Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

<b>Productive characteristics of maize hybrids at different cutting heights for silage and organic matter and mineral rates in post-harvest residues</b> - doi: 10.4025/actascianimsci.v35i2.16642

<p class="aresumo">Current trial evaluated yield, organic matter and mineral composition of the residual harvest of five maize hybrids at three cutting heights (15, 35 and 55 cm). The experimental design consisted of a randomized block split plot with three replications. Concentrations of N, P, K, Ca, MS, MM and MO in the samples were evaluated. No difference among hybrids occurred in stem diameter (22.4 mm), ear production (8.0 ton DM ha^-1), grain harvest index (37.3%) and total forage yield (15.0 ton DM ha^-1). Hybrid effect occurred for variables of mineral composition of harvest residues. With the exception of calcium, a rise in cutting height from 15 to 55 cm failed to increase the concentration of minerals in the residue. The amount of organic matter and mineral residues that remained in the field increased in proportion to crop height.</p> <p class="apalavrachave"> </p

Digestibilidade e parâmetros ruminais de rações contendo silagens de resíduo da filetagem de tilápia - DOI: 10.4025/actascianimsci.v28i4.613

It was evaluated total and partial digestibility coefficient (DC) of nutrients, ruminal parameters and microbial efficiency synthesis of rations with acid silage of tilapia filleting by-product (ASTB), fermented silage of tilapia filleting by-product (FSTB) and fish meal (FIME). Three Holstein steers (330 kg of body weight) were used, distribute in a 3 x 3 Latin Square Design. The chromium oxide was used as external marker of duodenal and fecal dry matter flow. The total and partial DC of nutrients didn’t differ (p>0.05) among experimental rations. The total DC of ethereal extract was higher (pAvaliou-se o coeficiente de digestibilidade (CD) total e parcial dos nutrientes, parâmetros ruminais e eficiência microbiana de rações com silagem ácida do resíduo da filetagem de tilápia (SART), silagem fermentada do resíduo da filetagem de tilápia (SFRT) e farinha de peixe (FAPE). Foram utilizados três novilhos da raça Holandesa (330 kg de peso corporal), distribuídos em delineamento quadrado latino 3 x 3. O óxido de cromo foi utilizado como indicador externo do fluxo de MS duodenal e fecal. O CD total e parcial dos nutrientes, não diferiu entre as rações experimentais. O CD total do extrato etéreo (EE) foi maior (

<b>Digestibilidade e parâmetros ruminais de rações contendo silagens de resíduo da filetagem de tilápia</b> - DOI: 10.4025/actascianimsci.v28i4.613 <b>Digestibility and ruminal parameters of rations containing tilapia filleting by-product silages</b> - DOI: 10.4025/actascianimsci.v28i4.613

Avaliou-se o coeficiente de digestibilidade (CD) total e parcial dos nutrientes, parâmetros ruminais e eficiência microbiana de rações com silagem ácida do resíduo da filetagem de tilápia (SART), silagem fermentada do resíduo da filetagem de tilápia (SFRT) e farinha de peixe (FAPE). Foram utilizados três novilhos da raça Holandesa (330 kg de peso corporal), distribuídos em delineamento quadrado latino 3 x 3. O óxido de cromo foi utilizado como indicador externo do fluxo de MS duodenal e fecal. O CD total e parcial dos nutrientes, não diferiu entre as rações experimentais. O CD total do extrato etéreo (EE) foi maior (p<0,05) para as rações com SART e SFRT. O CD intestinal do EE para a ração com FAPE foi menor (p<0,05) em relação às rações com SART e SFRT. Não houve efeito da inclusão das fontes de proteína sobre o pH e concentração de nitrogênio amoniacal do líquido ruminal e eficiência da síntese microbiana. A inclusão de 8% da SART e SFRT nas rações de ruminantes pode ser utilizada sem a ocorrência de diminuição na digestão dos nutrientes.<br>It was evaluated total and partial digestibility coefficient (DC) of nutrients, ruminal parameters and microbial efficiency synthesis of rations with acid silage of tilapia filleting by-product (ASTB), fermented silage of tilapia filleting by-product (FSTB) and fish meal (FIME). Three Holstein steers (330 kg of body weight) were used, distribute in a 3 x 3 Latin Square Design. The chromium oxide was used as external marker of duodenal and fecal dry matter flow. The total and partial DC of nutrients didn’t differ (p>0.05) among experimental rations. The total DC of ethereal extract was higher (p<0.05) on rations with ASTB and FSTB. The intestinal DC of ethereal extract on ration with FIME was lower (p<0.05) regarding to rations with ASTB and FSTB. There wasn’t inclusion effect of protein sources on pH and ammonia nitrogen concentration of ruminal fluid and microbial efficiency synthesis. The inclusion of 8% of ASTB and FSTB on ruminants’rations can be used without decreasing at nutrients digestion

Suplementação de novilhos nelore em pastejo de Brachiaria brizantha com diferentes níveis e fontes de concentrado Supplementation of Nellore grazing steers with different sources and concentrate levels

O objetivo deste trabalho foi avaliar o ganho médio diário (GMD) de novilhos em pastejo de B.brizantha cv. Marandu, suplementados com três tipos de suplementos, no período de julho a dezembro, em dois níveis de fornecimento. Foram utilizados 54 novilhos Nelore (nove por tratamento) com idade aproximada de 20 meses e peso vivo inicial de 370 kg. Os suplementos utilizados foram: suplemento rico em amido (AMI), rico em óleo (OLE) e suplemento composto de amido+óleo (A+O). Os suplementos foram fornecidos em níveis de 0,7 e 1,4% do peso vivo. A disponibilidade de lâminas verdes do capim-braquiária foi de 5,12 kg de MS/100 kg de PV. Os suplementos e níveis influenciaram o ganho médio diário (GMD). Nos dois níveis de fornecimento, o suplemento A+O promoveu o melhor desempenho. No menor nível de fornecimento (0,7% PV), os suplementos com AMI e OLE não diferiram entre si, mas ambos diferiram do suplemento A+O. Para este nível de fornecimento, o GMD foi 0,46; 0,44 e 0,57 kg para os tratamentos AMI, OLE e A+O, respectivamente. Resultados semelhantes foram observados no nível de fornecimento de 1,4% do PV. Neste caso, o suplemento A+O foi superior ao AMI e OLE, que não diferiram entre si. O GMD foi 0,58 kg para AMI, 0,61 kg para OLE e 0,72 kg para A+O. A suplementação com concentrados compostos pela mistura de alimentos ricos em amido (milho) e óleo (caroço de algodão) proporcionou melhor desempenho dos animais em comparação aos suplementados separadamente com as respectivas fontes, independentemente do nível de suplementação. O maior nível de suplementação (1,4% do PV) apresentou eficiência econômica inferior, quando comparada à do menor nível (0,7% do PV).<br>This work was carried out to study the daily average gain (DAG) of steers grazing Brachiaria brizantha cv. Marandu, supplemented, from July to December, with two levels of three different supplements. Fifty-four Nellore steers (9 for each treatment) aged approximately 20 months and initial average live weight of 370 kg were used. The experimental treatments were: AMI - supplement rich in starch (based on corn), OLE - supplement rich in fat (based on whole cottonseed) and A+O - supplement combination (based on mixture of AMI and OLE). All supplements were offered in .7 and 1.4% of liveweight (LW). The green blade availability was 5.12 kg DM/100 kg LW. Treatments and levels influenced DAG. In both levels of supplementation, the combination of feeds promoted higher performance. The lowest level (.7% LW) AMI and OLE was not different, and both were different from A+O. DAG was .44, .46, and .57 kg for AMI, OLE and A+O respectively. Similar results were registered on the higher level (1.4% LW) of supplementation. In this level A+O showed better performance than AMI and OLE that was not different. DAG was .58 kg for AMI, .61 kg for OLE and .72 kg for A+O. The supplementation with concentrates composed by the mixture of rich feeds in starch (corn) and oil (cotton seed) provided higher performance of the animals, that when supplemented separately with the respective sources, independently of the supplementation level. The higher supplementation level (1.4% of LW) showed lower economical efficiency, when compared to the smallest level (.7% PV)

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data