1. Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery
Loïc Sentilhes, et al. N Engl J Med. 2018 Aug 23;379(8):731-742. doi: 10.1056/NEJMoa1800942.
Background: The use of tranexamic acid reduces mortality due to postpartum hemorrhage. We investigated whether the prophylactic administration of tranexamic acid in addition to prophylactic oxytocin in women with vaginal delivery would decrease the incidence of postpartum hemorrhage. Methods: In a multicenter, double-blind, randomized, controlled trial, we randomly assigned women in labor who had a planned vaginal delivery of a singleton live fetus at 35 or more weeks of gestation to receive 1 g of tranexamic acid or placebo, administered intravenously, in addition to prophylactic oxytocin after delivery. The primary outcome was postpartum hemorrhage, defined as blood loss of at least 500 ml, measured with a collector bag. Results: Of the 4079 women who underwent randomization, 3891 had a vaginal delivery. The primary outcome occurred in 156 of 1921 women (8.1%) in the tranexamic acid group and in 188 of 1918 (9.8%) in the placebo group (relative risk, 0.83; 95% confidence interval [CI], 0.68 to 1.01; P=0.07). Women in the tranexamic acid group had a lower rate of provider-assessed clinically significant postpartum hemorrhage than those in the placebo group (7.8% vs. 10.4%; relative risk, 0.74; 95% CI, 0.61 to 0.91; P=0.004; P=0.04 after adjustment for multiple comparisons post hoc) and also received additional uterotonic agents less often (7.2% vs. 9.7%; relative risk, 0.75; 95% CI, 0.61 to 0.92; P=0.006; adjusted P=0.04). Other secondary outcomes did not differ significantly between the two groups. The incidence of thromboembolic events in the 3 months after delivery did not differ significantly between the tranexamic acid group and the placebo group (0.1% and 0.2%, respectively; relative risk, 0.25; 95% CI, 0.03 to 2.24). Conclusions: Among women with vaginal delivery who received prophylactic oxytocin, the use of tranexamic acid did not result in a rate of postpartum hemorrhage of at least 500 ml that was significantly lower than the rate with placebo. (Funded by the French Ministry of Health; TRAAP ClinicalTrials.gov number, NCT02302456 .).
2. Optimal feeding frequency of captive head-started green turtles (Chelonia mydas)
H Kanghae, K Thongprajukaew, P Yeetam, T Jarit-Ngam, W Hwan-Air, S Rueangjeen, K Kittiwattanawong J Anim Physiol Anim Nutr (Berl). 2017 Aug;101(4):667-675. doi: 10.1111/jpn.12583. Epub 2016 Sep 25.
Optimal feeding frequency was investigated to improve head-started propagation programme of juvenile green turtles (Chelonia mydas). The 15-day-old turtles (25-26 g body weight) were fed for ad libitum intake at one (1MD), two (2MD), three (3MD) or four (4MD) meals daily over a 3-month trial. Responses in growth, feed utilization, faecal characteristics, haematological parameters and carapace elemental composition were used to compare treatment effects. At the end of the feeding trial, no treatment had induced mortality. Growth performance in terms of weight gain and specific growth rate was similar in turtles fed 2MD, 3MD or 4MD (p > 0.05), but 1MD differed from these (p < 0.05), and feeding at excess frequency (3MD and 4MD) increased the within-group size variation. Turtles fed 2MD had significantly lower feed intake than in 3MD and 4MD groups, but the feed conversion ratios were similar. Faecal digestive enzyme analysis indicated higher catabolism of lipid and protein in the deprivation group (1MD), when compared with turtles fed at least twice daily. The feeding frequency did not affect the specific activities of carbohydrate-digesting enzymes. The results on enzymes activities were corroborated by the transition enthalpy characteristics of faeces, indicating nutrients remaining after digestion. The 2MD treatment also improved the haematological characteristics and the carapace quality, relative to low or excess feeding. Overall, the findings indicate that feeding juvenile green turtles twice a day is the preferred option in their head-started propagation. This promotes growth, reduces feed consumption, and improves health and carapace quality.
3. Key load indicators and load variability in professional soccer players: a full season study
José M Oliva-Lozano, Xavier Barbier, Víctor Fortes, José M Muyor Res Sports Med. 2021 Jul 14;1-13. doi: 10.1080/15438627.2021.1954517. Online ahead of print.
The aims of this study were to 1) determine the key load indicators in professional soccer through principal component analysis (PCA); and 2) analyse the load variability of each training and match day within the microcycle considering the principal components. Data from 111 load variables were collected using tracking systems in both training and match days (MD). The results showed that 7 variables, which belonged to the first two components of the PCA, explained 80.3% of total variance. Specifically, these variables were Metabolic power, total of steps, Fourier transform (FFT) duration, deceleration distance covered (2-3 m/s2), total of running actions (12-18 km/h; 21-24 km/h), and distance covered (6-12 km/h). Regarding the analysis of the load variability of each training and match day within the microcycle, the lowest load variability was observed in -1MD. Also, a great load variability in +1MD with significant differences compared to -5MD (p<0.001; d=0.49) and -4MD (p=0.01; d=0.26) was found. This study suggests the use of the PCA in the context of team sports to reduce the large number of variables, which are daily managed by strength and conditioning coaches, in addition to the analysis of load variability of each training and match day within the microcycle.