24 research outputs found

    Yield parameters and water productivity of tropical and overseeded winter forages

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    Intensive pasture exploitation with tropical forages is one of the most efficient forms ruminant production. However, the results depends on the knowledge about these forages and the experience in its management. The objective of this work was to evaluate water productivity (WP) and yield parameters of Megathyrsus maximum cv. Mombaça “Guinea grass” and Cynodon spp. “Bermuda grass”, in single culture and overseeded with oats + ryegrass in autumn/winter period. Irrigation management was done considering a depletion factor of 0.3 (70% of the humidity the field capacity). The experimental design was a randomized complete block design with four replications, in which the forages are the treatments with evaluation at the time of the cycles. For all evaluated parameters, the best results were obtained with the Guinea grass in exclusive cultivation. The TFP (Total Forage Productivity) of Guinea grass was superior to Bermuda grass (59.3 and 30.2 Mg ha-1, respectively), in accordance with its average LAI (Leaf area index) values of 4.8 and 2.5, respectively. The most efficient use of water occurred for Guinea grass in exclusive cultivation, and the intercropped crops did not present increases in the WP. In the autumn/winter period, the accumulated TFP of the exclusive crop of Guinea grass was higher than the other crops. However, the SDM of Bermuda grass was higher than the other crops. In winter, the highest LAI occurred in Guinea grass in exclusive cultivation, followed by the overseeded Guinea grass, 4.8 and 4.5, respectively. Consortia did not increase forage yield during the winter. The consortiums did not increase forage yield during the winter

    Lutzomyia longipalpis TGF-β Has a Role in Leishmania infantum chagasi Survival in the Vector

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    Despite the increasing number of studies concerning insect immunity, Lutzomyia longipalpis immune responses in the presence of Leishmania infantum chagasi infection has not been widely investigated. The few available studies analyzed the role of the Toll and IMD pathways involved in response against Leishmania and microbial infections. Nevertheless, effector molecules responsible for controlling sand fly infections have not been identified. In the present study we investigated the role a signal transduction pathway, the Transforming Growth Factor-beta (TGF-β) pathway, on the interrelation between L. longipalpis and L. i. chagasi. We identified an L. longipalpis homolog belonging to the multifunctional cytokine TGF-β gene family (LlTGF-β), which is closely related to the activin/inhibin subfamily and potentially involved in responses to infections. We investigated this gene expression through the insect development and in adult flies infected with L. i. chagasi. Our results showed that LlTGF-β was expressed in all L. longipalpis developmental stages and was upregulated at the third day post L. i. chagasi infection, when protein levels were also higher as compared to uninfected insects. At this point blood digestion is finished and parasites are in close contact with the insect gut. In addition, we investigated the role of LlTGF-β on L. longipalpis infection by L. i. chagasi using either gene silencing by RNAi or pathway inactivation by addition of the TGF-β receptor inhibitor SB431542. The blockage of the LlTGF-β pathway increased significantly antimicrobial peptides expression and nitric oxide levels in the insect gut, as expected. Both methods led to a decreased L. i. chagasi infection. Our results show that inactivation of the L. longipalpis TGF-β signal transduction pathway reduce L. i. chagasi survival, therefore suggesting that under natural conditions the parasite benefits from the insect LlTGF-β pathway, as already seen in Plamodium infection of mosquitoes

    Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

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    Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

    Caracterização patológica e molecular do vírus da laringotraqueíte infecciosa e diagnóstico diferencial em aves comerciais no estado de Minas Gerais

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    Exportado OPUSMade available in DSpace on 2019-08-13T11:45:55Z (GMT). No. of bitstreams: 1 disserta__o_rodrigo_macedo.pdf: 3889563 bytes, checksum: ed86eecacfba2f1933e460ae88fd9b46 (MD5) Previous issue date: 25A laringotraqueíte infecciosa (LTI) é uma doença que acomete o aparelho respiratório de galinhas. Em novembro de 2010, foi notificada sua ocorrência no sul do Estado de Minas Gerais. Visando a necessidade de controle da doença, foram realizadas coletas periódicas programadas em 17 das 27 granjas da região. No total, 159 galinhas de postura de idades múltiplas foram necropsiadas, sendo coletadas amostras de seios e conchas nasais, laringe, traqueia, pulmões, conjuntiva e encéfalo para posterior processamento histopatológico. Para extração de DNA, foram coletados apenas traqueia e gânglio trigêmeo, e em seguida era procedida a PCR. Durante a vigência do projeto (2012-2013), ocorreram três episódios isolados (em diferentes momentos) sugestivos de LTI, relacionados com a introdução de aves não vacinadas. As galinhas foram examinadas por veterinários do Instituto Mineiro de agropecuária (IMA), e amostras foram coletadas e enviadas ao laboratório de patologia da UFMG (um total de 18 galinhas). Cinco amostras positivas para o vírus da LTI (GaHV-1), incluindo uma amostra de estudos anteriores (2011), tiveram fragmentos do genoma sequenciados. Dois fragmentos para o gene ICP4, e um fragmento para o gene TK, onde foram alinhados a outras estirpes depositadas no GenBank. As galinhas coletadas durante as visitas foram examinadas também quanto à presença de lesões histopatológicas sugestivas de outros patógenos respiratórios, e à PCR foram pesquisados Mycoplasma gallisepticum e Mycoplasma synoviae. Um fragmento da região intergênica (IGSR) e um fragmento do gene mgc2, do genoma do M. gallissepticum, foram sequenciados e caracterizados. Dezoito codornas (Coturnix japonica) de postura da região também foram avaliadas quanto à presença de lesões para LTI à histopatologia, assim como para DNA viral à PCR. As galinhas coletadas durante as visitas programadas às granjas apresentaram lesões inespecíficas, e apenas quatro apresentaram células sinciciais à histopatologia, porém sem corpúsculo de inclusão. Já as galinhas enviadas pelo IMA, apresentaram lesões compatíveis com LTI, que consistiam em laringite e traqueíte fibrinosa aguda difusa moderada associada a descamação do epitélio e fusão de células epiteliais formando sincícios contendo corpúsculo de inclusão intranuclear. As amostras sequenciadas tiveram 100% de identidade entre elas, não havendo alteração nos fragmentos analisados durante três anos consecutivos (2011, 2012 e 2013). Além disso, as estirpes de Minas Gerais apresentaram mutações não sinônimas quando comparadas com as estirpes de um surto ocorrido em 2002, em São Paulo. As sequências obtidas não foram caracterizadas como de origem vacinal por não apresentaram as deleções observadas nas vacinas vivas atenuadas (CEO e TCO). Na análise do fragmento do gene TK não foi observada a mutação na posição 252 do gene, de uma treonina para metionina (relacionada a maior virulência da estirpe). Os achados epidemiológicos (baixa mortalidade e morbidade) associados à análise molecular do gene TK sugeriram que as estirpes eram de menor virulência. As vacinas vectoradas para LTI (FPV e HVT) foram implementadas na região em Agosto de 2011, porém, como esta alternativa começou a ser testada pela primeira vez no Brasil, tornou-se extremamente importante o seu acompanhamento. A introdução das vacinas vectoradas foram efetivas em reduzir a infecção viral, prevenindo a doença clínica e reduzindo a presença do DNA viral, especialmente no gânglio trigêmeo. Dentre as coinfecções observadas, a micoplasmose foi a principal, e a partir do sequenciamento de fragmentos do genoma, o M. gallisepticum foi caracterizado com alta variação nucleotídica entre as estirpes. As codornas não apresentaram lesões para GaHV-1 e os tecidos foram negativos à PCR, sugerindo que estas não estão envolvidas na manutenção do vírus na área. Embora a região não tenha apresentado outros surtos significativos de LTI, os resultados indicam que o vírus ainda encontra-se presente e circulante entre as aves e as granjas. Medidas de biosseguridade devem ser adotadas, e visam reduzir ou impedir oportunidades de disseminação do vírus. Além disso, o programa de vacinação deve ser uniforme para evitar a infecção de aves susceptíveis e a ocorrência de doença clínica, e este deveria ser estendido não só as aves comerciais, como também às aves de subsistência.Infectious laryngotracheitis (ILT) is a disease that affects the respiratory tract of chickens. In November 2010, its occurrence has been reported in southern Minas Gerais. For control of the disease, regular scheduled collections of tissues in 17 of the 27 farms in the area were carried out. In total, 159 laying hens of multiple ages were necropsied, and samples of sinuses and nasal turbinates, larynx, trachea, lungs, brain and conjunctiva were collected for further histological processing. For DNA extraction only trachea and trigeminal ganglion were collected, and then PCR was performed During the period of the project (2012-2013), three isolated episodes (at different times) suggestive of ILT, related to the introduction of unvaccinated birds occurred. The chickens (total of 18) were examined by veterinarians of Instituto Mineiro de Agropecuária (IMA), and samples were collected and sent to the pathology laboratory at UFMG. Five positive samples for ILT virus (GaHV -1), including a sample from previous studies (2011), had their genome fragments submitted to sequencing. Two fragments of ICP4 gene and a fragment of TK gene, which have been aligned to other strains, were deposited in GenBank. The chickens collected during the visits were also examined for the presence of histopathological lesions suggestive of other respiratory pathogens, and PCR was performed for Mycoplasma gallisepticum and Mycoplasma synoviae. Specific regions of the M. gallisepticum genome, a fragment of the intergenic region (IGSR) and a fragment of mgc2 gene, were sequenced and characterized. Eighteen egg-laying quails (Coturnix japonica) of the region were also evaluated for the presence of lesions for ILT by histopathology, as well as PCR for viral DNA. The chickens collected during scheduled visits to the farms had nonspecific lesions, and only four showed syncytial cells at histopathology, but without intranuclear inclusion bodies. On the other hand, chickens sent by IMA showed lesions compatible with ILT, which consisted of acute moderate diffuse fibrinous laryngitis and tracheitis associated with desquamation of epithelium and fusion of epithelial cells forming syncytia containing intranuclear inclusion bodies. The samples were sequenced and 100 % identity was observed among them, with no change in the fragments analyzed for three consecutive years (2011, 2012 and 2013). Furthermore, strains of Minas Gerais showed non-synonymous mutations compared with strains from an outbreak occurred in 2002, in São Paulo. The sequences obtained were not characterized as vaccine strains because no deletions were seen, in contrast to the sequence of the live attenuated vaccines (CEO and TCO). In the analysis of the TK gene fragment , mutation were not observed at position 252 of the gene for a threonine to methionine (related to the increased virulence of the strain). The epidemiological findings (low mortality and morbidity) associated with molecular analysis of the TK gene suggested less virulent strains. The vector vaccines for ILT (HVT and FPV) were implemented in the region in August 2011; however, as this alternative began to be tested for the first time in Brazil, it has become extremely important to monitor the birds from that area. The introduction of vector vaccines was effective in reducing viral infection, preventing clinical disease and reducing the presence of viral DNA, especially in the trigeminal ganglion. Among the co-infections observed, mycoplasmosis was the most prevalent, and from the sequencing of genomefragments, the M. gallisepticum was characterized with high nucleotide variation among the strains. No lesions to GaHV-1 were observed in tissue of quails by histopathology and in addition, all of them were negative by PCR, suggesting that they are not involved in the maintenance of the virus in the area. Although no other significant outbreaks of ILT was reported in the area, these results indicate that the virus is still present and circulating among birds and poultry farms. Biosecurity measures must be adopted with the aim to reduce or prevent chances of spreading the virus. Moreover, the vaccination program should be uniform in order to avoid infection of susceptible birds and the occurrence of clinical disease, and this should be extended not only to commercial poultry, but to backyard chickens as well

    Investigation of possible risk groups for human tuberculosis caused by Mycobacterium bovis in the state of São Paulo

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    Objetivos: Identificar e comparar grupos de pacientes potencialmente de risco para tuberculose zoonótica (TBz), investigando a existência de fatores associados. Apresentar a distribuição espacial dos casos de tuberculose (TB) em bovinos e dos casos humanos. Método: Trata-se de estudo descritivo de casos confirmados de TB por todas as formas clínicas, residentes no estado de São Paulo, do período de 2006 a 2015. Definiram-se seis grupos potenciais de risco para TBz conforme critérios estabelecidos pela literatura. A análise descritiva foi realizada separadamente para pacientes menores de 15 anos e pacientes com 15 anos ou mais de idade, comparando os grupos identificados com a população de estudo por meio do teste do Qui-quadrado/Exato de Fisher. A existência de associação entre TB intestinal e/ou ganglionar (aceita como proxy de caso suspeito de TBz) e as exposições de interesse foi investigada pelas estimativas da odds ratio bruta e ajustada, com os respectivos intervalos de 95% de confiança, usando regressão logística. . A distribuição dos casos suspeitos foram apresentados em mapas temáticos. Resultados: Aplicados os critérios estabelecidos para o estudo, foram incluídos 190.368 casos de TB por todas as formas clínicas. Dentre estes: 134 tinham menos de 15 anos e residiam em municípios com até 20.000 habitantes (grupo A); os demais tinham 15 anos ou mais, sendo 1.238 trabalhadores rurais (grupo B); 201 magarefes (grupo C); 1.012 residiam em municípios com até 20.000 habitantes e com rebanhos infectados pela TB (grupo D); 2.776 imigrantes sul americanos (grupo E); e 160 imigrantes africanos (grupo F). Os grupos B e F foram os que mais apresentaram características semelhantes à TBz descrita na literatura, destacando-se no grupo B as maiores proporções de casos de residentes em municípios com caso de TB em bovinos e das formas intestinal e ganglionar periférica. Enquanto que no grupo F verificou-se maior proporção de casos com a forma clínica ganglionar periférica e de coinfecção HIV/TB. Os grupos A, C e D também apresentaram características distintas em relação ao total de casos de TB e associadas à TBz segundo a literatura, porém de maneira menos nítida. O grupo E não apresentou características relacionadas aos casos típicos da TBz. Dentre os pacientes menores de 15 anos de idade, após ajustes, destacaram-se como fatores associados à TB ganglionar e/ou intestinal, residir em município com menores índices de urbanização e com casos de TB em bovino conforme registro oficial. Entte os pacientes com 15 anos ou mais de idade, destacaram-se as associações com a ocupação de trabalhador rural e com a de magarefe. A distribuição dos tipos de rebanhos bovinos foi ampla sendo registrados casos da doença em animais em praticamente todas as regiões do estado. Conclusões: Os dados de vigilância da TB humana e animal, permitiram identificar grupos de pacientes com características associadas à TBz, salietando a importância da aplicação da proposta de Saúde Única, além de oferecerem subsídios para o desenvolvimento de um componente para TBz na vigilância da TB no estado de São Paulo, assim como, para pesquisas sobre o tema.Objectives: To identify and compare groups of patients potentially at risk for zoonotic tuberculosis (zTB), investigating the existence of associated factors. To present the spatial distribution of cases of tuberculosis (TB) in cattle and human cases. Method: This is a descriptive study of confirmed cases of TB by all clinical forms, residents in the state of São Paulo, from 2006 to 2015. Six potential risk groups for zTB were defined according to literature. The descriptive analysis was performed separately for patients younger than 15 years and patients 15 years of age or older, comparing the groups identified with the study population using the Chi-square / Fisher\'s Exact test. The existence of an association between intestinal and/or ganglion TB (accepted as a proxy for a suspected zTB case) and the exposures of interest was investigated by the estimates of the crude and adjusted odds ratio, with the respective 95% confidence intervals, using logistic regression. The distribution of suspected cases was presented in thematic maps. Results: After applying the criteria established for the study, 190,368 TB cases were included in all clinical forms. Among them: 134 were less than 15 years old and lived in municipalities with up to 20,000 inhabitants (group A); the others were 15 years old or over, with 1,238 rural workers (group B); 201 magarefes (group C); 1,012 resided in municipalities with up to 20,000 inhabitants and with herds infected by TB (group D); 2,776 South American immigrants (group E); and 160 African immigrants (group F). Groups B and F were the ones that presented the most similar characteristics to the zTB described in the literature. In group B, the highest proportions of cases of residents in municipalities with cases of TB in cattle and of the intestinal and peripheral ganglion forms were highlighted. While in the F group there was a higher proportion of cases with peripheral ganglionic form and HIV / TB co-infection. Groups A, C and D also presented distinct characteristics in relation to total TB cases and associated with TB, according to the literature, but less clearly. Group E did not present characteristics related to typical zTB cases. Among patients younger than 15 years of age, after adjustments, they were identified as factors associated with lymph node and/or intestinal TB, living in a municipality with lower rates of urbanization and with cases of TB in cattle according to official records. Among the patients aged 15 years and over, the associations with the occupation of rural workers and magarefe stood out. The distribution of bovine herd types was extensive and cases of the disease were recorded in animals in practically all regions of the state. Conclusions: Human and animal TB surveillance data allowed the identification of groups of patients with characteristics associated with zTB, stressing the importance of applying the One Health proposal, as well as providing subsidies for the development of a component for zTB in TB surveillance in the state of São Paulo, as well as for research on the subject

    One Health and surveillance of zoonotic tuberculosis in selected low-income, middle-income and high-income countries: A systematic review.

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    BackgroundLittle is known about zoonotic tuberculosis (zTB) due to Mycobacterium bovis burden across the globe. The aim of this study was to describe zTB surveillance programs in selected WHO signatory countries and to assess the relationship of the disease with the country's income level and the risk of M. bovis transmission.MethodsWe searched the main articles databases and grey literature for guide documents published between 1980 and 2019. For inclusion, the articles and guide documents had to be in English, French, Portuguese, Spanish, or Italian. Only original articles and narrative and systematic reviews were accepted and the guide documents were required to be available on official websites. We excluded articles that did not focus on epidemiology, control and surveillance. We used bovine TB cases in livestock and wildlife populations as a proxy for the country's risk of zTB using data from the World Organization for Animal Health (OIE) published from 2015 to 2018. Countries were classified according to income level (World Bank's classification) and strength of zTB surveillance. The study was registered in PROSPERO under number CRD42018090603.FindingsWe included 13 articles and 208 guide documents including data from 119/194 countries (61.3%). We found a lack of surveillance data about zTB in over half (89.9%) of the 119 WHO signatory countries. Most surveillance systems perform passive surveillance and are not integrated into the One Health perspective, which was operating in 4/119 (3.4%) countries, all high-income. Many of these countries (71/119, 59.7%) have M. bovis circulating in their cattle herds, but only ~10% of them have implemented zTB surveillance activities.InterpretationOur findings highlight weaknesses in zTB surveillance worldwide, with a consequent lack of information that could support an adequate understanding of disease burden, especially in countries at major risk for M. bovis transmission. To meet this challenge, efforts will be needed to promote intersectoral policies, implementing the One Health strategy

    Economic Evaluations and Equity in the Use of Artificial Intelligence in Imaging Exams for Medical Diagnosis in People With Skin, Neurological, and Pulmonary Diseases: Protocol for a Systematic Review

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    BackgroundTraditional health care systems face long-standing challenges, including patient diversity, geographical disparities, and financial constraints. The emergence of artificial intelligence (AI) in health care offers solutions to these challenges. AI, a multidisciplinary field, enhances clinical decision-making. However, imbalanced AI models may enhance health disparities. ObjectiveThis systematic review aims to investigate the economic performance and equity impact of AI in diagnostic imaging for skin, neurological, and pulmonary diseases. The research question is “To what extent does the use of AI in imaging exams for diagnosing skin, neurological, and pulmonary diseases result in improved economic outcomes, and does it promote equity in health care systems?” MethodsThe study is a systematic review of economic and equity evaluations following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) guidelines. Eligibility criteria include articles reporting on economic evaluations or equity considerations related to AI-based diagnostic imaging for specified diseases. Data will be collected from PubMed, Embase, Scopus, Web of Science, and reference lists. Data quality and transferability will be assessed according to CHEC (Consensus on Health Economic Criteria), EPHPP (Effective Public Health Practice Project), and Welte checklists. ResultsThis systematic review began in March 2023. The literature search identified 9,526 publications and, after full-text screening, 9 publications were included in the study. We plan to submit a manuscript to a peer-reviewed journal once it is finalized, with an expected completion date in January 2024. ConclusionsAI in diagnostic imaging offers potential benefits but also raises concerns about equity and economic impact. Bias in algorithms and disparities in access may hinder equitable outcomes. Evaluating the economic viability of AI applications is essential for resource allocation and affordability. Policy makers and health care stakeholders can benefit from this review’s insights to make informed decisions. Limitations, including study variability and publication bias, will be considered in the analysis. This systematic review will provide valuable insights into the economic and equity implications of AI in diagnostic imaging. It aims to inform evidence-based decision-making and contribute to more efficient and equitable health care systems. International Registered Report Identifier (IRRID)DERR1-10.2196/4854

    Lactation curves and economic results of Saanen goats fed increasing dietary energy levels obtained by the addition of calcium salts of fatty acids

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    The objective of this study was to evaluate the use of calcium salts of fatty acids (CSFA) to increase the dietary energy levels for Saanen goats and their effects on the lactation curve, dry matter intake, body weight, and economic results of the goats. Twenty multiparous goats, weighing an average of 63.5±10.3 kg, were randomly assigned to one of four treatment groups, each receiving one of the following dietary energy levels: a control diet consisting of 2.6 Mcal of metabolizable energy per kg of dry matter (Mcal ME/kg DM) or a test diet supplemented with CSFA (Lactoplus®) to obtain 2.7, 2.8, or 2.9 Mcal ME/kg DM. Goats were housed in individual stalls and were fed and milked twice daily. The animals were evaluated until 180 days in milk by measuring dry matter intake and milk yield. These measurements were used to calculate feed efficiencies and the cost-benefit ratio of diet and lactation curves using Wood's nonlinear model. Increasing dietary energy levels showed no effect on body weight. Supplementation with CSFA did not limit dry matter intake; however, it changed the shape of the lactation curve by promoting a late peak lactation with a longer duration. Milk yields at 180 days in milk had a quadratic increase with a maximum energy level at 2.85 Mcal ME/kg DM. Increasing the dietary energy level for Saanen goats using CSFA changes their lactation curves, with the best milk production achieved with a 2.85 Mcal ME/kg DM diet; however, the greatest economic results were obtained with a 2.7 Mcal ME/kg DM diet
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