Critical Threshold of Average Weekly Weight Gain in Overweight Pregnant Women During the Second and Third Trimesters: A Strategy to Prevent Macrosomia.

Objective: The study aimed to obtain more evidence on the association of gestational weight gain and pre-pregnancy body mass index (BMI) with macrosomia. Methods: The data on 5409 live births delivered at Peking Union Medical College Hospital from July 2020 to June 2022 were collected. Group analyses were performed according to the presence or absence of macrosomia. Multivariable binary logistic regression and incidence heatmaps was used to analyze the related factors of macrosomia. Results: The following variables were significantly associated with macrosomia: overweight (odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.62-3.10), obesity (OR: 4.56, 95% CI: 2.93-6.98), excessive gestational weight gain (OR: 2.39, 95% CI: 1.67-3.43), gestational age at delivery at 39-41 weeks (OR: 3.83, 95% CI: 2.56-5.95), gestational age at delivery over 41 weeks (OR: 7.88, 95% CI: 4.37-14.19), education level of junior college or below (OR: 1.95, 95% CI: 1.19-3.09), and multipara (OR: 1.62, 95% CI: 1.09-2.42). "v" represents the mean weekly weight gain during the second and third trimesters. A higher v value increased the risk of macrosomia by 2.6-fold (95% CI: 1.37-4.89, P = 0.003). Compared to normal weight women, after adjustment for different pre-pregnancy BMI subgroups, overweight pregnant women had higher weekly weight gain in the second and third trimesters (OR: 4.57, 95% CI: 2.27-9.10, P < 0.001). Obese pregnant women had higher average weekly weight gain during the second and third trimesters, and the OR value for macrosomia was 11.33 (95% CI: 4.95-25.18, P < 0.001). To reduce the incidence of macrosomia in overweight pregnant women, v = 0.32 could be considered the critical threshold of average weekly weight gain in these women in the second and third trimesters of pregnancy. Conclusion: Pre-pregnancy BMI and weight gain during pregnancy are closely related to macrosomia. The introduction of average weekly weight gain values in the second and third trimesters of pregnancy probably help pregnant women minimizing adverse pregnancy-related outcomes.

What is already known about this topic? Pre-pregnancy BMI and GWG are both risk factors for macrosomia. It is very important to develop effective interventions based on pathogenic factors to promote the health of mothers and children. However, the threshold for maternal weight control in the second and third trimesters of pregnancy is unclear. What is added by this report? Our data suggest that the critical threshold of average weekly weight gain in overweight pregnant women during the second and third trimesters 0.32kg per week is beneficial to reduce the incidence of macrosomia. What are the implications for public health practice? The results of this study highlight the importance of weight management in women in the second and third trimesters, especially those who are overweight, and reasonable control of weight gain will contribute to maternal and fetal health.

Cochlosoma anatis in Poultry and its Industry Impact.

Cochlosoma anatis is a flagellated protozoan parasite classified in the Trichomonadidae family and is the causative agent of cochlosomiasis, an enteric disease of turkeys, waterfowl, and other wild birds. Cochlosomiasis symptoms largely consist of watery diarrhea, lethargic birds, depressed weight gain, and widespread flock morbidity causing flock nonuniformity. The known distribution of C. anatis is centered around areas of turkey production farms in the southeast United States, e.g., North Carolina, Missouri and Arkansas, but has been reported in other states and some other countries. Diagnosis is confirmed through examination of enteric mucosal scrapings using light microscopy. Following the withdrawal of approval of effective antiprotozoal medications for use in commercial animal production, cochlosomiasis has become a greater concern for commercial turkey industry professionals. Transmission of C. anatis occurs via the fecal-oral route, but the organism is fragile outside the host, suggesting the implication of a vector in the introduction of disease to susceptible farms. Research regarding C. anatis pathogenicity, transmission, and environmental involvement has been limited, creating a gap in cochlosomiasis knowledge. Future research is needed to further explore ways to prevent and treat cochlosomiasis, with needs centered on disease pathogenesis, transmission patterns, and prophylaxis and treatment methods.

Estudio recapitulativo- Cochlosoma anatis en la avicultura comercial y su impacto en esta industria. Cochlosoma anatis es un parásito protozoario flagelado clasificado dentro de la familia Trichomonadidae y es el agente causante de la coclosomiasis, que es una enfermedad entérica de pavos, aves acuáticas y otras aves silvestres. Los signos de la coclosomiasis consisten principalmente en diarrea acuosa, aves con letargo, disminución de la ganancia de peso y morbilidad generalizada de las parvadas, lo que provoca su falta de uniformidad. La distribución conocida de C. anatis gira en torno a zonas de granjas de producción de pavos en el sudeste de los Estados Unidos, principalmente en Misuri y Arkansas, pero se ha notificado su presencia en otros estados y en algunos otros pa'ises. El diagnóstico se confirma mediante el examen de raspados de mucosa entérica con microscop'ia óptica. Tras el retiro de la aprobación de medicamentos antiprotozoarios eficaces para su uso en la producción animal comercial, la coclosomiasis se ha convertido en una preocupación importante para los profesionales de la industria de pavos comerciales. La transmisión de C. anatis se produce por v'ia fecal-oral, pero es frágil fuera del hospedador, lo que sugiere la participación de un vector en la introducción de la enfermedad en granjas susceptibles. La investigación sobre la patogenicidad, la transmisión y el efecto ambiental de C. anatis ha sido limitada, lo que crea un vac'io en el conocimiento de la coclosomiasis. En el futuro será necesario investigar más a fondo las formas de prevenir y tratar la coclosomiasis, con la necesidad de enfocarse en la patogenia de la enfermedad, los patrones de transmisión y los métodos de profilaxis y tratamiento.

Ambient temperature exposure and rapid infant weight gain.

BACKGROUND: Childhood obesity is a major public health concern, and the global rate is rising. Rapid infant weight gain is a risk factor for later overweight. Studies have linked prenatal ambient temperature exposure to fetal growth, and preliminary evidence suggests postnatal exposure may be associated with infant weight gain. METHODS: Using a population-based historical cohort study including 1 100 576 infants born 2011-2019, we assessed the relationship between prenatal and one-month postnatal ambient temperature exposure and rapid infant weight gain. We used a hybrid spatiotemporal model to assess temperatures at the family's recorded residence at birth. Repeated weight measurements between birth and 15 months were used to model the outcome using the SuperImposition by Translation and Rotation (SITAR) method. We employed generalized linear models and distributed lag models to estimate the association between prenatal and postnatal exposure and rapid infant weight gain, defined as the upper tertile of the SITAR growth velocity. RESULTS: Overall, higher ambient temperatures were associated with rapid infant weight gain. The cumulative adjusted relative risk for the highest exposure quintile during pregnancy compared with the lowest quintile was 1.33 [95% confidence interval (CI): 1.25, 1.40], and the corresponding association for the first postnatal month was 1.19 (95% CI: 1.15, 1.23). Exposure to high ambient temperature during early and mid-pregnancy, as well as the first postnatal month, was associated with rapid weight gain, while during late pregnancy, exposure to low temperatures was associated with this outcome. CONCLUSIONS: Prenatal and postnatal ambient temperatures are associated with rapid infant weight gain.

The essential oil blend Agolin Ruminant L reduces methane production in vitro and in vivo when included in the drinking water of cattle.

Two experiments were conducted to determine the potential for the essential oil blend Agolin Ruminant L (Agolin) to reduce enteric methane (CH4) emissions from beef cattle when delivered via the drinking water. Experiment 1 evaluated aqueous solutions of Agolin (50 mg/L) and a non-protein nitrogen and mineral solution (uPRO ORANGE [uPRO]; 1.7 mL/L) individually and in combination, where Agolin was added to concentrated uPRO at 3, 4.5, 6% Agolin (w/w) prior to dilution with water at 1.7 mL/L, for a total of five treatments. These were incubated for 48 h with a medium-quality Rhodes grass (Chloris gayana) hay substrate, with gas production, CH4 concentration in gas, and digestibility measured in vitro. In Exp. 2, Droughtmaster steers (n = 24) were fed a basal diet of Rhodes grass hay and were allocated to one of three water treatments (n = 8/treatment) supplemented with either uPRO (2.27 mL uPRO/L water), or one of two inclusion rates of Agolin in combination with uPRO (2.27 mL uPRO and 6 µL Agolin/L water or 2.27 mL uPRO and 24 µL Agolin/L water) with enteric CH4 emissions, feed and water intake, and live weight gain (LWG) measured over 56 d. In Exp. 1, the inclusion of Agolin in uPRO at 6% w/w resulted in a reduction in CH4 production (15.8%; P = 0.003) and the proportion of CH4 in the gas produced (24.5%; P < 0.001). In Exp. 2, steers consuming the lower quantity of Agolin via drinking water had a 16.4% (P = 0.0027) reduction in CH4 production over the experiment, declining from 140 g/d during week 1 to 117 g/d in week 8. This inclusion rate of Agolin in the drinking water also resulted in a 25 g (17.6%) CH4/d decrease in emissions by steers compared to control steers (P = 0.0205). However, no significant differences in CH4 yield (g CH4/kg dry matter intake), or CH4 intensity (g CH4/kg LWG) by steers was observed between treatments. These results demonstrate that Agolin reduces CH4 emissions when mixed in aqueous solution under in vitro and in vivo conditions, providing a potential method to reduce enteric CH4 emissions from cattle in extensive production systems.

Effect modification of pre-pregnancy body mass index on association of gestational weight gain with birth weight.

Background: Maternal weight status, before or during pregnancy, is a significant determinant of fetus development, birth weight, and the short-term and long-term health outcomes of the offspring. Objective: This study aimed to evaluate the effect modification of pre-pregnancy body mass index (BMI) on the associations of gestational weight gain (GWG) and birth weight, as per the latest guidelines from the Chinese Nutrition Society. Methods: This is a retrospective cohort study performed in a tertiary hospital with the largest deliveries in Shanghai, China. This study included all women who had singleton live births from 2021 to 2022 (n = 50,391). Data on pre-pregnancy weight, GWG, and birth weight were extracted from the medical register system. Logistic regression models were used to estimate the associations of pre-pregnancy BMI and GWG with the risks of being small for gestational age (SGA) and large for gestational age (LGA). The potential for effect modification by BMI on the associations of GWG and birth weight was assessed using both additive and multiplicative scales. Results: Pre-pregnancy BMI and GWG were consistently associated with birth weight. We observed a positive effect modification by underweight on the relationships between insufficient GWG and SGA both in multiplicative (adjusted odds ratio (OR), 2.49, 95 % confidence interval (CI): 2.06-2.99), and additive (relative excess risk due to interaction (RERI), 3.04, 95 % CI: 1.70-4.37) scales. Similarly, obesity was found to modify the effect of excessive GWG on the risk of LGA (adjusted OR, 3.82, 95 % CI, 3.14-4.63; RERI, 14.67, 95 % CI: 7.92-21.41). Conclusion: Our findings indicate that increased GWG is associated with a higher risk of abnormal birth weight in singleton pregnancies. Additionally, there is evidence of an additive interaction between pre-pregnancy BMI and GWG on the risk of small for gestational age or large for gestational age.

Mental health and weight regain after bariatric surgery: associations between weight regain and psychiatric and eating-related comorbidities.

Objective: Weight regain is a common outcome of weight loss interventions. Mental health-related comorbidities, among other factors, can mediate weight regain regardless of the implemented treatment modality. This study explores whether postoperative psychopathological comorbidities are associated with weight regain after bariatric surgery. Subjects and methods: This cross-sectional study recruited 90 outpatients who underwent Roux-en-Y gastric bypass surgery. Anthropometric measurements were collected retrospectively from medical charts. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorder-IV (DSM-IV) Axis I Disorders (SCID-I) was applied to evaluate psychiatry diagnoses. Validated self-report instruments were used to assess depression, anxiety, alcohol use, impulsivity, binge eating, and body image dissatisfaction. Weight regain was defined as a ≥20% increase from the maximum weight lost. Level of evidence: Level III, cross-sectional study based on a well-designed study. Results: Overall, 55.6% of participants experienced weight regain. Notably, mental disorders such as current binge-eating disorder and lifetime diagnoses including bulimia nervosa, alcohol abuse/dependence, and obsessive-compulsive disorder were significantly associated with weight regain. However, controlled analysis found that, for mental disorders, only current binge-eating disorder (odds ratio [OR] 6.3, 95% confidence interval [CI] 1.26-31.06, p = 0.024) remained associated with weight regain. Eating-related psychopathologies also associated with weight regain included binge eating (d = 0.55; p = 0.013), eating disinhibition (d = 0.76; p = 0.001), higher hunger levels (d = 0.39; p = 0.004), and non-planning trait impulsivity (d = 0.69; p = 0.0001). Conclusion: Postoperative presence of psychopathological comorbidities, such as eating psychopathology and trait impulsivity, were associated with weight regain after bariatric surgery. These findings highlight the importance of addressing mental health in individuals experiencing postsurgical weight regain.

Prediction of the ideal gestational weight gain for reducing the risk of macrosomia/large for gestational age in women with gestational diabetes mellitus in northern Taiwan.

BACKGROUND: Appropriate weight gain reduces the risk of fetal macrosomia and large for gestational age (LGA) in women with gestational diabetes mellitus (GDM), especially in the second and third trimester. This study aims to identify the optimal weight g-ain for such women across several pre-pregnancy body mass index (BMI) categories to lower the risk of macrosomia and LGA. METHODS: This retrospective cohort study enrolled women with GDM in north Taiwan who delivered between January 2012 and July 2022. BMI cut-offs were based on Chinese-specific guidelines and used to classify the participants as underweight (<18.5 kg/m2), normal weight (18.5-24.0 kg/m2), overweight (24.0-28.0 kg/m2), or obese (>28 kg/m2). Receiver operator curve analysis was used to determine the optimum GWG cut-off ranges to predict macrosomia / LGA, and uni- and multivariate analyses were used to analyze risk factors. In addition, a multivariable model predicting macrosomia and LGA in infants was developed. RESULTS: A total of 963 participants was included in our analysis. Optimal mean weekly rates of GWG in the second and third trimesters were 0.43 kg/week and 0.61 kg/week, respectively, in the underweight and normal weight group, and 0.33 kg/week and 0.32 kg/week, respectively, in the overweight and obesity group. CONCLUSION: The 2009 IOM guidelines, offering weight gain recommendations for pregnant women, appear to be applicable to Asian women diagnosed with GDM. This indicates that it is essential for such women to maintain an adequate total GWG throughout pregnancy. Physicians should address GWG using the IOM guidelines and trigger intervention when it is required to reduce macrosomia and LGA occurrence.

Excessive Gestational Weight Gain, independent of BMI, is associated with Child Fat Mass Index at age 2 years in the Glowing Study.

BACKGROUND: Excessive gestational weight gain (eGWG) increases risk for pregnancy complications and future obesity for pregnant persons and children. Yet, it is unclear whether eGWG leads to higher child adiposity at 2 years, independent of pregnant person's body mass index while considering important covariates. Moreover, understanding the characteristics of pregnant persons experiencing eGWG will help design future targeted interventions. OBJECTIVE: The objectives of the analyses were to assess the association between eGWG and childhood adiposity at 2-years-old, while controlling for pregnant persons' body mass index (BMI) and other important covariates and to describe the characteristics of pregnant persons who experience eGWG during their second pregnancy. DESIGN: This is a secondary analysis of 221 pregnant persons and their 2-year-old children who were enrolled in the Glowing longitudinal observational study. PARTICIPANTS/SETTING: Participants were recruited between 2011- 2014 in central Arkansas. Participants were secundigravida persons with BMIs 18.5-35kg/m2, >20 years old, and who conceived without assistance. MAIN OUTCOME MEASURES: The main outcome measure was 2-year-old fat mass index measured by quantitative nuclear magnetic resonance. Secondary outcomes included: first pregnancy gestational weight gain (GWG), dietary and physical activity characteristics in between pregnancies, second pregnancy nausea levels, and motivation level to adhere to the GWG guidelines. STATISTICAL ANALYSIS PERFORMED: Multivariable regression analyses were used to examine the associations between GWG and childhood fat mass index at 2 years of age. Pearson correlations and Wilcoxon rank sum tests were used to identify the characteristics of pregnant persons who experienced eGWG. RESULTS: Pregnant persons' eGWG (ß = 0.503, P =0.03) was positively associated with child adiposity at age 2 years independent of maternal BMI (P = 0.3). Pregnant persons who experienced eGWG during their second pregnancy had greater odds of: eGWG in first pregnancies (OR = 7.5; P <0.001), dieting behavior (OR = 14.3; P =0.02), and low motivation to adhere to the GWG guidelines (OR = 11.2; P =0.009). Fewer participants had eGWG in their second pregnancy (52.5 %) compared to their first pregnancy (66.8%) which was different by BMI groups (BMI 18.5-24.9 kg/m2: 23.6% decrease in participants who gained eGWG, BMI 25-29.9 kg/m2: 20.0% decrease, and BMI ≥ 30 kg/m2: 37.9% decrease). CONCLUSIONS: EGWG among pregnant persons is associated with child adiposity at age 2-years. Pregnant persons who experienced eGWG during their second pregnancy reported low motivation to gain weight within guidelines, eGWG in first pregnancy, and reported prior dieting behavior. Future research focusing on patients with these characteristics may increase success of interventions designed to limit eGWG.

Rescue, Rehabilitation, and Feeding Schedule of a Franciscana Dolphin (Pontoporia blainvillei) Calf Stranded in Argentina.

The franciscana dolphin (Pontoporia blainvillei) is a small cetacean endemic to the coastal waters of the southwestern Atlantic Ocean. Due to its restricted distribution, it is subject to high bycatch mortality in the gillnets used for commercial and artisanal fishing. The rehabilitation of the franciscana is still a major challenge, as most attempts to rehabilitate stranded animals have failed. This study aims to present the case of the rehabilitation of a franciscana dolphin calf, stranded in San Clemente del Tuyú, Argentina, at the beginning of the predation period. The feeding strategy and nutritional profile at different stages during the 88 days of rehabilitation are meticulously detailed. Its diet was prepared by hand based on studies of milk composition, the feeding ecology of franciscana in Argentinean waters, and previous records of the Fundación Mundo Marino Rehabilitation Center. The diets were designed to meet the nutritional needs of franciscana dolphins. In addition, the hematological, cytological, and fecal analyses recorded during the rehabilitation are presented. Although the animal could not be released, due to its death, this report provides baseline information that can improve the ability of veterinarians to care for debilitated, live-stranded dolphins. This information may also be useful in the implementation and development of healthcare protocols for this species.

Effects of straw structure and component on feeding efficiency of yellow mealworm for insect protein production.

Elucidating the influence of straw structure and component on the feeding efficacy of yellow mealworm is pivotal for improving insect protein production from straw. This research utilized four distinct types of straws-water hyacinth straw (WHS), corn straw (CS), rape straw (RAS), and rice straw (RIS)-as the sole substrate for larvae. Results indicated that the straw utilization rate and fresh larval weight gain rate followed the order of WHS > CS > RAS > RIS. Analysis of straw structural characteristics demonstrated that decreasing straw hardness and cellulose crystallinity, while enhancing straw chewability, facilitated the ingestion of larvae. Feeding efficiency of yellow mealworm was positively correlated with the hemicellulose and crude protein content, and inversely correlated with lignin content in the straw. Additionally, the structural characteristics and components of straw significantly influenced the composition of the gut microbiota. These results offer valuable insights for optimizing yellow mealworm feeding on straw.

Society of Family Planning Committee statement: Contraception and body weight.

Understanding the relationship between contraception and body weight is an important clinical consideration. Body weight and size has the potential to affect fertility and the effectiveness of some contraceptive methods, although historically this association has not been applied within a person-centered context that would allow individuals to select their preferred contraceptive method. Further, individuals with higher body weights and larger sizes have unmet contraceptive care and counseling needs. This document aims to provide evidence-based, person-centered, and anti-racist recommendations that destigmatize contraceptive care across all body weights. Clinicians should: provide person-centered, unbiased contraceptive care, including counseling pregnant-capable individuals on their risk of pregnancy based on sexual practices and contraceptive use regardless of body weight or size; utilize evidence-based and person-centered contraceptive counseling to offer the full range of contraceptive methods regardless of body weight or size; counsel patients about any risks and benefits associated with body weight and size to assist in their selection of contraceptive methods, including emergency contraception; counsel individuals about the potential for weight change, particularly weight gain, associated with contraceptive methods as a possible factor in decision-making; and counsel individuals regarding the potential impact of weight management approaches, such as bariatric surgery and glucagon-like peptide 1 (GLP-1) agonists, on contraceptive efficacy.

Evaluation of the Effects of Diet-Induced Obesity in Zebrafish (Danio rerio): A Comparative Study.

OBJECTIVES: This study aimed to compare diet-induced obesity (DIO) models in zebrafish and investigate the complications and differences between sexes in biochemical and inflammatory parameters. METHODS: Adult animals of both sexes were divided into four groups (n = 50) and fed for eight weeks: control group 1: Artemia sp. (15-30 mg/day/fish); control group 2: commercial fish food (3.5% of average weight); obesity group 1: pasteurized egg yolk powder + soybean oil (5% of average weight); obesity group 2: Artemia sp. (60-120 mg/day/fish). Dietary intake, caloric intake and efficiency, body mass index, biochemical, inflammatory, behavioral, histopathological, and stereological parameters, and inflammation-related gene expression were investigated. RESULTS: Obesity group 1 was the most indicated to investigate changes in the anxious behavioral profile (p < 0.05), triglyceride elevation [52.67 (1.2) mg/dL], adipocyte hypertrophy [67.8 (18.1) µm2; p = 0.0004], and intestinal inflammation. Obesity group 2 was interesting to investigate in terms of weight gain [167 mg; p < 0.0001), changes in fasting glucose [48.33 (4.14) mg/dL; p = 0.003), and inflammatory parameters [IL-6: 4.24 (0.18) pg/mL; p = 0.0015]. CONCLUSIONS: Furthermore, both DIO models evaluated in the present study were effective in investigating hepatic steatosis. The data also highlighted that sex influences inflammatory changes and fasting blood glucose levels, which were higher in males (p > 0.05). The results show new metabolic routes to be explored in relation to DIO in zebrafish.

Maternal pre-pregnancy body mass index and gestational weight gain on adverse birth outcomes in Chinese newborns: a retrospective study.

BACKGROUND: Maternal and child health is an important measure of national well-being. This study further explored the individual and combined effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on adverse birth weight-related outcomes. METHODS: A retrospective study was carried out at a maternal and child health hospital from 2018 to 2021, and a total of 17,506 eligible women were invited to participate. The associations of pre-pregnancy BMI and GWG with adverse birth outcomes were examined by using restricted cubic spline regression and binary logistic regression. RESULTS: Pre-pregnancy BMI and GWG had non-linear associations with low birth weight and macrosomia. They were associated with an increased risk of macrosomia (Pre-pregnancy BMI for OR = 1.170, 95%CI:1.144 to 1.197, P < 0.001, and GWG for OR = 1.071, 95%CI:1.054 to 1.089, P < 0.001) and large for gestational age infant (LGA) (Pre-pregnancy BMI for OR = 1.125, 95%CI:1.111 to 1.141, P < 0.001, and GWG for OR = 1.045, 95%CI:1.036 to 1.054, P < 0.001). The high risk of low birth weight and preterm birth was observed among the group of women with inadequate GWG. The risks of macrosomia and LGA increased with pre-pregnancy BMI from low weight to overweight and obesity, and GWG from inadequate to overabundance, while small for gestational age infant was more prevalent in the low pre-pregnancy BMI group. CONCLUSIONS: Pre-pregnancy BMI and GWG exhibited non-linear associations with low birth weight and macrosomia. The various combinations of pre-pregnancy BMI and GWG had different effects on adverse birth weight-related outcomes.

Do preterm infants' retinas like bovine colostrum? A randomized controlled trial.

BACKGROUND: Bovine colostrum (BC) with liposomal delivery system (LDS) is a promising supplement to premature infant formula in absence of mother own milk. We propose that BC with LDS can target multiple etiological factors that threaten the developing retina, making premature infant less liable for retinopathy of prematurity (ROP). The aim of this study was to evaluate the effect of BC with LDS in the prevention of ROP. METHODS: This was a single center, randomized, controlled trial. Two hundred and eleven preterm infants of gestational age ≤ 32weeks were admitted to the NICU of Alexandria University Children Hospital, Egypt, and randomly allocated into either non-BC group (n = 105) or BC group (n = 106). Patients in BC group received 3.5 ml /kg/day of BC for 14 days. All patients were monitored for development of ROP, anemia, late onset sepsis (LOS), bronchopulmonary dysplasia (BPD), periventricular leukomalacia (PVL) and necrotizing enterocolitis (NEC), in addition to growth assessment. Multivariate binary logistic regression analysis was performed to determine factors predicting ROP development. RESULTS: Compared with the non-BC group, BC group was associated with a significantly lower incidence of ROP (5/100 vs. 16/100, respectively) with a p-value of 0.033. The administration of BC significantly decreased serum C- reactive protein (CRP) level and increased weight on day-14 of the study in comparison with the CRP level and birthweight at the beginning of study, with Cohen's D= -0.184, D = -2.246, respectively. Patients with suspected sepsis were significantly less in BC than non-BC group, p = 0.004. Patients with BC had significantly higher hemoglobin level on day-14 than non-BC-group, with median (IQR) 12.2 (11.0-13.9) and 11.7 (10.5-12.9), respectively. BC intake is one of factors that decreased development of ROP in univariate analysis. Nevertheless, weight gain and birth weight were the most significant factors affecting ROP development in multivariate-regression model. CONCLUSION: BC may reduce the incidence of ROP in preterm neonates aged ≤ 32 weeks. This might be due to keeping better Hb level and growth rate, as well as anti-inflammatory properties through its ability to decrease CRP level. TRIAL REGISTRATION: This work was registered on 06/13/2022 in clinicaltrial.gov with ID no.: NCT05438680 and URL: https://classic. CLINICALTRIALS: gov/ct2/show/NCT05438680?term=NCT05438680&draw=2&rank=1 .

Therapeutic Options for Recurrence of Weight and Obesity Related Complications After Metabolic and Bariatric Surgery: An IFSO Position Statement.

Obesity is a chronic disease that may require multiple interventions and escalation of therapy throughout the years. Until recently, no universal definition existed for recurrent weight gain and insufficient weight loss. Standardization of reporting is key so outcomes can be compared and data can be pooled. The recent IFSO consensus provided standard terminology and definitions that will likely resolve this in the future, and publishers will need to enforce for authors to use these definitions. This current IFSO position statement provides guidance for the management of recurrent weight gain after bariatric surgery.

Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis.

BACKGROUND: While the effect of pre-transplant weight on patient outcomes following heart transplantation (HTx) has previously been studied, data regarding the impact of dynamic weight change prior to HTx are extremely limited. OBJECTIVES: We sought to elucidate the interaction between HTx listing weight and weight change while waitlisted, and explore how that interaction impacts post-HTx survival in a continuous manner. METHODS: Adult patients listed for HTx from 1987 to 2020 were identified from UNOS database. Three-dimensional restricted cubic spline analysis explored post-HTx survival relative to both changes in BMI/weight and BMI at time of HTx listing. Continuous predictor variables were analyzed with Cox proportional hazards method. RESULTS: 9,628 included patients underwent HTx. Median recipient age was 55 [IQR 46-62] years, and 21% were females. 53% of patients lost while 47% gained weight on the waitlist. Median BMI (27.6 kg/m2 [24.3-31.3] vs. 27.4 kg/m2 [24.2-30.9], paired p < 0.001) and weight (84.8 kg [73.0-98.0] kg vs. 84.4 kg [72.6-96.6], p < 0.001) were similar at listing and transplant. One-year survival was 89.3%. Weight loss over 3 BMI points or 10 kg was associated with higher hazard of death irrespective of listing BMI. In non-obese patients, some weight gain (1-4 BMI points or 5-15 kg) was associated with improved survival. In cachectic patients (BMI < 18.5), failure to gain weight was associated with worse survival. CONCLUSIONS: Impact of weight change varies depending on listing BMI. While a survival benefit is seen in non-obese patients who gain some weight, significant weight loss is associated with poorer survival.

The impact of cohort inclusion/exclusion criteria on pregnancy weight gain chart percentiles.

Pregnancy weight gain standards are charts describing percentiles of weight gain among participants with no risk factors that could adversely affect weight gain. This detailed information is burdensome to collect. We investigated the extent to which exclusion of various pre-pregnancy, pregnancy and postpartum factors impacted the values of pregnancy weight gain percentiles. We examined pregnancy weight gain (kg) among 3178 participants of the US nuMoM2b-Heart Health Study (HHS). We identified five groups of potential exclusion criteria for pregnancy weight gain standards: socio-economic characteristics (group 1), maternal morbidities (group 2), lifestyle/behaviour factors (group 3), adverse neonatal outcomes (group 4) and longer-term adverse outcomes (group 5). We established the impact of different exclusion criteria by comparing the median, 25th and 75th percentiles of weight gain in the full cohort with the values after applying each of the five exclusion criteria groups. Differences > 0·75 kg were considered meaningful. Excluding participants with group 1, 2, 3 or 4 exclusion criteria had no impact on the 25th, median or 75th percentiles of pregnancy weight gain. Percentiles were only meaningfully different after excluding participants in group 5 (longer-term adverse outcomes), which shifted the upper end of the weight gain distribution to lower values (e.g. 75th percentile decreased from 19·6 kg to 17·8 kg). This shift was due to exclusion of participants with excess postpartum weight retention > 5 kg or > 10 kg. Except for excess postpartum weight retention, most potential exclusion criteria for pregnancy weight gain standards did not meaningfully impact chart percentiles.

Investigating discrepancies in findings between rigorous randomized trials and meta-analyses evaluating pregnancy interventions to limit gestational weight gain.

INTRODUCTION: Robust randomized trials consistently demonstrate little impact from diet and physical activity interventions on gestational weight gain (GWG) and clinical outcomes, although meta-analyses report some benefit. Our aim was to evaluate the effect of trial quality on treatment effect estimates and review conclusions. METHODS: We conducted a systematic review of dietary and/or physical activity interventions for pregnant women with a body mass index ≥18.5 kg/m2. We assessed studies for risk of bias and methodological features impacting reliability. Outcomes included GWG; gestational diabetes mellitus (GDM); pre-eclampsia; caesarean birth; and birth weight measures. For each outcome, a sequence of meta-analyses was performed based on intervention group and level of potential bias in the effect estimate. RESULTS: We identified 128 eligible studies. The most robust estimate from a combined diet and physical activity behavioral intervention, with only studies at negligible risk of bias, was a difference in GWG of 1.10 kg (95% CI -1.62 to -0.58; 17,755 women). There was no evidence of an effect on any clinical outcomes. CONCLUSIONS: Our findings highlight discrepancies produced by the indiscriminate inclusion of studies with methodological flaws in previous systematic reviews. Regular weighing of pregnant women is futile in the absence of clinical benefit.

Deoxynivalenol mycotoxin dietary exposure on broiler performance and small intestine health: A comprehensive meta-analysis.

The effect of DON mycotoxins on broiler production performance and the small intestine is a critical factor in the health and well-being of broilers. Several studies have been conducted on this topic and have reported varying results and conclusions. Therefore, it is necessary to conduct systematic reviews and meta-analyses to thoroughly examine and draw unique conclusions. In this meta-analysis, we conducted a systematic review of multiple studies on the effects of DON mycotoxins in broilers. The analysis comprised 26 articles from reputable journals, and 14 parameters were identified based on the predetermined criteria. The forest plot results showed that DON treatment significantly reduced the ADFI and ADWG (SMD-1.50, 95 %CI [-1.68, -1.18]; I2= 51 %; p < 0.00001) and affected FCR (SMD 0.95, 95 %CI [ 0.62, 1.28]; I2= 77; p < 0.00001). In addition, it affects the small intestine structure duodenum (SMD -3.46, 95 %CI [-3.88, -3.05]; I2= 48 %; p < 0.00001), Jejunum (SMD -5.35, 95 %CI [-5.86, -4.83]; I2= 62 %; p < 0.00001), Ileum (SMD -2.6, 95 % CI [-3.12, -2.08]; I2= 82 %; p < 0.00001). Furthermore, DON exposure affects immunoglobulin (SMD -1.92, 95 % CI [ -2.39, -1.46]; I2 = 54 %; p < 0.00001) and antioxidant activities (SMD -2.1, 95 % CI [ -2.45, -1.75]; I2= 47 %; p < 0.00001). The overall effect of DON treatment was statistically significant compared with that of the control group. Furthermore, funnel plot analysis for publication bias did not reveal any significant asymmetry in most included studies. The results of this meta-analysis indicate that DON mycotoxins have a significant impact on both production performance and small intestine health and require strategic intervention.

GDF15 knockout does not substantially impact perinatal body weight or neonatal outcomes in mice.

Growth differentiation factor-15 (GDF15) increases in circulation during pregnancy and has been implicated in food intake, weight loss, complications of pregnancy, and metabolic illness. We used a Gdf15 knockout mouse model (Gdf15-/-) to assess the role of GDF15 in body weight regulation and food intake during pregnancy. We found that Gdf15-/- dams consumed a similar amount of food and gained comparable weight during the course of pregnancy compared to Gdf15+/+ dams. Insulin sensitivity on gestational day 16.5 was also similar between genotypes. In the postnatal period, litter size, and survival rates were similar between genotypes. There was a modest reduction in birth weight of Gdf15-/- pups, but this difference was no longer evident postnatal day 3.5 to 14.5. We observed no detectable differences in milk volume production or milk fat percentage. These data suggest that GDF15 is dispensable for changes in food intake, and body weight as well as insulin sensitivity during pregnancy in a mouse model.