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Journal of Diabetes Research 2024Women with preexisting diabetes and gestational diabetes mellitus (GDM) are at higher risk for adverse maternal and neonatal outcomes. However, there is no consensus on...
Women with preexisting diabetes and gestational diabetes mellitus (GDM) are at higher risk for adverse maternal and neonatal outcomes. However, there is no consensus on a uniform approach regarding mode of birth (MOB) for all forms of diabetes. The aim of the study is to compare MOB in women with preexisting diabetes and GDM and possible factors influencing it. A retrospective cohort study of women with GDM and preexisting diabetes between 2015 and 2021 at a tertiary referral center was conducted. One thousand three hundred eighty-five singleton pregnancies were included. One thousand twenty-two (74.4%) women had a vaginal birth (VB) and 351 (25.6%) a caesarean section. Preexisting diabetes was significantly associated with caesarean section compared to GDM (OR 2.43). Five hundred fifty-one (40.1%) women underwent induction of labor, and 122 (22.1%) women had a secondary caesarean after IOL. Women induced due to spontaneous rupture of membrane (SROM) achieved the highest rate of VB at 93%. The lowest rates of VB occurred if indication for induction was for preeclampsia or hypertension. IOL was significantly less successful in preexisting diabetes with a VB achieved in 56.4% for type 1 diabetes and 52.6% of type 2 diabetes compared to GDM (78.2% in GDM; 81.2% in IGDM; OR 3.25, 95% CI 1.70-6.19, < 0.001). The rate of VB was higher who were induced preterm compared to women with term IOL ( = 240 (81.9%) vs. = 199 (73.2%); < 0.05). Parity, previous VB and SROM favored VB after IOL, whereas preexisting diabetes, hypertension, and IOL after 40 + 0 weeks are independent risk factors for caesarean delivery.
Topics: Humans; Female; Pregnancy; Diabetes, Gestational; Retrospective Studies; Tertiary Care Centers; Adult; Cesarean Section; Diabetes Mellitus, Type 2; Risk Factors; Labor, Induced; Diabetes Mellitus, Type 1; Delivery, Obstetric; Pregnancy Outcome; Pregnancy in Diabetics; Parturition
PubMed: 38883259
DOI: 10.1155/2024/5561761 -
Journal of Dairy Science Jun 2024Objectives were to determine the effects of 2 dietary microbial additives supplemented to diets of Holstein cows on productive performance and feed efficiency....
Objectives were to determine the effects of 2 dietary microbial additives supplemented to diets of Holstein cows on productive performance and feed efficiency. One-hundred and 17 Holstein cows were enrolled at 61 d (31 to 87 d) postpartum in a randomized complete block design experiment. Cows were blocked by parity group, as nulliparous or multiparous cows and, within parity, by pre-treatment energy-corrected milk yield. Within block, cows were randomly assigned to one of 3 treatments administered as top-dress for 140 d. Treatments consisted of either 100 g of corn meal containing no microbial additive (CON; 15 primiparous and 25 multiparous), 100 g of corn meal containing 5 g of a mixture of Clostridium beijerinckii and Pichia kudriavzevii (G1; 4 × 10 cfu of C. beijerinckii and 1 × 10 cfu of P. kudriavzevii; 14 primiparous and 24 multiparous), or 100 g of corn meal containing 5 g of a mixture of C. beijerinckii, P. kudriavzevii, Butyrivibrio fibrisolvens, and Ruminococcus bovis (G2; 4 × 10 cfu of C. beijerinckii, 1 × 10 cfu of P. kudriavzevii, 1 × 10 cfu of B. fibrisolvens, and 1 × 10 cfu of R. bovis; 15 primiparous and 24 multiparous). Intake of DM, milk yield, and BW were measured daily, whereas milk composition was analyzed at each milking 2 d a week, and body condition was scored twice weekly. Milk samples were collected on d 60 and 62 in the experiment and analyzed for individual fatty acids. The data were analyzed with mixed-effects models with orthogonal contrast to determine the impact of microbial additive (MA; CON vs. 1/2 G1 + 1/2 G2) and type of microbial additive (TMA; G1 vs. G2). Results are described in sequence as CON, G1, and G2. Intake of DM (22.2 vs. 22.4 vs. 22.4 kg/d), BW (685 vs. 685 vs. 685 kg) and the daily BW change (0.40 vs. 0.39 vs. 0.39 kg/d) did not differ among treatments; however, feeding MA tended to increase BCS (3.28 vs. 3.33 vs. 3.36). Supplementing MA increased yields of milk (39.9 vs. 41.3 vs. 41.5 kg/d), ECM (37.9 vs. 39.3 vs. 39.9 kg/d), fat (1.31 vs. 1.37 vs. 1.40 kg/d), total solids (4.59 vs. 4.75 vs. 4.79 kg/d), and ECM per kg of DMI (1.72 vs. 1.76 vs. 1.80 kg/kg). Furthermore, cows fed MA increased yields of pre-formed fatty acids in milk fat (>16C; 435 vs. 463 vs. 488 g/d), particularly unsaturated fatty acids (367 vs. 387 vs. 410 g/d), such as linoleic (C18:2 cis-9, cis-12; 30.9 vs. 33.5 vs. 35.4 g/d) and α-linolenic acids (C18:3 cis-9, cis-12, cis-15; 2.46 vs. 2.68 vs. 2.82 g/d) on d 60 and 62 in the experiment. Collectively, supplementing G1 and G2 improved productive performance of cows with no differences between the 2 MA.
PubMed: 38876222
DOI: 10.3168/jds.2024-24795 -
Journal of Dairy Science Jun 2024Feed efficiency is important for economic profitability of dairy farms; however, recording daily dry matter intakes (DMI) is expensive. Our objective was to investigate...
Assessing different cross-validation schemes for predicting novel traits using sensor data: an application to dry matter intake and residual feed intake using milk spectral data.
Feed efficiency is important for economic profitability of dairy farms; however, recording daily dry matter intakes (DMI) is expensive. Our objective was to investigate the potential use of milk mid-infrared (MIR) spectral data to predict proxy phenotypes for DMI based on different cross-validation schemes. We were specifically interested in comparisons between a model that included only MIR data (Model M1), a model that incorporated different energy sink predictors, such as body weight, body weight change, and milk energy (Model M2), and an extended model that incorporated both energy sinks and MIR data (Model M3). Models M2 and M3 also included various cow level variables (stage of lactation, age at calving, parity) such that any improvement in model performance from M2 to M3, whether through a smaller root mean squared error (RMSE) or a greater squared predictive correlation (R), could indicate a potential benefit of MIR to predict residual feed intake. The data used in our study originated from a multi-institutional project on the genetics of feed efficiency in US Holsteins. Analyses were conducted on 2 different trait definitions based on different period lengths: averaged across weeks vs. averaged across 28-d. Specifically, there were 19,942 weekly records on 1,812 cows across 46 experiments or cohorts and 3,724 28-d records on 1,700 cows across 43 different cohorts. The cross-validation analyses involved 3 different k-fold schemes. First, a 10-fold cow-independent cross-validation was conducted whereby all records from any one cow were kept together in either training or test sets. Similarly, a 10-fold experiment-independent cross-validation kept entire experiments together whereas a 4-fold herd-independent cross-validation kept entire herds together in either training or test sets. Based on cow-independent cross-validation for both weekly and 28-d DMI, adding MIR predictors to energy sinks (Models M3 vs M2) significantly (P < 10) reduced average RMSE to 1.59 kg and increased average R to 0.89. However, adding MIR to energy sinks (M3) to predict DMI either within an experiment-independent or herd-independent cross-validation scheme seemed to demonstrate no merit (P > 0.05) compared with an energy sink model (M2) for either R or RMSE (respectively, 0.68 and 2.55 kg for M2 in herd-independent scheme). We further noted that with broader cross-validation schemes, i.e., from cow-independent to experiment-independent to herd-independent schemes, the mean and slope bias increased. Given that proxy DMI phenotypes for cows would need to be almost entirely generated in herds having no DMI or training data of their own, herd-independent cross-validation assessments of predictive performance should be emphasized. Hence, more research on predictive algorithms suitable for broader cross-validation schemes and a more earnest effort on calibration of spectrophotometers against each other should be considered.
PubMed: 38876215
DOI: 10.3168/jds.2024-24701 -
Science Advances Jun 2024Orbital magnetism and the loop currents (LCs) that accompany it have been proposed to emerge in many systems, including cuprates, iridates, and kagome superconductors....
Orbital magnetism and the loop currents (LCs) that accompany it have been proposed to emerge in many systems, including cuprates, iridates, and kagome superconductors. In the case of cuprates, LCs have been put forward as the driving force behind the pseudogap, strange-metal behavior, and -wave superconductivity. Here, we investigate whether fluctuating intra-unit-cell LCs can cause unconventional superconductivity. For odd-parity LCs, we find that they are repulsive in all pairing channels near the underlying quantum-critical point (QCP). For even-parity LCs, their fluctuations give rise to unconventional pairing, which is not amplified in the vicinity of the QCP, in sharp contrast to pairing mediated by spin-magnetic, nematic, or ferroelectric fluctuations. Applying our formalism to the cuprates, we conclude that fluctuating intra-unit-cell LCs are unlikely to yield -wave superconductivity. If LCs are to be relevant for the cuprates, they must break translation symmetry.
PubMed: 38875341
DOI: 10.1126/sciadv.adn3662 -
Chronic Diseases and Translational... Jun 2024Growth differentiation factor-15 (GDF-15) is a stress response protein and is related to cardiovascular diseases (CVD). This study aimed to investigate the association...
BACKGROUND
Growth differentiation factor-15 (GDF-15) is a stress response protein and is related to cardiovascular diseases (CVD). This study aimed to investigate the association between GDF-15 and pre-eclampsia (PE).
METHOD
The study involved 299 pregnant women, out of which 236 had normal pregnancies, while 63 participants had PE. Maternal serum levels of GDF-15 were measured by using enzyme-linked immunosorbent assay kits and then translated into multiple of median (MOM) to avoid the influence of gestational week at blood sampling. Logistic models were performed to estimate the association between GDF-15 MOM and PE, presenting as odd ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
MOM of GDF-15 in PE participants was higher compared with controls (1.588 vs. 1.000, < 0.001). In the logistic model, pregnant women with higher MOM of GDF-15 (>1) had a 4.74-fold (95% CI = 2.23-10.08, < 0.001) increased risk of PE, adjusted by age, preconceptional body mass index, gravidity, and parity.
CONCLUSIONS
These results demonstrated that higher levels of serum GDF-15 were associated with PE. GDF-15 may serve as a biomarker for diagnosing PE.
PubMed: 38872765
DOI: 10.1002/cdt3.126 -
Npj Mental Health Research Jun 2024Mental health and substance use parity provides a rhetorical device and policy strategy for achieving more equitable financing of mental health and substance use...
Mental health and substance use parity provides a rhetorical device and policy strategy for achieving more equitable financing of mental health and substance use services, which the U.S. has pursued as a lead policy approach for improving access to mental healthcare. Parity implementation in the U.S. has improved access to care for children, but implementation challenges remain, leading to persistent treatment gaps and disparities, workforce shortages, and variable care quality. In the U.S., a recent policy change required health insurers to make available all of the data on their coverage and reimbursement practices for all health conditions. This new data enables a more detailed conceptualization of what parity means in children’s mental health and how it should be implemented and overseen. Researchers, clinicians, and advocates across the globe can use this data to build the case and the policy approach for parity, supporting more equitable financing of children’s mental health and substance use care and promoting families’ access to evidence-based care.
PubMed: 38871961
DOI: 10.1038/s44184-024-00070-1 -
International Journal of Reproductive... Mar 2023At the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, studies showed that the risk of severe disease was higher in pregnant women.
BACKGROUND
At the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, studies showed that the risk of severe disease was higher in pregnant women.
OBJECTIVE
This study investigates the characteristics of severe and critical types of COVID-19 coronavirus infection in pregnant women.
MATERIALS AND METHODS
This prospective cross-sectional study compared the medical records of 120 pregnant women with severe and very severe COVID-19 treated at the Infectious Disease Center, Shymkent, Kazakhstan from December 2021 to May 2022. Factors such as time of hospital admission, hospitalization period, maternal comorbidities, age, pregnancy and postpartum complications, pregnancy outcomes, and treatment type were analyzed.
RESULTS
87 (72.5%) pregnant women with severe and 33 (27.5%) with critical type of COVID-19 were included. The following data were obtained when comparing the pregnancy parity of the subjects, depending on the gestational age: in 1-12 wk, the indicator was 3.75 0.95; in 13-27 wk 3.00 (Q1-Q3: 2.00-4.00), in 28-40 wk 3.00 (Q1-Q3: 2.00-4.00). Severe COVID-19 coronavirus infection occurs in women with more than a third pregnancy (Me 3.00 [Q1-Q3: 2.00-4.00]).
CONCLUSION
There is a risk of disease progression to severe and critical COVID-19 in pregnant women older than 33 yr of age and at 28-40 wk gestation. Early referral to a doctor in hospital, timely hospitalization, and initiated treatment reduces the risk of aggravation of the patient's condition and development of formidable complications.
PubMed: 38868449
DOI: 10.18502/ijrm.v22i3.16167 -
Communications Medicine Jun 2024Emerging evidence suggests that post-stroke aphasia severity depends on the integrity of the brain beyond the lesion. While measures of lesion anatomy and brain...
BACKGROUND
Emerging evidence suggests that post-stroke aphasia severity depends on the integrity of the brain beyond the lesion. While measures of lesion anatomy and brain integrity combine synergistically to explain aphasic symptoms, substantial interindividual variability remains unaccounted. One explanatory factor may be the spatial distribution of morphometry beyond the lesion (e.g., atrophy), including not just specific brain areas, but distinct three-dimensional patterns.
METHODS
Here, we test whether deep learning with Convolutional Neural Networks (CNNs) on whole brain morphometry (i.e., segmented tissue volumes) and lesion anatomy better predicts chronic stroke individuals with severe aphasia (N = 231) than classical machine learning (Support Vector Machines; SVMs), evaluating whether encoding spatial dependencies identifies uniquely predictive patterns.
RESULTS
CNNs achieve higher balanced accuracy and F1 scores, even when SVMs are nonlinear or integrate linear or nonlinear dimensionality reduction. Parity only occurs when SVMs access features learned by CNNs. Saliency maps demonstrate that CNNs leverage distributed morphometry patterns, whereas SVMs focus on the area around the lesion. Ensemble clustering of CNN saliencies reveals distinct morphometry patterns unrelated to lesion size, consistent across individuals, and which implicate unique networks associated with different cognitive processes as measured by the wider neuroimaging literature. Individualized predictions depend on both ipsilateral and contralateral features outside the lesion.
CONCLUSIONS
Three-dimensional network distributions of morphometry are directly associated with aphasia severity, underscoring the potential for CNNs to improve outcome prognostication from neuroimaging data, and highlighting the prospective benefits of interrogating spatial dependence at different scales in multivariate feature space.
PubMed: 38866977
DOI: 10.1038/s43856-024-00541-8 -
Scientific Reports Jun 2024Whilst pharmacological therapies remain the cornerstone of pain management in chronic pain, factors including the current opioid epidemic have led to non-pharmacological... (Meta-Analysis)
Meta-Analysis
Whilst pharmacological therapies remain the cornerstone of pain management in chronic pain, factors including the current opioid epidemic have led to non-pharmacological techniques becoming a more attractive proposition. We explored the prevalence of medical device use and their treatment efficacy in non-cancer pain management. A systematic methodology was developed, peer reviewed and published in PROSPERO (CRD42021235384). Key words of medical device, pain management devices, chronic pain, lower back pain, back pain, leg pain and chronic pelvic pain using Science direct, PubMed, Web of Science, PROSPERO, MEDLINE, EMBASE, PorQuest and ClinicalTrials.gov. All clinical trials, epidemiology and mixed methods studies that reported the use of medical devices for non-cancer chronic pain management published between the 1st of January 1990 and the 30th of April 2022 were included. 13 studies were included in systematic review, of these 6 were used in the meta-analysis. Our meta-analysis for pain reduction showed that transcutaneous electrical nerve stimulation combined with instrument-assisted soft tissue mobilization treatment and pulsed electromagnetic therapy produced significant treatment on chronic lower back pain patients. Pooled evidence revealed the use of medical device related interventions resulted in 0.7 degree of pain reduction under a 0-10 scale. Significant improvement in disability scores, with a 7.44 degree reduction in disability level compared to a placebo using a 50 score range was also seen. Our analysis has shown that the optimal use of medical devices in a sustainable manner requires further research, needing larger cohort studies, greater gender parity, in a more diverse range of geographical locations.
Topics: Humans; Chronic Pain; Pain Management; Bayes Theorem; Low Back Pain; Transcutaneous Electric Nerve Stimulation; Equipment and Supplies; Treatment Outcome
PubMed: 38866854
DOI: 10.1038/s41598-024-63499-6 -
Journal of Cardiovascular Computed... Jun 2024Pre-eclampsia is a pregnancy related disorder associated with hypertension and vascular inflammation, factors that are also involved in the pathological pathway of...
BACKGROUND
Pre-eclampsia is a pregnancy related disorder associated with hypertension and vascular inflammation, factors that are also involved in the pathological pathway of aortic dilatation and aneurysm development. It is, however, unknown if younger women with previous pre-eclampsia have increased aortic dimensions. We tested the hypothesis that previous pre-eclampsia is associated with increased aortic dimensions in younger women.
METHODS
The study was a cross-sectional cohort study of women with previous pre-eclampsia, aged 40-55, from the PRECIOUS population matched by age and parity with women from the general population. Using contrast-enhanced CT, aortic diameters were measured in the aortic root, ascending aorta, descending aorta, at the level of the diaphragm, suprarenal aorta, and infrarenal aorta.
RESULTS
1355 women (684 with previous pre-eclampsia and 671 from the general population), with a mean (standard deviation) age of 46.9 (4.4) were included. The pre-eclampsia group had larger mean (standard deviation) aortic diameters (mm) in all measured segments from the ascending to the infrarenal aorta (ascending: 33.4 (4.0) vs. 31.4 (3.7), descending: 23.9 (2.1) vs. 23.3 (2.0), diaphragm: 20.8 (1.8) vs. 20.4 (1.8), suprarenal: 22.9 (1.9) vs. 22.0 (2.0), infrarenal: 19.3 (1.6) vs. 18.6 (1.7), p < 0.001 for all, also after adjustment for age, height, parity, menopause, dyslipidemia, smoking and chronic hypertension. Guideline-defined ascending aortic aneurysms were found in 8 vs 2 women (p = 0.12).
CONCLUSIONS
Women with previous pre-eclampsia have larger aortic dimensions compared with women from the general population. Pre-eclampsia was found to be an independent risk factor associated with a larger aortic diameter.
PubMed: 38866633
DOI: 10.1016/j.jcct.2024.06.001