Unplanned hysterectomy: a comprehensive analysis of race, ethnicity, sociodemographic factors, pregnancy complications, and cardiovascular disease risk factors

OBJECTIVE

To understand the risk of unplanned hysterectomy (UH) in pregnant women better in association with maternal sociodemographic characteristics, cardiovascular disease (CVD) risk factors, and current pregnancy complications.

DESIGN

Using Florida birth data from 2005 to 2014, we investigated the possible interactions between known risk factors of having UH, including maternal sociodemographic characteristics, maternal medical history, and other pregnancy complications. Logistic regression models were constructed. Adjusted odds ratios and 95% confidence intervals were reported.

RESULTS

Several interactions were observed that significantly affected odds of UH. Compared to non-Hispanic White women, Hispanic minority women were more likely to have an UH. The overall risk of UH for women with preterm birth (<37 weeks) and concurrently had premature rupture of membranes (PRoM), uterine rupture, or a previous cesarean delivery was significantly higher than women who delivered to term and had no pregnancy complications. Women who delivered via cesarean who also had preeclampsia, PRoM, or uterine rupture had an overall increased risk of UH. Significantly decreased risk of UH was seen for Black women less than 20 years old, women of other minority races with either less than a high school degree or a college degree or greater, women of other minority races with PRoM, and women with preterm birth and diabetes compared to respective reference groups.

CONCLUSIONS

Maternal race, ethnicity, CVD risk factors, and current pregnancy complications affect the risk of UH in pregnant women through complex interactions that would not be seen in unadjusted models of risk analysis.

Novel ensembles of COPRAS multi-criteria decision-making with logistic regression, boosted regression tree, and random forest for spatial prediction of gully erosion susceptibility

Gully erosion is considered as a severe environmental problem in many areas of the world which causes huge damages to agricultural lands and infrastructures (i.e. roads, buildings, and bridges); however, gully erosion modeling and prediction with high accuracy are still difficult due to the complex interactions of various factors. The objective of this research was to develop and introduce three new ensemble models, which were based on Complex Proportional Assessment of Alternatives (COPRAS), Logistic Regression (LR), Boosted Regression Tree (BRT), Random Forest (RF), and Frequency Ratio (FR) for spatial prediction of gully erosion with a case study at the Najafabad watershed (Iran). For this purpose, a total of 290 head-cut of gullies and 17 conditioning factors were collected and used to establish a geospatial database. Subsequently, FR was used to determine the spatial relationship between the conditioning factors and the head-cut of gullies, whereas RF, BRT, and LR were used to quantify the relative importance of these factors. In the next step, three ensemble gully erosion models, named COPRAS-FR-RF, COPRAS-FR-BRT, and COPRAS-FR-LR were developed and verified. The Success Rate Curve (SRC), and the Prediction Rate Curve (PRC) and their areas under the curves (AUC) were used to check the performance of the three proposed models. The result showed that Soil group, geomorphology, and drainage density factors played the key role on the occurrence of the gully erosion. All the three models have very high degree-of-fit and the prediction performance, the COPRAS-FR-RF model (AUC-SRC = 0.974 and AUC-PRC = 0.929), the COPRAS-FR-BRT model (AUC-SRC = 0.973 and AUC-PRC = 0.928), and the COPRAS-FR-LR model (AUC-SRC = 0.972 and AUC-PRC = 0.926); therefore, it is concluded that they are efficient and new powerful tools which could be used for predicting gully erosion in prone-areas.

In vitro fermentation characteristics and effective utilisable crude protein in leaves and green pods of Moringa stenopetala and Moringa oleifera cultivated at low and mid-altitudes

This study was conducted to assess the in vitro nutrient digestibility and utilisation of leaves and green pods of two Moringa species in supplementing the feed of ruminant animals during the dry season. Samples were analysed for proximate nutrients using official methods. The metabolisable energy (ME), organic matter digestibility (OMD) and effective utilisable crude protein (uCP) were estimated using the Hohenheim in vitro gas test method. Gas volume in Moringa stenopetala leaves and green pods was generally higher than those of Moringa oleifera. Gas volume for leaves was similar between low and mid-altitudes but was higher for green pods at mid-altitude. M. stenopetala leaves contained significantly higher ME (9.8 MJ/kg DM) and OMD (75%) than those of M. oleifera. Similarly, M. stenopetala green pods had higher ME and OMD values than those of M. oleifera. For green pods, the ME and OMD values were significantly higher at mid-altitude than those at low altitude although these values for leaves were similar between both altitudes. Moringa oleifera leaves had higher effective uCP than those of M. stenopetala. Nevertheless, the effective uCP was higher for green pods of M. stenopetala than those of M. oleifera. The effective uCP for leaves cultivated at mid-altitude was slightly higher than those at low altitude. This study suggested that leaves and green pods could be used as alternative energy and protein supplements for tropical ruminants, particularly during dry periods. It was further concluded that leaves were generally better in nutrient compositions and in vitro nutrient digestibility characteristics than green pods.

Effect of long-term heat exposure on peripheral concentrations of heat shock protein 70 (Hsp70) and hormones in laying hens with different genotypes

1. The effect of long-term, moderate heat stress (30 to 32 degrees C) on heat shock protein 70 (Hsp70) concentration in mononuclear blood cells and plasma concentrations of 3,5,3'-triiodothyronine (T3) and corticosterone in laying hens was investigated. 2. Three groups of 48 hens each (Ethopian line [Angete Melata, Na], New Hampshire [NH], F1 cross [Na x NH]) were divided into an experimental group (24 each) and a control group (24 each, ambient temperature 18 to 20 degrees C), respectively. All hens were kept in individual cages up to an age of 68 weeks and performance data were recorded. 3. Blood samples were taken from the wing vein of 12 hens from each group at weeks 22, 38, 51 and 65 (12 hens x 3 lines x 2 treatments). Mononuclear blood cells were isolated and Hsp70 concentrations were determined by Western Blot analysis with a monoclonal anti-Hsp70 antibody. T3 and corticosterone were measured with commercially available ELISA and RIA kits, respectively. 4. The moderate heat stress caused significantly increased Hsp70 levels compared with the control groups in weeks 51 and 65. However, the responses of the lines were not uniform at different ages. 5. In contrast, T3 levels were significantly decreased in stressed birds regardless of line and age. There was no effect of treatment and line on corticosterone levels during the experimental period. 6. Our results indicate that Hsp70 and T3 levels are affected by mild heat stress applied over a long period but are both involved in independent mechanisms of acquisition of thermotolerance. Further investigations are necessary to clarify whether the observed differences in Hsp70 response between the genotypes are indicators for differences in thermotolerance.