Performance of Rhode Island Red, Black Australorp, and Naked Neck crossbreds under alternative production systems

The effects of the production system, breed cross, and their interaction on performance, egg quality, and hatching traits were evaluated. Rhode Island Red and Black Australorp were crossed with Naked Neck chickens (first generation RNN, and BNN, respectively). These crosses were mated among themselves and crossed to produce four crossbreds: RR (RNN x RNN), BB (BNN x BNN), RB (RNN x BNN), and BR (BNN x RNN). Thirty-six pullets and 9 cockerels from each crossbred were maintained in three production systems: the aviary system (AV), conventional cages (CC), and enriched cages (EC). Thus there were 48 pullets and 12 cockerels in each production system. Bodyweight, egg production percentage, and egg weight were highest in EC, followed by CC and AV. Higher egg weight, egg surface area, and egg volume were also observed in EC compared with CC and AV. Fertility and hatchability were higher and early embryonic mortality was lower in AV than in EC and CC. Bodyweight, egg production percentage, egg weight, egg volume, and surface area were higher for RB and BR than for BB and RR. Fertility and hatchability were similar for RB and BR. RR was similar to BR, but lower than RB. BB had the lowest fertility and hatchability. Thus, chickens in EC performed better than in the other systems, except that hatching traits were better in AV. RB and BR performed better than BB and RR.Key words: breed crosses, chicken, egg quality, hatchability

Evaluation of three fast- and slow-growing chicken strains reared in two production environments

The present study evaluated performance, physiological response and economics of commercial fast growing (CFG), commercial slow growing (CSG), and Rhode Island Red (RIR) chickens under intensive and free-range rearing environments. After 21 days of rearing under the same intensive environment 240 birds from each strain were subjected to free-range and intensive rearing until they were 56 days old. Each treatment was replicated six times with 20 birds in each replicate. Body surface and cloacal temperatures, respiration and heart rates, feed intake, bodyweight and weight gain, feed conversion efficiency, growth efficiency, and liveability were recorded. Significant differences among strains were detected in physiological response and growth performance (except liveability). Rearing environment also caused significant differences in physiological parameters (except body surface temperature) and growth performance (except liveability). Significant interactions of the strains and production systems were detected. The CFG strain grew most rapidly under the intensive system with differences between strains being reduced in the free-range system. The RSG and CSG strains had similar respiration rates under the two production systems but differed significantly from each other. However, the CFG strain had a significantly elevated respiration rate in the free-range system. Total input cost of rearing CFG under the intensive system was highest ($3.54) among the treatments, whereas CSG under a free-range environment generated the highest profit ($0.37 per bird). In conclusion, rearing CSG under free range was the most economic farming strategy in today’s scenario.Keywords: economics, fast-growing, free range, growth, intensive system, physiology, slow-growing rural chickens

Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study

OBJECTIVE

To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west coast of the United States.

DESIGN

Prospective cohort study.

SETTING

Kaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern California, and Washington state.

PARTICIPANTS

1840 people with a first acute hospital admission for confirmed covid-19 by 22 April 2020, among 9 596 321 healthcare plan enrollees. Analyses of hospital length of stay and clinical outcomes included 1328 people admitted by 9 April 2020 (534 in northern California, 711 in southern California, and 83 in Washington).

MAIN OUTCOME MEASURES

Cumulative incidence of first acute hospital admission for confirmed covid-19, and subsequent probabilities of admission to an intensive care unit (ICU) and mortality, as well as duration of hospital stay and ICU stay. The effective reproduction number (RE ) describing transmission dynamics was estimated for each region.

RESULTS

As of 22 April 2020, cumulative incidences of a first acute hospital admission for covid-19 were 15.6 per 100 000 cohort members in northern California, 23.3 per 100 000 in southern California, and 14.7 per 100 000 in Washington. Accounting for censoring of incomplete hospital stays among those admitted by 9 April 2020, the estimated median duration of stay among survivors was 9.3 days (with 95% staying 0.8 to 32.9 days) and among non-survivors was 12.7 days (1.6 to 37.7 days). The censoring adjusted probability of ICU admission for male patients was 48.5% (95% confidence interval 41.8% to 56.3%) and for female patients was 32.0% (26.6% to 38.4%). For patients requiring critical care, the median duration of ICU stay was 10.6 days (with 95% staying 1.3 to 30.8 days). The censoring adjusted case fatality ratio was 23.5% (95% confidence interval 19.6% to 28.2%) among male inpatients and 14.9% (11.8% to 18.6%) among female inpatients; mortality risk increased with age for both male and female patients. Reductions in RE were identified over the study period within each region.

CONCLUSIONS

Among residents of California and Washington state enrolled in Kaiser Permanente healthcare plans who were admitted to hospital with covid-19, the probabilities of ICU admission, of long hospital stay, and of mortality were identified to be high. Incidence rates of new hospital admissions have stabilized or declined in conjunction with implementation of social distancing interventions.

Nonsurgical management of advanced hepatocellular carcinoma: a clinical practice guideline

Background

Practice guidelines based on a systematic review of the literature regarding the nonsurgical management of hepatocellular carcinoma (hcc) in North America are lacking. Resection and transplantation are the foundations for cure of hcc; however, most patients are diagnosed at an advanced stage, precluding those curative treatments. A number of local or regional therapies are used and are followed by systemic therapy for advanced or progressive disease. Other treatments are available, but their efficacy, compared with those standards, is not well known.

Methods

First, systematic review questions were developed. Literature searches of the medline, embase, and Cochrane library databases (January 2000 to July 2018 or January 2005 to July 2018 depending on the question) were conducted; in addition, abstracts from the 2018 annual meeting of the American Society of Clinical Oncology were reviewed. A practice guideline was drafted that was then scrutinized by internal and external reviewers.

Results

Seventy-seven studies were included in the guideline: no guidelines, two systematic reviews, and seventy-five primary studies published in full (including one pooled analysis). Five recommendations were developed.

Conclusions

There is no evidence for or against the use of local or regional interventions other than transarterial chemoembolization for the treatment of intermediate- or advanced-stage hcc. Furthermore, there is no evidence to support the addition of sorafenib to any local or regional therapy. Sorafenib or lenvatinib are recommended for first-line systemic treatment of intermediate-stage hcc. Regorafenib or cabozantinib provide survival benefits when given as second-line treatment. Antiviral treatment is recommended in individuals with advanced hcc who are positive for the hepatitis B surface antigen.

Association of Stress Hyper-Glycaemia on Outcomes of Hospitalized Non Diabetic Patients with First Attack of Acute ST Elevated Myocardial Infarction Underwent Thrombolysis

Coronary heart disease (CHD) is the most common cause of heart disease and serious cause of early death in developed countries around the world. Stress hyper-glycaemia has a bad prognostic implication in hospital outcomes in acute ST elevated myocardial infarction patients. It serves as a marker of myocardial damage, provides information about complications of acute MI and bad prognosis. The aim of this cross-sectional descriptive study was to find out prognostic implications of Stress hyper-glycaemia in non diabetic patients with first attack of acute ST elevated myocardial infarction underwent thrombolysis and conducted in the department of Cardiology in Mymensingh Medical College Hospital, Mymensingh, Bangladesh from June 2017 to May 2018. Total 249 first attack of Acute STEMI patients were included considering inclusion and exclusion criteria. The sample population was divided into two groups: Group I: Patients with first attack of acute STEMI underwent thrombolysis with non diabetic stress hyper-glycaemia (Blood sugar >7.8mmol/L and HbA1c <6.5), Group II: Patients with first attack of acute STEMI underwent thrombolysis with non diabetic normo-glycaemia (Blood sugar <7.8mmol/L and HbA1c <6.5). In this study, in non diabetic Stress hyperglycemic patients' death was 5.7% and in non diabetic normo-glycemic patients death was 0.6%. It was statistically significant (p<0.05). In non diabetic stress hyperglycemic patients, heart failure was 78.31% patients and in non diabetic normo-glycemic patients, it was 21.6%. It was statistically significant (p<0.01). Echocardiography showed that patients with non diabetic Stress hyper-glycaemia had mean ejection fraction (LVEF) was 44.01±4.93 and patients with non diabetic normo-glycaemia had mean ejection fraction (LVEF) was 47.70±5.71. It was statistically significant (p<0.01). In this study, in non diabetic Stress hyperglycaemic patients, cardiogenic shock was 16.1% and in non diabetic normo-glycemic patients, it was 3.7%. It was statistically significant (p<0.05). Mean duration of hospital stay, in non diabetic Stress hyperglycaemic patients was 5.07±0.566 and in non diabetic normo-glycemic patients, it was 3.52±0.850. It was statistically significant (p<0.001). In conclusion, the incidence of death, heart failure, cardiogenic shock and hospital stay were higher in non diabetic Stress hyperglycaemic patients than non diabetic normo-glycemic patients who admitted with first attack of acute ST elevated myocardial infarction.

Mapping imported malaria in Bangladesh using parasite genetic and human mobility data

For countries aiming for malaria elimination, travel of infected individuals between endemic areas undermines local interventions. Quantifying parasite importation has therefore become a priority for national control programs. We analyzed epidemiological surveillance data, travel surveys, parasite genetic data, and anonymized mobile phone data to measure the spatial spread of malaria parasites in southeast Bangladesh. We developed a genetic mixing index to estimate the likelihood of samples being local or imported from parasite genetic data and inferred the direction and intensity of parasite flow between locations using an epidemiological model integrating the travel survey and mobile phone calling data. Our approach indicates that, contrary to dogma, frequent mixing occurs in low transmission regions in the southwest, and elimination will require interventions in addition to reducing imported infections from forested regions. Unlike risk maps generated from clinical case counts alone, therefore, our approach distinguishes areas of frequent importation as well as high transmission.