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Objective To compare the effects of early and delayed cord clamping on the haemoglobin levels of neonates delivered at term. Methods This randomized controlled trial enrolled pregnant women during the second stage of labour. They were randomized into either the early cord clamping (ECC) group or the delayed cord clamping (DCC) group in the ratio of 1:1. Following delivery of the baby, the umbilical cords of participants in the ECC group were clamped within 30 s of delivery of the neonate while those of participants in the DCC group were clamped after 2 min from the delivery of the neonate. The primary outcome measure was the effect of ECC and DCC on the haemoglobin levels of neonates delivered at term. Results A total of 270 pregnant women were enrolled in the study. Their baseline sociodemographic and clinical characteristics were similar in both groups. There was no significant difference in the mean haemoglobin level between ECC and DCC groups at birth. The mean haemoglobin level of the neonates at 48 h postpartum was significantly higher in the DCC group than the ECC group. Conclusion DCC at birth was associated with a significant increase in neonatal haemoglobin levels at 48 h postpartum when compared with ECC. Trial Registration: The trial was registered at Pan African Clinical Trial Registry with approval number PACTR202206735622089.

The world is grappling with the COVID-19 pandemic caused by the 2019 novel SARS-CoV-2. To better understand this novel virus and its relationship with other pathogens, new methods for analyzing the genome are required. In this study, intrinsic dinucleotide genomic signatures were analyzed for whole genome sequence data of eight pathogenic species, including SARS-CoV-2. The genome sequences were transformed into dinucleotide relative frequencies and classified using the extreme gradient boosting (XGBoost) model. The classification models were trained to a) distinguish between the sequences of all eight species and b) distinguish between sequences of SARS-CoV-2 that originate from different geographic regions. Our method attained 100% in all performance metrics and for all tasks in the eight-species classification problem. Moreover, the models achieved 67% balanced accuracy for the task of classifying the SARS-CoV-2 sequences into the six continental regions and achieved 86% balanced accuracy for the task of classifying SARS-CoV-2 samples as either originating from Asia or not. Analysis of the dinucleotide genomic profiles of the eight species revealed a similarity between the SARS-CoV-2 and MERS-CoV viral sequences. Further analysis of SARS-CoV-2 viral sequences from the six continents revealed that samples from Oceania had the highest frequency of TT dinucleotides as well as the lowest CG frequency compared to the other continents. The dinucleotide signatures of AC, AG,CA, CT, GA, GT, TC, and TG were well conserved across most genomes, while the frequencies of other dinucleotide signatures varied considerably. Altogether, the results from this study demonstrate the utility of dinucleotide relative frequencies for discriminating and identifying similar species.

Microarray for transcriptomics experiments often suffer from limited statistical power due to small sample size. Quantile discretization (QD) maps expression values for a sample into a series of equivalently sized 'bins' that represent a discrete numerical range, e.g. 4 to 4, which enables normalized data from multiple experiments and/or expression platforms to be combined for re-analysis. We found, however, that informal selection of bin numbers often resulted in loss of the underlying correlation structure in the data through assigning of the same numerical value to genes that are in reality expressed at significantly different levels within a sample. Here we report a procedure for determining an optimal bin number for dataset. Applying this to integrated public breast cancer datasets enabled statistical identification of several differentially expressed tumorigenesis-related genes that were not found when analyzing the individual datasets, and also several cancer biomarkers not previously indicated as having utility in the disease. Notably, differential modulation of translational control and protein synthesis via multiple pathways were found to potentially have central roles in breast cancer development and progression. These findings suggest that our protocol has significant utility in making meaningful novel biomedical discoveries by leveraging the large public expression data repositories. [ABSTRACT FROM AUTHOR]

Because the sources of fine-grained sediment problems in river systems are diffuse, it is essential to assemble catchment scale information for informing management strategies. Sediment source-tracing procedures have increasingly been adopted in this respect. Accordingly, a recently refined composite tracing procedure was used to investigate contemporary sources of fine-grained channel bed sediment in 11 sub-catchments (364 km2) of the River Wensum Demonstration Test Catchment, in the eastern UK. The procedure incorporated a combination of statistical tests for discriminating source end members, plus numerical mass balance modelling incorporating weightings for within-source tracer variations and tracer-specific discriminatory power, as well as a combination of local and genetic algorithm optimisation coupled with Monte Carlo uncertainty analysis. Replicate Monte Carlo runs demonstrated the convergence of the modelling outputs within ±1% of the average medians. Relative frequency-weighted average median source type contributions were estimated to range between 27%-69% (agricultural topsoils; predicted deviate median inputs 0%-98% and 9%-100%), 0%-38% (damaged road verges; predicted deviate median inputs 0%-58% and 0%-100%) and 21%-48% (channel banks/subsurface sources; predicted deviate median inputs 0%-50% and 4%-50%). The study provides further evidence of the importance of channel banks and damaged road verges as sediment sources and the need to include such areas in catchment sediment management strategies. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To examine the association of alcohol consumption with well-being in mid-aged Australian women, taking into account other lifestyle factors. Methods A prospective, observational study was carried out among 438 urban Australian women aged 45-55 years at baseline. They were assessed annually for 8 years using a questionnaire on health and lifestyle, including self-ratings of well-being and daily 'hassles'. Statistical analyses were performed using cluster and repeated measures analyses. Results About 80% of the women had consumed alcohol in the week preceding the interview. Alcohol intake was weakly associated with well-being overall (p = 0.094). Women who consumed alcohol at moderate levels had higher well-being scores than non-drinkers or heavy drinkers, however, provided they were also non-smokers and exercised weekly or more (p for interaction = 0.023) (21% of all study participants). Everyday symptoms and stresses had a negative impact on well-being (all p values < 0.001). Conclusions Among women undergoing menopausal transition, well-being is positively associated with moderate alcohol consumption along with other lifestyle factors in a synergistic fashion, rather than any individual factor having a dominant or an independent effect. [ABSTRACT FROM AUTHOR]

PRACTICE IMPACT STATEMENTGlobally, one in three women experience physical and/or sexual violence and sub-Saharan Africa displays increased rates of gender-based violence (GBV) compared to other regions. There is limited information on the factors sustaining GBV among university students in sub-Saharan Africa as well as barriers and opportunities towards its effective prevention and management. This study explores and describes the GBV prevention needs at six universities in five sub-Saharan African countries (Ghana, Liberia, Nigeria, South Africa, Zimbabwe) using a qualitative approach. In-depth interviews (n = 27) were conducted with key stakeholders (faculty, staff, students, community members). Main findings showed that GBV is influenced by location and types of relationship with the perpetrator, and some of the barriers to implementing GBV prevention programmes are patriarchal norms, lack of awareness, and poor institutional infrastructure. Identified areas for opportunity are raising awareness, early warning signs for prevention, proactive system-wide response, justice for survivors, and fair punishment.Current prevention and response resources are not equitably available to individuals of all genders and sexual orientations at universities across sub-Saharan Africa. There is a need for promotion of institutional partnership, shared knowledge, and resources for addressing GBV among all university students within sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Objectives: To contrast the geometry of the femoral neck, and the lumbar spine (L1-L4), in atypical highimpact modalities of forwards and backs in Rugby Union football players. Methods: A homogeneous group of young adult rugby union football players were classified according to position as either forwards (n=33) or backs (n=28). Lumbar spine (L1-L4) and geometric variables of the femoral neck were obtained from dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) was adjusted for size using height, weight and bone area as independent variables. Multiple regression analysis was performed on selected variables after conversion to natural logarithms to identify power coefficients. Independent t-tests were used to compare playing groups. Results: There were no significant differences between forwards and backs in adjusted femoral neck BMD, cortical thickness (CT), or buckling ratio (BR). However, significantly greater values were identified between groups in subperiosteal width (SW, P=0.018), cross-sectional area (CSA, P=0.0001) and section modulus (Z, P=0.003). Adjusted BMD in individual L1-L4 vertabrae were significantly larger in forwards than backs (P=0.001-0.0001). Conclusions: The contrast between forwards and backs in a dual high-loading modality game such as rugby union football, suggest that forwards in particular, but also backs, demonstrate the functional skeletal adaptations necessary to tolerate and respond to the increasing physical demands required by players. [ABSTRACT FROM AUTHOR]

The persistence and emergence of new multi-drug resistant Mycobacterium tuberculosis (M. tb) strains continues to advance the devastating tuberculosis (TB) epidemic. Robust systems are needed to accurately and rapidly perform drug-resistance profiling, and machine learning (ML) methods combined with genomic sequence data may provide novel insights into drug-resistance mechanisms. Using 372 M. tb isolates, the combined utility of ML and bioinformatics to perform drug-resistance profiling is demonstrated. SNPs, InDels, and dinucleotide frequencies are explored as input features for three ML models, namely Decision Trees, Random Forest, and the eXtreme Gradient Boosted model. Using SNPs and InDels, all three models performed equally well yielding a 99% accuracy, 97% recall, and 99% F1-score. Using dinucleotide frequencies, the XGBoost algorithm was superior with a 97% accuracy, 94% recall and 97% F1-score. This study validates the use of variants and presents dinucleotide features as another effective feature encoding method for ML-based phenotype classification., (©2021 AMIA - All rights reserved.)

Land modified for human use alters matrix shape and composition and is a leading contributor to global biodiversity loss. It can also play a key role in facilitating range expansion and ecosystem invasion by anthrophilic species, as it can alter food abundance and distribution while also influencing predation risk; the relative roles of these processes are key to habitat selection theory. We researched these relative influences by examining human footprint, natural habitat, and predator occurrence on seasonal habitat selection by range-expanding boreal white-tailed deer (Odocoileus virginianus) in the oil sands of western Canada. We hypothesized that polygonal industrial features (e.g. cutblocks, well sites) drive deer distributions as sources of early seral forage, while linear features (e.g. roads, trails, and seismic lines) and habitat associated with predators are avoided by deer. We developed seasonal 2nd -order resource selection models from three years of deer GPS-telemetry data, a camera-trap-based model of predator occurrence, and landscape spatial data to weigh evidence for six competing hypotheses. Deer habitat selection was best explained by the combination of polygonal and linear features, intact deciduous forest, and wolf (Canis lupus) occurrence. Deer strongly selected for linear features such as roads and trails, despite a potential increased risk of wolf encounters. Linear features may attract deer by providing high density forage opportunity in heavily exploited landscapes, facilitating expansion into the boreal north., (© 2022. The Author(s).)

HL7 International's Fast Healthcare Interoperability Resources (FHIR) standard provides a common format for sharing health data (eg, FHIR resources) and a RESTful Application Programming Interface (eg, FHIR API) for accessing those resources via a FHIR server connected to an electronic health record system or any other system storing clinical data. Substitutable Medical Applications and Reusable Technologies (SMART) leverages FHIR to create an electronic health record (EHR) agnostic app platform. It utilizes the OAuth standard to provide for authorization and authentication. This paper describes the development and informal evaluation of Case Based Learning on FHIR (CBL on FHIR), a prototype EHR-connected FHIR/SMART platform to provide interactive digital cases for use in medical education. The project goals were to provide a more interactive form of CBL than is possible on paper to more realistically simulate clinical decision making and to expose medical students to modern informatics systems and tools for use in patient care., (© The Author(s) 2019. Published by Oxford University Press on behalf of the American Medical Informatics Association.)

Biologging data allow animal ecologists to directly measure species' fine-scale spatiotemporal responses to environments, such as movement - critical for our understanding of biodiversity declines in the Anthropocene. Animal movement between resource patches is a behavioral expression of multiple ecological processes that affect individual fitness. Protected area (PA) networks are a tool used to conserve biodiversity by sustaining habitat patches across vast heterogeneous landscapes. However, our ability to design PA networks that conserve biodiversity relies on our accurate understanding of animal movement and functional connectivity; this understanding is rarely tested in real-world situations due to the large geographic expanse of most PA networks. Using a tractable PA network mesocosm, we employ cutting-edge biologging technology to analyze animal movement decisions in response to a highly heterogeneous landscape. We analyze these data to test, in a novel way, three common hypotheses about functional connectivity - structural corridors, least cost paths, and stepping stones. Consistently, animals moved along structurally self-similar corridors. In reference to the Aichi 2020 Biodiversity Targets, relying on species to "stepping stone" across habitat remnants may not achieve protected area network conservation objectives.

Background and Aim: To identify the distribution and explore the relationship between ACTN3 genotypes and power and body composition phenotypes., Subjects and Methods: Case control and association studies were employed using a homogeneous group of players (n = 102) and a control group (n = 110). Power-related phenotypes were measured using the counter movement jump (CMJ) and body composition phenotypes by dual-energy X-ray absorptiometry (DXA). Statistics used were Pearson's chi-square, ANCOVA, coefficients of correlation and independent t-tests. Genotyping was carried out using polymerase chain reaction followed by enzymatic Ddel digestion., Results: Genotype proportions of players were compared with controls (p = 0.07). No significant genotype differences occurred between forwards or backs (p = 0.822) or within-forwards (p = 0.882) or within-backs (p = 0.07). Relative force and velocity were significantly larger in backs, power significantly greater in forwards; in body composition, all phenotypes were significantly greater in forwards than backs. Correlations between phenotypes were greater for the RX genotype (p = 0.05-0.01)., Conclusions: Relationships between ACTN3 genotypes and power or body composition-related phenotypes were not significant. As fat increased, power-related phenotypes decreased. As body composition increased, power-related phenotypes increased.

Aim: The present study examined the hypothesis that there were no significant differences between forwards and backs in the elements of leg power between the ID and DD genotypes of the ACE (I/D) gene in developing young adult Rugby Union players., Methods: Sixty-eight players were recruited to identify the distribution of genotypes between forwards and backs. Fifty-eight players were investigated for leg power. Forwards (n=28) comprised 15 ID and 13 DD genotypes, and backs (n=30) 19 ID and 11 DD genotypes. Leg power was measured on a force platform using a counter movement jump; the parameters of interest were peak and relative force, peak and relative power, displacement and velocity. The three-primer polymerase chain reaction was used to assay the region of interest for I and D variants of the ACE gene. The distribution of genotypes was determined by chi-square and comparisons between forwards and backs made using the independent t-test., Results: No significant differences were identified in the distribution of genotypes between forwards and backs (χ2=2.2, P=0.336). However, significant differences were identified between forwards and backs in a number of components of leg power. Backs had significantly larger values than forwards for relative force (1.50 vs. 1.30 Wt%, P=0.001) and relative power (27.1 vs. 24.3 W.kg-1, P=0.034) for the ID genotype, whereas backs had significantly larger values than forwards for displacement (0.42 vs. 0.38 m, P=0.049) and velocity (2.76 vs. 2.55 m.s.(-1), P=0.007) for the DD genotype., Conclusion: The characteristics of leg power identified will enhance the functional requirements of players according to playing position and commitment.

The effect of reproductive history on the risk of cervical, colorectal and thyroid cancers and melanoma has been explored but the results to date are inconsistent. We aimed to examine in a record-linkage cohort study the risk of developing these cancers, as well as breast, ovarian and endometrial cancers, among mothers who had given birth to twins compared with those who had only singleton pregnancies. Women who delivered a baby in Sweden between 1961 and 1996 and who were 15 years or younger in 1961 were selected from the Swedish civil birth register and linked with the Swedish cancer registry. We used Poisson regression to assess associations between reproductive factors and cancer. Twinning was associated with reduced risks of breast, colorectal, ovarian and uterine cancers, although no relative risks were statistically significant. The delivery of twins did not increase the risk of any cancers studied. Increasing numbers of maternities were associated with significantly reduced risks of all tumors except thyroid cancer. We found positive associations between a later age at first birth and breast cancer and melanoma, while there were inverse associations with cervix, ovarian, uterine and colorectal cancers. These findings lend weight to the hypothesis that hormonal factors influence the etiology of colorectal cancer in women, but argue against any strong effect of hormones on the development of melanoma or tumors of the thyroid.

In a Danish population, basal cell carcinoma (BCC) patients have a higher dermal mast cell prevalence in buttock skin than controls. This finding was supported by a functional link in mice between histamine-staining dermal mast cells and the extent of susceptibility to UV-B-induced systemic immunomodulation. It was important to confirm that this association was maintained in an Australian population with very different ancestry and sun exposure patterns. Australian BCC patients (n = 26) had significantly higher densities of mast cells in the dermis of buttock skin than control subjects (n = 25) (P = 0.0003, Mann-Whitney U-test). However, this correlation was lost at the sun-exposed site of the hand (P = 0.547, Mann-Whitney U-test). To further evaluate whether a relationship exists between dermal mast cell prevalence in sun-exposed skin and incidence of BCC in a larger study, biopsies of dorsal hand skin were obtained from an age-stratified random sample of 166 Queensland subjects, together with the 51 South Australian subjects, and dermal mast cell prevalence was quantified. Older subjects (over the median age of 42 years) had a greater incidence of BCC development (P = 0.0001, chi-square test) and significantly higher mast cell densities in hand skin (P = 0.0001, chi-square test) than younger subjects. However, mast cell density in sun-exposed hand skin was not significantly associated with BCC incidence. Finally, cellular expression of c-kit correlated with mast cell prevalence in non-sun-exposed skin, thereby implicating the stem cell factor-c-kit axis in the intrinsic mechanisms that regulate prevalence. These results show that high prevalence of dermal mast cells in buttock skin but not hand is associated with BCC development in an Australian population.

Background: Solar keratoses (SKs) are among the strongest determinants of skin cancer, but little is known about the success of measures to control these common skin tumors., Objective: To determine whether daily sunscreen application and/or beta carotene supplementation retards the rate of occurrence of SKs in adults in the medium term., Design: Randomized controlled trial conducted between February 1992 and August 1996., Setting: General community of the subtropical township of Nambour, Australia (latitude, 26 degrees south)., Participants: A total of 1621 adults aged 25 to 74 years. Interventions Participants were randomized to daily use of sunscreen (application of a high-protection sunscreen to their head, neck, arms, and hands every morning) or application of sunscreen at their usual discretionary rate. They were also randomly assigned to take either one 30-mg tablet of beta carotene or one placebo tablet each day., Main Outcome Measure: Change in the prevalent number of SKs in the intervention group relative to change in the control group., Results: The ratio of SK counts in 1994 relative to 1992 was lower in people randomized to daily sunscreen use (1.20; 95% confidence interval, 1.04-1.39) than in those randomized to discretionary sunscreen use (1.57; 95% confidence interval, 1.35-1.84). This 24% reduction is equivalent to the prevention of an average of 1 additional SK per person over that time. A reduction in the rate of change of SK prevalence was also seen in the sunscreen intervention group relative to the discretionary sunscreen group between 1994 and 1996, but it was not significant. No effect on the rate of change of prevalent SK counts was seen among those taking beta carotene supplements relative to those taking placebo tablets., Conclusions: Daily application of sunscreen retarded the rate of SK acquisition among adults in a subtropical environment, while a beta carotene supplementation of 30 mg/d had no influence on the occurrence of SKs.

Background: Although melanocytic nevi are the strongest known risk factors for melanoma, their etiology is not well understood., Objectives: This study was performed to assess the roles of constitutional pigmentary factors and sun exposure in the development of new nevi in adolescents., Methods: A cohort of 111 school children, aged 12 and 13 years at baseline, were followed up for 5 years. Whole-body counts of nevi of all sizes and detailed sun exposure histories were updated each year. Analyses of full-body nevus counts and of nevus counts on the face and neck region and on the shoulder and back region were undertaken by means of log-linear regression, allowing for repeated measures., Results: Mean whole-body nevus counts were 130.1 (SD = 69.9) in 1990 and 215.5 (SD = 127.1) in 1994. Shoulder and back counts were consistently higher than face and neck counts. Subjects with heavy shoulder freckling had increased nevus counts on all sites investigated, with a means ratio for whole-body counts of 1.11 (95% CI, 1.03-1.19), compared with those with no freckling. Those who spent all of their school lunch times in the midday sun had a means ratio of 1.62 (95% CI, 1.15-2.29) compared with those who spent very little time in the sun during the lunch period. Summer holiday sun exposure was not significantly associated with development of nevi in this adolescent cohort., Conclusion: The degree of freckling, especially on the shoulders, and habitual midday sun exposure, rather than holiday sun exposure, are significant determinants of melanocytic nevi in Queensland adolescents.

All melanocytic nevi on the faces and necks of a cohort of students, initially aged 12-14 y, were mapped and photographed annually for 4 y. The features of each nevus were charted yearly noting changes in size and profile, and the appearance or disappearance of any nevi on a student's face and neck was recorded. Nevi were classified by size (small, < 2 mm; medium, 2-5 mm; large, > 5 mm), and by profile (flat, raised). Data from 20 adolescents selected randomly from the cohort for detailed analysis showed males had about twice as many nevi as females, but there was little difference between sexes in their patterns of nevus development. Approximately half the nevi were small in all years; under 5% were large. Over the 4 y of follow-up the proportion of flat nevi dropped from 70% to 57%, whereas nevus numbers increased by 47% in year 1, with smaller increases in older students. Most new or disappearing nevi were small and flat, although both incident and disappearing nevi could be larger and/or raised. Of the existing nevi that altered in the follow-up period, the tendency was towards an increase in size among raised but not among flat nevi; a lowering of profile among small nevi; and a raising of profile among larger nevi; but there were many exceptions to this pattern. Among several host factors examined, inability to tan after sun exposure was found to be significantly negatively associated with the propensity of nevi to change size over the study period. Overall our findings indicate that, contrary to conventional belief, there is a measurable turnover among melanocytic nevi even in early life.

Monilethrix is an inherited hair dystrophy in which affected, fragile, hairs have an unique beaded morphology. Ultrastructural studies suggest a defect in filament structure in the cortex of the hair, and the hard keratins of hair and nail are thus candidate genes. In several families with autosomal dominant monilethrix, the disorder has been linked to the type II keratin gene cluster at chromosome 12q13. Recently, causative mutations in the critical helix termination motif in the 2B domain of the human hair basic keratin 6 (hHb6) have been identified. We now report the results of sequencing this domain in 13 unrelated families or cases with monilethrix. Five of the 13 had the same mutation as previously found, a G to A transversion leading to a lysine for glutamic acid substitution (E413K) in the 2B domain (residue 117 of the 2B helix) of hHb6. The mutation was confirmed by a restriction fragment length polymorphism assay developed for this purpose, and, as this mutation is evidently a common cause of the syndrome, for use in screening other cases. In eight families or cases, however, including three in whom linkage data are consistent with a defect at the type II keratin locus, no mutation was found in this domain of hHb6.

Elevated copper concentrations were determined for single larvae of Plectrocnemia conspersa in a copper-rich stream. Although larval copper concentration was reduced by at least 50% after clearing gut contents, its exponential decrease with increasing body weight remained unchanged. Analysis of instar V larvae from different sampling stations showed a steep increase in the concentration of copper in the larvae with that in the water at lower stream water concentrations, followed by a progressively less steep increase at higher stream concentrations. When captive larvae from a clean stream were introduced into a mine drainage stream, the amount of copper in fed and unfed larvae steadily increased, suggesting metal uptake from water and food. Survival and growth were comparable for introduced and captive resident larvae suggesting copper tolerance to be a general characteristic of P. conspersa.