Birth Events Research Articles

Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

BackgroundGlobally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers.MethodsA total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, kth event since the entry time, kth event since the time from the previous event, respectively.ResultsAmong mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers’ education level and household size were positively associated with recurrent birth events. Whereas mothers’ age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events.ConclusionThe WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects.

Exploring the potential for on-animal sensors to detect adverse welfare events: A case study of detecting ewe behaviour prior to vaginal prolapse

AbstractParturition is a critical period for the ewe and lamb, and the incidence of dystocia has known impacts on lamb and ewe welfare and productivity. Current methods of dystocia monitoring are mostly conducted through visual observation. Novel approaches for monitoring have also been suggested, including the application of on-animal sensor technologies for remote surveillance of parturition success. This short communication explores how the use of sensor-based parturition detection models can be applied for detection of adverse and successful parturition events, respectively, in pasture-based sheep (Ovis aries). Specifically, the alert profile of a single ewe that experienced vaginal prolapse is reported and compared with the alert profiles of 13 ewes that experienced typical birth events. Although the ewe that experienced vaginal prolapse exhibited some common precursor alerts similar to ewes that progressed through a typical birth event, the overall alert profile was markedly different for the prolapsed animal, with an increased number of alerts occurring from five days prior to the prolapse event. As successful parturition has significant welfare and productivity outcomes, application and validation of these research findings in a commercial system could greatly improve current methods of welfare monitoring at lambing.

STYKHYRY BEFORE CHRISTMAS IN ILLINA'S BOOK: OBJECTS OF SYMBOLIZATION

The article examines the hymnographic monument of the early Slavic literary Middle Ages - Stykhyry before Christmas, which are contained in the Illina's Book. Jesus Christ is the main object of worship in the Christmas alphabet Stykhyry. Another object of symbolization is the scraper couple (Jesus Christ and the Virgin Mary). The third object is the event of the birth of the Liberator of the world. In Stykhyry before Christmas, the literary symbolization of these objects is actively unfolding in all three directions. At the same time, in each direction the symbolization appears not homogeneous, but multifaceted. In the direction of establishing complicity in the phenomenon, three objects fall under the symbolism at once, which is rather an exception than the norm even in the "godly-virgin" hymnography, where the Son of God and the Virgin Mary are usually celebrated together. Images of Christ, the sacred couple, and the event of the Savior's birth are mostly represented by figurative universals with a wide (blossoming scepter) or fixed (unburned bush, seedless fruit, door, etc.) range of hymnographic applications. And in the direction of establishing communion with God, the emphasis is on a special form of interaction between the three incarnations of the Holy Trinity. This form is the manifestation of the gracious all-conquering power - the divine energy that overcomes the devilish realm of sin and liberates man.

Compassion fatigue and compassion satisfaction among Chinese midwives working in the delivery room: A cross-sectional survey

Background and AimsCompassion fatigue can negatively affect not only healthcare professionals’ physical and mental health but also the quality of care they provide and organizational outcomes. However, little is known about compassion fatigue among Chinese midwives working in the delivery room. This study aimed to examine compassion fatigue and compassion satisfaction levels among Chinese midwives working in the delivery room and correlate their compassion fatigue and compassion satisfaction. MethodsA multisite cross-sectional study with a convenience sampling approach was conducted at 62 hospitals in Henan Province, central China, from May to July 2020. The participants were recruited through an online survey. A self-designed sociodemographic and work-related data sheet, the Social Support Rating Scale (SSRS), and the Professional Quality of Life Scale (ProQoL) were used to measure the participants'basic information, level of social support, compassion fatigue(consists of burnout and secondary traumatic stress) and compassion satisfaction. Descriptive analysis was used to describe the characteristics of the participants’ social support, compassion fatigue and compassion satisfaction. Multiple linear regression analysis was employed to identify associations with the participants’ sociodemographic and professional characteristics, compassion fatigue and compassion satisfaction. ResultsA total of 213 questionnaires were completed, 206 of which were valid (96.71%). The majority of the participants reported moderate risks for compassion satisfaction (75.24%) and burnout (59.71%) and low risks for secondary traumatic stress (61.65%). Higher job satisfaction as a midwife, lower average working hours per week in the past year, higher social support, extroverted personality, and work recognition in the past month were positively associated with compassion satisfaction, explaining 48.7% of the total variance. Always considering giving up a midwifery career, lower social support, working a day-night shift, poor health condition, more exposure to traumatic birth events per month on average in recent years, and lower job satisfaction as a midwife were negative factors for burnout, explaining 35.3% of the total variance. Four factors, including more exposure to traumatic birth events per month on average in recent years, always considering giving up a midwifery career, working a day-night shift and poor sleep quality, were negatively related to secondary traumatic stress, explaining 14.2% of the variance. ConclusionsIn this study, midwives showed moderate levels of compassion satisfaction and burnout and low levels of secondary traumatic stress which should attract the attention of health institutions. A healthy and supportive work environment is crucial to midwives’ health, well-being and job satisfaction. Tailored strategies such as trauma management, emotional literacy, peer and social support networks should be implemented to support midwives’ compassion satisfaction, while prevent and lower midwives’ burnout and secondary traumatic stress.

Retrospective sampling of survival data based on a Poisson birth process: conditional maximum likelihood

Truncated survival data are observed retrospectively, if the death event falls into the study period. We find that estimating the survival distribution requires a model for the birth event. With births generated by a parametric Poisson process, we analyse the likelihood of parametric survival, stochastically independent of birth. Conditioning on the number of observed units reduces the number of parameters by one, and to two in our application. The compact support of an observation simplifies the proof of consistency. Furthermore, that we only need to show identification separately for the birth and the death distribution is helpful for demonstrating asymptotic normality. For identification of the survival parameters, a stronger criterion is needed than for a simple random sample, but is fulfilled in our application. In a simulation study, we find that the variance inflation by truncation can be substantial, and apparently is indeed so in our application. From 55,000 German companies that went insolvent between 2014 and 2016, we infer an average time to insolvency of six years and a negative linear trend of corporate foundations after the German reunification in 1990. Companies in Northern Germany survive longer than in the south.

Higher Levels of Postnatal Depressive Symptomatology, Post-Traumatic Growth, and Life Satisfaction among Gay Fathers through Surrogacy in Comparison to Heterosexual Fathers: A Study in Israel in Times of COVID-19

This study aimed to explore the psychological welfare, as indicated by postnatal depressive symptomatology, life satisfaction, and posttraumatic growth (growth after contending with stressful birth events), of Israeli gay fathers through surrogacy in comparison to heterosexual fathers. For that purpose, a sample of 167 Israeli fathers (M = 35.6, SD = 4.4) was recruited (68 identified as gay fathers through surrogacy and 99 as heterosexual fathers). Participants completed questionnaires assessing their postnatal depressive symptomatology, life satisfaction, and sense of posttraumatic growth after becoming fathers. Results indicated that gay fathers through surrogacy reported higher levels of life satisfaction and posttraumatic growth than heterosexual fathers. Yet, gay fathers also reported higher levels of postnatal depressive symptomatology than heterosexual fathers when life satisfaction or posttraumatic growth values were low or medium. The findings were interpreted in light of the hardships associated with cross-border surrogacy and the psychological outcomes associated with succeeding to become fathers after contending with them. The study contributes to the limited literature on postnatal depressive symptomatology and posttraumatic growth among gay fathers through surrogacy and provides clinicians and policymakers with relevant information on the psychological strengths and potential difficulties associated with cross-border surrogacy among gay fathers.

Modelling transmission of Mycobacterium avium subspecies paratuberculosis between Irish dairy cattle herds

Bovine paratuberculosis is an endemic disease caused by Mycobacterium avium subspecies paratuberculosis (Map). Map is mainly transmitted between herds through movement of infected but undetected animals. Our objective was to investigate the effect of observed herd characteristics on Map spread on a national scale in Ireland. Herd characteristics included herd size, number of breeding bulls introduced, number of animals purchased and sold, and number of herds the focal herd purchases from and sells to. We used these characteristics to classify herds in accordance with their probability of becoming infected and of spreading infection to other herds. A stochastic individual-based model was used to represent herd demography and Map infection dynamics of each dairy cattle herd in Ireland. Data on herd size and composition, as well as birth, death, and culling events were used to characterize herd demography. Herds were connected with each other through observed animal trade movements. Data consisted of 13 353 herds, with 4 494 768 dairy female animals, and 72 991 breeding bulls. We showed that the probability of an infected animal being introduced into the herd increases both with an increasing number of animals that enter a herd via trade and number of herds from which animals are sourced. Herds that both buy and sell a lot of animals pose the highest infection risk to other herds and could therefore play an important role in Map spread between herds.

Effect of non-pharmacological interventions for overweight/obese women with polycystic ovary syndrome on ovulation and pregnancy outcomes: a protocol for a systematic review and network meta-analysis

IntroductionMost overweight/obese women with polycystic ovary syndrome (PCOS) have infertility issues which are difficult to treat. Non-pharmacological interventions used for the management of infertility include lifestyle interventions, acupuncture therapies and...

Uterine fibroids increase the risk of preterm birth and other adverse birth events: a systematic review and meta-analysis.

BackgroundUterine fibroids may cause preterm birth. This meta-analysis evaluates the effect of uterine fibroids on the risk of preterm birth and other obstetric outcomes.MethodsUsing the literature review method, the databases PubMed, Medline, Embase and Central were retrieved to obtain relevant research literature. The selected studies were analyzed and evaluated. The literature was a cohort study or a case-control study of pregnant women as the research object and uterine fibroids as the exposure factor to observe adverse events during pregnancy. The chi-square test was used to test for heterogeneity. Subgroup analyses were used to explore sources of heterogeneity. Publication bias was assessed using Egger’s test. Enumeration data were described by odds ratio (OR). Measurement data were described by mean difference (MD). Calculate the confidence interval (CI).ResultsA total of 11 studies were included in this study, including 7 cohort studies and 4 case-control studies, with a total of 313,913 women. The probability of uterine fibroids among women was 3.99%. The results of meta-analysis showed that women with uterine fibroids experienced preterm birth <37 weeks (OR =1.43, 95% CI: 1.25 to 1.64, P<0.00001), preterm birth <34 weeks (OR =1.73, 95% CI: 1.34 to 2.25, P<0.0001), premature rupture of membranes (OR =1.38, 95% CI: 1.08 to 1.75, P=0.009), placental abruption (OR =1.60, 95% CI: 1.20 to 2.14, P=0.001), cesarean section (OR =2.09, 95% CI: 1.69 to 2.58, P<0.00001), and postpartum hemorrhage (OR =2.95, 95% CI: 1.86 to 4.66, P<0.00001) were all at higher risk, and the mean gestational age at delivery [mean difference (MD) =−0.58, 95% CI: −0.66 to −0.51, P<0.00001] and birth weight (MD =−117.82, 95% CI: −155.19 to −80.45, P<0.00001) were lower. Egger's test indicated that there was no publication bias among the included studies (P>0.05).ConclusionsPregnant women with uterine fibroids are at higher risk for preterm birth and other adverse obstetric outcomes and require closer monitoring.

Risk Factors and Outcomes Associated With Hypertensive Disorders of Pregnancy in Maternal Congenital Heart Disease

BackgroundAmong women with congenital heart disease (CHD), risk factors for hypertensive disorders of pregnancy (HDP) and the association of HDP with adverse outcomes are unknown. ObjectivesThe purpose of this study was to identify risk factors for HDP among women with and without CHD and to assess the association of HDP with adverse events. MethodsThis retrospective cohort study included the first live birth for each woman who was pregnant in Alberta, Canada, between January 1, 2005, and December 31, 2018. The prevalence of HDP among women with and without CHD was compared. Multivariable models were used to determine the independent associations between maternal characteristics and HDP and to assess the strength of associations between HDP and CHD with adverse events. ResultsOf the total birth events, 0.6% (N = 2,575) occurred in women with CHD. HDP were more common among women with CHD (11.2% vs 8.1%, P < 0.0001). Chronic hypertension and diabetes mellitus were strongly associated with HDP among women with CHD (adjusted odds ratio [aOR]: 4.56; 95% confidence interval [CI]: 2.95-7.03; and aOR: 3.33; 95% CI: 1.48-7.49, respectively). Coarctation of the aorta was the only CHD lesion independently associated with increased risk for HDP (aOR: 1.76; 95% CI: 1.02-3.02). HDP, as opposed to CHD, was more strongly associated with having a complicated delivery admission, preterm delivery, and small for gestational age infant. ConclusionsHDP were more common among women with CHD. The strongest risk factors for HDP among women with CHD were acquired. The presence of HDP, rather than CHD, was more strongly associated with certain adverse outcomes.

Association Between Birth Weight and Risk of Pregnancy-Induced Hypertension and Gestational Diabetes in Japanese Women: JPHC-NEXT Study.

BackgroundAlthough prevalence of low birth weight has increased in the last 3 decades in Japan, no studies in Japanese women have investigated whether birth weight is associated with the risk of pregnancy complications, such as pregnancy-induced hypertension (PIH) and gestational diabetes mellitus (GDM).MethodsWe used data from the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT), a population-based cohort study in Japan that launched in 2011. In the main analysis, we included 46,365 women who had been pregnant at least once, for whom information on birth weight and events during their pregnancy was obtained using a self-administered questionnaire. Women were divided into five categories according to their birth weight, and the relationship between birth weight and risk of PIH and GDM was examined using multilevel logistic regression analyses with place of residence as a random effect.ResultsCompared to women born with birth weight of 3,000–3,999 grams, the risk of PIH was significantly higher among women born <1,500 grams (adjusted odd ratio [aOR] 1.60; 95% confidence interval [CI], 1.17–2.21), 1,500–2,499 grams (aOR 1.16; 95% CI, 1.03–1.30), and 2,500–2,999 grams (aOR 1.13; 95% CI, 1.04–1.22). The risk of GDM was significantly higher among women born 1,500–2,499 grams (aOR 1.20; 95% CI, 1.02–1.42), albeit non-significant association among women in other birthweight categories.ConclusionsWe observed an increased risk of PIH among women born with lower birth weight albeit non-significant increased risk of GDM among Japanese women.

An Encomium for Jesus: Luke, Rhetoric, and the Story of Jesus by Jerome H. Neyrey

Reviewed by: An Encomium for Jesus: Luke, Rhetoric, and the Story of Jesus by Jerome H. Neyrey Pablo T. Gadenz jerome h. neyrey, An Encomium for Jesus: Luke, Rhetoric, and the Story of Jesus (New Testament Monographs 40; Sheffield: Sheffield Phoenix, 2020). Pp. vii + 222. £50/$65/€57.50. Distinguished NT scholar Jerome Neyrey is well known for his books and articles that argue that the authors of Matthew, John, and Hebrews followed Greco-Roman rhetorical conventions to communicate their message about Jesus in a way that their audiences would easily recognize. Similarly, in this monograph N. turns his attention to Luke's Gospel, considering it specifically through the lens of the rhetorical genre of encomium. The book is structured much like part 2 of N.'s earlier work on Matthew, Honor and Shame in the Gospel of Matthew (Louisville: Westminster John Knox, 1998). In chap. 1, N. introduces the book's thesis, that Luke, having received an education in rhetoric (see N.'s appendix) by means of the compositional exercises of the progymnasmata (which taught various rhetorical genres including encomium), composed his Gospel narrative to give Jesus praise according to the encomium's conventional topics (see Michael W. Martin, "Progymnastic Topic Lists: A Compositional Template for Luke and Other Bioi?," NTS 54 [2008] 18–41). Subsequent chapters individually take up those topics: [End Page 331] origins (chap. 2); nurture and training (chap. 3); accomplishments, considered in terms of the four canonical virtues of wisdom (prudence), justice, courage (fortitude), and selfcontrol (temperance) (chaps. 4–7, respectively); and noble death (chap. 8). Each of these chapters reviews what the rhetorical handbooks (e.g., those of Theon, Hermogenes, Aphthonius) said about a topic and considers how Luke employed that topic in composing his Gospel. Regarding origins (chap. 2), N. argues that Luke, much like Matthew, finds praise for Jesus by presenting the conventional ideas of honorable birth (David's native city, Bethlehem), distinguished pedigree (house of David; genealogy), and special events at birth (angelic proclamation; prophecies). N. later clarifies that Luke's presentation is also unconventional in its inversion of values (see Luke 1:52). Regarding training (chap. 3), N. examines Luke's presentation of Jesus's precocious exchange with the temple teachers and his obedience to his parents (2:41–52). N. also discusses Luke's use of another progymnastic exercise, that is, syncrisis, in the comparison between John the Baptist and Jesus. All this analysis is useful, suggesting that at least for Jesus's birth and upbringing, the progymnastic topic lists influenced Luke's composition. In chaps. 4–7, N. turns to Jesus's public ministry (the topic of deeds), viewed through the lens of the cardinal virtues. Anticipating the objection that the vocabulary for these virtues is largely absent in Luke, he explains that audiences would naturally have labeled Jesus's actions as pertaining to individual virtues without Luke having to do so explicitly. Thus, Jesus demonstrates practical wisdom because he distinguishes good from bad (6:43–45), advises choosing actions that are advantageous in God's eyes (14:13–14), and utters wise proverbs (5:31). He is just because he fulfills his duties toward God (4:43) and teaches various forms of justice (6:20–49). He is courageous because he endures assaults from evil spirits (4:1–13) and speaks boldly to his attackers (11:42–52). He is self-controlled, despite insults to the contrary (7:34–35), since he exhibits no inordinate desires (e.g., for wealth [12:33] or honor [18:14]). These are the most innovative chapters of N.'s work, but they are likely the ones that will elicit the greatest skepticism. For such a long section of Luke's Gospel (4:14–21:38), it seems difficult to speak of a template (pp. 53, 58) given such general guidelines. Regardless, N. along the way offers insightful observations on Lucan passages and themes (e.g., the meal scenes [p. 148]). In chap. 8, N. explains that Jesus's death qualifies as noble because, though he was just (23:4, 47), he suffered voluntarily (22:42) for the benefit of others (24:47) and was uniquely vindicated after his death through his...

The effect of microbial selection on the occurrence-abundance patterns of microbiomes.

Theoretical models are useful to investigate the drivers of community dynamics. In the simplest case of neutral models, the events of death, birth and immigration of individuals are assumed to only depend on their abundance—thus, all types share the same parameters. The community level expectations arising from these simple models and their agreement to empirical data have been discussed extensively, often suggesting that in nature, rates might indeed be neutral or their differences might not be important. However, how robust are these model predictions to type-specific rates? Also, what are the consequences at the level of types? Here, we address these questions moving from simple neutral communities to heterogeneous communities. For this, we build a model where types are differently adapted to the environment. We compute the equilibrium distribution of the abundances. Then, we look into the occurrence-abundance pattern often reported in microbial communities. We observe that large immigration and biodiversity—common in microbial systems—lead to such patterns, regardless of whether the rates are neutral or non-neutral. We conclude by discussing the implications to interpret and test empirical data.

Averaging of a Stochastic Slow-Fast Model for Population Dynamics: Application to the Development of Ovarian Follicles

We analyze a birth, migration, and death stochastic process modeling the dynamics of a finite population, in which individuals transit unidirectionally across successive compartments. The model is formulated as a continuous-time Markov chain, whose transition matrix involves multiscale effects; the whole (or part of the) population affects the rates of individual birth, migration, and death events. Using the slow-fast property of the model, we prove the existence and uniqueness of the limit model in the framework of stochastic singular perturbations. The derivation of the limit model is based on compactness and coupling arguments. The uniqueness is handled by applying the ergodicity theory and studying a dedicated Poisson equation. The limit model consists of an ordinary differential equation ruling the dynamics of the first (slow) compartment, coupled with a quasi-stationary distribution in the remaining (fast) compartments, which averages the contribution of the fast component of the Markov chain on the slow one. We illustrate numerically the convergence and highlight the relevance of dealing with nonlinear event rates for our application in reproductive biology. The numerical simulations involve a simple integration scheme for the deterministic part, coupled with the nested algorithm to sample the quasi-stationary distribution.

Predicting singleton antepartum stillbirth by the demographic Fetal Medicine Foundation Risk Calculator-A retrospective case-control study.

ObjectiveTo assess the risk of singleton intrauterine fetal death (IUFD) in women by the demographic setting of the online Fetal Medicine Foundation (FMF) Stillbirth Risk Calculator.MethodsRetrospective single-centre case-control study involving 144 women having suffered IUFD and 247 women after delivery of a live-born singleton. Nonparametric receiver operating characteristics (ROC) analyses were performed to predict the prognostic power of the FMF Stillbirth risk score and to generate a cut-off value to discriminate best between the event of IUFD versus live birth.ResultsWomen in the IUFD cohort born a significantly higher overall risk with a median FMF risk score of 0.45% (IQR 0.23–0.99) compared to controls [0.23% (IQR 0.21–0.29); p<0.001]. Demographic factors contributing to an increased risk of IUFD in our cohort were maternal obesity (p = 0.002), smoking (p<0.001), chronic hypertension (p = 0.015), antiphospholipid syndrome (p = 0.017), type 2 diabetes (p<0.001), and insulin requirement (p<0.001). ROC analyses showed an area under the curve (AUC) of 0.72 (95% CI 0.67–0.78; p<0.001) for predicting overall IUFD and an AUC of 0.72 (95% CI 0.64–0.80; p<0.001), respectively, for predicting IUFD excluding congenital malformations. The FMF risk score at a cut-off of 0.34% (OR 6.22; 95% CI 3.91–9.89; p<0.001) yielded an 82% specificity and 58% sensitivity in predicting IUFD with a positive and negative predictive value of 0.94% and 99.84%, respectively.ConclusionThe FMF Stillbirth Risk Calculator based upon maternal demographic and obstetric characteristics only may help identify women at low risk of antepartum stillbirth.

Maternal educational inequalities about adverse pregnancy outcomes observed in a rural area of a province of China during a time period (2010–2018)

BackgroundThe relationship between maternal education and adverse pregnancy outcomes is well documented. However, limited research has investigated maternal educational disparities in adverse pregnancy outcomes in China. This study examined maternal...

Exact distributions for stochastic gene expression models with arbitrary promoter architecture and translational bursting.

Gene expression in individual cells is inherently variable and sporadic, leading to cell-to-cell variability in mRNA and protein levels. Recent single-cell and single-molecule experiments indicate that promoter architecture and translational bursting play significant roles in controlling gene expression noise and generating the phenotypic diversity that life exhibits. To quantitatively understand the impact of these factors, it is essential to construct an accurate mathematical description of stochastic gene expression and find the exact analytical results, which is a formidable task. Here, we develop a stochastic model of bursty gene expression, which considers the complex promoter architecture governing the variability in mRNA expression and a general distribution characterizing translational burst. We derive the analytical expression for the corresponding protein steady-state distribution and all moment statistics of protein counts. We show that the total protein noise can be decomposed into three parts: the low-copy noise of protein due to probabilistic individual birth and death events, the noise due to stochastic switching between promoter states, and the noise resulting from translational busting. The theoretical results derived provide quantitative insights into the biochemical mechanisms of stochastic gene expression.

Using Longitudinally Linked Data to Measure Severe Maternal Morbidity.

To assess whether application of a standard algorithm to hospitalizations in the prenatal and postpartum (42 days) periods increases identification of severe maternal morbidity (SMM) beyond analysis of only the delivery event. We performed a retrospective cohort study using data from the PELL (Pregnancy to Early Life Longitudinal) database, a Massachusetts population-based data system that links records from birth certificates to delivery hospital discharge records and nonbirth hospital records for all birthing individuals. We included deliveries from January 1, 2009, to December 31, 2018, distinguishing between International Classification of Diseases Ninth (ICD-9) and Tenth Revision (ICD-10) coding. We applied the modified Centers for Disease Control and Prevention algorithm for SMM used by the Alliance for Innovation on Maternal Health to hospitalizations across the antenatal period through 42 days postpartum. Morbidity was examined both with and without blood transfusion. Overall, 594,056 deliveries were included in the analysis, and 3,947 deliveries met criteria for SMM at delivery without transfusion and 9,593 with transfusion for aggregate rates of 150.1 (95% CI 146.7-153.5) using ICD-9 codes and 196.6 (95% CI 189.5-203.7) using ICD-10 codes per 10,000 deliveries. Severe maternal morbidity at birth increased steadily across both ICD-9 and ICD-10 from 129.4 in 2009 (95% CI 126.2-132.6) using ICD-9 to 214.3 per 10,000 (95% CI 206.9-221.8) in 2018 using ICD-10. Adding prenatal and postpartum hospitalizations increased cases by 21.9% under both ICD-9 and ICD-10, resulting in a 2018 rate of 258.7 per 10,000 (95% CI 250.5-266.9). The largest increase in detected morbidity in the prenatal or postpartum time period was attributed to sepsis cases. Inclusion of prenatal and postpartum hospitalizations in the identification of SMM resulted in increased ascertainment of morbid events. These results suggest a need to ensure surveillance of care quality activities beyond the birth event.

Stereotypic Expansion of T Regulatory and Th17 Cells during Infancy Is Disrupted by HIV Exposure and Gut Epithelial Damage.

Few studies have investigated immune cell ontogeny throughout the neonatal and early pediatric period, when there is often increased vulnerability to infections. In this study, we evaluated the dynamics of two critical T cell populations, T regulatory (Treg) cells and Th17 cells, over the first 36 wk of human life. First, we observed distinct CD4+ T cells phenotypes between cord blood and peripheral blood, collected within 12 h of birth, showing that cord blood is not a surrogate for newborn blood. Second, both Treg and Th17 cells expanded in a synchronous fashion over 36 wk of life. However, comparing infants exposed to HIV in utero, but remaining uninfected, with HIV-unexposed uninfected control infants, there was a lower frequency of peripheral blood Treg cells at birth, resulting in a delayed expansion, and then declining again at 36 wk. Focusing on birth events, we found that Treg cells coexpressing CCR4 and α4β7 inversely correlated with plasma concentrations of CCL17 (the ligand for CCR4) and intestinal fatty acid binding protein, IL-7, and CCL20. This was in contrast with Th17 cells, which showed a positive association with these plasma analytes. Thus, despite the stereotypic expansion of both cell subsets over the first few months of life, there was a disruption in the balance of Th17 to Treg cells at birth likely being a result of gut damage and homing of newborn Treg cells from the blood circulation to the gut.

What Percentage of Mortality were Medically Certified among Total Registered Mortality in 36 States &amp; UTs of India During 2018-2020 and COVID-19 Mortality Age-Sex Distribution Pattern in India: A Cross Sectional Observational Research Study

The most significant event of birth and death must be certified medically / non-medically to prove or support the evidence of existence of birth and death of a particular person legal existence between the certified date / timings of birth and death. Apart from this legal significance, footage of births and mortality is central basic data required for policy and planning about a population group / country such as provisioning of fundamental requirements like food, cloth, housing, health care, transportation, education etc. The national / state programmes planning, management, implementation can be effectual and triumphant only if this statistical information of birth and death is specific, reliable, timely and correct. Hence, the certification / registration of births and mortality are significant as well as necessity of modern era. We aimed to assess percentage of mortality medically certified among total registered mortality in 36 States &amp; UTs of India during 2018-2020 and COVID-19 mortality age-sex distribution pattern in India during 2020 medically certified due to pandemic in India with available data resources. The mortality data for this cross sectional retrospective observational study were obtained through Civil Registration System of India under the RBD Act, 1969. The data available were obtained on medically certified cause of deaths from States/UTs has been collected, tabulated, analysed in compliance with the ICD - Tenth Revision (1993). The total registered death during 2018 was 6911197 for 2019 it was 7596849 and in 2020 8062070. The figure increased continuously during successive years but there is a question mark on this data. The total RD increased by 685652 numbers in 2019 compared to 2018 whereas despite the COVID-19 PANDEMIC impact the increase in figures during 2020 was 240148 only which are highly questionable? The researcher found that this controversy is also raised by several global highly accredited international organizations like WHO etc. This research study revealed that Bihar which is second most populous state in India ranked lowest in medical certification of cause of death, 2020 which is amazing. Bihar ranked lowest with only 3.4 percent medically certified deaths during 2020 the COVID-19 pandemic era. Hence a large number of mortality during COVID-19 era remains uncertified till date in states like Bihar. This observational research study revealed that the majority of COVID-19 mortality was found in the age group of 45 years and above accounting for 82.7 per cent of total deaths in the group. The percentage of female mortality aged 34 years and below as well as for 55-64 years age group and 65-69 years age group, to total female deaths are greater in comparison to corresponding age groups mortality for male while in other groups male mortality were more than females. Particularly in poor states like Bihar in India the lower socio-economic strata of population may be more affected by low MCCD which is chiefly due to failure of Public Health Management related largely to corruption, posting and other scams. Bihar ranked lowest with only 3.4 percent medically certified deaths during 2020 the COVID-19 pandemic era. Hence a large number of mortality during COVID-19 era remains uncertified till date in states like Bihar. The researcher has found that in states like Bihar the total registered deaths have increased continuously during study period while MCCD decreased continuously during the study period which is due to failure of public health management and corruption, posting scams etc., by which such states are putting highly incapable / untrained person on state programme officer etc vital posts. These irregularities or ignorance have put India’s data credibility in doubt at international level bringing shame to the nation.