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Background: The pan-Canadian Maternal-Infant Research on Environmental Chemicals (MIREC) study was established to determine whether maternal environmental chemical exposures were associated with adverse pregnancy outcomes in 2001 pregnant women. Objectives: The MIREC-Child Development (CD PLUS) study followed this cohort with the goal of assessing the potential effects of prenatal exposures on anthropometry and neurodevelopment in early childhood. Population: MIREC families with children between the ages of 15 months and 5 years who had agreed to be contacted for future research (n = 1459) were invited to participate in MIREC-CD PLUS which combines data collected from an online Maternal Self-Administered Questionnaire with biomonitoring and neurodevelopment data collected from two in-person visits. Preliminary Results: Between April 2013 and March 2015, 803 children participated in the Biomonitoring visit where we collected anthropometric measures, blood, and urine from the children. The Behavioural Assessment System for Children-2, Behaviour Rating Inventory of Executive Function, MacArthur-Bates Communicative Development Inventories and the Communication subscale of the Adaptive Behaviour Scale from the Bayley Scales of Infant and Toddler Development-III are available on close to 900 children. There were 610 singleton children who completed in-person visits for neurodevelopment assessments including the Social Responsiveness Scale, Wechsler Preschool Primary Scale of Intelligence-III and NEuroPSYchological assessments (NEPSY). Currently, we are following the cohort into early adolescence to measure the impact of early life exposures on endocrine and metabolic function (MIREC-ENDO). Conclusions: Data collection for the MIREC-CD PLUS study is complete and analysis of the data continues. We are now extending the follow-up of the cohort into adolescence to measure the impact of early life exposures on endocrine and metabolic function (MIREC-ENDO). MIREC-CD PLUS is limited by loss to follow-up and the fact that mothers are predominately of higher socioeconomic status and 'White' ethnicity, which limits our generalizability. However, the depth of biomonitoring and clinical measures in MIREC provides a platform to examine associations of prenatal, infancy and childhood exposures with child growth and development. [ABSTRACT FROM AUTHOR]

Background: Toxic metals, like lead, are risk factors for preterm birth (PTB), but few studies have examined low levels found in most Canadians. Vitamin D, which may have antioxidant activity, protects against PTB. Objectives: In this study, we investigated the impact of toxic metals (lead, mercury, cadmium and arsenic) on PTB and examined if maternal plasma vitamin D concentrations modify these associations. Methods: We investigated whether concentrations of metals in whole blood measured in early and late pregnancy were associated with PTB (<37 weeks) and spontaneous PTB in 1851 live births from the Maternal–Infant Research on Environmental Chemicals Study using discrete time survival analysis. We also investigated whether the risk of PTB was modified by first‐trimester plasma 25‐hydroxyvitamin D (25OHD) concentrations. Results: Of 1851 live births, 6.1% (n = 113) were PTBs and 4.9% (n = 89) were spontaneous PTB. A 1 μg/dL increase in blood lead concentrations during pregnancy was associated with an increased risk of PTB (relative risk [RR] 1.48, 95% confidence interval [CI] 1.00, 2.20) and spontaneous PTB (RR 1.71, 95% CI 1.13, 2.60). The risk was higher in women with insufficient vitamin D concentrations (25OHD <50 nmol/L) for both PTB (RR 2.42, 95% CI 1.01, 5.79) and spontaneous PTB (RR 3.04, 95% CI 1.15, 8.04). However, an interaction on the additive scale was not present. Arsenic was associated with a higher risk of PTB (RR 1.10, 95% CI 1.02, 1.19) and spontaneous PTB (RR 1.11, 95% CI 1.03, 1.20) per 1 μg/L. Conclusions: Gestational exposure to low levels of lead and arsenic may increase the risk of PTB and spontaneous PTB; individuals with insufficient vitamin D may be more susceptible to the adverse effects of lead. Given our relatively small number of cases, we encourage testing of this hypothesis in other cohorts, especially those with vitamin D‐deficient populations. [ABSTRACT FROM AUTHOR]

Reciprocity and negativity in social relationships are fundamental topics of social research rarely examined in sub‐Saharan Africa. Since the number and quality of relationships is associated with individual outcomes, these ties are particularly important in impoverished areas. We conducted a multi‐method study of the conditions associated with problematic networks and difficult people, including face‐to‐face surveys in Agbogbloshie (Accra, Ghana) and Kangemi (Nairobi, Kenya). While one quarter of all relationships were perceived to be difficult, results reveal significant differences between the two communities in terms of the composition of personal networks and the factors associated with difficulty at both relational and network levels of analysis. Kenyan networks are more difficult when there is an imbalance of assistance provided by the respondent (exploitation), while any imbalance (inequality) is problematic in Ghanaian networks. These findings underscore the importance of independent analyses of negative ties and difficult networks, contributing to a community‐based understanding of poverty in urban slums. [ABSTRACT FROM AUTHOR]

Background: Wide‐ranging restrictions on social and educational activities were imposed in 2020 in response to the COVID‐19 pandemic. These likely influenced the population dynamics of the head louse. Close physical contact between human hosts is required for transmission of this ectoparasite. Method: Pre‐ and post‐pandemic internet interest in the head louse in the UK was compared using Google Trends data from March 2017 to March 2022 and modeling using the Meta Prophet package. The influence of school holidays and school attendance was also investigated. Results: There was a sharp decline in internet searching of the term "head louse" from March 2020 onwards coinciding with COVID‐19 restrictions, and a large difference between pre‐ and post‐pandemic search volumes. No influence of school holidays or attendance on internet searching on the head louse was found. Conclusion: The results suggest pandemic restrictions have had a large effect on head louse incidence. [ABSTRACT FROM AUTHOR]

In recent years, as the implementation and use of Non‐Invasive Prenatal Testing (NIPT) have increased, the cost of the test has been decreasing. The cost of NIPT is expected to fall further in the upcoming years. As a result of the decreasing cost of NIPT, many jurisdictions may change their prenatal screening policies toward abandoning serum‐based screening and instead, implement and support NIPT as the first‐tier screening for all women. There are several concerns in replacing first‐trimester screening with NIPT. In this scoping review, we aimed to map the existing knowledge about possible issues in the systematic implementation of NIPT as the primary method of first‐tier screening and to assess if any jurisdiction has altered its policy and discontinued serum‐based prenatal screening in exchange for NIPT. The Medline database (Ovid) and Google Scholar was searched and all the studies discussing, investigating, or reporting on the systematic implementation of NIPT as the primary method of first‐tier screening were included. All the studies went through a two‐stage screening process and included full‐text articles were reviewed. We did not find any articles indicating a country or region that replaced traditional prenatal screening by NIPT. The included articles were charted, and the data about the possible issues in the systematic implementation of NIPT as the primary method of first‐tier screening are summarized narratively and presented in tables in four categories. The findings of this scoping review may be informative for stakeholders and policymakers regarding recent changes in NIPT implementation policies around the world and may aid with developing policy for NIPT implementation with a broader perspective. Key points: What's already known about this topic? Non‐Invasive Prenatal Testing (NIPT) is implemented mainly as a contingent test after a high‐risk assessment, and in a few instances, as a first‐tier test.More recently, as the use of NIPT has increased, the cost of the test has been decreasing, and two countries (Belgium and Netherland) now offer NIPT as the primary screening test to all pregnant women. What does this study add? It maps existing knowledge about various possible issues in implementing NIPT as a first‐tier screening test.It documents what jurisdictions have changed their policy toward implementing NIPT instead of traditional prenatal screening in the first trimester. [ABSTRACT FROM AUTHOR]

Promoting research in NHS trusts is known to be beneficial for patient outcomes and clinicians' attitudes towards research and recruitment to studies. Here the authors report their evaluation of a research champions initiative at a specialist mental health and community services trust. [ABSTRACT FROM AUTHOR]

We investigate firms that issue seasoned equity following a period of payouts to equity holders. Firms that engage in this roundtrip of equity exhibit strong growth in investment in capital expenditures. Issuing seasoned equity for payout firms does not appear to be associated with future declines in operating cash flow, but rather is associated more with large absolute increases in future cash flow. These firms tend to issue equity when their equity valuations are high, suggesting that market conditions matter. Our findings are consistent with firms issuing equity to use the capital for valuable investments in fixed assets, consistent with market assessments of growth opportunities. [ABSTRACT FROM AUTHOR]

The Belt and Road Initiative was introduced to further economic connections with partner countries and foster development within China. We examine the effect of the Initiative on Chinese cross‐border M&As. We find that the Initiative significantly increases the probability and the transaction amount of M&A deals in target countries. Moreover, the market reacts more positively to these deals. We find that the effect is entirely driven by state‐owned enterprises during our sample period and it is more pronounced in firms that are located on the more‐developed eastern coast of China. The evidence suggests that the announcement of the Belt and Road Initiative was followed by economically meaningful cross‐border M&A in targeted countries. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the potential collective opportunities and challenges of transforming real‐world data (RWD) to real‐world evidence for clinical effectiveness by focusing on aligning analytic definitions of oncology end points. Patients treated with a qualifying therapy for advanced non‐small cell lung cancer in the frontline setting meeting broad eligibility criteria were included to reflect the real‐world population. Although a trend toward improved outcomes in patients receiving PD‐(L)1 therapy over standard chemotherapy was observed in RWD analyses, the magnitude and consistency of treatment effect was more heterogeneous than previously observed in controlled clinical trials. The study design and analysis process highlighted the identification of pertinent methodological issues and potential innovative approaches that could inform the development of high‐quality RWD studies. [ABSTRACT FROM AUTHOR]

Group A Streptococcus (GAS) is a Gram‐positive bacterial pathogen that causes an array of infectious diseases in humans. Accumulating clinical evidence suggests that proinflammatory interleukin (IL)‐1β signaling plays an important role in GAS disease progression. The host regulates the production and secretion of IL‐1β via the cytosolic inflammasome pathway. Activation of the NLR family pyrin domain‐containing 3 (NLRP3) inflammasome complex requires two signals: a priming signal that stimulates increased transcription of genes encoding the components of the inflammasome pathway, and an activating signal that induces assembly of the inflammasome complex. Here we show that GAS‐derived lipoteichoic acid can provide a priming signal for NLRP3 inflammasome activation. As only few GAS‐derived proteins have been associated with inflammasome‐dependent IL‐1β signaling, we investigated novel candidates that might play a role in activating the inflammasome pathway by infecting mouse bone marrow‐derived macrophages and human THP‐1 macrophage‐like cells with a panel of isogenic GAS mutant strains. We found that the cytolysins streptolysin O (SLO) and streptolysin S are the main drivers of IL‐1β release in proliferating logarithmic phase GAS. Using a mutant form of recombinant SLO, we confirmed that bacterial pore formation on host cell membranes is a key mechanism required for inflammasome activation. Our results suggest that streptolysins are major determinants of GAS‐induced inflammation and present an attractive target for therapeutic intervention. [ABSTRACT FROM AUTHOR]

Background: In Canada, as is found globally, women of reproductive age are a growing demographic of persons living with HIV. Combination antiretroviral therapy (cART) treatment enables women living with HIV (WLWH) to become pregnant without perinatal transmission, and they are increasingly planning to become pregnant. Since 2014, Canadian guidelines no longer recommend routine elective cesarean birth (CB) for women who are virally suppressed and receiving cART. It is unknown whether their obstetric care has changed since this update. Our objective was to describe trends in cesarean births among WLWH in Ontario, Canada, over a 12‐year period. Methods: Our research is co‐led and codesigned with WLWH. We conducted a retrospective population‐level cohort study using linked health administrative databases at ICES (formally, the Institute for Clinical and Evaluative Sciences). Participants were all women who gave birth in Ontario, between 2006/07 and 2017/18. We assessed their intrapartum characteristics and used multivariable regression to determine an association between HIV status and CB, controlling for sociodemographic and clinical variables. Results: Since 2014, the overall proportion of CB among WLWH remained stable and was higher than among women without HIV (39.9% vs 29.0%, P < 0.001). In addition, the proportion of primary CB decreased between 2006 and 2010 and between 2014 and 2018 (28.5%‐19.3%), whereas the proportion of repeat CB increased (13.1%‐20.5%, P = 0.013). Conclusions: Because of decreasing HIV‐related indications for CB, more practitioners may be following the guidelines for first‐time mothers. Currently, no guidelines exist for care of WLWH with a previous CB, and opportunities for vaginal birth may be missed in this population. [ABSTRACT FROM AUTHOR]

Background: Gastroschisis is a congenital anomaly of the abdomen in which the intestines are found outside of the body at birth. While no clear causative factors have been identified, it is strongly associated with young maternal age. Other reported associations include low maternal socioeconomic status, low maternal body mass index (BMI), and smoking. Methods: This is a retrospective review of epidemiologic data relating to cases of gastroschisis in Ontario from 2012‐2018 in the Better Outcomes Registry & Network (BORN) Ontario database, which is the province's prescribed maternal‐newborn registry. We describe the epidemiology of gastroschisis in Ontario with respect to birth prevalence, maternal age, health, exposures, and geography. Results: The birth prevalence of gastroschisis is 2.31 cases/10,000 births. There was no apparent change in birth prevalence over the study period and there was no difference between male and female infants. Gastroschisis was associated with younger maternal ages and was inversely correlated with maternal BMI. Gastroschisis was associated with first completed pregnancy. Maternal diabetes was associated with a lower birth prevalence of gastroschisis than average. Mothers of babies with gastroschsis were more likely to report use of tobacco, alcohol, and drugs during pregnancy than those without gastroschisis, with marijuana use showing the largest increase in birth prevalence of gastroschisis. Mothers living in rural areas were more likely to have a baby with gastroschisis than those in urban centers, even after controlling for maternal age. Conclusions: This Ontario registry study reveals that mothers with babies with gastroschisis are more likely to be young and thin, live in rural areas, and report prenatal smoking, alcohol use, and drug use than women whose pregnancies do not have gastroschsis. [ABSTRACT FROM AUTHOR]

Scabies is a pruritic skin condition transmitted by Sarcoptic mites. A moderately strong correlation was observed between scabies word usage frequency and data from Savin et al.[6] on the percentage of patients admitted with scabies to the Edinburgh Skin Dispensary (1896-1960) (rs = 0.44) and for the Edinburgh Royal Infirmary (1908-1960) (rs = 0.58). The sampling interval was divided by this amount to obtain the cycle length.[5] Figure 1a shows scabies word frequency usage in the British English corpus from 1800 to 2019. [Extracted from the article]

Background Methods Results Conclusions Research on the impact of the COVID‐19 pandemic on mothers/childbearing parents has mainly been cross‐sectional and focused on psychological symptoms. This study examined the impact on function using ongoing, systematic screening of a representative Ontario sample.An interrupted time series analysis of repeated cross‐sectional data from a province‐wide screening program using the Healthy Babies Healthy Children (HBHC) tool assessed changes associated with the pandemic at the time of postpartum discharge from hospital. Postal codes were used to link to neighborhood‐level data. The ability to parent or care for the baby/child and other psychosocial and behavioral outcomes were assessed.The co‐primary outcomes of inability to parent or care for the baby/child were infrequently observed in the pre‐pandemic (March 9, 2019–March 15, 2020) and initial pandemic periods (March 16, 2020–March 23, 2021) (parent 209/63,006 (0.33%)–177/56,117 (0.32%), care 537/62,955 (0.85%)–324/56,086 (0.58%)). Changes after pandemic onset were not observed for either outcome although a significant (p = 0.02) increase in slope was observed for inability to parent (with questionable clinical significance). For secondary outcomes, worsening was only seen for reported complications during labor/delivery. Significant improvements were observed in the likelihood of being unable to identify a support person to assist with care, need of newcomer support, and concerns about money over time.There were no substantive changes in concerns about ability to parent or care for children. Adverse impacts of the pandemic may have been mitigated by accommodations for remote work and social safety net policies. [ABSTRACT FROM AUTHOR]

Background: In Canada, as is found globally, women of reproductive age are a growing demographic of persons living with HIV. Combination antiretroviral therapy (cART) treatment enables women living with HIV (WLWH) to become pregnant without perinatal transmission, and they are increasingly planning to become pregnant. Since 2014, Canadian guidelines no longer recommend routine elective cesarean birth (CB) for women who are virally suppressed and receiving cART. It is unknown whether their obstetric care has changed since this update. Our objective was to describe trends in cesarean births among WLWH in Ontario, Canada, over a 12-year period., Methods: Our research is co-led and codesigned with WLWH. We conducted a retrospective population-level cohort study using linked health administrative databases at ICES (formally, the Institute for Clinical and Evaluative Sciences). Participants were all women who gave birth in Ontario, between 2006/07 and 2017/18. We assessed their intrapartum characteristics and used multivariable regression to determine an association between HIV status and CB, controlling for sociodemographic and clinical variables., Results: Since 2014, the overall proportion of CB among WLWH remained stable and was higher than among women without HIV (39.9% vs 29.0%, P < 0.001). In addition, the proportion of primary CB decreased between 2006 and 2010 and between 2014 and 2018 (28.5%-19.3%), whereas the proportion of repeat CB increased (13.1%-20.5%, P = 0.013)., Conclusions: Because of decreasing HIV-related indications for CB, more practitioners may be following the guidelines for first-time mothers. Currently, no guidelines exist for care of WLWH with a previous CB, and opportunities for vaginal birth may be missed in this population., (© 2021 Wiley Periodicals LLC.)