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ObjectivesTo develop a nomogram to predict the likelihood of vaginal birth after caesarean section (VBAC) among women after a previous caesarean section (CS).DesignA retrospective cohort study.SettingTwo secondary hospitals in Guangdong Province, China.ParticipantsInclusion criteria were as follows: pregnant women with singleton fetus, age ≥18 years, had a history of previous CS and scheduled for trial of labour after caesarean delivery (TOLAC). Patients with any of the following were excluded from the study: preterm labour (gestational age <37 weeks), two or more CSs, contradictions for vaginal birth, history of other uterine incision such as myomectomy, and incomplete medical records.Primary outcome measureThe primary outcome was VBAC, which was retrospectively abstracted from computerised medical records by clinical staff.ResultsOf the women who planned for TOLAC, 84.0% (1686/2006) had VBAC. Gestational age, history of vaginal delivery, estimated birth weight, body mass index, spontaneous onset of labour, cervix Bishop score and rupture of membranes were independently associated with VBAC. An area under the receiver operating characteristic curve (AUC) in the prediction model was 0.77 (95% CI 0.73 to 0.81) in the training cohort. The validation set showed good discrimination with an AUC of 0.70 (95% CI 0.60 to 0.79).ConclusionsTOLAC may be a potential strategy for decreasing the CS rate in China. The validated nomogram to predict success of VBAC could be a potential tool for VBAC counselling.

Twelve Holstein bulls were used in a 4 × 4 Latin square design to investigate the effects of using whole-crop wheat hay (WCWH) as a substitute for Leymus chinensis (LC) on apparent digestibility, plasma parameters, ruminal fermentation, and microbial communities. Experimental treatments were four proportions of WCWH, 0, 33, 67, and 100%, as a substitute for LC (WCWH0, WCWH33, WCWH67, and WCWH100, respectively). The WCWH100 group showed a higher nutritional intake of crude protein (CP) and higher apparent digestibility of organic matter (OM), CP, and ether extract (EE) than the WCWH0 group (P < 0.05). Urea N, NH3-N, isobutyrate and isovalerate levels were higher (P < 0.05) in the WCWH100 group than in the WCWH0 group. 16S rRNA high-throughput sequencing analysis revealed similarities in the community composition, species diversity and relative abundance of dominant bacteria at the phylum and genus levels among the four groups. Collectively, our data indicated that WCWH can be used to replace LC in the diet of finishing dairy bulls without having a negative impact on apparent digestibility, plasma parameters, and ruminal bacteria composition. These results offer the first deep insight into the effects of replacing LC with WCWH on the performance parameters and rumen microbiota in Holstein bulls, and may aid in ruminant farming.

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The objective of this study was to evaluate the effects of dietary energy levels on growth performance, rumen fermentation and bacterial community, and meat quality of Holstein-Friesians bulls slaughtered at different ages. Thirty-six Holstein-Friesians bulls (17 months of age) were divided into a 3 × 3 factorial experiment with three energy levels (LE, ME and HE; metabolizable energy is 10.12, 10.90 and 11.68 MJ/kg, respectively) of diets, and three slaughter ages (20, 23 and 26 months). Results indicated that bulls fed with ME and HE diets had higher dry matter intake, average daily gain, and dressing percentage at 23 or 26 months of age. The ME and HE diets also reduced bacterial diversity, altered relative abundances of bacteria and produced lower concentrations of acetate, but higher butyrate and valerate concentrations in rumen fluid. Increasing in dietary energy and slaughter age increased the intramuscular fat (IMF) and water holding capacity. In summary, Holstein-Friesians bulls fed with ME and HE diets, slaughtered at 23 and 26 months of age could be a good choice to produce beef with high IMF. Slaughter age may have less influence than dietary energy in altering fermentation by increasing amylolytic bacteria and decreasing cellulolytic bacteria, and thus, further affecting meat quality.

To address the hypothesis that maternal uteroplacental insufficiency (UPI) increases severity of retinopathy of prematurity, we developed a composite rat model of UPI and oxygen-fluctuations and removed premature birth as a confounding factor. Timed-pregnant Sprague-Dawley dams underwent bilateral uterine artery ligation or anesthesia (control) at e19.5. Full-term pups developed in room air (RA) or an oxygen-induced retinopathy (OIR) model. Isolectin-stained retinal flat-mounts were analyzed for percent of areas of avascular/total retina (AVA) and of intravitreal neovascular/total retina (IVNV). Pup weights and serum and mRNA of liver and kidney VEGF, IGF-1, and erythropoietin (EPO) were determined. Multivariable mixed effects linear regressions and Pearson correlations were performed using STATA14. Postnatal growth restriction occurred in pups in UPI/RA, but not in UPI/OIR. Weight gain was similar between UPI/OIR and control/OIR pups. AVA was reduced and a trend toward reduced IVNV was seen in UPI/OIR compared to control/OIR. No difference in birth weights of UPI/OIR vs. control/OIR pups occurred. Serum and renal IGF-1 and EPO were significantly increased in UPI/OIR compared to control/OIR pups. In the absence of prematurity, UPI increased angiogenic factors in association with reduced OIR severity, suggesting that ischemia from UPI could yield protective angiogenic effects by offspring.

This study aimed to investigate the effects of compound probiotics (consisting of 10 8 cfu/g of Lactobacillus plantarum, 10 8 cfu/g of Pediococcus acidilactici, 10 8 cfu/g of Pediococcus pentosaceus, 10 7 cfu/g of and Bacillus subtilis) on growth performance, rumen fermentation, bacteria community, blood parameters, and health status of Holstein calves at the first 3 mo of age. Forty-eight newborn calves were randomly divided into the following 3 groups: control group (milk replacer with no compound probiotics), low compound probiotics group (milk replacer + 0.12 g of compound probiotics per head per day), and high compound probiotics group (HP; milk replacer + 1.2 g of compound probiotics per head per day). Starter pellets of the low compound probiotics and HP groups were coated with 0.05% compound probiotics. Milk replacer was provided from 2 to 63 d of age (6 L at 2-10 d, 8 L at 11-42 d, 6 L at 43-49 d, 4 L at 50-56 d, and 2 L at 57-63 d), and starter pellets were provided ad libitum from 7 to 90 d of age. Body weight and body size (d 1, 30, 60, and 90), blood (d 40 and 80), and rumen fluid (d 90) were analyzed using the one-way ANOVA procedure; fecal score was recorded daily and analyzed as repeated measures using the mixed model procedure. Results showed that diet supplemented with compound probiotics had no effects on the body weight, average daily gain, dry matter intake, and feed efficiency. At 90 d of age, diet supplemented with compound probiotics decreased the withers height. Immunity activities increased in the HP group, supported by the increased concentrations of serum total protein and immunoglobulins at 40 d of age, and by the increased activity of superoxide dismutase at 80 d of age. Diet supplemented with compound probiotics altered rumen fermentation, indicated by the decreased rumen acetic acid and propionic acid, and the increased butyric acid concentrations. Diet supplemented with compound probiotics improved the health status of calves, indicated by the decreased fecal score at 3 wk of age and the decreased medicine treatments. In summary, although diet supplemented with HP decreased the withers height, this level of probiotics is recommended to improve rumen development and health status of newborn Holstein calves.

Vaginal douching is a common practice and has been hypothesised to increase a woman's risk for human of contracting HIV and sexually transmitted infections (STIs). Our objective was to assess the prevalence of douching and its association with STIs, genital symptoms and HIV/STI knowledge among female sex workers (FSWs). We conducted a cross-sectional study of 837 FSWs with interviews and laboratory tests for HIV/STIs in a prefecture of Yunnan Province in southern China. Vaginal douching was reported by 84% of the women. We found a higher prevalence of vaginal douching practice among FSWs of Han ethnicity, and who were single or cohabitating. Douching was also significantly more common among more educated FSWs and those with greater knowledge of HIV/STIs, and as well as in FSWs who had experienced clinical symptoms in the previous 12 months. Douching was linked to higher risks of HIV (adjusted odds ratio = 2.29; 95% confidence interval 1.01-5.23) and herpes simplex virus type 2 infections (adjusted odds ratio = 2.18; 95% confidence interval 1.46-3.24) after adjusting for confounding factors. Medical professionals and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities. More prospective studies among FSWs are urgently required to identify the relationship between vaginal douching and HIV/STIs.