Temporal trends and spatial clusters of high risk for maternal death due to COVID-19 pre and during COVID-19 vaccination in Brazil: a national population-based ecological study.

OBJECTIVE: This study comprehensively analyzed the temporal and spatial dynamics of COVID-19 cases and deaths within the obstetric population in Brazil, comparing the periods before and during mass COVID-19 vaccination. We explored the trends and geographical patterns of COVID-19 cases and maternal deaths over time. We also examined their correlation with the SARS-CoV-2 variant circulating and the social determinants of health. STUDY DESIGN: This is a nationwide population-based ecological study. METHODS: We obtained data on COVID-19 cases, deaths, socioeconomic status, and vulnerability information for Brazil's 5570 municipalities for both the pre-COVID-19 vaccination and COVID-19 vaccination periods. A Bayesian model was used to mitigate indicator fluctuations. The spatial correlation of maternal cases and fatalities with socioeconomic and vulnerability indicators was assessed using bivariate Moran. RESULTS: From March 2020 to June 2023, a total of 23,823 cases and 1991 maternal fatalities were recorded among pregnant and postpartum women. The temporal trends in maternal incidence and mortality rates fluctuated over the study period, largely influenced by widespread COVID-19 vaccination and the dominant SARS-CoV-2 variant. There was a significant reduction in maternal mortality due to COVID-19 following the introduction of vaccination. The geographical distribution of COVID-19 cases and maternal deaths exhibited marked heterogeneity in both periods, with distinct spatial clusters predominantly observed in the North, Northeast, and Central West regions. Municipalities with the highest Human Development Index reported the highest incidence rates, while those with the highest levels of social vulnerability exhibited elevated mortality and fatality rates. CONCLUSION: Despite the circulation of highly transmissible variants of concern, maternal mortality due to COVID-19 was significantly reduced following the mass vaccination. There was a heterogeneous distribution of cases and fatalities in both periods (before and during mass vaccination). Smaller municipalities and those grappling with social vulnerability issues experienced the highest rates of maternal mortality and fatalities.

Effects of condensed tannin-amended cassava silage blend diets on feeding behavior, digestibility, nitrogen balance, milk yield and milk composition in dairy goats.

Condensed tannins (CTs) are phenolic compounds derived from secondary plant metabolism that act as part of the plant's chemical defense system against pathogen invasion and herbivorous attack. This study aimed to evaluate the intake, digestibility, nitrogen (N) balance, production and composition of milk from goats fed cassava silage with added levels of CTs. Eight Anglo-Nubian goats with a mean BW of 40 ±â€¯2.0 kg were distributed in a double Latin square design with four levels of CTs (0, 25, 50 and 75 g/kg DM) with four 20-day periods with 15 days of adaptation and five evaluation days for each period. No differences were observed in DM, NDF, CP intake and feed conversion (grams of DM intake (DMI) per gram of milk produced); however, when expressed as percent of BW, DMI showed a quadratic increase to 29.1 g/kg. As the level of supplemented CTs increased in the diet, the CP digestibility (P = 0.023), NDF (P = 0.044), non-fiber carbohydrates (NFC; P = 0.032) and total digestible nutrients (P = 0.033) exhibited a linear decrease. Furthermore, the addition of CTs to cassava silage induced a linear increase in N-fecal excretion (P = 0.014) and a positive quadratic effect on N-retained (P = 0.014) and N-balance (P = 0.024) as well as a positive quadratic trend in N-digested (P = 0.092). Milk urea N (P = 0.023) decreased linearly. The addition of CTs to cassava silage had a positive quadratic effect on ruminating time (P = 0.011). In addition, comparing the use or non-use from the orthogonal contrast test, the inclusion of CTs in goat diet increased water and N-intake, CP and NDF digestibility, spent time eating and ruminating and N-balance and decreased milk production corrected3.5%, fat milk content, milk urea N and dry defatted extract of milk. Thus, adding CTs to cassava silage at 25 g/kg total DM promoted goats' greater use of the diet without impairing feed conversion and the quality of goat milk produced. Dietary levels of 50 and 75 g/kg total DM are not recommended because under the conditions of this study, they reduced the productive efficiency of dairy goats.

Avaliação clínica de ovinos após a ingestão de elevada quantidade de manga / Clinical evaluation of sheep after high ingestion of mango fruit

Objetivou-se avaliar clinicamente os efeitos da administração intrarruminal de duas quantidades distintas de manga em ovinos. Foram utilizados sete ovinos machos, hígidos, que não receberam carboidratos não fibrosos por, pelo menos, seis meses previamente ao período experimental, quando se avaliou pH ruminal, total de protozoários no suco de rúmen, pH urinário, pH sanguíneo estimado e parâmetros vitais nos tempos zero, 12, 16, 20 e 24 após a administração da manga. Os sete ovinos foram distribuídos aleatoriamente em dois grupos e receberam 0,625% ou 1,875% da MS de manga/kg/PV (M1 e M2, respectivamente), distribuídos em delineamento cross-over, com uma parcela perdida, e 30 dias de washout. Os ovinos M2 apresentaram valores médios para pH ruminal significativamente inferiores a M1 a partir do tempo T12 (5,1 e 6,9, respectivamente), o que indica ocorrência de acidose ruminal. Os animais tratados com M1 não apresentaram alterações sistêmicas, ao passo que os ovinos tratados com M2 apresentaram acidose metabólica leve, detectada por meio do pH urinário ácido (4,8). A ingestão apenas de manga in natura na quantidade de 1,875% da MS de manga/kg/PV mostrou-se capaz de provocar acidose ruminal em ovinos, levando-os a: ligeira depressão, aumento da frequência cardíaca, diminuição dos movimentos ruminais e diarreia em alguns casos.(AU)

The aim of this study is to clinically evaluate the effects of intra ruminal administration of two different amounts of mango in sheep. The sample was of seven male healthy sheep, which did not receive non-fibrous carbohydrates for at least six months prior to the trial. Rumen fluid pH, total of protozoa in the rumen fluid, urine pH, estimated blood pH, and vital parameters were evaluated at the following times: zero, 12, 16, 20 and 24 hours after administration of the mango. The seven sheep were randomly divided into two groups and received either 0.625% or 1.875% of the dry matter of the pulp and mango peel per kg body weight (M1 and M2, respectively), distributed in cross-over design with a lost portion and 30 days washout. Sheep treated with M2 showed significantly lower average values for ruminal pH than the M1 since T12 (5.1 and 6.9, respectively), indicating the occurrence of ruminal acidosis. The animals treated with M1 showed no systemic changes, while the sheep treated with M2 had mild metabolic acidosis, detected through the lower urinary pH (4.8). The in natura mango ingestion in the amount of 1.875% of the dry matter of mango per kg of body weight proved to provoke rumen acidosis in sheep, leading these animals to: slight depression, rise in heart rate, diminished rumen movement, and diarrhea in some cases.(AU)

Cinética ruminal de dietas contendo farelo de mamona destoxificado / Ruminal kinetics of diets containing detoxicated castor bean meal

The kinetics of gas production and in vitro ruminal degradation of diets contained replacement of soybean meal (SBM) by detoxicated castorbean meal (DCBM) (0, 15, 30 and 45% of substitution) were evaluated in this study. Values of gas production of non-fibrous carbohydrates (Vf1), fibrous carbohydrates (Vf2) and total carbohydrates (V) showed quadratic behavior, and by observation of equations can be obtained inclusions of 25% the V and Vf1 obtained maximum values of 174.7 and 237.8 ml gas / g DM, respectively. The potential degradability (PD) and effective degradability (ED) of dry matter showed quadratic behavior and by observation of equations can be perceive that up to 18.0% there was an increase in the values of PD and ED that obtained maximum values of 93.7% and 55.7%, respectively. The replacement of SBM by DCBM from 15 to 30% increased the kinetics of gas production and rumen degradation.(AU)

In vitro rumen fermentation kinetics of diets containing oldman saltbush hay and forage cactus, using a cattle inoculum / Cinética de fermentação ruminal in vitro de dietas contendo feno de erva-sal e palma forrageira, utilizando inóculo bovino

The aim of this experiment was to evaluate, by means of the semi-automated in vitro gas production technique, fermentation kinetics of carbohydrates and degradability of dry matter (DM) and organic matter (OM) of diets containing oldman saltbush hay levels (8.4; 18.8; 31.2 and 48.3%) associated to forage cactus in natura. Pressure readings of the gases were done with a pressure transducer at 2, 4, 6, 8, 10, 12, 17, 20, 24, 28, 34, 48, 72 and 96h post-inoculation. The rumen kinetics was described by the following parameters: maximum potential of gas production, lag time and production rates of gas (k), fibrous carbohydrates (FC) and non-fibrous carbohydrates (NFC). It could be observed that the addition of oldman saltbush hay to the diets promoted a quadratic effect in the production of gases originated from NFC. However, there was no significant effect on the production of gases originated from FC and on production rates of gases from NFC and FC. The degradability of DM and OM did not differ due to the addition of oldman saltbush hay. The use of 8.4% hay and 74.9% forage cactus promoted the maximum potential of production of gases from the fibrous fraction of diets containing cactus and oldman saltbush hay.

O objetivo deste experimento foi avaliar, por meio da técnica in vitro semiautomática de produção de gases, a cinética de fermentação dos carboidratos e a degradabilidade da matéria seca (MS) e da orgânica (MO) de dietas contendo níveis de feno de erva-sal (8,4; 18,8; 31,2 e 48,3%) associado à palma forrageira in natura. As leituras de pressão dos gases foram feitas com transdutor de pressão às 2, 4, 6, 8, 10, 12, 14, 17, 20, 24, 28, 34, 48, 72, 96 horas pós-inoculação. A cinética ruminal foi descrita pelos parâmetros: potencial máximo de produção de gases, "lag time" e taxa de produção de gases (k) dos carboidratos fibrosos (CF) e não fibrosos (CNF). Verificou-se que a adição de feno de erva-sal às dietas promoveu efeito quadrático na produção de gases provenientes dos CNF, em que o menor valor observado (136,48mL) foi encontrado com a adição de 38,25% de feno, e o maior valor, com a adição de 8,4% de feno e 74,9% de palma forrageira. O tempo de latência teve comportamento quadrático em função da adição de feno. No entanto não houve efeito significativo na produção de gases provenientes dos CF (média de 111,6mL) e nas taxas de produção de gases dos CNF e CF que apresentaram média de 0,090h-1 e 0,028h-1, respectivamente. A degradabilidade da MS e MO não diferiram em função da adição de feno de erva-sal e apresentaram médias de 85,8 e 90,9%, respectivamente. O uso de 8,4% de feno e 74,9 de palma forrageira propiciou o máximo potencial de produção de gases da fração fibrosa de dietas contendo palma e feno de erva-sal.

Fracionamento de carboidratos e proteínas de gramíneas tropicais cortadas em três idades / Carbohydrates and proteins fractions of tropical grasses cut at three ages

Avaliou-se o fracionamento dos carboidratos e das proteínas das gramíneas tropicais tifton 85 (Cynodon dactylon cv Tiffon 85), braquiária (Brachiaria brizantha cv Marandu) e tanzânia (Panicum maximum Jacq. cv Tanzânia), cortadas aos 28, 35 e 54 dias de idade. Determinaram-se os teores de matéria seca (MS), matéria orgânica (MO), proteína bruta (PB), extrato etéreo (EE), fibra em detergente neutro corrigida para cinzas e proteína (FDN CP), fibra em detergente ácido (FDA), lignina (LIG), nitrogênio insolúvel em detergente neutro (NIDN) e nitrogênio insolúvel em detergente ácido (NIDA). Para PB determinaram-se as frações A, B1+B2, B3 e C, e para os carboidratos as frações A+B1, B2 e C. Foi utilizado o delineamento inteiramente ao acaso, em arranjo em parcelas (gramíneas) subdivididas (idades de corte). Houve efeito significativo (P<0,05) da idade de corte sobre os teores de MS, FDN CP, NIDN e NIDA. Os teores de PB apresentaram declínio com o avanço da idade. O capim-marandu apresentou teores elevados para as frações A+B1 e B2 dos carboidratos (25,5 e 34,8 por cento dos carboidratos totais, respectivamente) e para as frações A e B1+B2 das proteínas (28,1 por cento aos 35 dias e 53,8 por cento da PB aos 28 dias, respectivamente).

The carbohydrates and proteins fractions of tropical grasses Tifton 85 (Cynodon dactylon cv Tifton 85), brachiaria (Brachiaria brizantha cv Marandu), and Tanzania (Panicum maximum Jacq. cv Tanzania) were evaluated at cut ages of 28, 35, and 54 days. Contents of dry matter (DM), organic matter (OM), crude protein (CP), ether extract (EE), fiber in neutral detergent corrected for ashes and protein (NDF CP), fiber in acid detergent (ADF), lignin (LIG), neutral detergent insoluble nitrogen (NDIN), and acid detergent insoluble nitrogen (ADIN) were determined. For CP, the A, B1+B2, B3, and C fractions were determined. For carbohydrates, the fractions A+B1, B2, and C were measured. A completely randomized split-plot design was used. Effect of cut age on DM, NDF CP, NDIN and ADIN was observed. The CP contents decreased with the progress of the age for the three grasses. The Marandu grass presented high percentage of the fractions A+B1 and B2 for the total carbohydrate (25.5 and 34.8 percent, respectively) and of the fractions A and B1+B2 for the proteins (28.1 percent CP at 35 days and 53.8 percent CP at 28 days, respectively).

Níveis de ureia em dietas contendo co-produto de vitivinícolas e palma forrageira para ovinos Santa Inês / Urea levels in diets containing dried grape byproduct and forage cactus for Santa Inês sheep

Avaliou-se o efeito da inclusão de níveis crescentes de ureia sobre o consumo e a digestibilidade aparente dos nutrientes de dietas contendo coproduto de vitivinícolas desidratado (CVD) e palma forrageira in natura. Foram utilizados 16 ovinos da raça Santa Inês machos, não castrados, com peso médio de 37kg e média de idade de 11 meses. As dietas continham 60 por cento de CVD e 40 por cento de palma forrageira, e níveis crescentes de ureia, 0, 1, 2 e 3 por cento, na matéria seca (MS). O delineamento experimental foi o inteiramente ao acaso, e o experimento foi desenvolvido em dois períodos, com 15 dias de adaptação e cinco dias de coleta cada. Os consumos da MS, fibra em detergente neutro (FDN), carboidratos não fibrosos (CNF) e nutrientes digestíveis totais (NDT) apresentaram comportamento quadrático com valores máximos de 2,04; 0,66; 0,74; 1,50kg/dia, respectivamente. No consumo de proteína bruta (PB), a cada acréscimo de uma unidade percentual de ureia ocorreu aumento de 20 gramas no consumo de PB. Os coeficientes de digestibilidade da MS, PB, FDN e CNF apresentaram comportamento quadrático com valores máximos de 62,5; 85,0; 81,0; e 97,8 por cento, respectivamente. A inclusão de ureia até 2 por cento nas dietas contendo coproduto de vitivinícolas desidratado e palma forrageira in natura possibilitou incrementos no consumo e no coeficiente de digestibilidade dos nutrientes.

The effect of urea levels on intake and apparent digestibility of nutrients in diets containing dried wine grape byproduct and fresh forage cactus was evaluated. Sixteen male, non-castrated, Santa Inês sheep, averaging 37kg and 11-month-old were used. The diets had 60 percent of dried grape byproduct (DGB) and 40 percent of forage cactus, and increasing levels of urea - 0, 1, 2, and 3 percent in dry matter. Completely randomized designs with two periods with 15 adjust days and five days for samples collection was carried out. Dry matter (DM), neuter detergent fiber (NDF), non-fibrous carbohydrates (NFC), and total digestive nutrients (TDN) intakes presented quadratic behavior with maximum values of 2.04; 0.66; 0.74; and 1.50kg/day, respectively. For each increase of an unit percentage of urea an increase of 20 grams in the CP intake occurred. The digestibility coefficients of DM, CP, NDF, and NFC presented quadratic behavior with maximum values of 62.5, 85.0, 81.0, and 97.8 percent, respectively. The inclusion of urea up to 2 percent in the diets containing dried grape byproduct and fresh forage cactus made possible increases in nutrient intake and coefficient of digestibility of nutrients.