feeding strategies for dairy cows.
PubMed: 37008343
DOI: 10.3389/fvets.2023.1076777 -
Journal of Animal Science Jan 2023The temperament of dairy cows interferes in milk yield and quality, but there is a lack of consensus throughout the literature. Thus, systematic review (SR) and... (Meta-Analysis)
Meta-Analysis
The temperament of dairy cows interferes in milk yield and quality, but there is a lack of consensus throughout the literature. Thus, systematic review (SR) and meta-analysis (MA) methodologies were used to assess the effects of dairy cow temperament on milk yield. Our literature search included four electronic databases (CABI Abstracts, Web of Science, PubMed, and Scopus) and bibliographies of the publications included on MA. As inclusion criteria, we considered publications about the temperament of lactating cows and its effect on daily milk yield and total milk yield (whole lactation). A random effect-MA was carried out separately for daily milk yield and total milk yield related to each class of cows' temperament, 'low' (low reactivity, calm animals), 'intermediate' (intermediate reactivity), and 'high' (high reactivity, reactive animals). A total of eight publications reporting 75 trials were included in the analyses for daily milk yield, and three publications reporting nine trials for total milk yield. For daily and total milk yield the heterogeneity between publications was high (I2 = 99.9%). Cows of European breeds with intermediate temperament produced less milk daily than the calm (P = 0.020) and reactive ones (P < 0.001). In the case of primiparous cows, those with intermediate temperament produced less milk daily (P < 0.001) than the reactive ones, while for multiparous, the intermediate produced less than calm (P = 0.032) and reactive cows (P < 0.001). Regarding the stage of lactation, cows evaluated throughout lactation with a calm temperament tended (P = 0.081) to produce more milk than the intermediate ones, but less than the reactive ones (P < 0.001). For total milk yield, reactive cows tended to produce more than the calm (P = 0.082) and intermediate (P = 0.001) ones. Among European and primiparous cows, reactive cows produced more than the intermediate (P = 0.001). According to our results, we cannot confirm what we expected, that calmer cows would be the most productive for both daily and total yield.
Topics: Pregnancy; Female; Cattle; Animals; Milk; Lactation; Temperament; Parity
PubMed: 37004202
DOI: 10.1093/jas/skad099 -
PLOS Global Public Health 2022Hospital and community based-studies had been conducted for Urinary Incontinence (UI) in Sub-Sahara Africa (SSA) countries. A significant limitation of these studies is...
Hospital and community based-studies had been conducted for Urinary Incontinence (UI) in Sub-Sahara Africa (SSA) countries. A significant limitation of these studies is likely under-estimation of the burden of UI in SSA. It is therefore, imperative that a well-structured systematic review and meta-analytical models in SSA are required to accurately and reliably estimate the burden of UI. Medline/PubMed, Google Scholar, Africa Journal Online (AJOL) were searched to identified data on burden of UI studies in SSA. Two independent authors performed the initial screening of studies based on the details found in their titles and abstracts. The quality of the retrieved studies was assessed using the Newcastle-Ottawa Quality Assessment instrument. The pooled burden of UI was calculated using a weighted inverse variance random-effects model. A sub-group and meta-regression analyses were performed. Publication bias was checked by the funnel plot and Egger's test. Of the 25 studies included, 14 were hospital-based, 10 community- based, and 1 university-based studies involving an overall 17863 participants from SSA. The systematic review showed that the prevalence of UI ranged from 0.6% in Sierra Leone to 42.1% in Tanzania. The estimated pooled burden of UI across all studies was 21% [95% CI: 16%-26%, I2 = 91.01%]. The estimated pooled prevalence of stress UI was 52% [95% CI: 42%-62%], urgency UI 21% [95% CI: 15%-26%], and mixed UI 27% [95% CI: 20%-35%]. The common significant independent factors were; parity, constipation, overweight/obese, vaginal delivery, chronic cough, gestational age, and aging. One out of every five women in SSA suffers from UI. Parity, constipation, overweight/obesity, vaginal delivery, chronic cough, gestational age, and age were the most important risk variables. As a result, interventions aimed at reducing the burden of UI in SSA women aged 15 to 100 years old in the context of identified determinants could have significant public health implications.
PubMed: 36962388
DOI: 10.1371/journal.pgph.0000562 -
Frontiers in Public Health 2023The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19...
OBJECTIVE
The representativeness of participants is crucial to ensure external validity of clinical trials. We focused on the randomized clinical trials which assessed COVID-19 vaccines to assess the reporting of age, sex, gender identity, race, ethnicity, obesity, sexual orientation, and socioeconomic status in the results (description of the participants' characteristics, loss of follow-up, stratification of efficacy and safety results).
METHODS
We searched the following databases for randomized clinical trials published before 1st February 2022: PubMed, Scopus, Web of Science, and Excerpta Medica. We included peer-reviewed articles written in English or Spanish. Four researchers used the Rayyan platform to filter citations, first reading the title and abstract, and then accessing the full text. Articles were excluded if both reviewers agreed, or if a third reviewer decided to discard them.
RESULTS
Sixty three articles were included, which assessed 20 different vaccines, mainly in phase 2 or 3. When describing the participants' characteristics, all the studies reported sex or gender, 73.0% race, ethnicity, 68.9% age groups, and 22.2% obesity. Only one article described the age of participants lost to follow-up. Efficacy results were stratified by age in 61.9%, sex or gender in 26.9%, race and/or, ethnicity in 9.5%, and obesity in 4.8% of the articles. Safety results were stratified by age in 41.0%, and by sex or gender in 7.9% of the analysis. Reporting of gender identity, sexual orientation or socioeconomic status of participants was rare. Parity was reached in 49.2% of the studies, and sex-specific outcomes were mentioned in 22.9% of the analysis, most of the latter were related to females' health.
CONCLUSIONS
Axes of social inequity other than age and sex were hardly reported in randomized clinical trials that assessed COVID-19 vaccines. This undermines their representativeness and external validity and sustains health inequities.
Topics: Female; Humans; Male; COVID-19; COVID-19 Vaccines; Ethnicity; Gender Identity; Clinical Trials as Topic; Diversity, Equity, Inclusion
PubMed: 36891333
DOI: 10.3389/fpubh.2023.1069357 -
Indian Journal of Cancer Oct 2022The incidence of breast cancer in India has seen a rapid increase in recent years. Hormonal and reproductive risk factors for breast cancer have been affected by... (Review)
Review
The incidence of breast cancer in India has seen a rapid increase in recent years. Hormonal and reproductive risk factors for breast cancer have been affected by socioeconomic development. Studies on breast cancer risk factors in India are limited by the small sample size and specific geographical area. The current systematic review was carried out to assess the association of hormonal and reproductive risk factors with breast cancer in Indian women. A systematic review of MEDLINE, Embase, Scopus, and Cochrane database of systematic reviews were done. Relevant case-control studies published in peer-reviewed indexed journals were analyzed for hormonal risk factors such as age at menarche, menopause, and first childbirth; breastfeeding; abortion; and oral contraceptive pills use. Younger age (<13 years) at menarche was associated with high risk (odds ratio 1.23-3.72). Other hormonal risk factors with strong association were age at first childbirth and menopause, parity, and duration of breastfeeding. Abortion and the use of contraceptive pills did not have a clear association with breast cancer. Hormonal risk factors have a higher association in premenopausal disease and estrogen receptor-positive tumors. There is a strong association between hormonal and reproductive risk factors and breast cancer in Indian women. The protective effect of breastfeeding is related to the cumulative duration of breastfeeding.
PubMed: 36861707
DOI: 10.4103/ijc.IJC_271_21 -
Reproduction & Fertility Jan 2023Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy.... (Meta-Analysis)
Meta-Analysis Review
ABSTRACT
Endometriosis is a chronic and debilitating condition which can affect the entire reproductive life course of women with a potentially detrimental effect on pregnancy. Pregnancy (and increasing parity) can affect endometriosis by modulating disease severity and suppressing symptoms. Multiparous women could be less likely to suffer from endometriosis-related pregnancy complications than primiparous women. We aimed to systematically review the evidence examining the role of parity in the relationship between pregnancy outcomes and endometriosis. A systematic search of MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library was performed from inception to May 2022. We searched for experimental and observational studies. Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence with the risk of bias in non-randomised studies of interventions tool incorporated. Eleven studies were included in the meta-analysis. Primiparous women with endometriosis had almost double the risk of hypertensive disorders of pregnancy (OR: 1.99, 95% CI: 1.50-2.63, P < 0.001) compared to multiparous women with endometriosis. Primiparous women with endometriosis were at significantly increased risk of preterm delivery, caesarean delivery, and placenta praevia compared to primiparous women without endometriosis. There were no significant differences in outcomes when multiparous women with endometriosis were compared to multiparous women without endometriosis. There is limited evidence to suggest that primiparous women with endometriosis may be at higher risk of adverse pregnancy outcomes compared to multiparous women. The modulatory role of parity in the pathophysiology of endometriosis and its impact on pregnancy outcomes should be investigated.
LAY SUMMARY
Endometriosis can adversely affect pregnancy and cause complications that can affect both mother and baby. The severity and symptoms of endometriosis are lessened in pregnancy and with increasing births. Women who have previously given birth could experience fewer pregnancy complications than women giving birth for the first time. We reviewed the literature to compare pregnancy outcomes in women with endometriosis by whether they had given birth before or not. Our review included 11 studies. More women with endometriosis giving birth for the first time had blood pressure disorders in pregnancy than women with endometriosis who had given birth before. First-time mothers with endometriosis tended to have a baby born early, caesarean delivery, and an abnormally located placenta compared to those without endometriosis. This study supports the theory that women with endometriosis in their first pregnancy are at higher risk of complications and may benefit from additional monitoring.
Topics: Animals; Pregnancy; Female; Parity; Endometriosis; Pregnancy Outcome; Parturition; Pregnancy Complications
PubMed: 36821517
DOI: 10.1530/RAF-22-0070 -
PloS One 2023Neonatal near miss is a condition of newborn infant characterized by severe morbidity (near miss), but survived these conditions within the first 27 days of life. It is... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Neonatal near miss is a condition of newborn infant characterized by severe morbidity (near miss), but survived these conditions within the first 27 days of life. It is considered as the first step to design management strategies that can contribute in reducing long term complication and mortality. The aim of this study was to assess prevalence and determinants of neonatal near miss in Ethiopia.
METHODS
The protocol of this systematic review and meta-analysis was registered at the Prospero with a registration number of (PROSPERO 2020: CRD42020206235). International online databases such as PubMed, CINAHL, Google scholar, Global Health, Directory of open Access journal and African Index Medicus were used to search articles. Data extraction was undertaken with Microsoft Excel and STATA11 was used to conduct the Meta-Analysis. Random effect model analysis was considered when there was evidence of heterogeneity between the studies.
RESULTS
The overall pooled prevalence of neonatal near miss was 35.51% (95%CI: 20.32-50.70, I2 = 97.0%, p = 0.000). Primiparity (OR = 2.52, 95%CI: 1.62, 3.42), referral linkage (OR = 3.92, 95%CI: 2.73, 5.12), premature rupture of membrane (OR = 5.05, 95%CI: 2.03, 8.08), Obstructed labor (OR = 4.27, 95%CI: 1.62, 6.91) and maternal medical complications during pregnancy (OR = 7.10, 95%CI: 1.23, 12.98) had shown significant statistical association with neonatal near miss.
CONCLUSION
The prevalence of neonatal near miss in Ethiopia is evidenced to be high. Primiparity, referral linkage, premature rupture of membrane, obstructed labor and maternal medical complications during pregnancy were found to be determinant factors of neonatal near miss.
Topics: Infant; Pregnancy; Infant, Newborn; Female; Humans; Prevalence; Ethiopia; Near Miss, Healthcare; Parity; Morbidity; Dystocia
PubMed: 36809252
DOI: 10.1371/journal.pone.0278741 -
Risk factors associated with 31-day unplanned hospital readmission in newborns: a systematic review.European Journal of Pediatrics Apr 2023The purpose of this study is to synthesize evidence on risk factors associated with newborn 31-day unplanned hospital readmissions (UHRs). A systematic review was... (Review)
Review
UNLABELLED
The purpose of this study is to synthesize evidence on risk factors associated with newborn 31-day unplanned hospital readmissions (UHRs). A systematic review was conducted searching CINAHL, EMBASE (Ovid), and MEDLINE from January 1st 2000 to 30th June 2021. Studies examining unplanned readmissions of newborns within 31 days of discharge following the initial hospitalization at the time of their birth were included. Characteristics of the included studies examined variables and statistically significant risk factors were extracted from the inclusion studies. Extracted risk factors could not be pooled statistically due to the heterogeneity of the included studies. Data were synthesized using content analysis and presented in narrative and tabular form. Twenty-eight studies met the eligibility criteria, and 17 significant risk factors were extracted from the included studies. The most frequently cited risk factors associated with newborn readmissions were gestational age, postnatal length of stay, neonatal comorbidity, and feeding methods. The most frequently cited maternal-related risk factors which contributed to newborn readmissions were parity, race/ethnicity, and complications in pregnancy and/or perinatal period.
CONCLUSION
This systematic review identified a complex and diverse range of risk factors associated with 31-day UHR in newborn. Six of the 17 extracted risk factors were consistently cited by studies. Four factors were maternal (primiparous, mother being Asian, vaginal delivery, maternal complications), and two factors were neonatal (male infant and neonatal comorbidities). Implementation of evidence-based clinical practice guidelines for inpatient care and individualized hospital-to-home transition plans, including transition checklists and discharge readiness assessments, are recommended to reduce newborn UHRs.
WHAT IS KNOWN
• Attempts have been made to identify risk factors associated with newborn UHRs; however, the results are inconsistent.
WHAT IS NEW
• Six consistently cited risk factors related to newborn 31-day UHRs. Four maternal factors (primiparous, mother being Asian, vaginal delivery, maternal complications) and 2 neonatal factors (male infant and neonatal comorbidities). • The importance of discharge readiness assessment, including newborn clinical fitness for discharge and parental readiness for discharge. Future research is warranted to establish standardised maternal and newborn-related variables which healthcare providers can utilize to identify newborns at greater risk of UHRs and enable comparison of research findings.
Topics: Infant; Pregnancy; Female; Infant, Newborn; Humans; Male; Patient Readmission; Risk Factors; Mothers; Parity; Patient Discharge; Length of Stay
PubMed: 36705723
DOI: 10.1007/s00431-023-04819-2 -
Sudanese Journal of Paediatrics 2023Cerebral palsy (CP) is a group of disorders of movement and postural control caused by a nonprogressive defect or lesion of the developing brain. Several prepregnancy... (Review)
Review
Cerebral palsy (CP) is a group of disorders of movement and postural control caused by a nonprogressive defect or lesion of the developing brain. Several prepregnancy risk factors have been described including maternal age, parity and maternal diseases including epilepsy, diabetes and thyroid disease. There are few in-depth studies on the causes of CP. In the present systematic review, databases searched were Google Scholar and PubMed to identify data on determinants of CP in the world. Studies were included if they specifically mentioned CP as an outcome, the study objective is to identify factors associated with CP in children and all quantitative observational studies. JBI Critical Appraisal Tools were used to assess the methodological quality of a study. Papers that meet the inclusion criteria were rigorously appraised by two critical appraisers. 40 consistent determinants of CP in children from 95 research articles that meet inclusion criteria are included in the review. The majority of studies (24 articles) showed that premature babies and low weight were determinants of CP in children, whereas 15 studies showed that low Apgar scores were determinants of CP in children. The commonest determinants of CP in children are premature babies and low weight, low Apgar scores, intrauterine infection, congenital brain malformations, thyroid disease, premature rupture of membrane (PROM) and placental abruption. Preventing preterm delivery, low birth weight and intrauterine infection as well as immediate neonatal resuscitation for newborns with low Apgar scores may help to prevent CP in children.
PubMed: 38380410
DOI: 10.24911/SJP.106-1670589241 -
Cancers Dec 2022Policymakers require robust cost-effectiveness evidence of risk-reducing-surgery (RRS) for decision making on resource allocation for breast cancer (BC)/ovarian cancer... (Review)
Review
Policymakers require robust cost-effectiveness evidence of risk-reducing-surgery (RRS) for decision making on resource allocation for breast cancer (BC)/ovarian cancer (OC)/endometrial cancer (EC) prevention. We aimed to summarise published data on the cost-effectiveness of risk-reducing mastectomy (RRM)/risk-reducing salpingo-oophorectomy (RRSO)/risk-reducing early salpingectomy and delayed oophorectomy (RRESDO) for BC/OC prevention in intermediate/high-risk populations; hysterectomy and bilateral salpingo-oophorectomy (BSO) in Lynch syndrome women; and opportunistic bilateral salpingectomy (OBS) for OC prevention in baseline-risk populations. Major databases were searched until December 2021 following a prospective protocol (PROSPERO-CRD42022338008). Data were qualitatively synthesised following a PICO framework. Twenty two studies were included, with a reporting quality varying from 53.6% to 82.1% of the items scored in the CHEERS checklist. The incremental cost-effectiveness ratio/incremental cost-utility ratio and cost thresholds were inflated and converted to US$2020, using the original currency consumer price index (CPI) and purchasing power parities (PPP), for comparison. Eight studies concluded that RRM and/or RRSO were cost-effective compared to surveillance/no surgery for , while RRESDO was cost-effective compared to RRSO in one study. Three studies found that hysterectomy with BSO was cost-effective compared to surveillance in Lynch syndrome women. Two studies showed that RRSO was also cost-effective at ≥4%/≥5% lifetime OC risk for pre-/post-menopausal women, respectively. Seven studies demonstrated the cost-effectiveness of OBS at hysterectomy (n = 4), laparoscopic sterilisation (n = 4) or caesarean section (n = 2). This systematic review confirms that RRS is cost-effective, while the results are context-specific, given the diversity in the target populations, health systems and model assumptions, and sensitive to the disutility, age and uptake rates associated with RRS. Additionally, RRESDO/OBS were sensitive to the uncertainty concerning the effect sizes in terms of the OC-risk reduction and long-term health impact. Our findings are relevant for policymakers/service providers and the design of future research studies.
PubMed: 36551605
DOI: 10.3390/cancers14246117